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 195.

    IOt wasn't until I spent a year working as a support worker and looked into these illnesses that I realised that we all have OCD tendecies we all suffer some form of emotional rollercoaster and we all appear on the autistic spectrum.
    All we do is mock ourselves.

  • rate this

    Comment number 194.

    you are apparently also in trouble even if the word is not an equivalent to the medical term

    eg a firm was fined in 2009 for using the term IRONSIDE for a wheelchair bound bloke

  • rate this

    Comment number 193.

    @ Angela 190

    I'm sorry Angela but if it makes you angry then the best thing you can do is try to count to ten and realise that there are worse things going on in the world. People sometimes have shallow understanding of my personal issues, sometimes irritates me but you know what, I'm sure I have the odd shallow understanding of theirs so we're all evens.

  • rate this

    Comment number 192.

    Ive suffered with SAD and depression since my late 20s, i have no problem with people who jest about it, in fact it has made me who i am, people say i have a great SOH, which i believe is because of this. However, my ex-boss & ex-girlfriend both had OCD, they and their families were so embarrassed about it, they made other excuses as to their problem, neither would admit to it nor take medication.

  • rate this

    Comment number 191.

    Whilst I have no desire to give Offence, the problem is that Offence, like Beauty, is in the eye of the beholder.

  • rate this

    Comment number 190.

    I have OCD and it's quite common that when I tell someone about my condition they laugh and say something along the lines of, "Yeah, me too, I always do my dishes." It makes me really angry that people don't realise it is a serious condition and think that I allude to it as a "laugh."

  • rate this

    Comment number 189.

    @ 164.Terry G
    such words are only in danger of disappearing because the offended, NOT the afflicted have a disproportionate influence

  • rate this

    Comment number 188.

    It seems common to me, that people who are too lazy or useless to organise themselves, and waste half an hour a day looking for stuff (about 20 whole working days a year, or all their leave) often refer to those unlike themselves as "aspergic", "obsessive" etc., or just plain sad, for having time to think about such things. On the contrary, they just have more time per se.

  • rate this

    Comment number 187.

    I find this quite sad, to be honest. If a person uses a term humourously (my colleague often describes himself as having OCD because he likes things tidy), does that mean that they are ignorant or have no understanding? Or it does it just mean they have a sense of humour?

  • rate this

    Comment number 186.

    P.C. and all that nonsense drives me scatty - oh dear is "scatty" offensive? I suffer from anxiety but don't mind someone being called "anxious". Aren't we all becoming a bit "precious" in what we can and cannot say? My mum had a touch of OCD but we just accepted it as normal to try the front door umpteen times before you left the house. What's odd to one is normal to another. That's life!

  • rate this

    Comment number 185.

    I used to know a woman who took every (imagined) slight as a personal offensive attack. She came to work one day incensed at a friend who had totally "blanked" her, only for it to later turn out that both parties had been travelling in OPPOSITE direction on local buses, and the incident had lasted about 3 seconds! She never accepted that the friend probably never saw her. Some take offence easy

  • rate this

    Comment number 184.

    The first thing that BBC News needs to do is to stop using language to describe disabled and older people that is offensive. How often do we hear wheelchair bound - I often wonder if this to the tune of Simon and Garfunkel's classic or if someone has besieged a wheelchair user and tied them in? And the Elderly or the Disabled as though they are a group apart and not members of society as a whole.

  • rate this

    Comment number 183.

    "moved on it attitudes"?? Hmmm maybe. We are definitely much more thin skinned,easily wounded, determined to "seek" out offence wherever we can find it. People are far far too precious about their race, size, skin colour, disabilities, religion etc etc. If we seek to be truely equal shouldn't we insult "everybody" just the same? By protecting special cases we simply prove that they are not equal.

  • rate this

    Comment number 182.

    oooooh - I smell the nasty whiff of PC creeping in.......

  • rate this

    Comment number 181.

    If one wanted to insult a person for their affliction or whatever, there are offensive terms that would be used. Casually saying 'i'm a bit OCD' or 'x is a leper' shouldn't offend as, clearly, no offense is meant.
    I, like countless others, have lost family members to cancer - i don't know anyone offended by the term 'x is like a cancer of y' and i dont those terms do disservice to the conditions

  • rate this

    Comment number 180.

    Part of the problem here is that mental health is both society and patient-defined. Someone can have obsessive personality traits, but only suffer with OCD if these traits interfere with their normal day-to-day function. The same is true with bipolar traits (more accurately cyclothymia), which fall short of a defined condition, bipolar affective disorder, as certain circumstances are not met.

  • rate this

    Comment number 179.

    I remember when schools in some boroughs were told not to use the term 'black' at all (eg as in blackboard). These things can definitely be overdone, although the debate itself encourages people to think about how they express themselves, and it's clearly best to avoid causing needless offence. But when someone starts trying to rewrite the dictionary...

  • rate this

    Comment number 178.

    " "So if you need a word that describes an unpredictable, flip-flop, 2-state mentality, what word can you use without offending someone?"


    Emotionally labile, possibly. There are many causes, including consumption of narcotics (nicotine is one such), alcohol, stress [...] I've worked in forensic psychiatry for some while and find misuse of mental health terms insulting.

  • rate this

    Comment number 177.

    I recognise when I see in myself or others traits that are on the autistic spectrum or are obsessive compulsive. That said I do try to not refer to things as a disorder because the actual disorders can be quite debilitating for those who struggle with them. But I think it builds a bridge between us. I feel I understand, to a small degree, how an anxiety disorder can affect the way they live.

  • rate this

    Comment number 176.

    Bring back the monkeys in PG tips adverts, they were fun.


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