Out of Character (OOC):
Chronicle: Mage 2: The Dethroned Queen
Venue: Mage: The Awakening 2nd Edition
Chronicle Storyteller: Jerad Sayler
Assistant Storytellers: Hannah Nyland & Alex Van Belkum
Roleplaying Mental Illness
Playing Derangements or Mental Conditions can be a tricky
business, and there is little guide to be found for acting insane (at least
none that can be trusted). A well-played Derangement can add
spice and realism to your portrayals, so here are more than fifteen real
derangements with their clinical definitions and behavioral symptoms so you can avoid being a "Fish-Malk" (A Malkavian from VtM that yells "FISH!" whenever they end a conversation. Mad on a comic and manic level that is shitty role-play).
Mental illness is not funny, they can actually be quite horrifying on a personal level (see what I did there?). The following are possible mortal responses to Integrity loss in a Chronicles of Darkness (CoD) game.
I made an attempt to cross-check the mental illnesses with Conditions in the core CoD and I may not have them 100% right since Conditions are generalized and can be used to represent just about anything. These are merely forms the conditions may take and how they might pair up with mental illnesses.
Acute Stress Disorder (Condition: Shaken)
The person has been exposed to a traumatic event in which both of the following
were present:
· the person experienced, witnessed, or was confronted with an event or events
that involved actual or threatened death or serious injury, or a threat to the
physical integrity of self or others
· the person's response involved intense fear, helplessness, or horror
Either while experiencing or after experiencing the distressing event, the
individual has three (or more) of the following dissociative symptoms:
· a subjective sense of numbing, detachment, or absence of emotional
responsiveness
· a reduction in awareness of his or her surroundings (e.g., "being in a
daze")
· derealization
· depersonalization
· dissociative amnesia (i.e., inability to recall an important aspect of the
trauma)
The traumatic event is persistently re-experienced in at least one of the
following ways: recurrent images, thoughts, dreams, illusions, flashback
episodes, or a sense of reliving the experience; or distress on exposure to
reminders of the traumatic event.
Marked avoidance of stimuli that arouse recollections of the trauma (e.g.,
thoughts, feelings, conversations, activities, places, people).
Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping,
irritability, poor concentration, hypervigilance, exaggerated startle response,
motor restlessness).
The disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning or impairs the
individual's ability to pursue some necessary task, such as obtaining necessary
assistance or mobilizing personal resources by telling family members about the
traumatic experience.
Adjustment Disorder (Condition: Shaken)
The development of emotional or behavioral symptoms in response to an
identifiable stressor(s) occurring within 3 months of the onset of the
stressor(s).
These symptoms or behaviors are clinically significant as evidenced by either
of the following:
· marked distress that is in excess of what would be expected from exposure to
the stressor
· significant impairment in social, occupational or educational functioning
Agoraphobia
Anxiety about being in places or situations from which escape might be
difficult (or embarrassing) or in which help may not be available in the event
of having an unexpected or situationally predisposed Panic Attack or panic-like
symptoms. Agoraphobic fears typically involve characteristic clusters of
situations that include being outside the home alone; being in a crowd or
standing in a line; being on a bridge; and traveling in a bus, train, or
automobile.
The situations are avoided (e.g., travel is restricted) or else are endured
with marked distress or with anxiety about having a Panic Attack or panic-like
symptoms, or require the presence of a companion.
Bereavement (Condition: Guilty)
A reaction to the death of a loved one. As part of their reaction to the loss,
some grieving individuals present with symptoms characteristic of a Major
Depressive Episode (e.g., feelings of sadness and associated symptoms such as
insomnia, poor appetite, and weight loss). The bereaved individual typically
regards the depressed mood as "normal," although the person may seek
professional help for relief of associated symptoms such as insomnia or anorexia.
The duration and expression of "normal" bereavement vary considerably
among different cultural groups. The diagnosis of Major Depressive Disorder is
generally not given unless the symptoms are still present 2 months after the
loss.
However, the presence of certain symptoms that are not characteristic of
a "normal" grief reaction may be helpful in differentiating
bereavement from a Major Depressive Episode.
These include:
1) guilt about
things other than actions taken or not taken by the survivor at the time of the
death;
2) thoughts of death other than the survivor feeling that he or she
would be better off dead or should have died with the deceased person;
3)
morbid preoccupation with worthlessness;
4) marked psychomotor retardation;
5)
prolonged and marked functional impairment;
6) hallucinatory experiences
other than thinking that he or she hears the voice of, or transiently sees the
image of, the deceased person.
Brief Psychotic Disorder (Condition: Madness)
Presence of one (or more) of the following symptoms:
· delusions
· hallucinations
· disorganized speech (e.g., frequent derailment or incoherence)
· grossly disorganized or catatonic behavior
Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning.
Delusional Disorder (Condition: Madness)
This disorder is characterized by the presence of non-bizarre delusions which have persisted for at least one month. Non-bizarre delusions typically are beliefs of something occurring in a person's life which is not out of the realm of possibility. For example, the person may believe their significant other is cheating on them, that someone close to them is about to die, a friend is really a government agent, etc. All of these situations could be true or possible, but the person suffering from this disorder knows them not to be (e.g., through fact-checking, third-person confirmation, etc.). People who have this disorder generally don't experience a marked impairment in their daily functioning in a social, occupational or other important setting. Outward behavior is not noticeably bizarre or objectively characterized as out-of-the-ordinary.
Depersonalization Disorder (Condition: Spooked)
Persistent or recurrent experiences of feeling detached from, and as if one is
an outside observer of, one's mental processes or body (e.g., feeling like one
is in a dream).
During the depersonalization experience, reality testing remains intact. The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Dissociative Amnesia (Condition: Amnesia)
The predominant disturbance is one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.
Dissociative Fugue (Condition: Fugue)
The predominant disturbance is sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past. Confusion about personal identity or assumption of a new identity (partial or complete).
Dissociative Identity Disorder (Condition: Madness)
(Formerly known as Multiple Personality Disorder)
The presence of two or more distinct identities or personality states (each
with its own relatively enduring pattern of perceiving, relating to, and
thinking about the environment and self).
At least two of these identities or personality states recurrently take control
of the person's behavior.
Inability to recall important personal information that is too extensive to be
explained by ordinary forgetfulness.
Generalized Anxiety Disorder (Condition: Spooked)
Generalized anxiety disorder (GAD) is much more than the normal anxiety people
experience day to day. It's chronic and exaggerated worry and tension, even
though nothing seems to provoke it. Having this disorder means always
anticipating disaster, often worrying excessively about health, money, family,
or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply
the thought of getting through the day provokes anxiety.
People with GAD can't seem to shake their concerns, even though they usually
realize that their anxiety is more intense than the situation warrants. People
with GAD also seem unable to relax. They often have trouble falling or staying
asleep. Their worries are accompanied by physical symptoms, especially
trembling, twitching, muscle tension, headaches, irritability, sweating, or hot
flashes. They may feel lightheaded or out of breath. They may feel nauseated or
have to go to the bathroom frequently. Or they might feel as though they have a
lump in the throat.
Many individuals with GAD startle more easily than other people. They tend to
feel tired, have trouble concentrating, and sometimes suffer depression, too.
Usually the impairment associated with GAD is mild and people with the disorder
don't feel too restricted in social settings or on the job. Unlike many other
anxiety disorders, people with GAD don't characteristically avoid certain
situations as a result of their disorder. However, if severe, GAD can be very
debilitating, making it difficult to carry out even the most ordinary daily
activities.
GAD comes on gradually and most often hits people in childhood or adolescence,
but can begin in adulthood, too. It's more common in women than in men and
often occurs in relatives of affected persons. It's diagnosed when someone
spends at least 6 months worried excessively about a number of everyday
problems.
Intermittent Explosive Disorder (Condition: Madness)
Several discrete episodes of failure to resist aggressive impulses that result
in serious assaultive acts or destruction of property.
The degree of aggressiveness expressed during the episodes is grossly out of
proportion to any precipitating stimuli.
Obsessive-Compulsive Disorder (Condition: Madness)
Either obsessions or compulsions:
Obsessions as defined by (1), (2), (3), and (4):
1. recurrent and persistent thoughts, impulses, or images that are experienced,
at some time during the disturbance, as intrusive and inappropriate and that
cause marked anxiety or distress
2. the thoughts, impulses, or images are not simply excessive worries about
real-life problems
3. the person attempts to ignore or suppress such thoughts, impulses, or
images, or to neutralize them with some other thought or action
4. the person recognizes that the obsessional thoughts, impulses, or images are
a product of his or her own mind (not imposed from without as in thought
insertion)
Compulsions as defined by (1) and (2):
1. repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts
(e.g., praying, counting, repeating words silently) that the person feels
driven to perform in response to an obsession, or according to rules that must
be applied rigidly
2. the behaviors or mental acts are aimed at preventing or reducing distress or
preventing some dreaded event or situation; however, these behaviors or mental
acts either are not connected in a realistic way with what they are designed to
neutralize or prevent or are clearly excessive
Panic Disorder (Condition: Shaken)
People with panic disorder have feelings of terror that strike suddenly and
repeatedly with no warning. They can't predict when an attack will occur, and
many develop intense anxiety between episodes, worrying when and where the next
one will strike. In between times there is a persistent, lingering worry that
another attack could come any minute.
When a panic attack strikes, most likely your heart pounds and you may feel
sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you
might feel flushed or chilled. You may have chest pain or smothering
sensations, a sense of unreality, or fear of impending doom or loss of control.
You may genuinely believe you're having a heart attack or stroke, losing your
mind, or on the verge of death. Attacks can occur any time, even during
nondream sleep. While most attacks average a couple of minutes, occasionally
they can go on for up to 10 minutes. In rare cases, they may last an hour or
more. Panic disorder strikes between 3 and 6 million Americans, and is twice as
common in women as in men. It can appear at any age--in children or in the
elderly--but most often it begins in young adults. Not everyone who experiences
panic attacks will develop panic disorder-- for example, many people have one
attack but never have another. For those who do have panic disorder, though,
it's important to seek treatment. Untreated, the disorder can become very
disabling.
Panic disorder is often accompanied by other conditions such as depression or
alcoholism, and may spawn phobias, which can develop in places or situations
where panic attacks have occurred. For example, if a panic attack strikes while
you're riding an elevator, you may develop a fear of elevators and perhaps
start avoiding them.
Some people's lives become greatly restricted -- they avoid normal, everyday
activities such as grocery shopping, driving, or in some cases even leaving the
house. Or, they may be able to confront a feared situation only if accompanied
by a spouse or other trusted person. Basically, they avoid any situation they
fear would make them feel helpless if a panic attack occurs. When people's
lives become so restricted by the disorder, as happens in about one-third of
all people with panic disorder, the condition is called agoraphobia. A tendency
toward panic disorder and agoraphobia runs in families. Nevertheless, early
treatment of panic disorder can often stop the progression to agoraphobia.
Posttraumatic Stress Disorder (PTSD) (Condition: Broken)
Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that follows
a terrifying event. Often, people with PTSD have persistent frightening
thoughts and memories of their ordeal and feel emotionally numb, especially
with people they were once close to. PTSD, once referred to as shell shock or
battle fatigue, was first brought to public attention by war veterans, but it
can result from any number of traumatic incidents. These include kidnapping,
serious accidents such as car or train wrecks, natural disasters such as floods
or earthquakes, violent attacks such as a mugging, rape, or torture, or being
held captive. The event that triggers it may be something that threatened the
person's life or the life of someone close to him or her. Or it could be
something witnessed, such as mass destruction after a plane crash.
Whatever the source of the problem, some people with PTSD repeatedly relive the
trauma in the form of nightmares and disturbing recollections during the day.
They may also experience sleep problems, depression, feeling detached or numb,
or being easily startled. They may lose interest in things they used to enjoy
and have trouble feeling affectionate. They may feel irritable, more aggressive
than before, or even violent. Seeing things that remind them of the incident
may be very distressing, which could lead them to avoid certain places or
situations that bring back those memories. Anniversaries of the event are often
very difficult.
PTSD can occur at any age, including childhood. The disorder can be accompanied
by depression, substance abuse, or anxiety. Symptoms may be mild or
severe--people may become easily irritated or have violent outbursts. In severe
cases they may have trouble working or socializing. In general, the symptoms
seem to be worse if the event that triggered them was initiated by a
person--such as a rape, as opposed to a flood.
Ordinary events can serve as reminders of the trauma and trigger flashbacks or
intrusive images. A flashback may make the person lose touch with reality and
reenact the event for a period of seconds or hours or, very rarely, days. A
person having a flashback, which can come in the form of images, sounds,
smells, or feelings, usually believes that the traumatic event is happening all
over again.
Not every traumatized person gets full-blown PTSD, or experiences PTSD at all.
PTSD is diagnosed only if the symptoms last more than a month. In those who do
have PTSD, symptoms usually begin within 3 months of the trauma, and the course
of the illness varies. Some people recover within 6 months, others have
symptoms that last much longer. In some cases, the condition may be chronic.
Occasionally, the illness doesn't show up until years after the traumatic event.
Social Phobia (Condition: Spooked)
Social phobia is an intense fear of becoming humiliated in social situations,
specifically of embarrassing yourself in front of other people. It often runs
in families and may be accompanied by depression or alcoholism. Social phobia
often begins around early adolescence or even younger.
If you suffer from social phobia, you tend to think that other people are very
competent in public and that you are not. Small mistakes you make may seem to
you much more exaggerated than they really are. Blushing itself may seem
painfully embarrassing, and you feel as though all eyes are focused on you. You
may be afraid of being with people other than those closest to you. Or your
fear may be more specific, such as feeling anxious about giving a speech, talking
to a boss or other authority figure, or dating. The most common social phobia
is a fear of public speaking. Sometimes social phobia involves a general fear
of social situations such as parties. More rarely it may involve a fear of
using a public restroom, eating out, talking on the phone, or writing in the
presence of other people, such as when signing a check.
Although this disorder is often thought of as shyness, the two are not the
same. Shy people can be very uneasy around others, but they don't experience
the extreme anxiety in anticipating a social situation, and they don't
necessarily avoid circumstances that make them feel self-conscious. In
contrast, people with social phobia aren't necessarily shy at all. They can be
completely at ease with people most of the time, but particular situations,
such as walking down an aisle in public or making a speech, can give them
intense anxiety. Social phobia disrupts normal life, interfering with career or
social relationships. For example, a worker can turn down a job promotion
because he can't give public presentations. The dread of a social event can
begin weeks in advance, and symptoms can be quite debilitating.
People with social phobia are aware that their feelings are irrational. Still,
they experience a great deal of dread before facing the feared situation, and
they may go out of their way to avoid it. Even if they manage to confront what
they fear, they usually feel very anxious beforehand and are intensely
uncomfortable throughout. Afterwards, the unpleasant feelings may linger, as
they worry about how they may have been judged or what others may have thought
or observed about them.
