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Key points
- Identity-first language states a diagnosis as identity (for example, autistic rather than person with autism).
- A study of 728 autistic adults found that 87 percent preferred identity-first language.
- Person-first language describes the person before the diagnosis; for example, "person with schizophrenia."
In a recent conversation, I mentioned that I am neurodivergent. I was surprised to be corrected. My conversation partner attempted to challenge my thinking: "Why do you have to say 'I am'? You swim; are you also a swimmer?" I gave him grace for his unfamiliarity with the identity-first language and caught him up.
I Am Neurodivergent
The truth is, I am neurodivergent. My ability to declare that is the result of a lot of work in self-acceptance.
More than two decades ago, I was a quirky kid. In preschool, I hid my ears and ran at the sound of the hand dryer. By elementary school, I had developed a fascination with dogs and hypnosis, as well as quite a variety of tics. I broke a lot of social norms without even knowing it. I thought I was a bad kid.
I conflated following social norms with morality.
Middle school brought in a wave of quiet. My mouth got me in trouble, so I kept it shut. I attended an info session for the school's cheer team and was greeted with laughter when I asked if I could write a cheer for my dog for the try-outs (to be fair, I felt much more passionate about my dog than the school); my face glowed. I didn't think like other people. I just didn't get certain things.
I fell into depression.
If I could go back and talk to that kid, I would tell her she's neurodivergent. Some things that come to her easily are difficult for others, and things that are difficult for her are easy for others. She sees and experiences the world a little differently and has different preferences. It's all a part of who she is. She sees patterns and has a great deal of compassion. Unique perspectives breed innovation. The things people give her a hard time about are mostly just a failure to conform to their closed-minded expectations. Their brains work differently. And that's OK, too.
Those words would have granted me so much freedom.
Accepting myself as a neurodivergent person is healthy. A study of 728 autistic adults found that 87 percent preferred identity-first language (for example, autistic rather than person with autism) (Taboas et al., 2023). Neurodivergences like autism and attention-deficit/hyperactivity disorder (ADHD) are pieces that are part of who we are. This is not to say that supports are unnecessary — for example, psychotherapy to help with accompanying anxieties or noise-canceling headphones — but that these represent a different brain set-up.
I Have Mental Health Conditions
I also live with mental health conditions. I don't think it is necessary to state my diagnosis; however, I have felt at times to have gone to war with my mental health conditions.
Without harnessing, depression can steal my joy, motivation, energy, and will to live. Anxiety, on the other hand, can project a sense that I am in constant danger. Treatment for mental health conditions has included medication, hospitalizations, therapy, intensive outpatient treatment, and four rounds of transcranial magnetic stimulation (TMS).
I am happy to say that, at this point, I feel that I am winning the battles. My mental health conditions do not interfere with my life goals in any major way. I say that I am in recovery.
While my neurodivergence probably onset at birth, my mental health conditions did not take full hold until at least adolescence. After my first dance with serious symptoms and first hospitalization, it felt that many around me lost sight of me, seeing the illness instead. Perhaps they believed that the person behind that illness was no longer there.
The reality is that I have always been the same person. I am more than these diagnoses.
Still, my mental health conditions are not an identity to me. If a person chooses to utilize identity-first language for their condition (for example, if they prefer to be called "schizophrenic" as opposed to "having schizophrenia"), that is OK. I prefer to be called a person with a mental health condition.
In contrast to identity-first language, person-first language puts the person first (for example: a person with bipolar disorder rather than bipolar).
A research study wherein vignettes were distributed to counselors and counselors in training, half describing a "person with schizophrenia" and half describing someone as "schizophrenic" found that participants consistently had more empowering and kind attitudes when the individual was described as a person with schizophrenia (Granello, & Gorby, 2021).
They saw the person first.
A Personal Choice
This is not to say that we cannot celebrate strengths derived from mental health conditions or that some mental health conditions don't hold aspects of neurodivergence. Many do. Individuals who have experienced psychosis often have a change in how they integrate information and process the world. Some would call that an acquired neurodivergence. Similarly, some mental health conditions have been associated with creativity (Santosa et al., 2007).
Long story short, when it comes to what language to use with a mental health condition or neurodivergence, it is a personal choice. Let's leave it up to the person with the diagnosis.
References
Granello, D. H., & Gorby, S. R. (2021). It's time for counselors to modify our language: It matters when we call our clients schizophrenics versus people with schizophrenia. Journal of Counseling & Development, 99(4), 452–461.
Santosa, C. M., Strong, C. M., Nowakowska, C., Wang, P. W., Rennicke, C. M., & Ketter, T. A. (2007). Enhanced creativity in bipolar disorder patients: A controlled study. Journal of Affective Disorders, 100(1-3), 31–39.
Taboas, A., Doepke, K., & Zimmerman, C. (2023). Preferences for identity-first versus person-first language in a US sample of autism stakeholders. Autism, 27(2), 565–570.
