OCD, bipolar, schizophrenic and the misuse of mental health terms

Mouth with tape over it

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 ”

End Quote Bryony Gordon

"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."


  • 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

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.


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  • rate this

    Comment number 155.

    As a Homicidal, Personality Disordered, Manic Depressive, ADHD sufferer - I get offended when people use terms such as "Killing" time, or things are "Manic", or indeed that things are "Mental". Then I realise that I have mental health problems so I journey on packed commuter trains & buses and shout offensive remarks and abuse at total strangers just to get even. You know who I am.

  • rate this

    Comment number 154.

    Since 'Celebrities' all seem to excuse their bad behaviour on 'Bi-polar', I've noticed so many people claiming to be 'bi-polar' as if it's a fashion label. Likewise, with parents whose children don't do what they are told, the label OD or ADHD are bandied around to excuse personal responsibility. I feel sorry for the GENUINE sufferers of mental health issues who's conditions are trivialised.

  • rate this

    Comment number 153.

    @ 146

    Well spotted. Indeed the medical definition of a delusion (a specific symptom associated with psychotic illness) is:

    "An irrational belief, held with absolute conviction despite evidence to the contrary"

    Usually followed by a clause; "that is not widely accepted by society" or some such to preclude a huge percentage of the (religious) population from being defined as being mentally ill.

  • rate this

    Comment number 152.

    I do not care about the jokes. Jokes are funny. Jokes make me laugh.

    I suffer from two of the above, although I think I've cured the getting-up-to-check-the-windows-20-times-before-sleep part of OCD - that's nasty BTW, you _know_ they're shut after the first check *grrrrr*.

    I don't think people would crack those sorts of jokes if they knew. Maybe that's another reason I hide it from them.

  • rate this

    Comment number 151.

    I am saddened to see how many folk are posting basically to preserve their right to use mindless, offensive phrases. surely the english language has more to offer?

  • rate this

    Comment number 150.

    I am Biploar and to 'ban' people using these terms metophorically or jokingly because they may 'offend' someone is ridiculous. Goodness me, there will always be someone, somewhere who will be 'offended' at something! What are we to do, ban language altogether? If someone is offended that is their right, and it is my right to offend, although I wouldn't go out of my way to purposely offend anyone!!

  • rate this

    Comment number 149.

    It took a long time for me to be correctly diagnosed as Bi-Polar.
    For people to see it as a joke is distasteful and shows the lack of respect that this country has for mental health issues.
    Its getting better, but we need less celebs claiming to have had a 2 week quick fix in a clinic, and more like Stephen Fry who have really had to deal with this illness.

  • rate this

    Comment number 148.

    a) OCD can be very disruptive and distressing. Schizophrenia can sometimes be well controlled with medication. There is considerable variation between individuals.
    I agree, schizophrenia is a cruel condition, I'm just saying beware of making assumptions.

    b) Electro-convulsive therapy is used as a last resort in severe depression, not for these conditions. It's used because it's effective.

  • rate this

    Comment number 147.

    yes @ 96.monty_dog

    the PC brigade have plenty of time on their hands to drink flat white, eat carrots, and read the grauniard

    they are however impossible to offend themselves as they dont technically exist, and dont have a committee to arrange whist drives, reading evenings, and bring and buy sales

  • rate this

    Comment number 146.

    "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. "

    Sounds similar to what goes on in every week in religious buildings up and down the country...

  • rate this

    Comment number 145.

    being effectively reduced to a cartoon stereotype is one of the main reasons why people with MH disorders are so reluctant to tell anyone, or to seek professional help. it is not just the flippant way that these terms are used, it's the careless attitude towards the reality of the condition that is harmful and offensive.

  • rate this

    Comment number 144.

    It is nearly impossible to control language. Yes, we should attempt to make these terms understood as offensive - they are. But calls to remove things from dictionaries are a waste of time. Language is not what is written, it is what is said. Speakers need to change their habits.

  • rate this

    Comment number 143.

    It amazes me how easily some people take offence when none is intended.

    Look, if I wanted to offend you, you'd know all about it (moreover, I could do it in language acceptable on HYS!) but when I have no intention of offending you, it's your problem if you get upset, not mine.

  • rate this

    Comment number 142.

    ""1 Hour ago
    What about "Paranoid"?""

    Just because you are it doesn't mean they're not out to get you!

  • rate this

    Comment number 141.

    I think the myriad of questionable "disorders" that exist these days do more to stigmatise genuinely serious diseases such as OCD than just colloquially using the term in conversation. As has been said, no-one seems to simply be poor at something any more without it being a disorder. If everyone can qualify for a diagnosis, why should anything in mental health been seen with real severity?

  • rate this

    Comment number 140.

    "Terms like "bipolar", "autistic" and "schizophrenic" are often used in jest to describe character traits."

    I don't know anybody who uses these terms in jest and have never heard them used to describe character traits. Methinks this article says more about the authors circle of friends than anything else.

  • rate this

    Comment number 139.

    How long before you are not allowed to say anything, as there will always be someone who takes offence in one way or another?
    Reminder: To "Take Offence" means "To perceive an attack," not "I was attacked."
    If I said "My computer is throwing its toys out of its pram" I am in no way trying to insult babies having a temper-tantrum, just using a phrase that will be understood.

  • rate this

    Comment number 138.

    From the article: "You wouldn't hear someone being described as a bit diabetic."

    I refer to governments and transport networks as 'crippled', golfers as 'handicapped' and drunks as 'legless'. I have a fool-proof way of avoiding such language offending people, which is that I only have conversations with with well-adjusted, robust, sensible people.

  • rate this

    Comment number 137.

    There's a lot of unnecessary whining about how "the PC police are coming to take our words away!". No. That's a fiction. No one is forbidding anyone anything, all anyone is trying to do is educate everyone about the contributory factor the misuse of these terms has to an existing culture of stigma around mental illness. It's not complicated. Think before you speak. Is that so much to ask?

  • rate this

    Comment number 136.

    The recent comments here made about ADHD (#100) when applied to /any/ condition, are exactly the sort of thing that cause the offence. It's one thing to say that 'so and so is a bit XYZ' but when the condition is dismissed as a made up excuse, it's soul destroying for some. My teen has ADHD and Aspergers. It's real, it's hard work, and it's life changing. Being called a liar is not fun.


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