Just one little word makes a huge difference in how people view mental illnesses. If we want to help stop the stigma, we need to learn about semantics.
An Honest Conversation
“Pedro, you look terrible!” our friend blurted out as he walked across the empty church lobby.
Pedro laughed, although his face remained mostly frozen and the snort coming out sounded nothing like his usual laughter. After a whirlwind relapse of his non-Hodgkin’s Lymphoma, he looked like an extra from Schindler’s List.
“I’m so sorry,” our friend exclaimed, “I didn’t mean to say that!”
“It’s o.k.,” Pedro said. “I like the truth.”
Our friend had spoken the truth. Pedro looked terrible. His paralyzed face and emaciated frame made his lack of hair, eyebrows, and eyelashes seem like a minor thing.
At no point in the conversation, or any conversation with friends, family, or strangers, did anyone blurt out, “Pedro, you are cancer.” Semantics matter.
Semantics: The language used to achieve a desired effect on an audience, especially through the use of words with novel or dual meanings. The way we refer to someone who HAS an illness matters.
An Observation on Semantics
I had gestational diabetes during my first pregnancy. The diagnosis required immediate lifestyle changes to get me through the last few months of pregnancy. I also had to make lifestyle changes in my late thirties when I realized I could more easily fall prey to Type 2 Diabetes if I didn’t watch my weight. Once you have gestation diabetes, your chances of developing Type 2 diabetes increase by up to 50%, according to the CDC.
A curious thing happens with diabetes. Approximately nine percent of the US population has Type 2 diabetes. People generally know enough about the condition to know those with diabetes have to watch their sugar intake.
I’ve worked with people who identify as diabetic, and people who have diabetes. Those who identified as diabetic—as in “I AM diabetic” always seemed to over-identify with their diagnoses. They turned the phrase, “I’m diabetic” into an excuse or a crutch. Instead of exercising more, feeding themselves healthy foods, and actively trying to reverse the disease, they bemoan their life sentence. Granted, I don’t know a lot of people with Type 2 diabetes, but I have noticed a pattern.
On the other hand, those who take the “I HAVE diabetes” approach seem more balanced in their lives. They have a long-term health issue that requires them to make some adjustments, but they don’t plan on letting their diagnoses dictate their life. These friends always have the right kinds of snacks on hand, they let others know what to do if their condition suddenly worsens, and they have a lifestyle plan. When considering possible limitations, they always ask how they can still do the thing (usually some sport).
If We Want to Stop the Stigma, We Need to Change How We Speak
If we want to help stop the stigma surrounding mental illnesses, we need to start speaking about it as if it were a physical illness.
After all, one would not go around cheerily announcing, “I’m cancer!” or “I’m kidney failure!” or “I’m heart disease!” One HAS those medical conditions. The having rather than the being expresses inherent hope of using lifestyle changes, medical intervention, and follow-through, things will normalize.
When we refer to someone as schizophrenic or bipolar, we unconsciously dismiss them as less-than. Without meaning to, we take away their normalcy and replace it with a diagnosis. And for each of the hundreds of mental illness diagnoses, we talk about them differently. No one says, “My mom is Alzheimer’s,” but we often hear someone say, “my daughter is autistic.”
But what if we said, “My daughter has neuro-diverse ways of processing the world” rather than “my daughter is autistic.” Everyone understands the concept of diversity—even twins have differences. “My son has bipolar disorder” sounds so much more helpful than “My son is bipolar.”
When someone HAS something, like cancer, we immediately want to know the treatment plan. In fact, when Pedro had cancer, complete strangers would offer their opinion on the best treatment or ask about what protocol he had chosen.
Even with Alzheimer’s, we know to ask about medication, what helps, and what confuses. We have a general awareness of things we can do to come alongside a person who has Alzheimer’s.If we started to refer to all mental illnesses as something someone HAS rather than something someone IS, how would things change? #StoptheStigma #bipolar #alzheimers #autism Click To Tweet
Having Doesn’t Always Mean Getting Well
Some physical illness have no cure, just like some mental illnesses have no cure. And some physical illnesses have a comeback codicil. But eventually, one learns to live life in the present and ignore the shadowy scepter of relapse.
It took a few years to realize that every time Pedro had a sniffle, a headache, or a bout of dizziness that a rational reason existed to explain each of these things (common cold, dehydration, standing up too quickly). I fought against hyper-vigilance and helicoptering.
If you have a family member who receives a mental health diagnosis, remember to rein in your inner vigilante and refuse to fall into the trap of analyzing every laugh, giggle, unusual text or delayed response. These things do not mean your loved one has relapsed into mania or sunk into depression. Hyper-vigilance and helicoptering don’t serve anyone well.
Hacks for Helping to Stop the Stigma
1. Get in the Habit of Having Rather Than Being
It may take a month, six months, a year, or even two, but train yourself to refer to all mental illness as something people have rather than something people are. This one action will do the most to help stop the stigma of mental illness. It just seem like semantics, but semantics make a difference over time.
2. Find Ways to Come Alongside
Find ways to come alongside someone with a mental illness. Ask if they have a plan for what to do if their friends or family notices them sliding into depression, mania, or obsessing over food. Find out in times of stability how they want you to act during times of instability.
3. Accept the Person’s Limitations
Just like you wouldn’t push cake an ice-cream on a person with diabetes, you wouldn’t want to push late nights on a person with bipolar disorder. Find out if your friend or loved one needs to avoid certain things (alcohol, lack of sleep, or lack of routine can exacerbate symptoms of some mental illnesses).
If someone says they need to take a nap, go to bed, or eat something, don’t argue, poke fun, or cajole them. You don’t need to know the details just accept the limitations the person has to live with.
4. Separate the Behavior from the Being
If you know someone with bipolar disorder, you may have developed a sensitivity to phrases such as crazy, around the bend, manic, loco en la cabeza, or insane. No one wants to get labeled as crazy. Once again, semantics comes into play here. A person experiencing a manic episode my do things that seem unreasonable or crazy to those who love them. But that doesn’t make the person permanently crazy.
If we want to help stop the stigma, people’s inexplicable behavior should engender compassion in us, not labels.
5. Reach Out Even if it Feels Uncomfortable
If a friend or someone you love seems to be struggling, reach out. Let them know you respect their privacy but stand by willing to help and support in whatever way feels right. Only through open conversations, education, acceptance, and planning can those with mental illness experience the support that they need to navigate the confusing waters of their diagnosis. Above all, they need to know that they are not alone. They are not pariahs.