Updated on January 28, 2023
Words matter. The language that we use to talk about a particular topic can have a profound effect on how we think about and relate to it.
Think for a moment about mental illness. It could be the only disease in which people who have it feel guilty for doing so, or, in some cases, are made to feel as if it is their fault. This stigmatization is directly related to the language that we use regarding mental illness and the people who suffer from it.
Maybe you have heard someone ask, “Are you insane?,” or use the term “mental” to describe someone else. These stigmatizing terms pop up in the public arena and in popular culture, too. For example, at a political rally, a prominent politician said that someone he did not agree with “needs a psychiatrist” and used pejorative names like “wackadoodles” to describe his opponents. He even said such people needed to visit a local mental hospital.
This stigmatizing language can feel like a slap in the face for people who do struggle with mental health issues. Such comments degrade what a person is going through, make mental illness seem like a less important health issue than others, and create the impression that mental illness only describes “psychos” (not everyday people who we know and can relate to).
Did You Know?
In actuality, mental illness is very common in the U.S.. If we ourselves have not suffered from it, we know friends, family members, and/or neighbors who live with it. Here’s a quick look at mental health statistics, according to the National Alliance on Mental Illness:
- About 1 in every 5 adults in the United States experiences mental illness in any given year. That equates to about 51.5 million people.
- Also, about 19.1 percent of U.S. adults (about 48 million people) have experienced an anxiety disorder. This includes conditions such as obsessive-compulsive disorder (OCD) or post-traumatic stress disorder (PTSD).
- Annually, about 8 percent (19.4 million people) experience a major depressive disorder in any given year.
- Some 3.6 percent of people experience PTSD (about 9 million people).
- About 9.5 million people (or 3.5 percent) experience a co-occurring mental illness and substance use disorder.
- About 7 million people (2.8 percent) have bipolar disorder.
- Less than 1 percent experience schizophrenia (about 1.5 million people).
The Negativity We Inadvertently Assign to Illness
Imagine for a moment what would happen if the same negative tone were applied to any other disease. Would you ever think to say, “You need chemo – your brain cells are so damaged already…” Would you comment or shame someone who is struggling with heart disease? Would you call someone “cancer-ic” or make fun of a person who has a brain tumor that causes an inability to speak or function normally? These conditions are devastating. Making fun of them simply isn’t accepted and should never happen.
Yet, with mental health, it does occur. In short, language matters. The specific mental health words we choose to use make a difference—a big one at that.
Think About What You May Have Said
There are many examples of how people use a negative tone when discussing mental health. Yet, most don’t recognize what they are saying and how it affects others. Consider these examples:
- The use of “psychotic” to describe someone who may have a strange idea
- The use of “schizo” to describe someone in a derogatory manner
- The use of “unhinged” to describe someone suffering from a panic attack or mania
- The use of “crazy,” “insane,” or “delusional” to describe someone who has a different opinion
- The use of “brain dead” to refer to someone who is behaving inappropriately, doesn’t appear to react quickly enough, or espouses a different point of view
All of these are examples of inappropriate language that stigmatizes people with mental illness.
Why It Matters
Stigma isn’t unique to mental health; there are other health-related conditions that people may not seek help with due to prejudices and preconceived ideas. However, the degree to which the language we use reflects this stigma is somewhat unique. Despite those who argue that the actions a society takes are far more important than the specific words members of that society use, the truth is that discriminatory language keeps stigmas socially acceptable. As long as words such as “crazy” and “psycho” are casually tossed around, and as long as individuals joke about how some belong in a mental institution, those who need mental health care will have one more obstacle to overcome when seeking treatment.
The Connection Between Words and Associations
A lot of research has gone into understanding how the human brain works and the associations it connects to language. Current understanding poses the idea of two systems in the mind, System 1 and System 2.
System 1 is the function of the brain that operates quickly and intuitively, without a clear sense of voluntary control. It’s the part of the brain that oversees most of our day-to-day actions, such as walking, reading, and understanding the subtext of social interactions. These are things that we generally do without putting much thought into the logistics.
System 2 is the function that oversees actions that require more thought and effort. It’s the conscious, reasoning self that has to weigh options and make choices, solve complex problems and mathematical equations, and park a vehicle. Unlike activities such as walking or chewing that, for most people, don’t require much thought, activities that fall under System 2’s jurisdiction require planning, experience, and higher thinking.
Our System 1 brain has been evolving for millions of years to take care of complex problems without requiring much mental effort. Our System 2 brain, on the other hand, its comparatively immature. It also tends to be lazy, meaning that we fall back on System 1 intuition and functioning as much as possible.
When thinking about ourselves, we identify with System 2, or the choices we make and actions we consciously take. However, System 1 is always working in the background, helping us make sense of the world and building a complex framework through which we perceive everything.
Our System 1 brain is particularly important when it comes to language. When we hear a word, we subconsciously create associations with that word based not only on its literal definition but the context in which it was used. If a word is consistently used in a certain context to convey a certain meaning, the connotation becomes cemented in our minds. It takes conscious effort—System 2 effort—to overcome the associations we connect with the word.
Understanding the Power of Words
Once we understand the processes that certain words trigger in our brains, it’s easier to grasp why it’s important to be more thoughtful when deciding which words to use, particularly when it comes to mental health. Language is emotionally charged, making it necessary to be aware of how the words we use not only reinforce our own biases but the preconceived ideas of those we talk to.
Things to avoid may include:
- Calling someone “OCD” to mean that we believe they’re overzealous when it comes to cleanliness or organization; this isn’t the same as living with clinical obsessive-compulsive disorder
- Describing someone who’s naturally thin as “anorexic;” anorexia nervosa is a complex condition that involves far more than a quest to be a certain body size
- Saying someone is bipolar when they experience natural mood swings
- Using words such as “crazy,” “psycho” or “schizo”
Using words related to mental illness casually or to say something negative about someone else subconsciously reinforces the idea that mental illnesses are shameful, and seeking help is a last resort for someone who’s truly broken. This can be a roadblock for someone who needs mental health care, or it can create negative feelings about a clinical diagnosis.
How Person-First Language Can Help
Using person-centered language can make a drastic difference in the way people feel about words that others use. It is more than a focus on a politically correct term for mental illness. And it can help an individual to see how much they are valued, not their condition and not labels. Here are a few changes to make today.
Table of Common Terms (And What to Use Instead)
|Common Term||Better Term||Why|
|Suffering from mental illness||Living with a mental illness||A mental illness is not always a negative thing.|
|Mentally ill person||A person with a mental illness||People are not defined by their mental illness. There is much more to them than that.|
|Disturbed, crazy, lunatic, psycho||A person living with schizophrenia (or bipolar disorder, PTSD, etc.)||Negative labels like disturbed or crazy tend to be stigmatizing. Describing the mental health disorder that they are living with is a better use of mental health words.|
|Suffers from substance abuse||Has a substance use disorder||Avoiding the use of words like suffers and abuse and substituting the diagnosable disorder when talking about drug and alcohol addiction is less hurtful.|
|Schizophrenic, bipolar, borderline||A person living with schizophrenia, bipolar disorder, etc.||People are not bipolar, schizophrenic, or borderline. Instead, they are living with a diagnosable mental health disorder.|
A respectful mental health vocabulary can improve public perceptions about mental illness. Still, some people might think that those who want to move from negative mental health language to person-centric language are “too sensitive.” Some might say it is just using a “politically correct” term for mental illness. Others may feel that those who have a mental health diagnosis are somehow getting let off the hook.
Here’s the truth. What was the norm before in many aspects of society is no longer acceptable. From gender identity to sexual harassment, what was once considered “okay” or ignored and never spoken about for fear of shame decades ago, is now understood as unacceptable. The same is true for stigmatizing language about mental health.
Keep in mind that every person has value and is deserving of respect. Reducing them to a label or using derogatory terms to describe them is both disrespectful and hurtful. A mental health diagnosis doesn’t define a person; it’s a guide for treatment.
When You Make the Change
When you decide to focus on person-centered language, you choose to help people with a variety of conditions see that their health is just as important as anyone else’s. And this can help to encourage these individuals to seek out the help they need. Such help can pave the way for them to better their lives and improve their ability to contribute to the community. This is especially true for those individuals who have been marginalized by socioeconoic conditions or who believe that no help is available to them. Some don’t believe they deserve help, which is even more tragic.
Take a moment right now to consider your language. Are you choosing language that is sensitive to people with mental illness? Or could you make a few changes that could help others improve their perspective? Consider this: When you take the time to be careful about your selection of words, you are putting compassion first. With the choice of respectful words, mental health perception in general improves. Would any of these changes be too hard to make when they could so easily benefit others?
Think of the Golden Rule here. Treat others as you want to be treated. It’s that simple.
Show Each Other Respect
Mental health treatment programs are available to help individuals living with anxiety, depression, and a wide range of other conditions. If you or someone you know has not researched or contacted such a program, or you’ve put it off thinking that you could handle it on your own, now may be the time to reach out for help. When you do, you will be helping others with the same conditions, by sending the message that mental illness—like other physical health issues—is nothing to be ashamed about.