“Rules” for Talking About Our Mental Illnesses

Rules for talking about mental illness - things we're not supposed to say, e.g. I'm mentally ill, I suffer from depression

Just to get things started, I’ll say that I’m “mentally ill”, I “suffer from” depression, and I’m a little bit “crazy”, although the degree varies over time. Now that we’ve got that out of the way, there are a lot of people who like to take a stand against terminology that is thought to stigmatize mental illness. But when it gets to the point where we’re not even “supposed to” be talking about mental illness at all, it starts to get rather ridiculous.

Person-first language

The idea of person-first language is that you should talk about the person rather than the illness. That means saying someone is a person with bipolar disorder rather than they are bipolar. My personal take is that we have the right to define our own identity however we see fit.

At the same time, it’s not particularly appropriate for other people to try to define someone’s identity. I think that’s the case whether we’re talking in terms of illness, gender, sexuality, culture, or what have you. I probably wouldn’t refer to someone as being bipolar unless I knew they identified that way.

Regardless, though, I don’t think anyone should be taking issue with people self-identifying as “I am bipolar”.

How to talk about suicide

This graphic on how to talk about suicide was passed on by Anja at twitter.com/CalculatingMind:

How to talk about suicide: chart of problematic and preferred things to say

Some people take issue with the term “commit suicide”. However, if you read enough blog posts, you’ll find plenty of mental health bloggers dropping that term in. Chances are, they’re doing so without even giving it a second thought.

If you asked 100 people if they thought “commit suicide” implied a criminal act, I bet at least 99 would say no. Would it be offensive to talk about suicide with the intention that it should be a crime? Sure. I just don’t think anyone is using it that way. There are many common phrasings in the English language that begin to lose their literal meaning when paired in that way. As a result, I’m not sure that this is the right thing to be devoting so much time and attention to, as it’s doubtful that it ends up changing people’s underlying beliefs.

What does matter, though, is media reporting of suicides, but that has nothing to do with political correctness. Suicide contagion is a very real and very dangerous phenomenon, and media outlets need to be responsible in their reporting to avoid sparking a reactive increase in suicides.

How people say we should be talking about mental illness

An article in the HuffPost says that instead of calling someone a patient, we should call them someone “who receives help/treatment for mental health or substance use problem or a psychiatric disability.” Wow, try saying that five times fast without looking.

Mental Health America says it’s “hurtful” to call someone bipolar or schizophrenic. Except who’s actually feeling hurt? Doing a quick scan of their board of directors, none mention in their blurb that they have a mental illness. If they’re the ones getting their feelings hurt, how much does that actually matter?

Time to Change says that we can’t talk about “the mentally ill” or say people are “suffering from” a mental illness. That’s nice, but I’ve done a shit-ton of suffering over the years, thank you very much. It’s my mentally ill party and I’ll suffer if I want to.

An article on HealthPartners.com cautions that we should not use “‘mental illness’ as an aggregate term”, and instead should use “mental illnesses” or “a mental illness”. That’s some pretty serious semantic nit-picking.

Science Daily explains “why you should never use the term ‘mentally ill.'” Too bad, so sad, I already used it at the beginning of this post.

If we really want to get creative about not saying “mental illness”, though, we can turn to Mindfreedom.org, which suggests that I could be called a “Consumer/Survivor/eX-inmate (CSX)”, “person who identifies as a survivor of psychiatric atrocities”, or my personal favourite, “different”. Sometimes creativity is a good thing, other times, you just want to be different.

It’s my party and I’ll be crazy if I want to

One thing I don’t understand, because words just shouldn’t behave that way, is using “mental health” as a synonym for “mental illness.” Yet if you were to substitute “physical health” and “physical illness”, people’s understanding of the English language suddenly returns. “Mental illness” is not a four-letter word, and it seems to me that beating around the bush is more stigmatizing than openly acknowledging that mental illness is a thing. It reminds me of Steven Pinker’s concept of the euphemism treadmill, where people are regularly feeling the need to come up with new words with essentially the same meaning because the old words became tainted by the stigma around whatever it is the words are referring to.

That little pet peeve aside, my biggest issue is when “normal” people say things that minimize the “suffering” of the “mentally ill”. Allow us to feel like crap, and keep your judgy-pants to yourself. There are more than enough people on that bandwagon already.

What should we be focusing on?

I think it really comes down to what researcher Patrick Corrigan talked about in his book The Stigma Effect. Stigma is not rooted in words; it exists with or without them. The labels are mostly a convenient place to hang the stigma hat on. Sure, tackling the more egregious terms is a good thing, but focusing on nitpicking means losing sight of the real underlying issues. Trying to word police how people talk about their own mental illness experiences totally misses the boat in terms of changing public attitudes.

Perhaps what’s more important than telling people how they should be talking about mental illness is getting them to talk about it in the first place.

So if I want to call myself crazy, mentally ill, depressive, or whatever, that should be the least of anyone’s concerns.

Book cover: A Brief History of Stigma by Ashley L. Peterson

My latest book, A Brief History of Stigma, looks at the nature of stigma, the contexts in which it occurs, and how to challenge it most effectively.

You can find it on Amazon and Google Play.

There’s more on stigma on Mental Health @ Home’s Stop the Stigma page.

38 thoughts on ““Rules” for Talking About Our Mental Illnesses”

  1. I can’t ever see myself as identifying as “a consumer of psychiatric atrocities,” no. Anyway, “psychiatric atrocities” sounds more like being abused in the psychiatric healthcare system (One Flew Over the Cukoo’s Nest -style) than being mentally ill.

  2. “That’s nice, but I’ve done a shit-ton of suffering over the years, thank you very much. It’s my mentally ill party and I’ll suffer if I want to.”

    In my worst moments, all I want is the recognition that I am suffering.. but because it is due to a mental health condition, apparently we can’t talk about it? Where do these organizations get their ideas?

    Please say that I am suffering and recognize it. Maybe if we accept the suffering, we will reduce the stigma; a term I think I’ll keep in the repertoire too.

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