“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. Great post. I often have this struggle too, but never thought about the distinction between mental illness and mental health. I struggle too with the use of the word ‘crazy,’ but that is just me. I agree it is your party and you should get to use whatever language you want. After all you have enough other things to worry about. Keep up the good work!

  2. I agree! All of these “rules” about what we are allowed to say when it comes to “mental illness” gets a bit confusing and overwhelming, and it gives people, (ie me) even more anxiety about possibly offending someone, which is not what our intentions are. I think as long as one uses common sense when discussing such topics they are safe. It’s better to talk about it than not talk about it at all, which is what will happen if we keep making all of these “rules” on what we are supposed/not supposed to say. Thank you for sharing!

  3. aguycalledbloke

    A totally solid and excellent post Ashley – l will be honest, at times it is a struggle to remember what to say as a sufferer of poor quality mental health’ or as you would term it mental illness.

    I am super uber cautious at times when writing about my own health prior to diagnosis and sometimes forgive me have to simply think ‘fuck it, it’s my health and l’ll jolly well write it as it is!” As Kristian says above, we are now living in this super sensitive society that is scared at a bouncing freckle that it gets awkward writing – l can offend people without ever even realising, but sometimes all this politically charged and correct language does is infringe and upset more and more people by its dumbing down.

  4. Outstanding post, Ashley!
    Seriously, I could’t agree with you more when it comes to the news media reporting about person’s with a mental illness… They should be reading one of your posts to learn the correct terminology.
    “Perhaps what’s more important than telling people how to talk about mental illness is getting them to talk about it in the first place.”
    That statement alone, speaks volumes.
    Talk more about the illnesses, disorders, EDUCATE! The more discussions brought into the light, the better.
    Just because someone has (or) is mentally ill, does not always mean their a serial killer.
    … And this is why I rarely watch the news. They piss me off!

  5. Great post. Now a days we have to be careful with so much that we say, not to upset others. But who are the “others?” It’s us! We are those people they are talking about..and sometimes it’s a bit ridiculous. The world needs education…from the right people. I personally hate when people say they are so “OCD,” because their place is clean. People that don’t suffer don’t know the struggle. However, I take that my time to educate them..or just blow it off. They say we are not our disorder. And…we are not..but sometimes it does take over a bit of our life..when it can feel like we are our illness. It’s a part of us. Does it really matter how we label it? I just want to be validated.

  6. Agree! And oops according to your post, I say a lot things wrong! I think we still need to work on an open conversation about mental health/illness and I’m fine with a lot of terms as long as there is respect. I experience a lot a frowned faces when I open up about my ‘condition’ as I call it, not to offence people. People have the tendency to silence me and tell me ‘to take good care’ and ‘that everything will turn out fine’. There is other ground work to be than playing semantics. (sorry for the smallest rant!)

  7. I am trying to talk less about other people and their issues and just write more fiction. Problem solved! When I discuss myself though, I’m going to say what I want, and if anyone has a problem with that, they can quit reading. It’s a huge farking deal to some people that we never ever call a migraine a “headache,” but you know what? Sometimes I say I have a big fucking headache or a BFH when I have a migraine, and I’m not going to stop. 😛😛😛

  8. A very interseting and thought provoking post. Having been unable to work twice in my life due to mental illness -depression, anxiety and “an epsiode” as one nurse called it I find it is not what you call it but people’s reaction. In the end names, political correctness none of it matteres; the only thing that matters is that someone listens to you and hears your story, and kindness.

  9. I’ve gotten yelled at for not using “people first” language when referring to my own diagnoses. That kind of annoys me. I understand if other people want to be referred to that way and I will try to remember and honor that, but please don’t police my words about myself and my own condition.

  10. Fantastic post, Ashley! I think, due to there being a stigma around mental health for years, that people who do not have a mental illness or disability assume its easier to associate mental health/illness solely negative. So that when we open up to them, theres just no understanding, only pity, sympathy and not knowing how to talk back to us about it.

  11. I think above all it is important to respect other people’s wishes of how they would like to be addressed. It’s similar to gender identity – if someone prefers a different pronoun there’s zero harm in using it and the same holds true for mental illnesses. In my experience, there are a lot of people who suffer(ed) from mental health problems but still don’t like to be treated as fragile little porcelain cups. Usually, it’s enough to treat us with the same decency and respect like everyone else and if that’s already an issue for someone, one should not waste the time engaging with said person.

  12. There shouldn’t be rules on how to talk about mental heath. I do have a pet peeve when someone says they have mental health issues or are mentally ill. There shouldn’t be shame in identify as what you have. For me, if I can’t admit to others what I have, I go back to being ashamed when I shouldn’t be.

    I can understand needing to be careful when talking about suicide though. Words only have negative meanings if we let them. This just shows how bad the stigma of mental health still is

  13. I love this post, especially your point that you should let people SELF-identify however they want, and identify others using their preferred terms. It seems that euphemisms are just a way to make people who USE the euphemisms feel better/more comfortable – regardless of whether they are accurate or helpful.

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