I was at a Twelve Step meeting recently and heard several references to the “mentally ill.” One was a woman who said she had a mentally ill sister and that was one reason she didn’t like to have friends over as a kid. Another was a man who said on his block growing up there was alcoholism, mental illness and incest (just like that, in that order) in the families of his friends, so he didn’t want them at his house but didn’t want to go to their houses either. The last was a woman struggling with having grown up in an alcoholic home and having an alcoholic boyfriend and she listed taking anti-depressant meds and going to therapy as things she was doing to try to improve her situation. For her, it seemed, nothing was helping her feel good enough to get out of bed or do the things she cared about, including the meds and therapy, but she was doing the things society had prescribed for “people like her.” Psychiatric drugs and therapy are protocol even though they haven’t proven to have better results than, say, cooking and eating a meal with friends, playing tennis, or singing in a choir. Well, I doubt they’ve ever been statistically compared.

When people call someone in their family “mentally ill,” what does it mean? The term mental illness has gotten out of control vague. There is no way to prove someone does or doesn’t have a mental illness in the way it is referred to, so why don’t we hear people say, “There’s someone in my family who’s extremely challenging for me (and others perhaps)”? Why don’t we hear descriptions of the behavior, how people feel in response to it, and what concerns it brings up in an honest way where the speaker owns their own experience?

Using the term mental illness might seem like a quick and easy way to reach common ground with other people, for some, but it doesn’t give accurate detail, so people don’t know what is being referred to. Since things like nail biting, leg shaking and restlessness are now becoming mental illnesses, it’s more important than ever to be specific in speech or writing about what we are referring to. Not long ago, homosexuality was a mental illness and currently premenstrual cramps and moodiness, gender non-conformity, and children or teens not obeying authority are all mental illnesses. When someone describes a mentally ill sister, all we know about her is that her behavior has been stigmatized. She is probably taking the label for the family (and society).

The other reason it’s problematic to use the term mental illness is that most people by now have been labeled with one (or more). So those listening or reading are likely to feel alienated by the term. People are questioning what it means more and more and it’s starting to sound old-fashioned to those with more multicultural awareness and understanding of mental diversity. People are starting to see the political and socioeconomic factors that go into who gets that label, and who doesn’t. In order to get insurance coverage for therapy, one needs a diagnosis of a mental illness. Some may say, “But I’m talking about MAJOR mental illness. My sister is schizophrenic/psychotic.” For one thing, “anti-psychotic” drugs have been some of the top selling of ANY pharmaceuticals in this country, so it’s important not to underestimate how many people have MAJOR mental illness labels. Most importantly, though, even in cases of extreme diagnoses, and extreme behaviors and situations, people will not know what you mean unless you describe it. Using a label is stigmatizing, so it is more powerful and clear to say what is actually going on; then others can understand, connect and empathize with a unique situation.

When I hear labels used, I have to talk myself down, remind myself that not everyone has been studying mental diversity for the past 15 years and not everyone investigates the language they use. This talking myself down takes time and during that time there is a disconnect between me and the one using a label. It’s similar to if you are listening to a white person make racist comments or use the word “nigger” or a heterosexual use the word “faggot” or a man “bitch.”

A close family member has struggled with substance addictions and extreme mood swings for as long as I can remember. Another family member once said to me, “I think your (family member) is bipolar.” I was in my mid-20’s and it had never occurred to me to label this family member. This could be because she was high on the social totem pole: she owned a nice house, made plenty of money, was very active in life and had an extroverted, yang personality. Perhaps I had never thought to label her since she had labeled me and I was the one in the family to be stigmatized for awhile. The term bipolar would have served to stigmatize her but not clarify, heal or deeply explain any of her behavior, its roots or how it affected me (or others). Since I experienced and still experience a lot of agony, pain and fear (as well as joy, love, nurturance and comfort) in response to her behavior, labeling her might feel like retaliation, or it might give me a chance to put the stigmatizing lens on her after she’d (unfairly I’d say) put it on me. But it wouldn’t be honest. She could get that diagnosis as readily as most people who’ve gotten it, but it’s a low blow. It’s dehumanizing and lacking love and empathy to resort to a label.

I recently asked a friend who hears voices (and has gone through quite a bit in the mental health system, gotten diagnoses and taken psychiatric drugs in the past) if her parents label her. She replied, “They love me too much to label me.” Enough said.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Chaya, thanks for writing this excellent piece. I too react to the term “mentally ill” the same way I do to racist,homophobic or sexist epithets. I get tired of hearing from people in our movement who use the term because they think it’s the only way they can communicate with the general public, when all they’re doing is perpetuating misinformation. Emotional pain and extreme states are not “illnesses.”

    But I have to admit that I’m partial to the late Howie the Harp’s favorite term for his fellow people with psychiatric histories: “crazy folks.” I’m willing to claim that one.

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  2. A name is a kind of label. In The Journey Home by Kryon/Lee Carroll, a true name is described as sounds that convey the energy of the essence of one’s whole being. A label that focuses only on what’s perceived to be a person’s problem obviously doesn’t convey this wholeness. Wholeness arises when all parts connect, synchronously or harmoniously, rather than in a disharmonious, disordered way.

    Identifying wholeness enables people to connect healthily to it. Focusing on someone’s inner harmony (health) increases it until one is wholly harmonious, and thus well-ordered. Brainwave technology does this, proving it’s so ( — I’m not paid to share this). Labels that do the opposite increase disorder, harming people, colluding with the disease, initiating and perpetuating it.

    It’d be unethical to use brainwave technology to play back the sounds of one’s inner disharmony until the whole brain is disharmonized. That’d clearly be mental torture. Yet, awareness campaigns think they’re doing good to promote social norms that do that. They promote labels that reflect back people’s (perceived) inner disharmony. That approach is so tragically misguided that people who follow it obviously can’t take realizing the harmful effects they cause all at once. In that way, they know not what they do.

    Abusers who traumatize people benefit when victims’ perceptions of who abused them are considered disordered, unclear or not credible. This is why I avoid calling people “crazy,” especially when one may not understand everything they’ve experienced.

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  3. Thanks Irene!!!! I love what you say, sooo true. I started using my Hebrew name “Chaya” around the time I was labeled. Even though Nicole is my legal name, Chaya came first as it was the name of my great grandmother and somehow my parents chose Nicole as an English version of Chaya. Chaya, which means life, feels more whole to me, perhaps because it comes froma sacred, older language than Nicole, I believe.
    I so agree that our names need to reflect our wholeness!

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  4. Chaya – I am so glad you wrote this. I definitely relate to the feeling of having to breathe deeply and collect myself when people start dropping the words “mental illness” around. I actually find the phrase extremely triggering in ways that are not so great or healthy for me. Like, it just hurts me to hear those words. I still have so much healing to do around language and the associations that certain words hold.

    I have a lot of internal conflict with my ethos of “meeting people where they are at”/honoring individual choice of language and the ugliness of those words in my ears. It’s a tough dialogical space to inhabit, to be ethically inclined to straight-up tell a person that evidence indicates that they are wrong…while at the same respecting that a person’s reality is their reality. I don’t want to be a person who gets didactic on folks, but I really have to tell the truth as I reasonably understand.

    I do, admittedly, sometimes like to use the “mental illness” phrase without quotations in blogpost titles…just as a relevance-hook…then I try to deftly destroy the concept in the body of the writing.

    Thanks again for the writing and for the work out in the world.


    Ps. Darby, I really like “crazy folks” – it has the same appeal as “mad” – but, is a little more down home. I think I want a t-shirt that just says ‘crazy folks’

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  5. I totally feel you Faith. It hurts me to hear those words too! I think we are feeling the pain that those words have imparted upon millions for many years. As empathetic people even words can hurt and even if they are not directed at us.
    I believe we have healing to do within ourselves but especially we have a message to continue to bring to others to facilitate the healing of the words we use and how and why. Being sensitive to language is a gift in that we can teach others and lead the revolution!

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  6. Chaya, I am a MIA writer (my blogs are “Voiceless in America” and I am informed and encouraged by your writing. Please read the following post; it is an invitation to join with other writers and individuals who have been through the mental health, the in -patient and correctional systems, in collaborating on a book dedicated to promoting change in the mental health system.
    Greetings Chaya
    I am the writer/blogger of Voiceless in America for MIA and I have been reading your posts with great interest. I recently contacted author/publisher Robert Whitaker to discuss my goal of putting together the collective voices of the MIA community in a book that would address several vital issues that may be of interest to you. I am enthusiastic about your participation in this project given the critical nature of the issues and your own views and experiences. Perhaps you would be interested in contributing? A collaborative and compelling book might go far in informing and motivating a great number of people.
    The issues are;
    Recognizing the huge and powerless group of voiceless individuals who struggle to exist amongst us;
    1. Those who are abused into silence through child abuse, incarceration, hospitalization
    2. those who are coerced into muteness due to the mental health system’s failure to speak out against psychiatry’s dependence on and use medication and of diagnostic labeling,
    3. Those who are marginalized into silent suffering due to poverty, lack of education and lack of opportunity to speak out.
    4. Those individuals who are shamed into silence due to social stigma and misinformation about emotional distress.
    5. Those who suffer alongside the voiceless population (family, friends, mental health workers)
    Identifying the Voices that have presumed to speak for the Voiceless population and who, with great authority and funding define who they are, tell them what their problems are, tell them what to do and inform them about what they need.
    1. The Organizations; American psychiatric Association, American Psychological Association, the AMA,
    2. The Pharmacological Companies
    3. Political Groups
    4. Social groups that promote prejudice and stigma
    Giving the Voiceless their opportunity to speak;
    This large section of the book would contain chapters from the following
    1. Writers/bloggers within the MIA community who have struggled with and survived the mental health system and can share their experiences
    2. Writers from MIA who have posted their views on psychiatric practices, medication etc.
    3. Interviews with Voiceless individuals outside of MIA who can share their important experiences with medication, incarceration, abuse, hospitalization
    Proposing solutions for these issues

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