Words are powerful, they tell us what something is, how to respond to it, how to feel towards it and so being aware of how and when we use them is essential. There are few other topics where this is more pertinent than in mental health and mental illness awareness.
To begin to unpick this I spoke to Libby-Mae Ford and Pheebs Jameson, who are both mental health/mental illness awareness advocates on their Instagram and Twitter profiles, on their points of view and lived experiences.
I also spoke to Dr Lucy Foulkes, an academic psychologist and author of ‘Losing Our Minds: What Mental Illness Really Is – and What It Isn’t’.
The conversation around the misuse of psychiatric language is a vast and complex one.
To start, I’d like you to think about some words and phrases: psychotic, manic, bipolar, OCD, dissociated, triggered, schizo, psychopath, sociopath, split personality, alters, delusional.
These are just some examples of mental illnesses/disorders and symptoms that some might refer to as being more “severe”. The word that immediately comes to mind for me, is stigmatised.
The first time I saw someone misuse the term 'triggered', was on Twitter. During the height of the pandemic last summer, a video went viral of a couple at a restaurant eating through a hole in their masks, underneath the video on Twitter I saw multiple people reply simply with “I’m triggered”.
This word being misused and appropriated, was incredibly frustrating and bordering on offensive. I live with the effects of Complex Post Traumatic Stress Disorder (C-PTSD) every day and seeing 'triggered' being thrown about like it was a catch all term for being slightly 'weirded out' was just so disappointing.
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I’m not alone in this frustration, there is a whole host of activists, academics and professionals who want to see a better understanding from the public at large of what these words actually mean, when they should be used, how and by who.
As an extension of this, there is also a lot to be said about equating normal, human experiences to mental illness. On this topic, Dr Lucy Foulkes has a lot to input and contribute.
Foulkes is an honorary lecturer in psychology at UCL and as mentioned previously, author of ‘Losing Our Minds: What Mental Illness Really Is – and What It Isn’t’, an insightful discussion around mental illness/disorders, whether we should even be using the words 'illness' and 'disorder' and exploring the spectrums that all distressing psychological experiences sit on.
I first came across her writing in a Guardian article, ‘What we’re getting wrong in the conversation about mental health’. I was struck particularly by something Foulkes said in relation to the impulse to diagnose oneself when experiencing “negative feelings”.
Foulkes said “we need to figure out a way to talk about these negative emotions without sending the message that there’s something dysfunctional about you for feeling that way…This means resisting the temptation to label all negative feelings with psychiatric terminology.”
Speaking to Foulkes, I asked her about how the push for mental health awareness may have inadvertently negatively impacted the lived experiences of those who live and struggle with mental illnesses/disorders.
In response, Foulkes stated that this push is “broadly a good thing”, noting the importance of people feeling less alone. But she adds that there has been an unintended consequence “when you release psychiatric terminology such as ‘PTSD’ and ‘bipolar’ into the public consciousness, these terms can be taken on by people for whom they might not be useful or accurate.”
Foulkes has an understanding and empathetic view on this misuse, noting that “everyone wants language to understand their experience” but that those armed with this terminology largely do not have “the depth of knowledge…to understand what these disorders really are. As a consequence, in many cases people with these disorders are still not understood, and still stigmatised.”
The word, ‘stigmatised’ crops up again.
I spoke to Libby-Mae Ford, co-author of mental illness recovery anthology ‘Through the Hourglass’ and mental illness awareness advocate. I have personally followed and admired her advocation for many years. You can follow Libby on Twitter and Instagram.
Discussing the topic of mental health awareness she pointed out that “to some who struggle with mental illness, it can seem very performative” and reiterated that “it’s not enough to just be aware and supportive a few days of the year.”
On the possible harmful repercussions of specific psychiatric language entering common usage, Libby discussed the importance of having a full and nuanced understanding of what these terms mean to those who live with the symptoms or disorders they describe.
On the usage of the word ‘mania’ she said, “I think people who haven’t experienced mania struggle to understand what it really is.” And notes that people often boil it down to “feeling hyper” “spending loads of money” but rarely discuss the psychotic symptoms that many people experience as a part of their manic episodes.
Another voice in this discussion I wanted to include was that of Pheebs Jameson, who like Libby I have followed and admired for their advocation of mental illness awareness.
Pheebs is co-founder of The Speak Up Space, a safe, listening ear and signposting service for survivors of sexual violence and was interviewed by the BBC on Woman’s Hour, you can follow them on Instagram and on Twitter.
Responding to question on the inadvertent affects of mental health awareness, Pheebs had this to say: “As someone who lives, and is determined to function with, an incredibly debilitating mental illness, I know my symptoms are often seen as “insane” or they are deemed as “unstable”, not palatable.”
They continued, “People will challenge this view and say “aren’t we all working towards the same goal?”, are we? How can we be working towards the same goal, when so many disregard, stigmatise and restrict those who live with symptoms such as psychosis, delusions, persistent suicidal ideations, struggles with personal hygiene and so much more?”
On the topic of specific language entering common usage, Pheebs spoke out against the tendency to generalise those who experience the symptoms of more severe mental illnesses/disorders, which leads to misconceptions around the wide spectrum of how they are experienced.
They also noted that certain words such as “psycho”, “delusional” or “manic” are still frequently used as insults and negative descriptors, stigmatising those who live with these symptoms and illnesses/disorders further.
Dr Lucy Foulkes pointed out an important aspect of this language misuse being that “if everyone is using the same words, there is no language left for people at the sharp end of the spectrum. If every reaction to a stressful event is PTSD, then people who who really do meet a diagnosis of PTSD…will struggle to be understood or taken seriously.”
Journeying back to my story about Twitter, social media clearly has a great part to play in this.
Foulkes notes that social media “favours brevity: short clear soundbites and hashtags like ‘It’s ok to not be ok’” and emphasises the need for social media campaigns to “promote the fact that this subject is tricky” and “explain that mental health is a spectrum, promote useful ways of talking about different forms of distress across that spectrum”.
From Libby and Pheebs, they both acknowledged the failures of social media platforms to address those who are still stigmatised and that there needs to be widespread education on those stigmatised disorders such as schizophrenia, bipolar, OCD and eating disorders. There is an opportunity for those with a huge audience to begin to tackle this, Libby said but then there is also always the risk of making things more “palatable” on social media, as Pheebs put it.
Looking to the future and the ‘solution’ (if there is one) to some of the damage that has been done by everything previously discussed in this article, it appears to be every bit as complex as the discussion itself.
Libby addressed the need for mental health being added to the curriculum at schools, to aid an early understanding of what is and isn’t a mental illness, but also to signpost ways to access help if you need it commenting “I think maybe if we had been made aware of warning signs, I may have reached out for help a lot sooner”.
As with every aspect in this discussion, Dr Lucy Foulkes’ thoughts on any solution are nuanced and multi-faceted. She reiterated that “we cannot campaign to clarify the line between health and illness, because no such line exists – it’s a spectrum.” And that “We also need to be careful to avoid dismissing people with milder disorders” but that “we need to promote ways of taking seriously different types and levels of symptoms without needing to reach for the psychiatric dictionary – in schools, universities, workplaces homes and online.
This is a topic that needs to continue to be discussed and added to, there is no simple answer, and we can’t go back to a place as a society where this language is not known. So, now that we have it, what can we each do in our understanding and learning to make sure that we use it correctly?
In the UK, the charity Mind is available on 0300 123 3393.