By Beth Hopwood, a member of the Thompson Centre Patient & Family Centred Care Committee
People often make casual remarks or jokes about mental illness. Referring to someone’s quirks as “OCD,” expressions of anger as “going mental,” or disappointment as “depression” is a harmful misuse of language. It often stems from a lack of knowledge about mental illness. Although it may seem harmless or indirect it can have damaging effects on those affected by mental illness. It reduces language that describes something intense and disabling into an exaggerated character flaw or insult. In this way, it strips sufferers of a legitimacy that’s already difficult to obtain.
The words used to identify mental illness are important for those affected by it. They act as a way to label what they’re going through, separating the person from the illness. This restores a sense of self that can be fragile during difficult times.
Would you ever poke fun at someone for having the measles or epilepsy? Probably not. Most people would find comments about physical illness inappropriate, because they trivialize real suffering. But somehow mental illness escapes this logic, perhaps because it isn’t seen as existing on the same plane as other illnesses.
This can stem from the belief that thoughts, behaviour and mood are always under the control of the individual and therefore could be changed if only that person tried a little harder. This isn’t true. Mental illness is a physical illness, one that affects the brain and manifests as disturbances in behaviour, feelings, perceptions and thoughts.
Stigma
Stigma is a negative stereotype. Discrimination is unfair treatment that occurs because of the stereotype.
Let’s take a look at some of the specific ways people with mental illness experience stigma:
- Feeling at Fault: Believing that they are the cause of their illness.
- Feelings of Failure: The impression that they could overcome their problems if they had stronger character; that negative outcomes are the result of personal failure.
- Feeling Devalued: Belief that one is abnormal or unworthy of help.
- Exclusion: People avoid what they don’t understand, putting those with mental illnesses at a disadvantage. This can lead to social rejection, lost job opportunities or access to a safe housing.
All of these attitudes increase the incentive to conceal. The burden this adds to illnesses that already affect mental well-being can be highly damaging. It intensifies shame. And shame prevents people from acknowledging their problems and seeking out the help they need. This goes further still. Not only does shame prevent access to help, it also hurts a person’s ability to be receptive to treatments that require cooperation (e.g. CBT, psychotherapy, mindfulness). In this sense stigma inhibits not just access to help, but also receiving help successfully.
Reinforcement from Language
Using casual language around mental health strengthens stigma.
Imagine you have severe Obsessive Compulsive Disorder. This might mean you have urges to check things in your home repeatedly, to the extent that you can barely leave the house or hold down a job. This is intensely distressing and you are aware that your behaviour is counterproductive and harmful. But no matter how hard you try you can’t stop. You know you need help but are too ashamed to discuss it with anyone.
While grocery shopping you see a couple in the cereal aisle. When the women changes her mind about a cereal and puts it back on the shelf, the man steps forward to reposition the box so that it lines up with the others. Rolling her eyes the woman says, “God, you’re so OCD, I can’t take you anywhere.” They both chuckle a little and walk away.
This remark deepens your feelings that you aren’t normal and that if anyone knew the true extent of your problems you would be ridiculed and rejected.
The suggestion here isn’t that we should all become militant language police. There’s a challenge not to overdo it with censorship, particularly because of the silencing effect of mental health stigma. We don’t want to be so frightened of using language around mental illness that it prevents healthy communication and expression. There’s still a need for discussion and understanding. Thoughtful reflection of the words you use and how you use them is a good start.
Language can also present an opportunity for understanding. It’s useful in helping us imagine what life’s like for those with mental illness. Healthy people also experience a wide range of emotions and mental states. Perhaps we can use our experiences of anxiety, intrusive thoughts, distress and sadness to imagine what it’s like for those who endure these on a vastly more intense and disabling scale.
In this way, language is a type of window, a way of seeing into the lives and challenges of someone else.
So what can we do to improve?
Think about what you’re saying. What do you really mean to say? Chances are, someone listening has been affected by the words you’re using. One in five Canadians will experience mental illness in their lifetime. Someone you know has likely been affected. The casual language you use to embellish a story is probably personal for someone hearing you.
If you catch yourself saying something you didn’t really intend, correct yourself or apologize. Talk about it. Everybody makes mistakes, but the way we respond to our mistakes can make all the difference.
Positive actions you can take to reduce stigma:
- Choose your words. Pay attention to the language you use. Challenge others when their words may be hurtful.
- Be compassionate. Treat those with mental illness with the same kindness you would for a person with any other illness.
- Talk about it. Discuss it. This means asking questions, listening to other points of view and opening yourself up to other opinions.
- Educate yourself. Learn more about the issues. Here are some good resources for information about mental health:
Citations:
http://ontario.cmha.ca/mental-health/mental-health-conditions/stigma-and-discrimination/
https://en.wikipedia.org/wiki/Mental_disorder
http://www.cmha.ca/media/fast-facts-about-mental-illness/#.V0N_KNdTo4A
http://letstalk.bell.ca/en/end-the-stigma/