12/02/2009 05:12 am ET Updated Nov 17, 2011

Words Matter in Mental Health Debate

After receiving some thoughtful comments from people suffering from manic-depression, I would like to follow up on my last post ("Lies and Lying Liars Hurt the Mentally Ill"). In that previous piece, I wrote about how serial criminals like mass murderer Brian Nichols and rapist/hostage taker Leeland Eisenberg damage the cause of the mentally ill by claiming to be insane.

I also wrote that they are not the only charlatans who blame mental illness for their bad behavior. As I pointed out, in the past decade or so it has become fashionable for celebrities to allege that they have been diagnosed with manic-depression or other disorders du jour. I noted that many of them do so after breaking the law.

I recognize that manic-depression, also known as bipolar disorder, can include psychotic elements, and that mania can be devastating. I have compassion for anyone who truly suffers from this condition, but psychosis is not included in the name of the illness. And, as Barack Obama said during the primary against Hillary Clinton, "words matter."

Celebrities know this. They know that words like "manic-depressive" and "bipolar" sound tame, whereas "psychotic" and "schizophrenic" terrify people. I can't recall a single celebrity, with the possible exception of Beach Boys' front man Brian Wilson, who has ever used the P or S words in discussing his or her disorder.

To understand why this is so, one need only remember the movie, Psycho, in which an individual with a split-personality operates with a semblance of normalcy as a hotel owner only to become a knife-wielding, transvestite murderer. In the advertising campaign for that movie, the title of the film was severed horizontally across its six letters to emphasize the schizoid nature of the protagonist.

No wonder people think that psychotics and schizophrenics are violent.

As I have written before, people with these diagnoses do commit crimes, but the vast majority do not.

Still, many members of the public shudder upon learning that Risperdal, Perphenazine and Abilify, medications that co-workers or friends may be taking, are "anti-psychotics."

By contrast, drugs taken by manic-depressives, like lithium, possess a benign classification. They are known as mood-stabilizers, which doesn't sound ominous. Likewise, those with anxiety disorders often take tranquilizers, another word that doesn't frighten anyone.

I know a woman, probably the most paranoid person I have met, who has refused to take Risperdal, not because she doesn't need it, but because it would imply that she is psychotic, something she doesn't want to acknowledge.

Again, I do not want to diminish the struggles endured by people like Carrie Fisher, Anne Heche and Margot Kidder, all of whom have reportedly been diagnosed with bipolar disorder. But in disclosing their mental illness, they have not had to worry too much about stigma.

Similarly, Paris Hilton knew that she risked almost nothing and in fact hoped to gain sympathy by claiming that, while she was in jail, she overcame several disorders from childhood. Such statements make mental illness appear to be a joke, a game that one can play.

For those of us living with severe mental illness, it is no game. It is a condition that most of us will never fully overcome. We may be able to tame and manage it, but it will always be there. That doesn't mean that it will prevent us from leading productive, happy and successful lives, but it does mean that it is serious and can't be swatted away, as one would a fly.

It's not just Hilton who has engaged in such a charade.

It is also someone like Mel Gibson, who claimed to be a manic-depressive in a documentary about Australia's National Institute of Dramatic Art, where he was once a student. The story leaked last year, no doubt because Gibson was seeking to manipulate the public two years after his career came to a halt when he engaged in an anti-Semitic rant and resisted arrest for drunk driving in the Malibu area. He directed his anti-Semitism at a police officer, who happened to be Jewish.

In an interview some years ago with the Sydney Morning Herald, Gibson was quoted as saying, "I had really good highs, but some very low lows." In speaking of his supposed disorder in this fashion, he made it sound as if manic-depression is hip, like taking uppers and downers. This must cause much frustration and embarrassment for those who actually do experience the debilitating swings of this illness.

Still, it bears repeating that no one views schizophrenia or psychosis as hip.

As for Gibson, his problem is not that he has battled substance abuse or, allegedly, manic-depression. His problem is that he is a hatemonger, a quality he shares with his Holocaust-denying father.

Of course, he would never admit this. Instead he did what all celebrities do after behaving badly; according to reports, he checked himself into a rehab facility.

I can't control the actions of celebrities, who will forever claim to be bipolar, manic-depressive, obsessive-compulsive or anything else that sounds similarly innocuous and chic. But, like our current president, I believe that words matter. That is why I am trying to rescue locutions like "psychotic" and "schizophrenic," which have been unfairly demonized.

By now, we should all know their true meaning: divorced from reality, not violent.