The literary concept of madness is not exactly the same as the medical definitions of mental illness. In fiction, “madness” is most often vague. I go directly to Jane Eyre’s rival — Mr. Rochester’s wife — living out her tortured life in the attic of their home. I’m not blaming Charlotte Bronte for the lack of diagnosis. 1847 is a long time before Freud.
After the rise of psychoanalysis, “madness” was defined, but it was often just as unrealistic as Bronte’s madwoman. Domineering mothers, people with split personalities and crazy geniuses all became stock characters in general and genre fiction. Even the descendents of Freud, Jung and Adler became familiar stereotypes. The beard, the sofa, the cigar, answering every question with a question…
In horror, and to a considerable extent in suspense, thrillers and mysteries, madness figures in many plots. Edgar Allan Poe, H.P. Lovecraft and Robert Louis Stevenson, all utilized madness. In one form or another, characters who might be described as having narcissistic personality disorder, bi-polar disorder with delusional and suicidal ideation, or paranoid schizophrenia pop up throughout their stories.
If you add the relatively new understanding that many behavioral disorders, including Obsessive Compulsive Disorder, are neurological and not caused by the icy parenting styles of “refrigerator Moms” than the use of madness in fiction is due for a major shift in mindset. Even if you’re not familiar with the “refrigerator Mom,” you’ve probably met her in dozens of books and movies, where her withholding of love creates “monstrous” children.
A few years ago I stumbled on an old dictionary of psychological terms in my mother’s library. It was from the mid 1960s and, yes, OCD was blamed on Moms. This 1960s point-of-view still lingers in a lot of simplistic stories. It’s a disservice to people who suffer from real disorders and it’s usually a cheap shot, shortcut for the writers.
But getting back to MADNESS and the mayhem that monsters cause, the very real genetic disorder porphyria is often sited as the “vampire” disease. It’s often sited as the cause of King George III’s erratic behavior. I’ve also read that his madness might have been arsenic poisoning. Arsenic, mercury and other deadly ingredients were used in cosmetics and patent medicines for generations. This was terrible for the physical and mental health of the people of the past — but it’s kind of great for writers.
I haven’t checked out the newly published edition of the DSM (official diagnostic manual) that is used by mental health caregivers and insurance companies, but I’ve heard some that some of the revisions will have a lasting impact on mental healthcare. I’m also betting that the new DSM will be a source for making a new brand of fictional monsters.