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By Jon Kelly and Denise Winterman BBC News Magazine
Terms like "bipolar", "autistic" and "schizophrenic" are often used in jest to
describe character traits. But how harmful is it to bandy the names of such
conditions about?
It's a common form of hyperbole.
The neighbour who keeps his house tidy has Obsessive Compulsive Disorder (OCD).
A socially awkward colleague is autistic. The weather isn't just changeable,
it's bipolar.
Such analogies are so familiar they surely qualify as cliches. They are also
inaccurate and, to many, deeply offensive.
Campaigners are targeting what many say is an increasingly common practice -
deploying the language of clinical diagnosis to describe everyday personality
traits.
Using these terms metaphorically is just a joke, not to be taken seriously,
argue some. Others, however, warn that this serves to further obfuscate
conditions that are widely misunderstood and stigmatised.
Either way, you don't have to look hard for evidence of such terminology being
deployed in this manner - even from sources you might not anticipate.
In December 2010 the Observer newspaper apologised for describing TV presenter
Gok Wan's dress sense as "schizophrenic". The International Monetary Fund's
September 2011 World Economic Outlook, characterised a volatile global economy
as "bipolar". In an article for the Sunday Times, the writer Robert Harris
described Gordon Brown and Richard Nixon as displaying "political Asperger's
syndrome".
The mental health metaphor also has the distinction of having been deployed by
that noted savant of the English language, Katie Price. During a court
appearance in which she insisted she had been spraying scent rather than using
her mobile phone while driving, the glamour model said: "I am quite OCD about
my perfume habits, all my friends know that I'm always spraying perfume."
Research suggests these are far from isolated examples. A 2007 study of the
terms "schizophrenia" and "schizophrenic" in the UK national press found that
11% of references were metaphorical, with broadsheet papers more likely to
deploy such phrasing than tabloids. By contrast, cancer was only used in this
manner in 0.02% of cases.
Gordon Brown and Richard Nixon Gordon Brown and Richard Nixon were compared to
those with Asperger's
If anything, the UK is less prone to this tendency than other developed
nations. Separate surveys in the United States, Germany and Switzerland found
respectively that 28%, 58% and 31% of references to the condition were
metaphorical.
Nonetheless, Arun Chopra, a consultant psychiatrist at Queen's Medical Centre
in Nottingham and the author of the British research, believes the tendency has
a negative impact on the treatment of patients.
He argues that deploying terms in such a way contributes to public
misunderstanding - for instance, reinforcing the false notion that
schizophrenia is a "Jekyll and Hyde" illness related to split personalities.
Moreover, he says it can be deeply upsetting to patients and their families,
and recalls seeing a woman whose son was diagnosed with the condition bursting
into tears when she read a newspaper article which described the weather as
"schizophrenic".
"The use of the word as a metaphor is tremendously damaging," Chopra adds.
"It's part of the process of creating a stigma around mental illness.
Start Quote
It doesn't offend me when people trivialise it - it's almost a vehicle
Bryony Gordon
BBC's Ouch! Blog
"You would never hear it used in relation to a physical condition. You wouldn't
hear someone being described as a bit diabetic."
As such, he says he would like the Oxford English Dictionary to remove its
secondary definition of schizophrenic: "With the implication of mutually
contradictory or inconsistent elements".
Of course, deploying medical language to describe character traits is hardly a
new phenomenon. Words like cretin and lunatic were originally formal terms to
describe specific conditions before they more commonly came to be used
pejoratively.
However, not all those affected by frequently misapplied conditions object to
their use in this manner.
The Daily Telegraph columnist Bryony Gordon, who has been diagnosed with OCD,
says she frequently has to point out that her disorder involves more than
simply cleaning her house.
But she feels that attempting to clamp down on this kind of use of the term
veers close to political correctness - and, moreover, that she is grateful the
condition is, at least, widely discussed.
"It doesn't offend me when people trivialise it," she says. "It's almost a
vehicle to talk about it.
"In a way it's a good thing because people acknowledge it exists. You're stuck
in your own head and to see other people making light of something makes you
think, 'Ah, this is what's happening.' It makes you feel better about it."
Most advocates for such conditions disagree, however.
Andrew McCulloch, chief executive of the Mental Health Foundation, argues that
using a clinical diagnosis to describe minor personality traits can only serve
to fuel misunderstanding.
"The upside is that we have moved on from a fear of mentioning these things at
all, but it is a tiny step forward," he says. "The trouble is these terms all
come to mean the same thing. Then they become as unpleasant as describing
someone with schizophrenia as a lunatic.
"The reality is we still have a long way to go when it comes to educating
people about mental health. People might use these terms more frequently now
but the stigma of having a mental illness is as bad as it has ever been."
Still, attempts by some mental health service users to reclaim pejorative
labels under the banner of so-called "mad pride" demonstrate that there is
unlikely to ever be consensus about the best way to respond.
The flippant use of such terms nowadays may offend some and not bother others.
But such a dynamic is part of the words' evolution, says Joel Rose, director of
OCD Action.
"Five years ago people wouldn't have known what you were talking about if you
mentioned OCD," he says. "Now they have a sense of what it is about and use it,
but don't really fully understand it. The next five years will be about working
to fully educate people.
"What we want people to understand is how serious and debilitating OCD can be.
We're talking about people who might clean a floor repeatedly for eight hours
or someone who can't leave the house. It's not having a tidy house or arranging
the tins of food in your cupboard. We also want to get across that it is
treatable."
Indeed, many of those diagnosed with the condition have successfully learned to
manage it. Overcoming its metaphorical use, however, may prove more difficult.
Definitions
Schizophrenia is a diagnosis given to some people who have severely disordered
beliefs and experiences. It's used to describe a wide range of symptoms. During
an episode of schizophrenia, a person may lose touch with reality, see or hear
things that are not there, hold irrational or unfounded beliefs, and appear to
act strangely.
OCD is a common form of anxiety disorder involving distressing, repetitive
thoughts. Obsessions are distressing or frightening repetitive thoughts which
come into your mind automatically. Compulsions are actions people feel they
must repeat to feel less anxious or stop their obsessive thoughts.
Bipolar disorder is a mood disorder characterised by swings in a person's mood
from high to low - euphoric to depressed. People in a high phase can get
themselves into difficulties they would normally avoid - they may spend money
they don't have or give away all their possessions. In a low phase, people feel
hopeless, despairing and lethargic, become full of self-blame and self-doubt
and have difficulty concentrating.
Source: Mental Health Foundation