Please Stop Using Mental Health Diagnoses as Jokes and Adjectives
Nope, you’re not ‘so OCD’ and nor is the weather ‘bipolar’
We’re barely into the year and I’m already over it. I’ll be sitting in a work meeting, and then, suddenly, there it is.
“Forgive me, I’m quite OCD about grammar and spelling.”
“I’m a bit schizo (or bipolar) about this decision, sorry. I’ve changed my mind.”
“I’m so busy at the moment, I feel schizophrenic, like I have multiple personalities to deal with multiple tasks.”
Statements like these slide their way into the dialogue. A fleeting moment. It generates a few laughs. Some sympathetic nods. “I’m a bit like that too, I totally get it.” The conversation moves on, and everyone forgets about it. Except me.
I’m sitting there, in immense discomfort, wondering whether it’s an appropriate time to say something now, later, or never. Maybe an email? A follow-up phone call? Awkward.
Why we need to stop ‘adjectifying’ mental health diagnoses
When I do summon the courage to say something, the most common response I receive is an absolute classic: “but it’s just a joke, I mean no harm — can’t you take a joke?”
Nope, I can’t.
Not when OCD pushed me to the brink of suicide.
The reality is, when people joke about OCD/bipolar/schizophrenia/any other mental health disorder, they inadvertently reinforce harmful stereotypes.
The resulting impact of these incorrect stereotypes is misdiagnosis.
This is what happened to me. I was experiencing sudden and intense intrusive thoughts, and I was petrified. My intrusive thoughts centred around the idea that I might lose control and hurt someone. It took being sick enough to end up in the care of the crisis team before an experienced psychiatrist told me that I had OCD. I was floored. I’d seen four doctors and one psychotherapist before I had hit breaking point, none of whom recognised OCD.
My interactions with professionals were contrasting, to say the least. Early on, I’d been brushed off with “you’ve got a bit of anxiety” and was told to join the queue for a private psychiatrist. As I became more unwell (and confused), doctors tried to figure out the ‘reasons’ behind my horrific thoughts, assessing whether there were any psychotic features — which of course, increased my fears and anxiety ten-fold. I became incredibly unwell during the time that elapsed between initial consults and diagnosis. In short, I received my diagnosis almost too late.
While in recovery, I learned that in medical school, doctors are told to look out for OCD only as a fear of contamination, or for rituals such as handwashing and flicking switches. I was mortified, but not surprised. It matched the lack of understanding that I’d experienced. Shamefully, my first thought upon hearing my diagnosis was also how can it be OCD when I don’t have a problem with germs? It had been the only way I’d ever seen OCD portrayed.
For people like me, it’s incredibly frustrating when the general population think that Sheldon Cooper’s door-knocking routine from Big Bang Theory is what living with OCD is like. A little cute, a minor inconvenience, but nothing too serious — right?
While ‘just-right’ and contamination are common OCD themes, and ritual-like compulsions can be present in many, these types of OCD are really only the tip of the iceberg. I was seven professionals deep into my journey when I met my current psychologist, who confirmed what the internet had told me long before — that I had Pure-O.
Many mental health disorders are misrepresented and are made worse by inaccurate portrayals in media. These are then further reinforced by the casualisation and stereotyping in our everyday language.
The impact of this is significant. People (and many medical professionals) don’t recognise the patterns of common mental health disorders, resulting in misdiagnosis, the wrong type of help and/or therapy, or no help at all. It also means people are generally less empathetic to those who are struggling. If my fellow OCDers and I could have a dollar every time someone said something along these lines ‘OCD is one of the better ones, at least it’s helpful, right?’ we’d be millionaires (or at least be able to afford our therapy).
This is why this is a plea to stop with the jokes.
The most common culprits
I’ve actually heard all of these being said out loud, mostly in a professional setting. Yep, I’m cringing too.
Stereotype #1: Using OCD to describe a preference for being tidy, having order, colour coordination, or being particular about spelling and grammar.
Misrepresentation: “I’m so OCD about the way my desk looks. It has to be clean.”
- OCD is characterised by uncomfortable, uncontrollable, repetitive, intrusive thoughts, leading to compulsions. The themes can be endless, not just limited to a fear of germs. For those who live with OCD, it can be all-consuming — it’s not a choice nor preference, and no one with OCD would ever describe themselves as ‘so OCD’. When I briefly struggled with contamination, it involved repetitively sanitising objects that people may have touched when no one else was looking, and anxiously thinking about what I’d missed, well after work had finished for the day — sometimes even into the weekend. It was not as simple as wanting a ‘clean-looking’ desk.
- OCD affects approximately 1–2% of the population
- Suggested alternatives: Tidy/pedantic/orderly/picky/particular
Stereotype #2: Using schizophrenia as an adjective to describe being too busy, indecisive and/or erratic, or having multiple personalities
Misrepresentation 1: I’m feeling schizophrenic, there’s so much work on. Misrepresentation 2: They were a little schizophrenic about this decision, they seemed to change their tune — it was almost like we were talking about two different people.
- What it actually is: schizoaffective disorder is characterised by psychotic symptoms and mood symptoms. Schizophrenia can be defined by many different experiences and behaviours, including a lack of interest, disconnecting from others, hallucinations and delusions. Multiple personality disorder is not the same as schizoaffective disorder or schizophrenia.
- Schizoaffective disorder/schizophrenia affects approximately 0.3% of the population
- Suggested alternatives: Busy/indecisive/confused/erratic
Stereotype #3: Using bipolar to describe indecisiveness
Misrepresentation: I’m a little bipolar about this decision — I’ve changed my mind.
- What it actually is: Bipolar disorder affects your mood, which can be characterised by mania/hypomania (feeling high) and depressive episodes. It doesn’t mean having dual personalities, or changing your mind about a decision quickly — and it certainly shouldn’t be used to describe the weather.
- Bipolar disorder affects 1–2% of the population
- Suggested alternatives: Indecisive or ‘I’ve changed my mind’
Why I’m feeling hopeful
There are some days when I simply don’t have the bandwidth to challenge people when they’ve misspoken. I’ve learned to pick my battles. I find myself assessing the cost to my own mental health when choosing advocacy, and then thinking about the possible defensive stance I have to take when validating my own lived experiences. It can be exhausting. Is it even worth it, I wonder? And sometimes, the answer is no.
But when I do say something, 9 times out of 10, people are generally understanding. Most are willing to take the time to learn from lived experiences and commit to being more mindful when choosing their words. That is all I can ask for. We’re all on a journey of learning, and I can’t say I’m perfect with my word choices either.
“The man who moves a mountain begins by carrying away small stones.” — Confucius.
What makes me hopeful is that I grew up in the 90s, and the playground ‘jokes’ I heard at school were hideous, particularly around race, culture, disability, and LGBTQIA+ issues. I reflect on the journey that society has taken in recent decades to be more inclusive — and I can only wish the same for the mental health community.
With mental health issues becoming more prevalent during these trying pandemic times, the more we can phase out the poor use of language, the better off we’ll all be.
