Myths, Mischief, and Misconceptions

Medical terminology frequently drains into the non-professional population, which often adopts medical diagnoses inappropriately. Phrases like, “You’re giving me a heart attack,” or, “Don’t get psychotic about it” are usually said flippantly, without harmful intent, but can be offensive. Recognition that open acknowledgment of an illness might produce discomfort causes many people to whisper phrases like, “He has cancer.”

In particular, the invocation of psychiatric diagnoses by the lay public frequently reinforces misinformation that leads to increases in stigmatizing psychiatric patients. The term, schizophrenia, was first used by Swiss psychiatrist Eugen Bleuler over 100 years ago to describe a specific form of psychosis. Bleuler employed the word—schizo, meaning “split”; and phrenia, meaning “mind”—to describe patients’ confusion and fragmented thinking. However, the literal meaning has caused many in the general population to erroneously assume that the illness describes split (or, multiple) personality. In many cases “diagnosis epithets” are used as hurtful accusations. There are common examples:

“He acts strange; is he an Aspy, on the spectrum” implies that nonconforming behavior suggests a diagnosis of autism and devalues individuals with the disorder.

“My first wife was borderline” is code for describing the spouse as difficult to live with and subtly blames her for the failure of the marriage.

“I wish you wouldn’t get all excited and manic about this” suggests the person who may be moderately hyperactive has bipolar disorder, a very serious illness.

“Don’t be anorexic; have dessert with me” invokes the label of a serious illness to challenge the dining behavior of the companion.

“You are so OCD” accuses an individual who may be especially careful or perfectionistic of possessing pathological traits.

“When he gets angry, he goes all schizo” reflects the speaker’s attitude that this expressed anger is unreasonable, suggestive of psychosis, such as schizophrenia.

“She is so ADHD” might be a description of someone who appears disorganized, distracted, or forgetful.

“The horror movie upset him so much, it gave him nightmares and PTSD” conflates a serious and well-defined psychiatric diagnosis that usually persists for long periods with an acute, minor upset.

"Don't be antisocial, come to the party" misidentifies a person who resists socialization as a sociopath.

Examples like these usually are not meant to bestow formal psychiatric diagnoses. Most are not intended to be taken literally or even seriously. But referencing psychiatric terminology by nonprofessionals promotes misinformation and, when used in negative ways, expands stigmatization of individuals who suffer from mental illness. These mischaracterizations trivialize the suffering endured by those disabled by the disorder. Just as many people will assertively confront others who use racist or misogynistic phrases, now, in May, which is formally designated as “Mental Health Month,” let us begin to stand up to those who use psychiatric terms that devalue others.