Mental Health Blog

How to Speak About Mental Health & Mental Illnesses

Two people sitting in chairs at a table, across from each other. A speech bubble above both of their heads. The one on the left has a lightbulb inside, and the one on the right has a tangled up black line.

What if the way we speak is offensive, hurtful, harmful, or just plain mean, and we don’t even know it?

The words we use and the way we speak are quite important. Yes, much of human communication is non-verbal – think of our expressions, gestures, and body language (University of the People, 2023). But language itself is unparalleled when it comes to communicating our feelings, emotions, and attitudes.

Words aren’t simple. There is the literal definition of a word, and then there are its positive or negative connotations. Consider the difference between saying “house” and “home” despite their shared meaning (University of the People, 2023). A house is a structure where a person may live, and so is a home. Yet the word “home” also represents warmth, comfort, shelter, and security. This is why our language choices matter.

We must always strive to use inclusive language; one that does not exclude any person, and that isn’t hateful, stigmatizing, or prejudiced (The University of British Columbia, n.d.). Language that was acceptable and common in the past may have different meanings as society evolves. Let’s focus on how we can ensure that we are discussing matters related to mental health and mental illnesses in a way that isn’t harmful or hurtful. Some of you may be wondering: why should we care?

1 in 4 people experience mental health issues (Nunn, 2014). 1 in 5 Canadian youth personally experience a serious mental health complication (Free Your Mind, 2021). People who struggle with mental health illnesses are often marginalized and discriminated against. The effects are worsened symptoms and a reduced chance of receiving appropriate treatment (Borenstein, 2020).

First, we will discuss words to avoid.

Then, we will discuss important considerations when phrasing our sentences.

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WORDS TO AVOID

It is easy to substitute certain words for others once you are aware of the issues they carry.

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“Psychotic”, “crazy”, “disturbed”, “insane”. 

You may have heard these terms used to describe people (i.e. “a psychotic person”, “a crazy person”, “a disturbed person”, or “an insane person”). This reduces someone’s identity to their condition, and these terms are offensive. Rather than use these words, say, “a person experiencing psychosis”, “a person experiencing mania”, “a person with disorientation”, or “a person experiencing hallucinations” (Bulthuis, 2013). These acknowledge the condition that someone is experiencing and the behaviours they may be exhibiting without dehumanizing the person. We will discuss person first approaches more in the ‘Phrasing’ section.

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“Normal”. 

Instead, use “usual” or “typical”. These terms are less hurtful (Bulthuis, 2013). There isn’t a real definition of what “normal” means because every person is atypical in some way. Rather than divide people into categories of “normal” or “abnormal”, consider the specific implications you are trying to convey and use an alternative word.

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“You’re being so bipolar”, “I’m OCD about it”, “I’m depressed after that test”.

Using the above terms indicates the following: bipolar refers to rapidly changing states, OCD is synonymous for a non-pathological need to be highly organized, and depression is a temporary sadness (Wollenweber, 2021). In terms of mental health, these are all incorrect definitions. The usage of mental illnesses in common language may perpetuate myths and stigmas about them. It often carries the assumption that a mental illness is equivalent to a negative personality trait.

Instead of saying “psycho”, use unreasonable, emotional, or illogical. 

Instead of saying “anorexic”, use thin, slender, or skinny. 

Instead of saying “bipolar”, say unpredictable, inconsistent, or temperamental.

Instead of saying “PTSD”, say distressed, tense, or nervous.

Instead of saying “depressed”, say sad, upset, down, or blue. 

Instead of saying “OCD”, say clean, organized, distressed, or obsessed.

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PHRASING

If you don’t have someone close to you that has a mental illness, imagine that you do. Picture how you would like this person to be addressed and spoken about, and what you wouldn’t like to hear. These are the principles you should apply to all people living with a mental illness.

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Don’t assign negative connotations.

Don’t use “afflicted with”, “suffers from” or “is a victim of” a mental illness. The best terms to use are “lives with a mental illness” or “has a mental illness”. When discussing someone with asthma, high blood pressure, or diabetes, we don’t say that they are “suffering from” these conditions (Bulthuis, 2013). this is because it implies that someone is unwell due to their illness. This is not a fair assumption to make. People with a mental illness can lead a happy, healthy, and fulfilling life while living with their diagnosis.

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Avoid using a disability first approach.

A disability first approach can often be offensive. Consider the following phrasing: “a blind person”, “a deaf person”, “a mentally ill person”, or “a schizophrenic”. These, quite literally, put the disability before the person. Instead, try using a person first language approach. Examples of this are “a person who is deaf”, “a person who is blind”, “a person with a mental illness”, “a person living with schizophrenia”, or “a person living with a mental health issue”. This approach acknowledges that a person is more than just their diagnosis (Bulthuis, 2013). In fact, we are all multifaceted people. One’s identity is not necessarily their illness or disability. That said, sometimes an individual will prefer to use identity first language when addressing themselves and would like others to do the same (EARN, n.d.). Choosing this approach for oneself still recognizes that we are all people, but that one considers their conditions and lived situations as essential to their identity. It is most correct to use the person first approach when you do not know what the person prefers. If they self-identify differently, do not correct them and address them how they please.

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While it may seem that you “can’t say anything these days” (Nunn, 2014), the truth is that language can reinforce negative stereotypes and potentially harm others. People living with a mental illness may not feel comfortable expressing that certain language is offensive. It is kinder to avoid those words and that phrasing in the first place.

Gary Nunn (2014) said it well: “[When] chatting to friends and colleagues, will I have another ‘manic’ day at work? In all honestly, probably. But it’s hardly a chore for me to replace that with ‘super busy’. Will I, as a journalist, use language to stigmatise people with mental health problems? Never.” 

We do not have to be journalists to avoid stigmatizing people. We just have to be informed citizens who care.

(Note: The Free Your Mind Mental Health Society is an independent youth-led organization. The contents of this blog are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. In the event of a medical emergency, please call your doctor or 911 or other local emergency numbers immediately.)

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References 

Borenstein, J. (2020). Stigma, prejudice and discrimination against people with mental illness. American Psychiatric Association. https://www.psychiatry.org/patients-families/stigma-and-discrimination#:~:text=Public%20stigma%20involves%20the%20negative,have%20about%20their%20own%20condition. 

Bulthuis, E. (2013). 7 terms to avoid when talking about mental illnesses, and better ones to use. HealthPartners. https://www.healthpartners.com/blog/mental-illnesses-terms-to-use-terms-to-avoid/#:~:text=You%20might%20hear%20someone%20casually,something%20else%20in%20those%20terms 

EARN. (n.d.). Person first and identity first language. https://askearn.org/page/people-first-language#:~:text=Person%20first%20language%20emphasizes%20the,is%20equally%20appropriate%20depending%20on 

Free Your Mind. (2021). https://freeyourmindinitiative.com/ 

Nunn, G. (2014). Time to change the language we use about mental health. The Guardian https://www.theguardian.com/media/mind-your-language/2014/feb/28/mind-your-language-mental-health 

PublicDomainPictures.net. (n.d.) https://www.publicdomainpictures.net/en/view-image.php?image=484703&picture=complicated-thoughts-disorder 

The University of British Columbia. (n.d.). Inclusive language resources. https://equity.ubc.ca/resources/inclusive-language-resources/ 

University of the People. (2023). Why is language important? Your guide to the spoken word. https://www.uopeople.edu/blog/why-is-language-important/#:~:text=Language%20helps%20us%20express%20our,different%20from%20your%20own%20culture. 

Wollenweber, N. (2021). Offensive language about mental illness. San Jose Writing Center. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.sjsu.edu/writingcenter/docs/handouts/Offensive%20Language%20About%20Mental%20Illness.pdf