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wundayatta's avatar

What is your preferred terminology for people whose brains work differently?

Asked by wundayatta (58354 points ) May 19th, 2011

@MyNewtBoobs quarreled with me when I was complaining about terms like crazy, insane, nuts, and the like. I said I preferred the term “mental illness.” She replied as follows”

Mental illness is, at best, incorrect most of the time. For bipolar, it’s a disorder, not a disease or illness (the organic, genetic part – it’s a bit different with syphilis). But mostly, illness seems to say that you’re sick, which you aren’t. Most mental disorders you simply think and feel differently than the “normal” population does, but you aren’t sick, you aren’t wrong, you aren’t twisted. Mental illness suggests that you should spend all your time popping pills and trying to get better and be normal; mental disorder says “It’s different, I work with it, now GTF over it.” Disorder aims to create a wider circle of tolerance, whereas illness does the exact opposite – it stigmatizes and excludes. Course, if you have a mental disorder or illness or whatever you want to call it, you can call it whatever the fuck you want to. And I’m not hugely offended by it most times, unless people have given me a reason to think that they aren’t just saying a word and my issues with “illness” are their opinion at large.

I think this is a well-thought-out point of view. So it made me wonder what others think about the terminology that is used for people with manic-depression (bipolar) or schizophrenia or depression or any of the other conditions like these.

Is calling someone crazy offensive? How about saying “mental disorder,” or “mental illness?” What do these terms—both medical and colloquial—mean to you? Which ones are dismissive and which ones a respectful?

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30 Answers

_zen_'s avatar

Mental disorder means there can be order. It’s just in disarray (my words).

Mental illness reads likes sickness, disease, of which there may or may not be a cure – but I aint sticking around to find out if you’ve found one.

So I’ll go for mental disorder.

MyNewtBoobs's avatar

<OMG, I’m so red from blushing.>

Response moderated
MyNewtBoobs's avatar

My favorite colloquialism for really crazy stuff – meeting the clinical requirements for psychosis, delusion, etc – is “nutter butters”. I usually only use terms like crazy, nuts, losing your marbles, etc, if I feel that it’s really severe enough to really fit – just because you have a diagnosis doesn’t make you crazy in my book. Being crazy makes you crazy. Yes, I know how helpful that is. For example, my Nana is currently “losing her marbles”, because a) She’s pretty far gone in the dementia arena and b) I’m remarking upon how she used to have marbles, and used to not just decide to disrobe and have her children give her a gyno exam in the grocery store, and now she does, and that’s a real shame, and this loss of marbles is what’s hurting my aunt and mother so terribly. I also know the clinical definitions of psychotic, delusional, and insane, and if I’ve used them as terms, you can bet your ass I’m using them in a clinical sense, not as a colloquialism.

_zen_'s avatar

@MyNewtBoobs and Day… it’s interesting that in your PC country with all kinds of strange terms that try to include everyone or insult no-one, a term has yet to be created for this purpose. Obviously, mentally-challenged or psychologically challenged do not fit the bill, being both inacurate and just plain wrong, but you get the idea.

Coloma's avatar

Sure, their are plenty of certifiable mental illnesses, disorders, that deserve respect and empathy.

Two, however…pathological narcissism and passive aggressive PD….well…I take no issue with calling these spades, spades.
A lot of these behaviors can also just be called emotionally arrested development. I have had plenty of run ins with these incredibly unaware, oblivious, entitled, sneaky, manipulative,dishonest, selfish types, and, well, sorry…..while I may understand the ‘whys’ of their conditions, does not change the fact, they are first class assholes!

Male or female.

I have empathy for those that truly struggle with their mental and emotional health, but…sorry…I prefer to keep my distance.

I have no desire to ‘manage’ anothers mental health problems or be on ‘guard’ for their B.S.

I take, what I call, the psycho/spiritual approach.

My mantra is ‘Namaste, fuck off!” lol

Hawaii_Jake's avatar

I am bipolar. I have a mental illness. To say that it is only a disorder, therefore I should “GTF over it.” is insulting, wrong, and dangerously dismissive. Statements like that place blame on the victim and do not help to create tolerance as claimed.

“But mostly, illness seems to say that you’re sick, which you aren’t.” I am dismayed at this statement. I have an illness that centers in my brain. To say it’s anything else flies in the face of scores of years of careful research by dedicated clinicians who are attempting to provide medication and other therapies that help me live a better life.

‘Disorder aims to create a wider circle of tolerance, whereas illness does the exact opposite – it stigmatizes and excludes.” I see it from the polar opposite viewpoint. An illness is not my fault, whereas a disorder is something I can control. I am incensed that I should be told I should be able to control the way my brain functions.

If I were diabetic, would anyone deny me the medication necessary for me to live? If I had cancer, I ask the same question.

Just because you cannot see it does not mean it is not an illness. Just because it is widely misunderstood does not mean that there is something wrong with me.

Crazy, nutter-butters, psycho, losing my marbles, and other such terms are insulting.

MyNewtBoobs's avatar

@hawaii_jake Kinda feel like that’s directed at me. Is it not?

Coloma's avatar

@hawaii_jake

I completely agree. I don’t consider a person with chemical, neurological dysfunctions to be even remotely close to your average run o’ the mill oblivious egotist.

To me the difference is between hurting yourself and hurting others.

Depression and mood swings and ups and downs can be hard on a loved one, or friend, but…not the same thing as those that prey on others vulnerabilities and kindneses in a predatory and exploitive manner.

Hawaii_Jake's avatar

@MyNewtBoobs : I am responding to what is written in the OP.

MyNewtBoobs's avatar

@hawaii_jake Ok. Seeing as how much of what was in the OP I wrote, as well as a few other things you included, the question still stand, but ok. Just for reference: I spent about a decade and a half with the diagnosis of bipolar. I’m not unfamiliar with it, or the various theories surrounding it, or how people treat bipolar. And I wasn’t saying anyone with bipolar should GTF over it, but rather people who freak out and think a diagnosis of bipolar automatically means you’re a crazed, abusive serial killer without any regard for severity or other personal factors should GTF over it.

Hawaii_Jake's avatar

Let me be clear:

Mental illness is, at best, incorrect most of the time. ~ Can we get some statistics or a source for this over-generalization?

For bipolar, it’s a disorder, not a disease or illness (the organic, genetic part – it’s a bit different with syphilis). ~ (Source) Disorder and illness are interchangeable.

But mostly, illness seems to say that you’re sick, which you aren’t. ~ This flies in the face of decades of research to the contrary.

Most mental disorders you simply think and feel differently than the “normal” population does, but you aren’t sick, you aren’t wrong, you aren’t twisted. ~ This statement is teetering on the edge of proclaiming that no one is normal.

Mental illness suggests that you should spend all your time popping pills and trying to get better and be normal; mental disorder says “It’s different, I work with it, now GTF over it.” ~ I do take medication for my illness just like a diabetic takes insulin. I’m happy if others don’t have to take medication, but I do, or I cease to function effectively on any level.

Disorder aims to create a wider circle of tolerance, whereas illness does the exact opposite – it stigmatizes and excludes. ~ As I stated above, I could not disagree with this statement more. In my opinion, the statement is backwards.

Course, if you have a mental disorder or illness or whatever you want to call it, you can call it whatever the fuck you want to. And I’m not hugely offended by it most times, unless people have given me a reason to think that they aren’t just saying a word and my issues with “illness” are their opinion at large. ~ I choose to use the word illness.

For me, the word illness liberates me from what I always thought was my fault. I thought the depression and the down times were my fault that I should somehow snap out of or pull myself up by my own bootstraps to overcome. I thought the mania was normal. I thought staying awake for long periods and working on projects was what everyone did, until I had a boss who pointed out to me that I did my best work when I was well rested.

Calling it an illness means that something can be done about it, and I don’t have to feel guilty for being the way that I am.

Words have power. I am offended when I am called crazy, loony, nuts, etc. I am also offended when I am called a fag or faggot. Perhaps I’m overly sensitive.

King_Pariah's avatar

Call me crazy, insane, batty, nuts, I don’t care (unless you’re a doc and you say sociopathic/potential serial killer, then I get irritated), however if someone does take offense to it, treat them with the proper respect and call it by what they would prefer (disorder normally passes as the politer way to go about it).

MyNewtBoobs's avatar

@hawaii_jake Ok, I get the feeling that I’ve somehow hugely offended you. Despite you not actually addressing them to me. Which wasn’t at all my intent. But can’t there be some gray area between “not an issue at all” and “homicidal manic we must lock up”? And also, if you want to argue with me, could you at least have the decency to argue with me, instead of quoting me but saying you aren’t arguing with me? A bit passive-aggressive.

I don’t think anyone is normal – I spent years and years and years trying to figure out just what was normal, and just what it was that I was/did that was so not normal. Turns out, normal is largely an illusion that very little of the population has, and normal =/= healthy. “Normal” was having a really, really shitty home life in my school, not this really healthy, happy, well-adjusted, Molly Ringwald family.

If it helps at all, I will call you whatever you want, right up until whatever issues you have start being really harmful to me. Then, less so. You can find the other terms offensive, and so far, you’ve given me no reason on this site to apply them to you. But I’ve found that if you can’t have a little fun with such serious things, you’ll create depression in yourself just from not being able to laugh.

Hawaii_Jake's avatar

@MyNewtBoobs : I’m trying to stick to the OP. I don’t know what thread or wherever the quotation above came from, so I’m trying to be objective.

Yes, there can be a gray area between the terms you mentioned.

My point boils down to the fact that I felt trapped in a world where everything I did was wrong, and I couldn’t stop doing those things. When I found out I had an illness that could be treated, I was flabbergasted. I had no idea that what was troubling me might not be the result of my upbringing, but might instead be in my brain.

To say that no one is normal makes diagnoses of any mental illness impossible. I actually know a lot of normal people. They have their happy times and react accordingly. They have their troubles and handle them the best they can.

I’ve had times without medication not by my choice, and those times led to one thing: hospitalization. Without the medication, I don’t react to the happy times accordingly, and the troubles become demons literally.

I don’t mean harm to anyone. I mean to speak what I perceive as truth.

For me, that truth is liberation through terms like illness and marginalization through terms like crazy or nuts or wacko.

I hope this turns the heat down on the conversation. I genuinely mean for it to.

mazingerz88's avatar

For people whose brain works differently…for some reason anything with the Mental word in it seems problematic on the get go. So I don’t like either.

Personally I would go for Intellectual Condition or INCON. Let’s see…

Intellectual Condition is, at best, incorrect most of the time. For INCON-A, it’s a disorder, not a disease or illness (the organic, genetic part – it’s a bit different with syphilis). But mostly, illness seems to say that you’re sick, which you aren’t. Most INCON you simply think and feel differently than the “normal” population does, but you aren’t sick, you aren’t wrong, you aren’t twisted. INCON suggests that you should spend all your time popping pills and trying to get better and be normal; INCON, “It’s different, I work with it, now GTF over it.” INCON aims to create a wider circle of tolerance, whereas INCON does the exact opposite – it stigmatizes and excludes. Course, if you have INCON-A or INCON-B or whatever you want to call it, you can call it whatever the fuck you want to. And I’m not hugely offended by it most times, unless people have given me a reason to think that they aren’t just saying a word and my issues with “INCON” are their opinion at large.

Does that work?

King_Pariah's avatar

Normal is a term that is relative and abstract, technically you could say everyone is normal or that everyone is abnormal.

MyNewtBoobs's avatar

@hawaii_jake I think there can be behavior that is less normal, as it were. But I also think that there’s huge pressure on bipolar people to pop an atypical anti-psychotic cocktail, and if you don’t, well, we won’t wait for you to murder someone, we’ll just lock you up right now like you did it already (and it doesn’t really matter if Seroquel or Geodon or whatever actually works, you’ll be on it, bitch!). If someone wants to deal with it differently, or embrace certain parts of having bipolar, they’re ostracized from the psych community. And I think that a LOT of psychologist don’t really question if the behavior is actually harmful; if it’s abnormal, it’s gotta go. I spent most of my life having the entire psych community tell me there was something horribly, horribly wrong with me. As it would turn out, no, there wasn’t, but none of them ever took the time to figure out what was going on, or come to their own conclusions. I love psychology, but I have huge issues with the institution of psychology in this country and how it treats people.

Hawaii_Jake's avatar

@MyNewtBoobs : I’ve been lucky in my association with the psychological community in the US. Both my hospitalizations have been by my own decision.

I’m also lucky that the medication I’m given works for me. I see so many for whom it doesn’t, and I ache for them. I still have issues, but they’re manageable with the medication, therapy, and other things like exercise. (I happen to be allergic to Seroquel. Wow! Complete body rash. Yuck. And Geodon knocked me on my ass. I could hardly stand up when I was taking that stuff. What I’m on now is much more benign, and it works.)

I’m not sure why this got me so charged up. Yes, I am. It hits too close to home. I’m not crazy, and I don’t want to be labelled that way.

The human condition allows for a seemingly infinite range of expression and action. Some of that is healthy and some not. Unfortunately, the guidelines for the unhealthy part are still evolving.

I am glad that you seem to have come through with your native intelligence intact, and with a healthy understanding of yourself. I applaud you.

ANef_is_Enuf's avatar

I don’t care. I’ve lived with mental illness for pretty much my entire life, and I’ve really never found any label to be offensive. What I find offensive are the people who want to insinuate that it isn’t real, or that it is something that a person can just ‘get over it.’
Anything you say to me with the intention of being hurtful is going to upset me, to some degree. It’s the tone that people use more than the words.
As you can see by what I’ve just written, I typically call it mental illness. Or even sickness, sometimes. I guess to some degree being ill or being sick makes me feel like it is something that can be treated.. or even cured. On the other hand, I also have a personality disorder along with my mental illness, and that feels more concrete. I know that it is something that will probably never go away, and treatment for personality disorders tends to be kind of spotty. So, maybe that’s why I stick with ‘illness.’ All in all, I don’t think about the semantics so much as the intentions.

wundayatta's avatar

Thank you guys for listening to each other and making your understandings of these issues clearer for all of us. I didn’t mean for anyone to take this personally. It’s just that I do see that there is disagreement about which terms individuals prefer to describe our conditions.

I had a real hard time framing the question because I wanted to not use any terms that might be perceived as pejorative by anyone. I came up with the “brains work differently” phraseology, and used the details to provide example. @MyNewtBoobs—I hope you don’t mind that I used your words as an example for this. They were out there in public, so I felt I could quote you, but I didn’t want you to feel attacked because of how people responded to them.

Maybe we all just have different ideas about this. There are contexts in which I find “crazy” to be fine. Or “nuts.” “Loon.” But maybe that’s because I call myself those things. When other people use the terms and it isn’t ironic, that’s when I get upset.

When I was reading Jameson’s book after I was diagnosed, I first discovered one of the terminology issues: bipolar disorder vs manic-depression. Some people prefer one, and others the other. Personally, I don’t care.

What I care about is respect. Not so much respect for me as respect for people with brain disorders or mental illnesses or whatever the fuck we want to call them. I’m crazy, and I expect to be respected for that. That’s because my craziness is an advantage.

It makes me think differently and to have different perspectives from most people on a variety of issues. My craziness has also taught me how to be empathetic to others with the same issues, and indeed, with any health issue. I can do that now because I’ve been there. I am proud to be crazy, because if the way most people behave is normal, there is no way in hell that I want to be normal.

However, as a statistician, I know that “normal” is a mental construct that doesn’t actually exist. Everyone is unique in a myriad of ways. We have some kind of idea of what the most common characteristics that more people seem to share, and each of us, individually, calls our own idea of that “normal.” Then, since we are tribal creatures, we try to fit in so we won’t be ostracized.

Unfortunately, we seem to ostracize people who are too far from “normal.” They are scary. We don’t understand them. We can not explain their behavior. It is too crazy.

We all try to fit in because we know what happens to those who are too different. Nobody wants to be ostracized for that. And how many of us, even those who know better, see some guy bouncing down the sidewalk on his toes and think “hmmmm, Aspergers” instead of “how weird?” Or we see someone talking a mile a minute and never stopping for anyone else to talk, think, “mania,” instead of “what a narcissist?” Or see a woman so thin her bones are showing and think “anorexia” instead of “how creepy,” and cross the street to avoid her?

Words both help and hinder the process of education. Different people interpret them in different ways. Probably most people don’t even have any awareness at all of the significance of the way they say things. We want respect, not dismissal. We want people to pay attention to us as much as anyone else, not to shy away in fear. We want people to understand that if we act weird even in narcissitic ways, we can be treated. We also want people to know that some of our so-called “problems” actually might have a benefit. And others that make us different may be neutral in effect.

We want people to know that there is room for more variation in behavior and still not need to be ostracized. Hah! Where do I come off saying what “we” want? This is actually what I want. Maybe others do, too. I’ll let them speak for themselves.

I do a number of things that people disapprove of, in general. Most of them are harmless. One or two are considered harmful in some cultures, but not others. Normal in my society does not include a very important part of me, so I hide it until I have determined that someone might not judge me for it. I think of myself as a good person, but I know there are people who, if they knew more, would not agree with my self-assessment. Maybe all of us have parts of our personalities that are like that. If you read the statistics, you’d say so. If you listen to what people say about those behaviors, you’d think that there are only a few pariahs out there, and everyone else is a model of rectitude.

I’d just as soon stick a stick up those rectitudes. Ass soon as I can find one long enough.

MyNewtBoobs's avatar

@wundayatta If I had a problem with it, I would have flagged it. You’re cool.

Plucky's avatar

I think the term “crazy” has extremely varied meanings and intentions; it depends on who is saying it, whom they are saying it to, how they say it ..and in what situation.

If you are using the term to outright insult someone, then they will most likely take it as an insult. If you are calling someone, who has a mental illness/disorder, crazy ..then, yeah, it’ll probably be received as an insult. If you are joking around with your friends and you say “Ha, that’s crazy!” ..they will probably not take it as an insult.

It just really depends on the context and situation.

As for myself, I have plenty of labels. The only time I’ve ever really been insulted by someone using the terms crazy, insane, nuts, loony, etc ..are when they were intended to insult myself or someone else. I use the above terms as well. But I would never call someone whom I know is schizophrenic, bipolar, etc., a crazy person.

Of course, there are times when one walks by a person on the street that isn’t acting quite “normal” and we think “ok… just keep walking”. That is normal behaviour; we all do it or have done it. It may not be ideal but we are only human.

augustlan's avatar

I’ll echo what @ANef_is_Enuf said. I don’t really have a preference, and I can see a case being made for using any number of terms. As for how I refer to my own issues, I just name them: Anxiety, depression, panic attacks. I think I’m most likely to use an umbrella term when I suspect there’s a mental illness/disorder in someone else, but don’t have confirmation of that or what their diagnoses is.

Seelix's avatar

I deal with depression and anxiety/panic. I have no problem with the terms “mental illness” or “mental disorder”. Just don’t maliciously call me crazy or a nutjob or a basketcase, and I’m fine. I refer to my SSRIs as my “crazy pills” all the time.

Rather than worrying about how PC the labels are, people should be concentrating on alleviating the stigma associated with the illnesses/disorders/whatever.

iphigeneia's avatar

I think they usually apply to where a person fits on the autism spectrum, but I have heard the terms neurotypical and non-neurotypical used in this sense. I do think that saying ‘mental disorder’ or ‘mental illness’ is fine, but I can understand how, unfortunately, some people feel they are made inferior because of this terminology and the way mental illness is still in some ways taboo.

wundayatta's avatar

@Seelix Seems to me there’s a relationship between terminology and stigma. In a way, I don’t care because I can pass for normal. I have enough control to only be really different in safe situations—like when I am with other people like me or in anonymous situations online. But seeing as how I like who I am when I have this diagnosis, I don’t like it when people disparage it.

I think crazy is a badge of pride. I think life tends to be more intense for people with minds that are significantly different from the norm. I think that brings out more innovation and creativity. It’s just harder to control and focus. But there are ways of working with us that can channel our talents in a useful way even though we, on our own, may be scattered and dysfunctional.

I think the mainstream idea is that we should be treated so we can approximate a level of normality that allows us to “play” well with others. It doesn’t have to be that we. Instead of changing us, we could change the environment so it is more suited for our talents. Work could be designed around us to support us and take advantage of our talents. People can be educated about what goes on with us so the mundanes can not be afraid and also be more supportive.

We could choose to be treated and medicated to levels we want, because we know there is still a place for us. Ah. Pipe dreams. And I don’t even smoke. ;-)

Bellatrix's avatar

I don’t want to wade too deeply into this discussion because I do not suffer from a mental illness/condition/disorder although I have had a bout with depression so maybe I do, but I don’t feel qualified to tell people who have ongoing mental health problems what they should or should not be called.

The use of the phrases normal and abnormal disturb me though. I don’t see people who suffer from mental health problems as abnormal. I see them as people who are challenged by mental health problems. Certainly if someone is found to be criminally insane, they may fall well outside the bounds of acceptable behaviour but it disturbs me to categorise people as normal and abnormal. That’s my two cents worth anyway.

BeckyKytty's avatar

Preferred Terminology?

Outside the box?

wundayatta's avatar

It is so not outside the box to use the phrase “outside the box.” Anyone who uses that phrase has got to be as normal as… corn flakes.

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