Why the Words We Use to Talk About Mental Health Are Important

The stigmatizing of mental illness continues to discourage people from seeking help or speaking openly about their experiences.

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Apr 30 2015, 7:00pm

Image via SBS

This article originally appeared on VICE UK.

Political correctness gets a bad rep. People associate it with the thought police, an erosion of civil liberties, or just tedious liberals. But frankly, political correctness mostly boils down to one ancient philosophy—don't be a dickhead.

The need to use language considerately and sensitively while still allowing freedom of expression is an enduring concern, however bored you are by the debate surrounding it. It's particularly true when it comes to the way we speak and write about mental health.

Bullying and discrimination often come in verbal or written forms and, in 2013, a YouGov poll found that, "People with mental health problems are widely seen as the most discriminated-against group in Britain." In the week the poll appeared, "mental patient" and "psycho ward"–themed fancy dress costumes had to be removed from stores nationwide.

"The limits of my language mean the limits of my world," the Austrian philosopher Ludwig Wittgenstein wrote. "Language is how we codify things. If we shift language then we shift perceptions," says James Leadbitter, an artist and activist who has been diagnosed with borderline personality disorder and who is also known as the vacuum cleaner.

However far we may imagine we've come from the "lunatics," "hysterics," and "imbeciles" of the 19th century, or the "spazzes" and "spackers" of more recent times, it really isn't that far. The stigmatizing of mental illness continues to discourage people from seeking help or speaking openly about their experiences. "It took me 12 years of pronounced problems to see someone about it and I do think that language is a part of that. I probably have prejudices about mental health myself," Jan*, who has been diagnosed with social phobia, told me.

A 2007 study conducted with school-age children found that "help-seeking by mentally ill young people may be improved by interventions that address both their lack of factual information about mental illness, and those which reduce their strong negative emotional reactions towards people with mental illness." The study also found that the kids used words like "disturbed," "nuts," "retard," and "div"—among others—relatively frequently.

After Andreas Lubitz, copilot of the Germanwings plane that crashed in the Alps, killing 149 passengers, was found to have a history of depression, the Sun's headline roared, "Madman in Cockpit" while the Mail asked, "Why on Earth was he allowed to fly"? Forever one to mistake a horrible tragedy for an opportunity to promote his personal brand, Piers Morgan insisted that no one on medication for depression should be allowed to fly a plane. "Frankly, I don't care if the copilot, 28-year-old Andreas Lubitz, was mad, bad or sad," he wrote.

There is a fatalistic idea that people like Morgan buy into and enshrine in the language they use: that something like depression stays with you always and marks you as being incapable of doing anything, ever. Like the people that insist that all Muslims should apologize or explain the actions of Islamic extremists who they've never met, Morgan and his ilk use language to demonize a large and infinitely varied section of society. The result, of course, only increases stigma.

The Lubitz headlines are nothing new. When Frank Bruno was sectioned under the Mental Health Act in September 2003, the Sun's now infamous front-page headline was, "Bonkers Bruno Locked Up"—a line that then editor Rebekah Brooks realized was too extreme after she'd left the office.

"Language is how we codify things. If we shift language then we shift perceptions" –James Leadbitter

Other celebrities have received similar treatment in recent years. Britney Spears has been described as " screaming mad" and Danniella Westbrook is apparently keen on going on the odd "mad Twitter harangue." Still, these brief examples barely scratch the surface.

Andrew Scull is a historian of psychiatry and the author, most recently, of Madness in Civilization, a book that explores the cultural history of madness, from ancient Palestine to today. He tells me that "the language is sort of a trap here" because, for thousands of years, "madness has brought a stigma with it and this stigma is one way in which suffering is brought." Headlines like the "Bonkers Bruno" one are, Scull says, good examples of this. Different cultures have often supplied this stigma, depending on fashion and circumstance. "By the early 18th century there are a lot of spoofs and jokes at the expense of 'hysterical' patients and people suffering from 'the spleen,'" Scull tells me by way of example.

The history of mental health terminology also shows that words are used indiscriminately until that use reaches a tipping point and they then become unacceptable or unfashionable. What is true for everyday language is also true for medical terminology and I spoke to a number of people who had various concerns about the diagnoses they'd received over the years. Often, these concerns were with the language or the assumptions inherent in the language. "Disorder" is a word that occurs again and again as a problem. Schizophrenia is currently a highly problematised term. A recent Daily Beast article on this made a wider point:

Considering all the words for mental illness, both those used by medical doctors and those that are cruel slurs used by the general public, it is striking how many of them have connotations of being broken or disorganized: deranged, crazy (which means cracked—itself a derogatory term), unglued, having a screw loose, unhinged, off the wall.

One way of overcoming the harmful power of certain words is to reclaim them in the way that some in the black community have reclaimed the word nigger. The psychiatric survivors movement sees terms like madness and mental illness as being ones that can be worn with pride. Amy*, who has depression, tells me that, "I often use the language in quite a flippant way because I find that irreverence takes away its secret power."

She admits that this could simply mean that she's internalized society's stigmas but says it "feels better than being dour." Leadbitter says that "there have been times when I've been really ill and the colloquial use of words like mental, crazy, and bonkers has really hurt," but goes on to tell me that, "I can reclaim this language. I can say, 'Yes, I am crazy.'" Of course, others disagree, seeing these words as being evocative of dark, Victorian days.

The important thing, though, is that those with personal experience of mental health issues and those sensitive to the realities involved carry out this discussion. One of the chief complaints of those who feel that political correctness has "gone mad" is that their language is being policed. "If you tell people how they can and can't use words they don't respond well. The idea is to think about how language use affects people," says Leadbitter.

What you can say among friends is, as ever, not exactly the same as what you can say among people you don't know or in a public space. Media outlets—which hold positions of power in our society, however much financial trouble they may be in—can't treat their front pages like their front rooms. We may be scared of how other people think and feel. We may be scared of how we think and feel. We may find the perceived vulnerabilities of others unbearable.

These things may all be true but it is also true that showing kindness and sensitivity in the language we use should not be a grave imposition on our being – it should be a basic requirement of our humanity.

* Name has been changed

If you are concerned about the mental health of you or someone you know, visit the Mental Health America website.

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