You might hear someone casually use words like, “crazy,” “unhinged,” or “psychotic.” These terms are clearly insulting when describing someone living with a mental illness. And they can also be harmful when talking about something else in those terms. For example, calling something that seems disjointed “schizophrenic.”
Some of these phrases are unmistakably inappropriate, but there are also terms that many people don’t know could be offensive. For that reason, I give my own friends and family, as well as loved ones of patients I work with, a list of words to avoid when talking about mental illnesses. While some people may or may not mind some of these words, it’s good practice to always be considerate.
The more we work toward being thoughtful and showing respect, the closer we get to ending the damaging stigmas surrounding mental illnesses.
Here are seven terms to avoid when talking about mental illnesses – and better alternatives to choose instead.
1. Don’t use: “Mental illness” as a collective term
Instead, use: “Mental illnesses” or “A mental illness”
Mental illness is a broad term. It doesn’t reflect what a person is actually dealing with. For example, if you say that someone has “cardiac issues,” that doesn’t really provide much information about what they’re going through. There are many different types of heart problems, and not all patients with cardiac problems have had a heart attack.
Similarly, not everyone with a mental health issue has been suicidal or depressed. There are many different mental health issues. And two people with the same clinical diagnosis can present very differently, too. So, to be respectful of people’s individual experiences, it’s important to use language that also acknowledges that mental illnesses are not all the same.
2. Don’t use: “Afflicted by mental illness”, “suffers from mental illness” or “is a victim of mental illness”
Instead, use: “Living with a mental illness”
Having a mental health diagnosis isn’t necessarily a negative thing. “Suffering” implies that someone is unwell and unhappy. There is also an unfair stigma painting mental illnesses as a weakness. People with mental health issues are able to live fulfilling, healthy lives. And there are a wide range of treatments, so there are many reasons to stay hopeful.
Some people with mental health issues find that their experiences have actually changed their life for the better. They may be more empathetic, more artistically inclined or better able to help others around them. We would never say that someone is “suffering from asthma” or “suffering from diabetes.” We would say they have diabetes or they have asthma. A mental health diagnosis shouldn’t be construed more negatively than any other health condition.
3. Don’t use: “Mentally ill person” or “Person who is mentally ill”
Instead, use: “Person with a mental illness” or “Person living with a mental health issue”
People with mental health issues have far more sides to them than their mental illnesses. To accept someone as a person first is not only more respectful, but honors the many other parts to them outside of their diagnosis. This is called using “person first” language.
One way to practice person first language is to imagine how you would like to hear someone else speaking about your close family member or friend in the same situation. Shifting your perspective can help you reframe how you think and speak about people with mental illnesses and similar stigmatized subjects
4. Don’t use: “Schizophrenic, psychotic, disturbed, crazy or insane”
Instead, use: “Person living with schizophrenia”; “Person experiencing psychosis, disorientation or hallucination”
We would never call someone “a cancer-ic” or “heart diseased.” People with mental health issues are unfairly labeled by their medical condition. People are people, not illnesses. This is another example of “person first” language.
In everyday conversation it’s still common to hear things like, “What a crazy driver” or “That movie was insane.” In addition to changing how you speak about people, challenge yourself to also use these alternate words when describing a thing or a situation.
5. Don’t use: “Normal behavior”
Instead, use: “Usual behavior” or “typical behavior”
There’s no clear definition of what “normal” is. And it can cause others to feel hurt or defensive if their experience is classified as not fitting into the category of “normal.” Using words like, “usual” or “typical” sounds less critical. (Not to mention, every one of us atypical in one way or another.)
6. Don’t use: “Substance abuse,” “addict” or “user”
Instead, use: “Substance use disorder”
Those who struggle with the misuse of drugs or alcohol aren’t simply choosing to “abuse” a substance. . There are often neurobiological factors and emotional health issues which lead to this behavior. Calling this a substance use disorder accepts these other factors. It removes some of the blame that comes with the term “substance abuse” and is a small, but significant, way to offer your support for those recovering from addiction.
7. Don’t use: “Committed suicide”
Instead, use: “Died by suicide” or “lost by suicide”
When someone believes that ending their life is truly the best decision, they are likely not seeing reality around them clearly. This is a symptom of some mental illnesses. To say someone “committed” suicide suggests blame. We would never blame someone for dying from cancer. So, we should use language that avoids blame and shame if someone’s mental health issues caused them to die by suicide.
Making these language adjustments around how we talk about mental illnesses may also encourage people to feel more comfortable having open conversations and seeking help for suicidal thoughts or self-harming behaviors.
Working to stop the stigma
We can, and must, all be a part of the important work to destigmatize mental health. It may feel like a small thing at the time, but every conversation matters when it comes to improving how we talk about mental illnesses and how we make space for everyone to feel validated and supported.
Make It OK is a HealthPartners campaign that works to end the stigma surrounding mental illnesses. It offers tools and resources for practicing how to have a positive and supportive conversation. You can also. Sign the pledge and take a stand against stigma.
If you or someone you know is experiencing symptoms of a mental health illness, your primary care doctor or clinician can be a great person to talk to. At HealthPartners, you can choose a video visit or in-person appointment. Primary care doctors and clinicians can diagnose and treat hundreds of conditions, including mental illnesses. They can also refer you to one of our mental health specialists if needed.
For immediate resources, contact the Crisis Connection (612-379-6363) or the 988 Suicide & Crisis Line by dialing 988. You can also find help through NAMI Minnesota.