Explaining that I have schizophrenia is something very personal. It involves experiences that are often shamed by society, but I feel the conversations and the rhetoric in the mental health community are lacking to fully support and clarify the complexity of mental health –and furthermore the uniqueness of schizophrenia or psychotic disorders.

And let me state, ‘psychotic’ is a horrible word to describe these experiences. My hope is that eventually mental health professionals will choose to abandon that word. It is full of negative connotation and fear, because colloquially it is most often heard in conjuncture with ‘killer.’ It is used often to sensationalize violence or murder, basically anything demonic. Yet mental health professionals don’t get that. They seem to be oblivious how words, even those deemed clinical, can serve as great barriers to understanding when used in a pejorative way in common day language. (And to make it perfectly clear–practically no one with schizophrenia is likely to be homicidal. Like the general population, it is very rare. Not even a percentage point of people.) ‘Psychotic’ generally means the person is likely disabled, vulnerable, and victimized–not dangerous–which is a huge difference in expectation from how that word is often applied.

Recently, I saw a posting by past APA President Paul Appelbaum, M.D., appointed to guide the DSM revision process, on twitter sharing an article, “Portal Now Open for Makig DSM a ‘Living Document.‘”

It says, “Proposals for changes to DSM-5 can now be submitted at a publicly available portal on the APA website. It is a first step toward creating the ‘living document’ that the DSM-5 Task Force envisioned for the future of DSM, to keep up with emerging scientific data about mental illness…”

It says, “Visitors to the portal are guided through steps to submit proposals for the following specific kinds of revisions:

Changes to an existing diagnostic criteria set that would markedly improve its validity.

Changes to an existing diagnostic criteria set that would markedly improve reliability without an undue reduction in validity.

Changes to an existing diagnostic criteria set that would markedly improve clinical utility without an undue reduction in validity or reliability.

Changes to an existing diagnostic criteria set that would substantially reduce deleterious consequences associated with the criteria set without a reduction in validity.

Addition of a new diagnostic category or specifier.

Deletion of an existing diagnostic category or specifier/subtype.

Corrections and clarifications, including changes aimed at improving the understanding and application of an ambiguous diagnostic criterion, specifier, or text.”

Notice, however, that none of the possible revision choices are specifically to examine or modify words to reduce stigma.

To me, there is such a gap in understanding from a mental health professional to someone like myself who lives with their clinical labels (word choice). I think most mental health professionals will admit there is stigma — but there seems to be a gap in their realization that they could help by studying word choices and modifying their own clinical language. It should be a paramount concern if they are serious at propelling understanding when there is non-definite way of word choice that they are making definite in their diagnostic manual. These words in diagnostic labels largely shape a common vernacular and influences how people identify themselves. This should be acknowledged as having a great effect.

Besides changing categories and criteria with no known etiology, I think greater focus should be on word usage to help dispel common misconceptions. It might actually have the greatest impact while we wait to eventually have possible breakthrough scientific discoveries.

The word ‘psychotic’ is the adjective of ‘psychosis.’ The Greek psykhe, or “mind” combines with the Latin suffix -osis, “abnormal condition,” to form the meaning.

An “abnormal condition of the mind” sounds like it could describe a lot of considered mental and physical brain conditions, and in fact psychotic is a broad term that covers many experiences related to symptoms, like hallucinations, that can come from many different causes and has nothing to do with a person’s morality, personality, or character that is assumed by popular culture.

While ‘psychotic’ has a correct and meaningful literal root, it has taken on another form of invidious meaning in common day language that is despicable. I do not think it should be continued to be used as clinical to describe my symptoms. I cringe every time it is used.

For example, it in no way helps me to communicate my experiences to others using the description ‘psychotic’ in everyday language. I’ll never say, “I’m psychotic everyday.” I’ll tell my friend, “I experience hallucinations everyday.” I stay clear away from ‘psychotic,’ because that term brings to mind a scary killer—more so than I think schizophrenia does. ‘Schizophrenia,’ the name of my diagnosis and a type of psychotic disorder, also has known problems as a label as well.

Some countries, like Japan and South Korea, have abandoned the term ‘schizophrenia’ and re-named it to reduce misunderstandings and misconceptions, because the term itself has an unclear literal meaning to the personal experience, is tied to an idea of an outdated “cannot recovery” thinking (Kraepelinian model), and also colloquially misused. (To see an article explaining the countries reasoning for changing the term, see here.)

For the APA to ignore the possibility of having revisions on words to reduce stigma as worthy considerations for changes, they seem detached from the reality of what most people find difficult with certain clinical words and underestimate their effect.

Mental health professionals, please take it upon your role to form better language. Be wary of using words that are used colloquially in such a demonizing way to be clinical. Promote compassion in the public by considering stigma a top priority for your profession in creating labels for your diagnostic criteria. Have education campaigns to re-educate people on proper language. Focus actual research on word choice, as belief it or not, it is a very worthy area to explore and improve. You are providing words to be a basis of discussion for the public and for people in their personal lives. Words matter and need great consideration in describing personal experiences.

For an organization or group like the APA to define labels of people, understanding the effects of your chosen words should be a high consideration in your efforts to make lives and the vernacular better for people you are suppose to support and serve. Yes, it is okay to abandon words when they have taken on new meanings and have been misused. It has already been done throughout history when words are used as a term of unjust abuse rhetoric.

DSM task force, I implore you to list publicly as part of your efforts in creating diagnostic labels and criteria to lead efforts to de-stigmatize mental illnesses. At least state that as part of your objective in creating labels.

Perhaps with special attention by you, the public will pay close attention and be re-educated in proper ways to describe and perceive someone like me–someone not scary or a demon, but someone who is loved by many, intelligent, kind, friendly, and deserves so much more than the current rhetoric. Someone who deserves a chance to not be demonized or assumed to be a villain, as that is truly unfair and uncharacteristic. We all deserve the best words possible.