Words have meaning. Meaningless misuse of words increases stigma

When I was younger I remember having a vague understanding of why we couldn't use words like "retard" in daily life to describe things that we didn't like, but it was always more of a "I can't do this" than a "I shouldn't do this because" kind of thing. It didn't really fully make sense until I was older. And even when I was teaching high schoolers (which I did for a year after college), I had difficulty explaining to them why they shouldn't call things "gay." The easily spouted wisdom of "how would you like it if your name was used to describe things other people considered uncool or dumb?"I would say. To which they'd always reply "I probably wouldn't care." Of course, they would care, but it actually isn't a great example. Because really, that's not the real problem. It's taken me years to realize it's a matter of stigma. In my daily work as a psychiatrist, I listen to people's stories and symptoms and I help formulate a diagnosis and treatment plan for them. It's been a pet peeve of mine for years now when people tell me about how they're "manic" or "bipolar" with no understanding of the words or what they mean. "Well Dr, I have these mood swings you see. One second I'm fine, and the next I'm mad, and a second later I'm angry, and then I'm fine again." Or they use it to mean that they sometimes get very angry for no reason. But they casually throw out the word "bipolar" as if any unwanted display of emotions meets the criteria. I then painstakingly go through the diagnostic criteria, and more times than not, the patient realizes they in fact are not bipolar. Why does this bother me? First, bipolar disorder has been portrayed as this whimsical, unwanted disorder of too many emotions. It's nothing to be bipolar, other than to have some mood swings, in this day and age. Everyone is "bipolar" at some point, according to this rule. The truth is, bipolar disorder is a very difficult disorder to diagnose and treat. And it can have devastating effects on people's lives. Being manic isn't this state of mind to aspire to. It's not just a high level of energy and changes in mood that everyone experiences. A true manic episode includes days without sleep, high energy, increased risky behaviors, and poor judgement. I'll likely end up writing an entire blog about bipolar disorder, so I'll only touch on it here. People in a manic episode sometimes quit their jobs, spend all their savings on trinkets, sell their homes, uproot their lives, only to "wake up" or crash out of it later, and find themselves unable to repair the consequences. This isn't something to aspire to. Sure, some artists do their best work when manic. And I'll also likely one day get to a blog on the possible Darwinian advantages to mental illnesses. Many people go undiagnosed for years because the mania feels "good" and they don't recognize it for what it truly is. But it's not something enjoyable. Treatment for bipolar disorder is also not pleasant. Mood stabilizers and antipsychotics have many side effects, and shouldn't be taken lightly or unnecessarily. The same can be said for OCD. Everyone comes in with "my OCD is acting up. I like things organized a certain way and I'm always cleaning things." Again, OCD is a life altering disorder that is very difficult to live with and treat. People with OCD spend their day fighting off obsessions and intrusive thoughts. Not only about germs and contamination. Some people have intrusive thoughts or obsessions that they may have killed someone, or hurt someone. And the only way to protect themselves and others are from the compulsions. Not just washing their hands a lot. But "if I don't wash my hands seven times, I'll die." or "I have to lock the door five times, otherwise someone will break in and murder my family." They may know it's not true, but they can't fight off the thoughts, and they can't stop themselves from the compulsions. You diminish the distress someone else is experiencing by misusing the diagnosis. It's very important to understand that. I wouldn't say "ugh I was so asthmatic today" if I had some trouble breathing during a workout that was beyond my skill. To say that would be to assume that asthma is somewhat controllable (ie, if I worked out more I wouldn't have gotten winded) and that it is transitory. It would diminish what asthmatics go through on a daily basis if their asthma is poorly controlled. Second, causal misuse of words increases stigma in mental illness the same way calling something "gay" does. Here's how. If I call something I don't like "gay" I'm not only using it to describe something that is bad, but I'm inherently calling being gay bad, right? So if I call my friend "bipolar" when they're acting in a way that I don't approve of, I'm inherently calling being bipolar a bad thing. If my friend who truly is bipolar hears me say this over and over again, they feel like there is something else wrong with them. Not only their illness, but that people don't accept it. They will hide their symptoms and not seek help. Calling someone "schizo" when they're acting differently than the norm makes people think schizophrenia is something funny, and demeans people who actually suffer from this illness. So let's all take some time to be more conscientious about the words we are using, and the way we describe things.