Words matter: How should we talk about mental illness?

“So, I am thinking about how to talk about my….well….my, you know, my mental illness. I mean, my brain disorder. Well, I don’t know how to describe what it is.”

Words do matter and how we talk about what we experience is important. It may be that through the years a person’s symptoms have led to a diagnosis, one that is listed in the DSM-IV. When that becomes clearer, or clear enough, there are ways for these symptoms to be treated, usually by a combination of medications and programs. The major “s” listed by the National Alliance on Mental Illness are schizoaffective disorder, autism spectrum disorders, obsessive-compulsive disorder, panic and anxiety disorders, and borderline personality disorder.

One of the lively conversations today is around how to talk about these illnesses. “Mental Illness is an illness like any other” is a phrase we have heard. However, that does underestimate the way that most illnesses can be determined. Diabetes or cancer or heart disease are measurable, based on biological data. “Mental” illnesses are not yet in that category. We go on symptoms, as mentioned above, and we don’t have a brain scan at this time to indicate why these symptoms occur. While treatable, the causes of mental illnesses are not completely known.

Still, there are many who say that mental illnesses are physical disabilities. They are biologically based and arise in some way from the brain. Therefore, we use the medical model of treatment. “Here are the medications to try in order to alleviate the ‘illness.’” This understanding has at least one enormous benefit. It may reduce the stigma that is present around “mental illness.” What has been known as “mental” illnesses can now be called “brain disorders.” It sounds less stigmatizing, removes the burdens of blame for what causes these symptoms, and can empower those who are living with the shadow of self-recrimination to speak and act more openly in society. Living into that reality, however, still leaves more work to be done. Some people think the word “disorder” is too clinical and medical.

For instance, when I mentioned that I had been using the words “brain disorder” to describe my son’s mental illness, bipolar disorder, it was very clear to him that this is was not the way that he wanted me to talk about this part of his condition. He said just use “bipolar.” I sincerely apologized because I had not asked him before, and I felt that I had used words that were inappropriate. He is an adult who is fully alive, filled with honed wisdom, has a creative wit, and I deeply love him. He was direct in pointing out that I had erred in his case.

Language can be tricky. It can elucidate things or muddy things. So what can we do? Keep on keeping on working on language seeking to describe how things are. It will not be perfect since someone will always come up with an “on the other hand” perspective on what you are seeking to make general and universal. Now I have come to understand even better from my son that perhaps the best thing is to talk with the person who is affected by a “mental illness” or a “brain disorder” or “depression” or “bipolar” or whatever to see how they see it themselves. This is all about relationships anyway. Connecting with someone who is affected by mental illness/brain disorder/etc. may reveal something new and fresh in our own understanding and therefore lessen our perplexity and confusion about our use of language.

Alan Johnson,

Interfaith Network on Mental Illness and Caring Clergy Project

To post a response to this blog please visit The Recovery Trust.

The Recovery Trust, a Colorado-based nonprofit, has added a new resource for families in need of education and support. It is a free, secure, online forum through which family members can join with others in the same situation.

The forum is moderated by a team of mental health professionals, psychiatrists, family members and people who have experienced mental illness, all of whom have received extensive training in their role as facilitators. Users of the forum can access a large database of information about these illnesses, FAQs and links to other resources.