Language serves as our primary method of communication, enabling us to connect, share thoughts, emotions, and experiences. This fundamental role gives language significant power—it can be liberating, uplifting, and inspiring, but equally harmful when used inappropriately. The words chosen to discuss mental health conditions carry particular weight, as they influence how society views and responds to these issues. Research indicates that public understanding of mental health terminology often differs significantly from clinical definitions, and certain words can perpetuate stigma or cause harm. This article examines the power of words in mental health discourse, explores the differences between lay and clinical understanding of mental health terminology, identifies problematic language to avoid, and presents more respectful alternatives. It also addresses the collective responsibility of society to evolve our language around mental health in ways that promote understanding, reduce stigma, and support those affected by mental health challenges.
Language Shapes Perceptions of Mental Health
Research has shown that certain general terms used to describe mental disorders are understood by most people to have similar meanings. A study published in BMC Psychiatry found that terms like "mental disorder," "mental illness," and "mental health problem" were viewed with very similar meanings by the public. However, "psychological issue" was perceived as encompassing a broader range of conditions. This research, conducted by Jesse S. Y. Tse and Nick Haslam, Ph.D., with the University of Melbourne, involved a nationally representative sample of 600 adults in the U.S. and highlighted the gap between public perception and clinical terminology as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The DSM, published by the American Psychiatric Association (APA), serves as the authoritative guide to the diagnosis of mental disorders used by healthcare professionals in the U.S. and much of the world. The latest edition is the DSM-5-TR, published in 2022. While concepts and classification of mental disorders have received significant attention, how these concepts and terms are understood by laypeople has received much less consideration, despite its importance for effective communication and reducing stigma.
The Impact of Problematic Language
Many words and phrases have become ingrained in daily vocabulary based on dated misconceptions of mental health. While society has progressed from some of these damaging views, and people often don't intend harm with their language choices, the continued use of problematic vocabulary can still cause harm and perpetuate stigma.
Some particularly harmful examples include:
Using "committed suicide" - This terminology originates from when suicide was considered a crime and a sin. The word "committed" is associated with committing crimes or sins, which inaccurately frames suicide as a moral failing rather than a health crisis. More thoughtful expressions include "took their own life," "ended their own life," or "died by suicide."
Describing someone who is organized as "OCD" - Being clean, tidy, and particular is not the same as living with clinical obsessive-compulsive disorder, which is a serious mental health condition that can significantly impair daily functioning.
Talking about being "bipolar" when experiencing everyday mood swings - Natural fluctuations in mood differ significantly from bipolar disorder, which involves distinct episodes of mania/hypomania and depression that can last for days or weeks.
Saying "I'm depressed" or "that's depressing" when feeling sad - This trivializes clinical depression, a serious condition characterized by persistent sadness, loss of interest, and other symptoms that significantly impact daily life.
Using stigmatizing terms like "psycho" or "schizo" - These words are derogatory and stigmatizing to people living with schizophrenia or other psychotic disorders.
Describing someone thin as "anorexic" - Anorexia nervosa is a complex mental health condition that involves much more than just weight loss, including intense fear of gaining weight, distorted body image, and restrictive eating patterns.
Saying "I'm going to kill myself" when frustrated or embarrassed - This expression is insensitive to people who are suicidal or have lost loved ones to suicide.
The Evolution of Mental Health Language
Language around mental health is constantly evolving, with some terms becoming outdated and stigmatizing over time. Words like "psychotic" and "neurotic," which originated in different contexts, have evolved to become emotionally charged and inappropriate in modern discussions of mental health.
In a similar way that we would struggle to understand terms like "Inbox," "Unfollow," and "Selfie" from ten years ago, mental health terminology requires regular reassessment to ensure it remains respectful and accurate. The "Mad Pride" movement exemplifies this evolution, as it seeks to reclaim language around mental health and reverse the negativity associated with experiencing poor mental health. This movement involves past and present users of psychiatric services and emphasizes that people should be proud of their "mad identity."
The process of language evolution is further complicated by the nature of mental health conditions themselves. Many symptoms that are now considered part of mental health disorders would have been normal and protective responses for our ancestors tens of thousands of years ago. For example, anger would have helped protect against threats, and sadness would have signaled the need for help and support from the community.
Identity and Mental Health Language
Mental ill-health impacts fundamental parts of personal identity, including relationships, work performance, and educational outcomes. The way societies frame mental health language can either reinforce or challenge these identity impacts.
Different individuals may have varying preferences for terminology based on their experiences and needs. For example: - Some people find diagnostic labels stigmatizing but may find them essential when accessing benefits or accommodations. - The phrase "mental illness" is regarded by some as unhelpful due to the lack of consensus on an agreed organic component to distress. - "Mental ill-health" or "mental health problems" may be preferred alternatives. - The term "recovery" has also been controversial because it means different things to different people.
Exploring people's thoughts around such terms can help reach a shared understanding that respects individual experiences and needs.
Collective Responsibility in Mental Health Language
Changing how we talk about mental health requires a collective effort across society. Everyone has a role to play in evolving language that promotes understanding and reduces stigma. High-reach media, in particular, has a responsibility to model respectful language given its wide influence.
Little by little, through citizen activism and a new generation of celebrities willing to open up about their own experiences with mental health problems, our language is slowly catching up with centuries of mystifying mental illness. Society has moved beyond the times when people experiencing symptoms they didn't understand were locked away, hoping they would "stop existing."
We now recognize that mental health problems exist in our homes and communities, that they are common, and that they can be addressed through prevention, timely treatment, and concentrated societal effort. Addressing the mental health crisis starts with talking about it in appropriate ways.
Being Mindful in Mental Health Communication
Being thoughtful about language extends beyond specific diagnoses and conditions to how we discuss mental health in general contexts. For example, when someone has attempted suicide and survived, describing them as "unsuccessful" implies that there was a desired outcome of death, which is both insensitive and inaccurate.
Mindful communication also involves recognizing that 1 in 6 people experience high levels of distress or a common mental health problem each week. Being respectful and thoughtful in mental health-related language can positively impact the brain's "associative activation" and, consequently, the emotions of people around us.
Conclusion
The language we use when discussing mental health matters profoundly. It shapes perceptions, influences how people experiencing mental health challenges are treated, and either reinforces or reduces stigma. Research shows significant differences between public understanding and clinical terminology, highlighting the need for more effective communication.
Certain words and phrases perpetuate outdated and harmful views of mental health, while more respectful alternatives can promote understanding and support. The evolution of mental health language reflects broader societal changes in how we view and respond to mental health challenges.
Changing how we talk about mental health is a collective responsibility that requires awareness, mindfulness, and commitment from everyone. By choosing our words carefully and thoughtfully, we can contribute to a more supportive and understanding society for people experiencing mental health challenges.