Sticks and Stones

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Category: Interpersonal Psychiatry, Mental Illness

Sticks and Stones

“In the end, we will remember not the words of our enemies, but the silence of our friends”. – Martin Luther King, Jr.

In wholehearted agreement with Dr. King, it is also important to recognize the power that the words, even if they are seemingly caring sentiments from our allies, can hold.

Words are a construct. They are often culturally, regionally, ethnically, and situationally specific, but whatever the context, they hold weight. Words matter. The childlike magic of making wishes before

blowing delicate white seeds is shattered when you are told dandelions are weeds. In the same way we don’t mean to shame a dandelion, words, even when they come from a caring friend or family member can impact a person struggling with a substance use disorder or a mental health concern. It can make that person feel the shame of being a weed.

We must protest any label that turns people into things- “he is an addict”, “she is borderline”, “they are so OCD”.

The burden of stigma, in relation to mental health or substance use diagnoses, is impacted by the implication of control one has throughout the course of their disease and the personal liability of the person for attaining the condition. Hurt feelings are not what to take away from these facts. Stigma adversely affects health outcomes and quality of life. A person who accepts they are at fault for their own severe depression, obsessions/compulsions, or substance use disorder is less likely to seek help. Access to care becomes limited not only by insurance constraints or scarcity of providers, but also because the person doesn’t want to reach out. Their self-stigma provides another obstacle to overcome on the path to recovery. A change in phrasing can contribute significantly to brighter futures and connect the person with necessary services and interventions.

Regrettably, there is rarely one solution to a ubiquitous societal issue, but it’s important to take steps towards positive progress. An easy way to work towards the goal of reducing the stigma surrounding mental health and substance use disorders is to use “person first” language. This redirects the problem from being the person to an issue afflicting the person that can be addressed. Your friend or family member is not a junkie. Your friend is someone struggling with an opioid use disorder. Because your significant other doesn’t like the dishes in the sink doesn’t make him “so OCD”. This trivializes the plight of your coworker who has almost exigent compulsions to recheck the door lock several times before leaving for work, and so is always late for a morning meeting. They don’t do this to be flippant of their coworkers’ time. They are struggling with symptoms of their obsessive-compulsive disorder. In short: one should not be defined by a diagnosis. Turning people into objects is debasing and perpetuates stigmas.

Understand that any effort to reduce shame and provide avenues to treatment is not in vain. In any given year, one in five adults in the US has a diagnosable mental disorder, one in 12 has a substance use disorder. Half of all chronic mental illnesses begin by age 14. There is one death by suicide every 12 minutes in this country – it is more common than homicide. People with mental illnesses and most substance use disorders are no more likely to be violent than those without. People with mental health diagnoses are 10 times more likely to be victims of a violent crime. Sticks and stones won’t always break bones, but misused words can magnify these already grim statistics.

For more resources/information (and statics above gathered from):
National Institute of Mental Health –
Centers for Disease Control and Prevention –
Substance Abuse and Mental Health Services Administration –

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