Stigma and Mental Illness: Exploring Derogatory Terms
We have probably all been guilty of using derogatory terms to describe those who have a mental illness. We were conditioned as we grew up to look at people as either "normal" or "abnormal" based on their outward behavior and how they fit in with society's norms.
We may have heard a parent, friend, or acquaintance mock those with a mental health problem. We may have also heard appalling stories through the media of violence connected to someone with a mental illness. As members of a free society, we have the choice to accept or rebuff people based on our own personal reasons. The problem with stigma and mental illness is that discrimination inevitably follows; therefore, social acceptance is very important.
I would like to look at how mental health terminology and slang terms play a part in the wider picture of stigma, discrimination, and mental illness.
I have already used the term “mental illness." I use this term because it is widely accepted as the appropriate phrase—but it doesn’t sit well with me. We tend to accept this term because psychiatry uses it freely. We are usually told that being mentally ill means you have a chemical imbalance, or a genetic predisposition.
The fact is that psychiatrists know little about what is going on in the brain, and there are no tests for chemical imbalance. Despite this, most people do accept psychiatry; none more so than the sufferers themselves, many of whom rely on psychiatric medications. Those who do not have a mental health problem also rely on psychiatry, as most perceive the “mentally ill” as a difficult group of people who do not fit in, and need to be in some way controlled. In other words it makes for an easier life all round to have a psychiatric service.
Someone or some “body” has to stop these people from roaming the streets performing “crazy” behaviors, murdering people, talking out loud, shouting in public or exposing themselves? This is the picture ingrained in our psyche.
What Does “Mentally Ill” Really Mean?
There seems to be some confusion about whether the word “mental” points to the mind or the brain. For me personally, I always think of mental as pertaining to the mind. Our “mentality” is a result of how we think, respond and assimilate; an attitude or cognition. If it meant pertaining to the brain, wouldn’t we use the word cerebral? If we used the word cerebral, would that then point to an area of intellect? Of course it would, but the fact is that many people who suffer with mental illness are highly intelligent, articulate people.
Do you see how much confusion there is surrounding this basic term used in psychiatry?
We all think of illness as having a biological foundation and perceive it as sickness or disease. If you put the words “mental illness” together, you get:
- Sickness of the brain
- Disease of the brain
- Sickness of the mind
- Disease of the mind
It all sounds very serious doesn’t it? Given that psychiatry is based on a chemical imbalance theory, we tend to accept mentally ill people are indeed “diseased." This can act in favor of sufferers by indicating they are not to blame. It is when you consider that anxiety problems, a fear of an object, or a constant very low mood (depression) are termed mental illnesses; the definition does seem rather exaggerated to say the least. Reacting to a difficult point in your life with certain thoughts or behaviors sounds pretty normal to me! We would be rather wooden, unfeeling and empty if we didn’t react.
Is Depression a Chemical Imbalance?
Verdict: Being told you have a mental illness should relieve you of blame, but if you suffer with an anxiety problem or depression, or any other less severe “mental illness”, you are under the same umbrella term as those with severe mental illness such as schizophrenia. There needs to be a new term or terms that reflect this. Perhaps some of the emotional and behavioral disorders should simply be removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM).
You have exactly the same chance of having to deal with stigma and being discriminated against, if you have an anxiety disorder or depression, as you have if you suffer from schizophrenia or any other severe mental illness. This is despite the fact that you may be reacting to a traumatic childhood, death of a loved one, or a similar highly stressful life event.
Terms Used to Describe Mental Illness
We have all heard derogatory terms used to describe someone who has “mental illness." Here are a few to jog your memory:
- Mad as a hatter
- Screwy – having a screw loose
- Wacko (whacko)
Can you imagine mocking someone with an illness such as cancer or heart disease? Of course it simply would not happen. So why is it so easy for the general public to use such phrases that demean and demoralize those who are suffering with their mental health?
It is my opinion that it is easy because history has not known any other way. This doesn’t make it okay, but I suspect that most people who use these terms don’t actually see any harm in it. People even call each other these names in fun when there is no mental health problem. Stereotyping mental illness is accepted, just as stereotyping such groups as gay people are.
Many years ago when I was training to be a nurse, I was working in the casualty department when a young girl of 16 yrs was brought in, after attempting suicide on the beach. She had drunk a small bottle of rum and taken a lot of pills. After she had had her stomach washed out, and still in her slightly drunken state, she tried to leave. I remember the staff nurse putting her finger to the side of her own head and telling the girl she was a “nutter”! I can still see the look on that girl’s face. The humiliation and shame sent her reeling into heavy sobs. I don’t doubt that this still happens today, even if it is behind the patients’ backs.
How People with Mental Health Problems Describe Themselves
“I am a Person Who Has a Mental Health Problem”!
Have you been guilty of calling someone a bipolar, a neurotic or a schizo’? This is another way that stigma is created. Would you say “that cancer lady”? You are more likely to say “that lady who is suffering with cancer." People who have a diagnosed mental health disorder do not wish to be known as the title of their disorder. They are suffering with, and trying to live with that disorder. I do know that this happens within the psychiatric profession itself. I have overheard many times a person being identified as “that bipolar”, “that schizo-affective,” etc., and this is by psychiatric nurses!
Check out the video above to see how some sufferers see and describe themselves.
Mad, Maniac, Lunatic, and Insane
These words have been around for so many years that we don’t bat an eyelid when using or hearing them. In my mind, the words mad, lunatic and insane, are words that should be reserved for the absolute worst of the worst mental health scenario when describing someone. Saying that, I believe someone would rather be called mad, than be told they are suffering from “madness”!
We tend to use these words more when describing a mass murderer, or with a violent act that has been connected to mental illness in the media. The words “madness” and “lunacy” conjure up pictures of people frothing at the mouth like some rabid animal. We tend to think of people in chains back in the old days of the asylums, along with ghoulish shrieks in the night at full moon! Can someone who has panic disorder, depression, or even schizophrenia be tarred with the same brush as a mass murderer?
Most people who live with schizophrenia would say they are not “lunatics” and despite what the public thinks, most have never been violent or had any trouble with the law. These harsh terms can be connected to any mental health disorder at whim; even to those who have lost all self esteem and confidence already as a result of their disorder.
The same applies to the word “maniac." Does it go without saying then that a person suffering from mania is a maniac? Using the word “maniac” sounds so much worse, and yet it is also a word that is used in humor between friends, as well as describing someone with a mental health problem. The implications of calling someone who has a manic phase with bipolar disorder a “maniac” would be catastrophic to those people.
Insanity is probably best left to the court rooms, but even that term has been abused and debated over.
Stigma and Discrimination in the Future
Apparently 1 in 4 people will suffer from a so-called mental illness in their life. That’s a quarter of the population. The person, who is flippantly using derogatory terms or mocking someone today, could have a mental health problem themselves next month! Some sufferers will say “sticks and stones will break my bones, but words will never harm me." Others will be mortified at the thought of being perceived as “crazy” or “cuckoo."
In my opinion, what is most important is to change the basic terminology; those that define what mental illness is in the first place. We have the DSM to thank for maintaining stigma and discrimination for those who have “emotional” problems. When you have depression or a phobia in the same diagnostic book as schizophrenia, many of you will be struggling to avoid being discriminated against at some point in your lives.
Have you ever mocked anyone with a diagnosed mental health problem? Be honest!
Words are important. They define everything, and yet are open to personal interpretation, thus misinterpretation! The media has a lot to answer for, as they use archaic derogatory terms for emphasis and sensationalism.
Using derogatory terms is set out in the homes of families. Children are innocent, and often don’t understand anything about “mental illness” until they are well into their teens. It is up to the adults of society to dispel the stigma and discrimination, by refraining from talking about someone who is suffering, in a demeaning or mocking fashion.