'Two words on a stranger's t-shirt shook the breath out of me.'

Have you ever heard or seen a word or phrase that made you feel intensely uncomfortable with who you are?

Until about eight years ago, I had never been on the receiving end of discriminatory language. And yet it managed to find a way into my white, straight, agnostic, charmed life. The first time it happened, I was walking through a shopping centre. The words assaulted me suddenly, shook the breath out of me: ‘PSYCHO BITCH’ emblazoned on a woman’s black T-shirt in hot pink. They wobbled with her breasts as she walked.

I felt like I was going to be sick. Heat rushed into my face. I had only just recovered from a psychotic episode. Suddenly, the word ‘Psycho’ was embedded in my brain. Was it short for psychotic? Psychopathic? It didn’t matter. All I knew was that the word ‘Psycho’ was inextricably linked to the word ‘Bitch’. And that meant I was a Psycho Bitch.

Derogatory language to describe mental illness is age-old and entrenched deeply in our everyday conversations. Words like ‘the nut house’, ‘the psycho ward’, ‘going mental’ ‘committing suicide’ ‘going schizo’. The list goes on: nuts, loony, loony bin, screw loose, bonkers, nutcase, nutter, off their rocker, basket case, whack job, lunatic, cuckoo… I could keep going, but I try and work to a word limit.

Even needing an appointment with a psychiatrist or psychologist is often joked about. This language, and the way we use it, insidiously perpetuates stigma surrounding mental illness and mental health care. The words are often used humorously, which minimises and even completely sweeps aside the suffering experienced by people who have a mental illness. Or they are used in an openly derogatory manner to express distaste or disgust.

Even patients’ interactions are sometimes rife with hypocrisy in this area. After the birth of my first baby in 2006, I experienced my first episodes of Bipolar 1 Disorder (including mania, psychosis, and catatonic depression). I was an inpatient in the mother baby unit of a private psychiatric hospital when, one of the other mothers bemoaned the lack of understanding of her Postnatal Depression shown by her family.

Then in the next breath she turned to me and said: ‘At least we’re not like the real crazies in the rest of the hospital.’

I was too shocked to respond.


I know many people who have been or are going through mental illness who joke about it. Sometimes humour is part of their defence mechanism and necessary for their recovery. Everyone must find their own way to communicate and express themselves.

That said, I don’t believe in joking about mental illness with people who haven’t experienced it. Mental illness is perceived differently to other diseases and disorders. Not everyone believes it even exists. If sufferers of mental illness joke about their illness with people who have never gone through it, it gives the rest of the world permission not to take our experience seriously. Sometimes sitting with our own discomfort of taking it seriously will encourage the person we’re talking to, to do the same.

I do joke about my illness with close friends who have also experienced mental illness, but I won’t belittle them, or myself, or minimise the illness in the process. I don’t make these jokes with people who haven’t been through it, because to do so legitimises language that doesn’t speak my truth.

We are more aware of how we use language than ever before. But we are nowhere near eliminating discriminatory language around mental health and illness from our vernacular. We can start by questioning what popular culture serves us, or by pointing out that suicide is not a crime when the word ‘committed’ has been put carelessly in front of it. And we can think carefully before joking about another human being’s suffering.

The language we use to refer to mental illness is powerful. It can perpetuate the existing stigma, or it can shape acceptance, tolerance, and understanding for future generations. We don’t get to choose whether we are landed with a mental illness. But we do get to choose how we talk about it.
Let’s choose not just wisely, but kindly.

Anita Link is a writer, a mother of two, a small animal veterinarian and a passionate mental health advocate. You can read more from Anita on her blog Thought Food.