How Psychiatry Softened Its Language to Make Pathologising Ourselves Palatable

Dr Jess discusses the six stages of evolution of language from lunacy to mental health - and the sinister reasons behind them

There is a pattern I have been observing for years now, not just in my work, but in the cultural air we all breathe, and it is so obvious once you notice it that you can’t unsee it. Psychiatric language has not remained static or scientific (I mean, was it ever those things?).

It has shifted, stretched, softened, rebranded, and re-packaged itself repeatedly to become more palatable to the general public.

This is a marketing strategy. We must remember throughout this discussion that psychiatry and psychiatric medication is a massive, extremely profitable industry - and industries require marketing.

This industry wants us to think we have mental health issues. The more of us are using the system, the more money they make.

The more acceptable the language becomes, the easier it is for people to identify with it, internalise it, and ultimately adopt psychiatric frameworks voluntarily. Not because the evidence has improved, and not because the science has evolved, but because the vocabulary has been redesigned to feel less threatening, less stigmatising, and more aligned with everyday human experiences.

The end result? Millions of people now describe themselves using psychiatric terminology, often casually, often inaccurately, and often in ways that encourage self-pathologisation. Everything from ‘my depression’ through to ‘I’m a bit psycho.’ Psychiatry wormed its way in, and now everyone is using the language - but let me ask you something?

Would you consider yourself insane? A lunatic? Would you call yourself sick in the head? Are you deranged? Are you abnormal? Disordered?

Or would you prefer to say that you have ‘mental health’?

Mmmhmmm.

The early language: Insanity, lunacy, hysteria

Let’s start with the early vocabulary of psychiatry, which was not soft, subtle, or relatable. It was blunt, moralistic, and openly oppressive.

Women were labelled hysterics.
Men were labelled insane or lunatics. There were no ‘mental health teams’ to call, only the Lunatic Asylums.
People in distress were seen as mad, deranged, or mentally sick.

This language clearly separated the ‘mad’ from the ‘sane’, the ‘normal’ from the ‘abnormal’, and the ‘healthy’ from the ‘sick’. There was no pretence of nuance or empathy. The purpose of these labels was not to support people, it was to control them, institutionalise them, and legitimise coercive treatments.

The problem for psychiatry was that this vocabulary eventually became socially unacceptable. As society shifted, these terms were no longer effective tools for recruiting public acceptance. They were too obviously violent and dehumanising.

So the profession rebranded. Again. And again.

Phase two: Mental illness

As psychiatry sought legitimacy in the 20th century, the language shifted from moral judgement to medicalisation. Psychiatry as an industry had to start mimicking medicine in order to be taken seriously - and so, it did.

‘Insanity’ became ‘mental illness’.
‘Hysteria’ became ‘psychological disturbance’.
‘Madness’ became a ‘medical condition’.

This was a deliberate reframing. By adopting the language of physical illness, psychiatry positioned itself alongside medicine. The public were told that mental states could be categorised like diseases, diagnosed like infections, and treated like physiological disorders.

The shift worked. Hospitals expanded. Pharmaceutical companies grew. Diagnosis manuals multiplied. Society embraced the ‘illness’ model because it sounded scientific, even when the evidence wasn’t there. No one asked for proof that these illnesses existed.

But the term ‘illness’ implied severity. It still carried stigma. It still suggested something chronic, pathological, and abnormal.

Some people argued against it, and talked of stigma and social control. So the language softened again.

Phase three: Mental disorder

By switching to ‘disorder’, psychiatry removed the implication of disease and replaced it with dysfunction. Disorder sounds far less frightening than illness. It suggests something that can be managed, tweaked, or adjusted.

You’re not sick, you’re ‘disordered’.
You don’t have a disease, you have a ‘pattern’. That can be treated.

It sounds gentler. More neutral. Less accusatory.

And it worked brilliantly. Diagnostic categories grew exponentially. The DSM ballooned. Childhood behaviours became disorders. Women’s trauma responses became disorders. Normal human reactions became disorders. Trauma became a disorder. Sadness was a disorder. Fear was a disorder. Anger was a disorder. Distrust was a disorder. Fucking everything you can think of.

But again, the word still implied that something was wrong with you.

And that wasn’t palatable enough for mass adoption. So what did they do next?

Phase four: Issues + difficulties

Around the 1990s–2000s, there was another shift of marketing and branding in psychiatry. Mental disorder became mental health issues or mental health difficulties.

These terms feel almost friendly - human, everyday, something everyone can relate to. Who hasn’t had an ‘issue’? Who hasn’t had a ‘difficulty’?

And now, they were talking of ‘mental health’ - a deliberate positive reframing. Health = positive. Disorder = negative.

But with that softening came something else: a flattening of meaning. Trauma, stress, grief, burnout, loneliness, oppression, abuse, fear - all swept into the foggy, vague category of ‘mental health issues’.

The language became so elastic that it could encompass anything from domestic abuse to a bad week at work. And in that ambiguity, psychiatry gained cultural power.

Because once everything becomes a mental health issue, then everyone becomes a mental health patient.

And they didn’t even have to change the DSM - which always retained the language of disorder and illness. To the world, it was ‘mental health issues’ on glossy magazines and TV talk shows - but in psychiatry and pharma - make no mistake - it was still mental disorders. ptsD. bpD. asD. adhD. gaD. aspD. eupD.

They never moved from the disorder model behind closed doors, but they knew that publicly, the language needed a rebrand to ‘mental health’…

Phase five: Mental health (full stop)

Then came the boldest linguistic leap: they dropped the word ‘issues’ altogether.

Now the language is simply ‘mental health’.

‘Take care of your mental health.’
‘We’re worried about your mental health.’
‘Mental health affects us all.’

Of course it does. So does physical health. So does sleep. So does being alive.

But by making the language universally applicable, psychiatry positioned itself as the default lens through which we understand human experience.

Everything from trauma to boredom, from grief to rage, from violence to exhaustion is now described as mental health.

People I meet will often say to me, “I’ve got mental health.”

Like.. Yep. Okay. What does that even mean?

This is the point where self-pathologisation exploded. Because if everything is mental health, then everyone must have a mental health problem at some point.

And that’s the goal: universal psychiatric identification. Endless customers.

Phase six: Neuro-language

This is the part where I am going to get in trouble, I know. I know.

But it has to be said, because its so obvious. I cannot be the only person to notice this.

The latest shift in the psychiatric language is the move toward ‘neuro’ framing - neurodiversity, neurodifference, neurospicy, neuro-atypical, neurotypical... These words sound scientific, but are not grounded in neurological evidence. Many of these categories have no clear biomarkers, no consistent neurological signatures, and no stable scientific definitions.

But the ‘neuro’ language is incredibly powerful because:

• it feels factual

• it feels biological

• it sounds scientific and flashy

• it makes people think of brain scans and science they can’t actually decipher

• it feels morally neutral

• it feels identity-based rather than illness-based

• it gives people a community

• it gives the industry a new marketing frontier

It is psychiatry’s most effective rebrand to date: a way to classify even more behaviours as innate brain differences rather than context-driven responses to trauma, oppression, or environment.

And once again, it encourages people to identify with categories that have been softened, aestheticised, and made culturally desirable.

The linguistic journey is the strategy weapon

If you map this progression, a pattern emerges:

Hysteria → insanity → lunacy → mental illness → mental disorder → mental health issues → mental health → neurodiversity/neurodifference

With each step, the language becomes:

• less stigmatising (hmmm, debatable)

• less precise

• easier to identify with

• more culturally acceptable

• more profitable

• more useful for pharmaceutical markets

• more effective in drawing ordinary people into diagnostic frameworks

Language is the tool. Softening is the method. Self-pathologisation is the outcome.

Are we paying attention?