Common Expressions that Reinforce Mental Health Stigma (and What to Say Instead)

Although we may not realise it, the way we use language can inadvertently contribute to mental health stigma. In today's article, Bryce Evans explores five common expressions we use that may affect our attitude toward mental health. By encouraging more respectful language and offering non-stigmatising alternatives, Bryce aims to change perceptions, increase awareness, and stop the shame associated with mental health conditions.

Can you remember the last time you saw a man with a psychiatric disorder play the lead role in a romantic comedy? It’s rare.

Instead, we often see mental health conditions linked to murder and violence on screen. Movies and TV regularly misrepresent or stereotype mental health conditions for laughs or scares. These representations teach us to fear or ridicule people with mental health issues.

The stories we tell are powerful, and so is the language we use.

Stigmatising language around mental health is ingrained in our culture, which can make it difficult to recognise. But “crazy,” “mental,” or “psycho” are throwaway, common expressions that reinforce negative perceptions of mental health conditions. It can have consequences. Some research indicates that mental health stigma may prevent people from seeking treatment for their mental health.

We can be more mindful of how we speak in our daily lives to change perceptions, improve mental health awareness, and eliminate shame.

Here are five terms that (inadvertently or not) reinforce mental health stigma, followed by suggestions on what to say instead.

5 expressions that reinforce mental health stigma

1. “Commit suicide”

Why it’s offensive:

A person “commits” murder or another crime. If we look it up in the Cambridge Dictionary, the first definition of commit says, “To do something illegal or something that is considered wrong.”

Part of mental health stigma is implying – even accidentally – that those who struggle have a moral failing rather than an illness. This misconception can cause people to feel ashamed and hide their mental health issues, making it harder for them to get the help they need.

Alternative:

The following phrases are more appropriate to describe suicidal behaviour:

• “Died by suicide”
• “Took their own life”
• “Ended their life”

2. “I just want to kill myself”, or “It’s making me want to kill myself”

Why it’s offensive:

Some stormy days or frustrating moments can be expected in life, and we will often communicate them with family or friends. However, “I just want to kill myself” is stigmatising language used as a short form or “jokey” way of expressing disappointment, embarrassment, or annoyance.

While these hyperbolic expressions are usually reflexive and made without ill intention, they’re a flippant way to express frustration. Mental health stigma often trivialises suicidal ideation as “attention-seeking” or “dramatising” without thinking about the struggles and severe consequences people endure daily.

So, joking about suicide reinforces (incorrectly) that it’s not something to be taken seriously, but something said for effect.

Alternative:

We all get angry, stressed, or tired. However, it’s more helpful to accurately describe your problem and emotions than to use hyperbole to prove a point.

• “I’m frustrated by all the paperwork”
• “I’m finding my job stressful at the moment”
• “I tripped in front of everyone – I was so embarrassed”

3. “Psycho,” “insane,” “lunatic,” etc.

Why it’s offensive:

We use derogatory terms like “psycho” to describe someone or somebody’s actions as unreasonable or socially unacceptable. Often, “psycho” implies that someone is violent and should always be kept at arm’s length. It lumps mental illnesses together, suggesting that everyone with a mental health condition is irrational or dangerous.

“Insane,” “lunatic,” “idiot,” etc. used to be real mental health terms in diagnoses. Over time, they got adopted as insults. Although we can argue that definitions and usage evolve, we’d do better to cut out stigmatising language around mental health than argue over what these terms “truly” mean today.

Alternative:

We communicate better when we avoid exaggerated language.

• If the landlord doubles your rent, he’s not “insane” – he’s greedy
• It isn’t “crazy” to break the speed limit – it’s irresponsible
• Your boss didn’t “go psycho” – they were irritated or angry

4. “Schizophrenic” or “depressive”

Why it’s offensive:

Thinking that schizophrenia or depression makes up most of an identity is a form of mental health stigma. Labelling a person as a “schizo” or “depressive” can reinforce that perception for everyone, including the person with the condition.

Alternative:

• Someone has schizophrenia
• Someone lives with depression
• Someone is being treated for schizophrenia and depression

5. “I’m so depressed”

Why it’s offensive:

In a similar way to “I just want to kill myself,” many people offhandedly use this phrase to express frustration, sadness, or dissatisfaction with their life or circumstances.

Saying this, amongst other things you shouldn’t say to someone with depression, might detract from the symptoms and severity of the illness. Depression is a medical condition.

According to the National Health Service (NHS), mixed anxiety depressive disorder is one of the most common mental health conditions in the United Kingdom, with 1 in 10 adults affected in any given year. However, being common does not make depression “less serious” or lessen the negative consequences if it goes ignored and untreated.

Alternative:

Easy! Just say how you actually feel.

• “I’m disappointed with my test score”
• “I’m finding this frustrating, and it’s sapping my motivation”
• “I’m upset”

The takeaway

Our culture has long used stigmatising language around mental health to exaggerate, insult, or dismiss those living with a condition. Likewise, it can be difficult to notice stigma when we’re so at home with common expressions.

It’s time to change the conversation. Using more sensitive language in our day-to-day lives improves mental health awareness, which, in turn, creates a more supportive environment for people to seek professional help without shame.

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