How to Write a Character with Anxiety and Panic Disorder: An Interview with Fay Onyx (Part 2)

Here on the blog, I feature a bi-weekly interview with an expert on how to write about a character with a chronic illness or disability that they struggle with. While I still recommend getting a sensitivity reader for your work, use these posts to consider how you can accurately portray disabled characters. Today’s feature is anxiety with Fay Onyx. Shout out to Fay for taking the time to answer my questions.

1. How is anxiety commonly represented in media?

When people with anxiety are depicted in media, their anxiety is usually pretty acute. They are constantly worrying, overwhelmed, or self-criticizing. While this is a realistic depiction of a bad anxiety state, it is also unrealistic because the characters rarely, if ever, have coping strategies, therapists, or other forms of medical treatment. As someone with anxiety, I find this deeply disturbing. It is like watching someone trapped in my worst moments without any of the tools that helped me get to a better place.

Sometimes characters are struggling with anxiety because they are now experiencing situations that are more intense than those they have previously experienced. This does make sense, as stories tend to be about conflict and dramatic events, and it is something that can happen in real life. For example, if a person who is coping well with anxiety enrolls in graduate school, the stress of their new environment can increase that person’s anxiety beyond what their current coping strategies can handle. However, when this happens in the real world, people can take actions to make things better. For example, in my second year of graduate school, I was overwhelmed by anxiety, so I started seeing a psychiatrist and a therapist. This helped immensely.

When I see intensely anxious characters, it reminds me of the times I was in a similar bad place and the fact that they never get help is painful. In addition, the fact that so few characters get help or use coping techniques sends the message that there isn’t anything that can be done to make things better, as if being overwhelmingly anxious is just an expected part of life for people with anxiety disorders.

The solution to this problem is to show characters with anxiety using coping strategies and getting medical support when it is appropriate. If a character regularly experiences intense anxiety that is hard to cope with, they should at least be thinking about medical options, like trying out a new medication, increasing a medication dose, starting therapy, or having therapy more frequently. However, because many people don’t have adequate access to medical care, cost may be a major factor in what the character can afford to do.

In addition, regardless of their access to medical treatment, all character should have some coping strategies that they use. Common coping strategies include include orienting and breathing techniques that can be used to address intense moments of anxiety, having support people present for stressful events like doctor visits, and a wide variety of self-care and wellness practices, such as hugs, music, journaling, exercise, soothing distractions, using weighted blankets, and spending time with animals. Keep in mind that what works for each person is going to be highly individual.

Finally, characters should have some way of addressing toxic mental cycles where their mind obsessively fixates on something, like a worry, stressful interaction, or intrusive thought. Self-reassurance is the standard response to this, but characters that have spent more time building up their knowledge of anxiety and coping tools will know that direct reassurance that repeats negative thoughts ultimately feeds negative mental cycles. Instead, they will do things like set judgments aside, think of a time when they felt differently, and reframe the situation.

“The fact that so few characters get help or use coping techniques sends the message that there isn’t anything that can be done to make things better.”

2. What are some common pitfalls or stereotypes writers should avoid, perhaps things that are often misunderstood about this condition?

One of the important things to know about anxiety is that it is different than just a more extreme version of neurotypical worry, stress, or fear. Although stress, worry, and fear are experienced by people with anxiety, having an anxiety disorder is a unique mental experience. For one thing, there are unique traits, like panic attacks and mental cycles, that are part of having anxiety, which don’t happen to neurotypical people. But it is more than that. My brain is different than a neurotypical one. Without my medication, my mind and body are in a state where they have strong fearful reactions to even mild situations, and they don’t calm down on their own. It takes a lot of active work for me to calm myself down any time that I get triggered or am anxious. This is why neurotypical people can’t use their personal experiences of stress, worry, and fear to understand what it is like to have anxiety.

Another important thing is that the symptoms and experiences of anxiety are unique to each person. Also, the coping tools that help each person are individual too. For example, I am a person who gets overstimulated easily so I find a quiet room to be calming. However, someone else with anxiety might find that the absence of distractions in quiet environments gives their thoughts more opportunity to follow harmful cycles.

In addition, it is important to know that different people with anxiety are anxious about different things. I have a family member with anxiety who hates talking to strangers on the phone, but I’m fine calling up businesses and talking to strangers when I want to make an order or ask a question. In contrast, my anxiety (combined with my sensitivity) comes out in careful planning that prepares for all sorts of possibilities.

Another example is intrusive thoughts. I know that other people with anxiety struggle a lot with intrusive thoughts. But for me, intrusive thoughts aren’t a big deal. When a terrible thought pops into my head, like the idea of me putting my hand into the garbage disposal, I recognize it as an intrusive thought. I know that I have intrusive thoughts because they are upsetting and this recognition allows me to let go of the intrusive thought. Other people’s minds don’t let go so easily. However, I do struggle with something that is similar to an intrusive thought—it is a mental fixation on my breathing. This fixation is uncomfortable and it disrupts my natural breathing patterns, which causes my breathing to become more uncomfortable, thus causing a stronger fixation on my breathing. If not interrupted, this can start a cycle that leads to hyperventilation. Fortunately, I now have a lot of tools that help me disrupt this cycle.

Hopefully, these examples make it clear how diverse anxiety is. When crafting a character with anxiety, it is important to avoid the generic, one-size-fits-all stereotype of anxiety. Instead, create unique characters with distinct traits and symptoms that they struggle with.

“Anxiety is different than just a more extreme version of neurotypical worry, stress, or fear.”

3. What are things you can’t do because of your condition? What are things you can do?

While there aren’t that many things I can’t do, there are a lot of things I don’t want to do because they are unpleasant to me. I don’t want to have a high pressure career. I don’t want to watch horror movies. I don’t want to engage in thrill-seeking activities, like sky diving and other extreme sports.

Not wanting to do something is different from not being able to do something. When I don’t want to do something, there is no longing or desire to make me feel like I’m missing out. It only becomes a problem when there is something that is hard for me, like a noisy and crowded environment, that gets in the way of me doing something I want to do, like go to a friend’s birthday party.

One area where I do feel like I’m missing out is the fact that I’m super sensitive to caffeine. I do have some chocolate, but I avoid every other source of caffeine. This is sad to me because I love the taste of coffee and would like to enjoy coffee ice cream or tiramisu.

In addition, I have a hard time with any TV or movies that are dark or tense. This sensitivity has grown over time, so mostly I watch mysteries, documentaries, lower tension reality TV (like The Great British Bake Off), romantic comedies, and children’s shows.

Another important factor is my misophonia. For me, it feels like certain sounds, like humming, and repetitive motions, like bouncing feet, hijack my brain and prevent me from being able to think normally. Because my brain can’t filter out those sounds or movements, they interfere with my ability to focus on anything else. This is an unpleasant experience that I work to avoid using a number of strategies, like carefully positioning where I sit or moving objects, like chairs, between me and fidgeting people. I also work hard to be first in line for buses so that I can get a window seat where I can look outward and not see all of the fidgeting people on the bus.

Anxiety can also make everyday things harder to do. For example, finding new medical providers, like a doctor and dentist, after moving is overwhelming to me. I respond to that intensity by going slowly and only doing a few pieces of these hard things each day. This works great when I only have a few of them to do, but when there are more of them, things can pile up and create a stressful backlog that is always in the back of my mind.

This can get a bit limiting sometimes, but most of the time I really like my quiet life of staying home and only interacting with friends one-on-one or in small groups.

4. What advice would you give to someone who wants to accurately write about a character with this condition?

I suggest choosing several specific anxiety triggers for this character. These are the things that the character is most anxious about. They can be connected to particularly upsetting events in the character’s past, or they can be things that are just hard for them, like talking on the phone.

Next, decide how the character’s anxiety manifests. Does the character experience their anxiety as a hyper-critical internal voice, a sequence of worries, obsessive planning, easily going into a fight, flight, freeze, or fawn response, having difficulty calming down, or something else? What are the character’s other symptoms? For example, do they have panic attacks, intrusive thoughts, insomnia, digestive problems, or shortness of breath? Are there specific unhealthy mental cycles that they can get stuck in?

Finally, decide how the character deals with their anxiety. Are they taking a medication? If so, how does this medication help them and what are its side effects? Do they have a therapist? If so, how do they meet with their therapist and how often do they see them? How do they deal with anxiety triggers and panic attacks (if they have them)? What coping tools do they use when they are in the middle of a stressful situation? How do they help themselves recover after something upsetting has occurred? What do they do to help themselves break out of unhealthy mental cycles? How do they address other symptoms, like insomnia or digestive troubles?

All together, this should create a portrait of the character’s anxiety that will make it clear when anxiety will affect them, how it will affect them, and how they cope with it.

“Because most depictions of anxiety spend a lot of time on these harmful cycles, I rarely get to experience heroic characters with anxiety.”

5. Any other thoughts, comments, or suggestions for writers?

Be careful about how deep into negative thoughts and mental cycles you get when depicting anxiety. As a person with anxiety, it is particularly hard for me when harmful thoughts are the focus of portrayals, as they can be triggering. Sometimes these mental cycles become so dominant that the character has a toxic relationship with themselves in which they are constantly saying mean things to themselves and putting themselves down. This is so painful to witness that I usually have to stop watching shows with portrayals like these. Because most depictions of anxiety spend a lot of time on these harmful cycles, I rarely get to experience heroic characters with anxiety.

Doing things in a better way goes back to depicting coping strategies and medical care. Focus on what the character is struggling to do, such as navigating a crowded environment, and how they help themselves cope, like talking themselves through doing difficult things. Focusing on depicting practical struggles keeps the disability present in the character’s life without needing to spend as much time on negative thoughts. This creates more room for the character to relate to themselves in supportive and positive ways, while still being affected by their anxiety (a type of representation that is badly needed).

One of the best examples of this that I have come across is The Far Meridian, a magical realism podcast about Peri, a young woman with agoraphobia who copes with her home magically moving to different locations. What makes The Far Meridian work so well is that it is focused on Peri’s struggle to cope with extraordinary circumstances. While Peri does struggle significantly with negative thoughts and feelings, she has multiple coping strategies and she does also relate to herself in positive ways.

Read Part 1 of the interview here.


Fay Onyx is a queer, nonbinary, disabled writer, podcaster, and game designer whose work centers characters living at the intersections of oppression. Hir podcast, Writing Alchemy, includes a tabletop role-playing series about the adventures of disabled, neurodivergent, and chronically ill heroes. Fay is also the creator of Magic Goes Awry, a high fantasy role-playing game that is light on rules and heavy on magical mayhem. As a writer, Fay creates resources to help storytellers and game designers represent disability respectfully, including a monthly Q&A series, a Decolonizing Games Resource List, and a series of articles about harmful disability tropes.

Find Fay: Website | Twitter | Patreon

Thank Fay for this article with a small one-time donation: https://ko-fi.com/S6S4BFL0

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A chronic nerd’s thoughts. Topics include disability, sci-fi and fantasy books, video games, TV shows, and other things I care about. Check out my 2021 series on how to write disabled characters. Sign up for my newsletter to receive blog posts directly to your email.

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