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Stigma and Mental Illness: Exploring Derogatory Terms

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People who have a mental health disorder have to live with stigma and discrimination. The popular use of slang terminology doesn't help.

People who have a mental health disorder have to live with stigma and discrimination. The popular use of slang terminology doesn't help.

Language Matters When It Comes to Mental Health

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.

Psychiatry Knows Little About the Brain

The fact is that psychiatrists know little about what is going on in the brain, and there are no tests for chemical imbalances. 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 around 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. 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 from 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.

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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.

Being told you have a mental illness should relieve you of blame, but if you suffer from an anxiety problem or depression, or any other less severe “mental illness”, you are under the same umbrella term as those with severe mental illnesses 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, the death of a loved one, or a similar highly stressful life event.

Crackers - a term for  mental illness

Crackers - a term for mental illness

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:

  • Cuckoo
  • Mad as a hatter
  • Screwy (having a screw loose)
  • Bananas
  • Loopy
  • Crackers
  • Wacko (whacko)
  • Loony
  • Nuts
  • Freak
  • Crazy
  • Weirdo

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.

“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 from cancer."

People who have a diagnosed mental health disorder do not wish to be known by the title of their disorder. They are suffering 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 is 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 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 courtrooms, 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 that define what mental illness is in the first place. We have the DSM to thank for maintaining stigma and discrimination against 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.

Final Thoughts

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.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


meloncauli (author) from UK on August 27, 2018:

I think you misinterpreted the meaning behind why I said this. I have the utmost respect for ALL people with any degree of severity of mental health problem. Anxiety is a state that ALL people suffer from from time to time. Classing it too hastily as a 'mental illness' doesn't always help.Schizophrenia is most definitely a recognised diagnosable mental illness.

Rowrow on August 22, 2018:

I don’t like how the author says if you have anxiety you’re put on same group as someone with schizophrenia. People with schizophrenia ARE human- they are people like everyone else. It’s society that is ignorant overall and prefers not to think about or have to deal with this illness, so it marginalizes people who happen to get schizophrenia. I grew up in the 60s. Our songs and language made sure to reassure us that WE were Not crazy- it was them- we were ok. I think most of society does that to make sure there’s a line to keep people with schizophrenia away from us so we don’t have to acknowledge them or think of ways to help them or change things so they will be welcomed into our world.

meloncauli (author) from UK on July 06, 2016:

Thank you so much for your comment.

Mona Sabalones Gonzalez from Philippines on July 02, 2016:

I appreciate this article very much, because it challenges those who attach a stigma to mental illness and those who make fun 0f the mentally ill. I also appreciate how you showed the difference between one who is mentally ill and one who is going through a difficult time.

endrun on February 05, 2016:

No this is not helpful at all. Thomas Szasz said it best:a person simply cannot have a "mental illness." There is no such a thing. The mind cannot be "sick" any more than the mind can be "well." The mind is an abstraction. But--those true believers--especially those who find "secondary gain" or so called--prefer to describe themselves as having a "brain disease." Dr. Szasz didn't agree with that either. If one has a brain tumor, migraines, or has a head trauma, they have a brain disease. Otherwise they have no such thing. What they may have is "life issues", "issues of living", issues in living, or some similar description. And most importantly, behavior is not equivalent to "disease" or "illness." Now, if everyone adopted this mindset--including notably the basic idea that Psychiatry is not a bona fide medical specialty-- then--and only then--does the problem of "stigma"(a better term for this would be "the inputation of a permanent disability based on frivolous evidence at best"), so much as even begins to disappear.

I shall give an example. I have Celiac Sprue, which is a condition involving a chronic malnutritive state as long as certain grain proteins are ingested. This has been identified in medicine for centuries, but if one listens to Jimmy Kimmel in the states, the impression is easily derived that it has only existed in people's minds and in the last five to ten years. Now, since 2002 I have been on the required diet and began taking civil service exams in my city toward getting a job, but this process despite scoring and ranking high on several since that time, is that I was only called to one interview--which was in 2015--and at that interview, I was discriminated against on the basis of someone giving information on this very specific medical condition I have had to overcome. The employer denies it and has hired an attorney and we are at the very basic fact finding stage after seven months after filing my complaint, the employer filing its ANSWER, me filing a REBUTTAL, and all five persons in attendance at this job interview having gone through the first round--and perhaps the only round--of direct questioning by the agency worker. Now---I have consulted an attorney and it turns out these agency reviews as required by the law are all cursory and the prospects of prevailing at litigation is abysmal due to judicial bias against such cases no matter the evidence or anything. Thus, it appears I am going through the process of being victimized not just once, but multiple times. We'll see. Since the employer chose to affirm that this subject was discussed at the job interview and at the same time implausibly proclaims it was I as the job applicant who introduced it--it would appear that if anyone tends to believe such a story that person is living on another planet. The state agency reviewing this rubbish of a scenario proclaims also that it cannot entertain the publicity against me of five point five years ago which falsely accused me, in conjunction with an involuntary commitment, of threatening the life of the then Mayor(who had posted derogatory comments on a blog toward me inciting anger based on the various legal and illegal forms of discrimination he exhibited on there as a potential employer at the time under the city civil service system). Psychiatry of course was distinctly disinterested in any facts pertaining to that which might tend to alleviate any concern and of course was solely interested in deriving a "diagnosis", which was duly done and then after the attending shrink changed my legal status from involuntary to informal(meaning, in theory, I could leave the hospital at that point) the directing Psychiatrist cancelled this falsly proclaiming he had "examined" me and found me to be in need of further commitment--when in fact he never so much as popped his head in to see me on that ward. So you see it is all lies, the newspaper ran a story after I contacted it seeking specific information on why I was being accused of what I was being accused of--which of course hospital staff didn't feel I should learn(the article contained a phrase that went "among other things"(never delineated as to what that meant exactly) which was deemed acceptable in describing me under the premise of the headline as "dangerous"). So, the simple fact is that Psychiatry is NOT a victimless crime and contrarwise among the most dangerous crimes committed against the innocent---and it, like "Herpes" or "Chlamydia" or "HIV/AIDS" or "Gonorrhea"--represents "an infection once transmitted onto or into a person is among the most intransigent to rid oneself of, let alone effect a true "cure" at any point in time during their ENTIRE REMAINDER OF THEIR LIVES.

Psychiatry is a CRIME. It PUNISHES its victims in ways that NEVER CEASE. Thus, to say that merely changing the terms of the means upon which the victim is criminalized--thus making it what--from a Felony to some sort of Misdemeanor(??)--is someone representative of some level of justice inputed to the victim of an inherently criminal enterprise---is simply akin to proclaiming a deadly tornado or hurricane "a bit of a breeze."

Debra Hargrove from North Carolina on November 01, 2015:

Great Hub about stigma which is a roadblock for many who need help from getting the help. Speaking up about the illness of mental health is vital to be able to understand what it is all about. No one is immune to having mental health issues.

meloncauli (author) from UK on July 17, 2014:

Hi Keri

In my opinion, schizophrenia would stay where it is in the grand scheme of things! Where stigma is concerned, there will always be stigma associated with any mental health 'tag'. Thinking more on the subject, we don't even know for sure if some of the more severe mental illnesses are a reactionary state in some way similar to depression.

Keri on July 16, 2014:

I agree with many of the points in this article. However, I disagree with trying to create a bigger distinction between depression/anxiety and schizophrenia in order to decrease the stigma associated with "less severe" problems. Where does that leave those with schizophrenia and bipolar disorder? I think the solution is to make people more aware of how common any mental health problem is.

meloncauli (author) from UK on April 05, 2014:

You have my backing on all of those Nick!

Nick on April 04, 2014:

I'm compiling a list of new mental illnesses that should be included in the new DSM version.

Compulsive mental illness labeling disorder

- A compulsive disease in which every mental weakness must be given a label.

Obsessive authority disorder (or Ego trip disorder)

– A disease in which a person dislikes or cannot tolerate challenges to their authority. Typical among psychiatrists.

Psychiatrist’s arrogance disorder

- A disease prevalent among the psychiatric profession

ADBIBD (Attention deficit because I’m bought disorder)

Zero conscience disorder

Money before the public good disorder

- A disease in which people place money and their self-serving interests before the public good.

If anyone disagrees with my new labels, why is it that those in authority and in the psychiatric profession are allowed to create names and categorise the rest of society for our weaknesses, but we are not allowed to categorise them?

If anyone has any new labels to add to the list, please share.

meloncauli (author) from UK on January 05, 2014:

Thanks for your comment. I see how you have read the point I made about anxiety being under the same umbrella as schizophrenia. I didn't quite mean it as you think. Anxiety is common, very common. A low mood or low to medium level depression is also fairly common. These are usually responses and for many the symptoms can go away quite quickly even without treatment. Schizophrenia on the other hand is a major mental illness that usually needs constant treatment, often for life. Joe Public needs to see the difference between the two - both without discrimination of course. There is little need in my opinion for anxiety related disorders or a low to medium depression to be classed as a mental illness....this is just my opinion. We all know there is stigma attached to ANY mental illness, so why make some normal response conditions open to prejudice? Thanks for your comment :)

GeneWeen on January 05, 2014:

Just wanted to add an important point. In peer reviewed, and rigorously professional scientific studies, it has been clearly concluded, in study after study, that persons with a lived experience of mental ill health, are far more likely to be the VICTIMS of crime. Especially violent crime. The so called normaltons without the experience of living with a mental illness, are always more often the perpetrators of violent crime.

Another point I must highlight. You claim in the blog that individuals living with periods of anxiety, depression, or phobias, should not be co-categorised in the DSM with such diagnostic constructs as Schizophrenia. That is prejudicial, discriminatory, and further perpetuates stigma in a profound way. Think about it. It makes no sense and is offensive on many levels.

meloncauli (author) from UK on December 14, 2012:

Thanks Melovy. I am so sad that your friend had to be treated that way. I was told I would never be well by a psychiatrist once many years ago. I remember that day like it was yesterday and the effect it had on me. I am glad to say I proved him completely wrong!

The trouble with psychiatry is, if a pill doesn't have a desired effect, they often don't provide you with any other answers, so you get stuck in the loop of psychiatric dependency and ever pessimistic that you can recover.

As for your sister, it can be frustrating when someone won't allow the help and support. You are right to accept her on her own terms. I believe there are many such people as your sister who suffer but do not get the help they need.

Thanks for dropping by :)

Yvonne Spence from UK on December 14, 2012:

Another great hub. I so agree with you regarding how damaging labels can be. A dear friend of mine was diagnosed as "schizophrenic" and spent some time in and out of hospital years ago. I was horrified at some of the "treatment," - for instance being interviewed by a psychiatrist in front of an audience of students, and the psychiatrist then saying things like, "See the patient refuses to respond," when she felt overwhelmed by his questions. Most people would feel that way, even it perfect mental health!

Eventually somewhere along the line they changed her diagnosis to something else, which to me shows the pointlessness of labelling the person. My friend eventually managed to get art therapy (at first when she asked for it the psychiatrist said something along the lines of, "But you are not normal, not like other people. It wouldn't help you." It's my feeling that standing up for herself then and getting that art therapy was the start of her breaking free of the stigma. She's not been in hospital for years now, and is just exactly, "like other people."

I also have a sister with ongoing mental health problems that are fairly severe. Such is her fear of stigma that she vehemently denies she is mentally ill and will accept very little support. It can be very challenging to be around her at times, partly because of the urge to help her but of course doing it against her will isn't going to help! When I do see her (we live some distance apart) I find it helps to notice on my own feelings and allow them, rather than trying to change her.

meloncauli (author) from UK on November 29, 2012:

Thanks Leah.

If you chose to have a mental health disorder, I would imagine that would become another mental health disorder!

Leah Lefler from Western New York on November 28, 2012:

This is a fantastic hub, meloncauli, and it is very important that people realize that no one chooses to have a mental health disorder. I have heard many cruel names for those who are not neurotypical - words like "crazy," and "wackadoodle." These words are hurtful and create terrible labels for those who struggle with any form of depression, anxiety, or other mental health issue.

catgypsy from the South on November 09, 2012:

Thanks Sarita. The only reason I would like to be able to know what she has is so I can research it and learn how to help her better. I love your idea about using a non-clinical name.

meloncauli (author) from UK on November 09, 2012:

Thanks for commenting SaritaJBonita! I think it's great to have a completely different pet name for a mental health disorder. What society doesn't realize is how much impact being given a psychiatric "tag", can have on a person's life.

meloncauli (author) from UK on November 09, 2012:

I absolutely agree gsidley! That is a good way of looking at it. Thanks for dropping by :)

Best wishes to you

SaritaJBonita on November 08, 2012:


There are times when people get so depressed they can actually become catatonic. Back in the '50s there was an experiment where researchers poked depressed patients with a thumbtack to evaluate how quickly or slowly they reacted. Some depressed patients didn't even pull away when jabbed more than once.

As far as the label of mental health problems go, I kind of like the term "Beeper" for Bipolar Disorder. I find it almost empowering to use a non-clinical nickname for my illness.

When it comes to helping friends with mental health problems, simply being there for them and being sincere is the important thing. A "label" should be used simply to diagnose an illness and allow doctors to be on the same page when exchanging health information. It's sad and frustrating that labels have become so much more than that..