Let’s Stop Using Mental Illnesses as Figures of Speech

Once every five minutes, someone somewhere says they’re “sooo OCD” about sorting emails, using Purell during flu season, or wearing day-of-the-week underwear on the correct days. This statistic is made up, but it is certainly true that OCD, the acronym for Obsessive Compulsive Disorder, is often misappropriated as a synonym for orderly, clean or nitpicking.

Using names or acronyms of mental illnesses to hyperbolize innocuous idiosyncrasies and experiences has become pervasive in our cultural dialogue (and Twitter feeds). It is important we end this trend, not because it is my pet peeve (which it is) and not because I am the PC Police (which I am not). It is important because making these flippant references (1) trivializes how devastating the illnesses can be and (2) perpetuates myths and misunderstandings.

OCD: Beyond Orderliness
OCD is an anxiety disorder in which an individual experiences unwanted and intrusive thoughts (obsessions), often compelling them to repeatedly perform behaviors and routines (compulsions) to temporarily ease their anxiety. However, public understanding of this disorder has been blurred by adoption of its acronym by people who are just, well, neat freaks.

“The comment ‘I’m so OCD’ has unfortunately become synonymous with ‘I’m obsessive’ (I think or worry a lot) or ‘I’m compulsive’ (I like things neat and organized),” says Dr. Jeff Szymanski, executive director of the International OCD Foundation. “During OCD Awareness Week, we try to educate the general public by encouraging people to learn the difference as OCD is in fact a serious psychological disorder that can have a severe impact on people’s daily lives. The ‘D’ in OCD matters.”


In reality, OCD is diagnosed when an individual experiences obsessions and compulsions for a significant amount of time each day (usually more than an hour), in a way that interferes with his or her life. And OCD is complex and diverse — many with OCD experience obsessions and compulsions that have nothing to do with cleanliness (like fear of self-harm) or that may even be messy (like hoarding).

Perhaps television and film portrayals of OCD are partially responsible for the one-dimensional stereotype of OCD as a quirky penchant for tidiness and hygiene. “Hollywood has created the belief that OCD is just checking, hand washing, or germs,” says Ethan S. Smith, an actor and OCD advocate. “Some characters even use their OCD to their advantage, almost like a skill or superpower, as in the television series Monk.” And while it is way too easy to find examples of public figures jokingly refer to their “touch of OCD,” others like actress-turned-writer Mara Wilson are speaking out against the trend.

Thus, if you just love the Container Store and have no genuine suspicion of this disorder, it is both insensitive and inaccurate to reference OCD. Some fun words you can use to describe yourself more properly include anal, persnickety or punctilious.

PTSD: Beyond Bad Memories
Has anyone else noticed that former college Biology majors insist their organic chemistry classes gave them PTSD — to the point of cliché? Somehow I doubt the experience of receiving your first B has given you anything beyond a bitter slice of humble pie. Too often people hyperbolize the impact of horror movies, embarrassing dates, standardized testing, etc., as inducing PTSD.


Unfortunately, PTSD is not that simple. “PTSD results from neurophysiological changes that occur due to a traumatic experience in which a survivor’s physical and emotional safety are substantially threatened and in which case the ability to cope is completely overwhelmed,” explains Michele Rosenthal, who is a post-trauma coach, award-nominated author, radio show host, PTSD survivor and the founder of HealMyPTSD.com and the Heal My PTSD forum. “This results in biological and chemical changes in the brain and body, plus a very altered perspective on personal identity and the survivor’s place in the world.” Her recent book, Your Life After Trauma: Powerful Practices to Reclaim Your Identity, provides a workbook of insightful treatment strategies for survivors and their therapists.

PTSD symptoms can include flashback episodes, nightmares, emotional numbing or detachment, feeling like you have no future, hyperarousal, insomnia, guilt, impaired memory, and more. So maybe enduring a Red Sox losing streak is a little unnerving for you, but it would be an offensive oversimplification to exaggerate the extent of this hardship with a PTSD reference.

And it’s not just political correctness at stake, Rosenthal attests:

When comments reduce PTSD to the level of a tough exam or a sports team loss (or as someone recently tweeted to me, weather change) it’s not only disrespectful of the survivor experience but also serves to reinforce an attitude of disregard. In this way, such comments increase mental health stigma in the public arena and can dramatically reinforce survivors’ self-criticism, which hampers recovery efforts. Minimizing PTSD in the outer world can increase feelings of shame, self-blame and negative beliefs in the survivor’s inner world. ‘I should just be able to get over it’ is a comment I hear from many of the survivors with whom I work. That’s an inaccurate statement and holds back progress.

Schizophrenia: Beyond Erratic Behavior
For years, doctors and advocates have appealed to the media to stop applying the term schizophrenic to politicians, the stock market, weather or sports teams. In the age of social media, this should apply to all of us. Though it is true that some dictionaries include a secondary definition of schizophrenic as “having contradictory or antagonistic qualities and attitudes,” this usage perpetuates a flawed and stigmatizing perception of the illness. In actuality, Schizophrenia is a chronic and severe illness that may interfere with a person’s ability to think clearly, manage emotions, make decisions, and relate to others. It varies from case to case with possible symptoms ranging from delusions and hallucinations to emotional flatness and trouble with memory.


Over a decade ago, psychiatrists from Harvard Medical School published a report finding that of the 1,740 newspaper articles from 1996 to 1997 including the words schizophrenia, schizophrenic or schizo, nearly a third were mentioning the disorder metaphorically. The authors concluded: “We look forward to the day when prevention and education — not metaphor and demonization — are the dominant messages carried to the public by the news media.”

Unfortunately, it appears not much has changed. Stanford neuroscientist Dr. Patrick House counted that 38 percent of schizophrenia references printed in the New York Times during 2012 were metaphorical. As House points out, “if Congress was indeed acting schizophrenic, it would have flattened emotions; social withdrawal; and be prone to delusions, hallucinations, paranoia, and occasional disordered thought.”

Interestingly, the standards editor at the Times has since issued a note advising against the metaphorical use of schizophrenic, explaining “besides the misconception that it suggests a split personality, using the word lightly or metaphorically can seem insensitive.”

While I have run into the above examples the most, there are many more, from a constantly changing taste in music as ADD to sudden outbursts of tweeting as Twitter Tourette’s.

The more the names of mental illnesses occur in our conversations as facetious self-diagnoses and misappropriated adjectives, the more difficult we make it for those with clinical diagnoses to speak out and be heard. While some may believe the trend of mentioning these illnesses in jest marks progress from a time when we did not mention them at all, I think we can do better.

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