Since first being diagnosed with depression and generalized anxiety in my early 20s, I felt the stigma of being considered “abnormal.” Back then, I regularly heard friends use pejorative words like “nuts,” “psycho,” “schizo,” “insane” and “looney tune” as general insults to anyone for any transgression. The not-so-subtle message: It’s okay to mock those with mental health issues — that we are somehow weird, stupid, scary or dangerous.
The culture was no more forgiving. I was 15 in 1972 when Sen. Thomas Eagleton (Mo.), the running mate of Sen. George McGovern (S.D.), was removed from the Democratic presidential ticket. His offense? He had been hospitalized several times for depression and was, as a result, politically deemed unfit for office.
Three years later, my grandmother took me to see “One Flew Over the Cuckoo’s Nest,” the Oscar-winning film about life in a psychiatric hospital and the harsh treatments used there. In common parlance, the film was described as being about an “insane asylum” or a “loony bin” filled with people who were “crazy” or “nuts.” A few years after the film came out, a study reported that “young adults who watched the film developed a negative attitude toward people with mental health issues and the institutions/practices meant to help them.”
For a teenager like me, already recording my bouts of depression and anxiety in a secret journal, the depictions in the film proved terrifying, and prevented me from asking for help. Would I, too, be sent to the “loony bin?” More than a half-century later, a chapter of the National Alliance on Mental Illness (NAMI) lamented that “the image [the film] depicted of both mental health and the mental system [remains] incredibly damaging.”
Victor Schwartz, a psychiatrist at New York University School of Medicine who helped organize the Media and Mental Health Initiative at Stanford University, said that disparaging “language can feel shame-inducing. It makes it harder for people to reach out for help or admit they are having mental health problems.”
Stigmatizing language can become a stumbling block to treatment and support and increases the likelihood of these problems worsening before treatment is instituted. According to the American Psychiatric Association, more than half of people with mental illness don’t get help for their disorders because they fear being treated differently or losing their jobs.
Melody Moezzi, author of the memoir, “Haldol and Hyacinths: A Bipolar Life,” recalls how the shaming language used to describe her diagnosis “stopped me from getting better help sooner. It led me to hide hallucinations and other symptoms out of fear for how these symptoms might be viewed by society and by the medical establishment.”
Schwartz also explained how “using language around mental illness as a source of comedy or mockery is hurtful to those who experience mental illnesses.” He points out that while no one sees humor in someone having a stroke or cancer, it’s often allowable to ridicule those with a mental health condition. Think tennis player Naomi Osaka, Olympic gymnast Simone Biles and even Prince Harry.
For instance, Piers Morgan, the British television personality, criticized Osaka after she quit the French Open for mental health reasons. “Unfortunately, Ms. Osaka is . . . an arrogant spoiled brat,” he wrote in a British newspaper, “whose fame and fortune appears to have inflated her ego to gigantic proportions.” He added that she was “weaponizing mental health to justify her boycott.”
And after Simone Biles cited mental health concerns as her reason for pulling out of several Olympic gymnastic competitions, “Saturday Night Live’s” Michael Che posted on Instgram, “Man, I wanna make fun of Simone Biles.” (He later deleted the post, claiming his account was hacked.)
Another way that language can worsen stigma is to reduce a person to a diagnosis. “A person is not their illness,” says Eve Byrd, a psychiatric and mental health clinical nurse specialist who is director of the Carter Center’s Mental Health Program.
Referring to someone as, “a schizophrenic,” instead of a person with schizophrenia, dehumanizes them. “An illness is a part of their life and experience and does not define who they are,” Byrd said. Bruce Liese, a professor of family medicine and psychiatry and clinical director of the Cofrin Logan Center for Addiction Research and Treatment at the University of Kansas, said that people are too quick to use these kinds of linguistic shortcuts: “He or she is a drug addict. He or she is an alcoholic.” But they are not, he added, they are people with these health issues; instead we should say, “He or she suffers from alcoholism.”
Mental health experts often point to how “people with cancer” or “people with AIDS” have forcefully advocated to be referred to that way, rather than as a “cancer victim” or “AIDS sufferer.” I’ve learned that lesson, as well: I am a son, a brother, an uncle, a dog dad and a person who suffers from depression. But I am not “a depressive.”
And, after all these years, I now understand that I am not “abnormal.” To that point, years ago, my mother, a social worker who suffered from chronic depression, told me one afternoon at the beach, “I’m so happy that everyone in the family is in treatment,” an acknowledgment that we all suffered from anxiety or depression. My mom, who died four years ago, surely would have agreed with the experts today who say that openly talking about mental health can break down the stigma associated with different conditions.
You don’t need to be an Olympic athlete to see the signs that our culture is becoming more informed and accepting when it comes to mental health, especially by younger people. A 2014 study found that young adults in California, relative to other age groups, have more positive attitudes and beliefs about people with mental health challenges.
In my family, one of my nieces, a 21-year-old college senior, lives with generalized anxiety disorder, adjustment disorder and attention-deficit/hyperactivity disorder but has made clear she does not feel stigmatized. Her grandmother, my mom, would be proud of her openness and that she has sought treatment at a relatively early age.
“Because of my family and my friends I never felt like I would be misunderstood or that I had to hide it. I’m definitely lucky that way,” my niece explained on the phone.
When I asked her about the mean-spirited words some directed at Biles, she replied:
“The language of belittling it, just putting ‘mental health issues’ in quotes, that’s super problematic because it’s making a serious issue. You just can’t do that anymore. That’s not where we’re at as a society, at least not in my generation.”