‘That’s So Crazy’

Why the way we talk about mental health matters

Sandy Allen
Jul 16, 2019 · 8 min read
Illustration by Louisa Bertman

AA year ago, for one month, I ran a private experiment. Whenever I heard someone say the words “crazy” or “insane,” I surreptitiously recorded the event in a notes doc on my phone. I recorded instances of “schizophrenic or “schizo” too, though those happened less often. I wrote the time (most of the time) and context and only noted the speaker if it was someone famous, like on TV or in a song. As in my first entry, the afternoon of the first day of the month:

1. 5:00 pm PST “Crazy” by Britney on the radio at a grocery store in San Francisco

I began this exercise because I wanted to better understand a facet of our vernacular that had come to irritate me greatly. It’s a two-parter.

First: We use words like “insane” and “crazy” a lot.

Second: When we use them, we don’t often use them literally. In other words, we don’t use them to speak about craziness or insanity. Having recently completed a book about my late uncle, Bob, who was diagnosed with schizophrenia, I was aware of just how little language people tend to have for this topic. In my experience, most people are uncomfortable and unpracticed talking about insanity, craziness, madness, mental illness. They do so vaguely, and with lowered voices and fallen eyes. Many favor euphemisms like “unstable” or “disturbed.” People have “issues.” People will tell me they know someone, you know, “like that.”

I began to notice all the “insanes” and “crazies” in our speech a few years ago, after I started reading and understanding more about the real situation in this country for people diagnosed with psychiatric disorders. It was like tuning into a radio frequency; the signal came through clear:

2. 10:43 pm Friend saying, “Let’s get crazy!”

3. 10:50 pm someone asking me whether my week has “been insane”

4. 11:00 am a friend saying “that’s so crazy”

When we use a word to mean something else, we imply, however subtly, a real relationship between qualities of the two. Going into the experiment, my thesis was that most of this figurative language that relies on “insane” and “crazy” would be attempting to say something negative. Inconveniences, difficulties, awfulness, inconstancy.

My sense was these choices of language amount to a powerful way we affirm the broader prejudice against people labeled with psychiatric disorders. A term for this kind of prejudice is “psychiatric ableism.” Ableist language courses, largely unchecked, through much of our speech — words like “lame,” “blind,” “deaf,” “dumb,” used often to mean negative things.

Which isn’t to say that when someone uses a word like “crazy” or “insane” they mean to offend actual people. My guess is they’re not thinking about actual people at all. We are practiced at this.

How often we Americans walk briskly past someone on the street, someone whose humanity we pretend we cannot still feel.

26 1:54 pm Facebook friend posting “Crazy and amazing” interview with Quincy Jones

27 6:09 pm friend at dinner “Something crazy happened yesterday”

II used to say “crazy” and “insane” freely and often. I thought nothing of it. Then ten years ago, I got something in the mail from my mom’s older brother, a hermit who lived in the desert, and it has sent me down a different path.

Uncle Bob had mailed me his autobiography manuscript, typed on a typewriter in all capital letters and punctuated mostly with colons. It proclaimed to be a “true story” about being “labeled a psychotic paranoid schizophrenic.” He wanted my help in getting the story “out there.”

A few years into working on the project, I made a conscious decision to stop saying “insane” and “crazy.” Even so, I’d still slip up. I’d hear myself say one of these words or even “bonkers” or “nuts” and I’d feel shame I’d not caught my tongue.

Over time, though, my tongue learned a new way, as tongues are often capable of doing when you make a choice with your head. I’m trans, so I’ve thought a lot about whether tongues can change (I believe they can) and I think heads can change when tongues are forced to.

44. 9:08 pm drag race all stars Aja describes how “crazy” her character is three times

45. 9:20 pm Milk impersonating a “crazy” person during her character during the Bachelor sketch

My experiment — writing down every “insane” or “crazy” — grew old almost immediately. It became annoying, interruptive, opening my notes app, keeping what I was doing discrete. Top 40 radio in public spaces and flipping through channels and the Discover tab were all minefields. During conversation, after hearing an “insane” or “crazy,” I began to add a beat before I opened my phone to record it, worried others might catch on. I worried what they’d think of me, for sort of spying on them.

It’d feel particularly lousy when someone I loved or a podcast I adore or a favorite singer suddenly tossed out a bunch of “insanes” and “crazies.” I’d internally sigh and open my phone. A friend sent me an otherwise hilarious video, one that had a big “schizophrenic” punchline. (I typed in the doc: “When that happens it’s like finding a wad of spit in your salad.”)

47. Deadspin article about Fergie’s “insane” national anthem

48. 9:13 pm watching Beast Warrior Netflix show “insane” obstacle course

49. IG story about an antique shop “This place is insane”

50. 11:43 am two Slack messages with “crazy”

Gradually, I saw that my guess — that people were using “insane” and “crazy” to express negative things — wasn’t quite right. Sometimes that was true. In fact sometimes what I recorded was really explicit bigotry — Carrie using “schizo” as an insult on Sex and the City.

Or this entry (between a friend remarking on an “insane view” and someone saying “must be crazy” about my book tour):

55. 9:37 am NRA spokeswoman in the New York Times “people who are crazy should not be able to get firearms.”

I’ve written before about the GOP and the gun lobby’s scapegoating of people with psychiatric disabilities and why such rhetoric is abhorrent. Contradictory to the bogeyman stereotype, those who’ve been psychiatrically diagnosed are no likelier to be violent than anyone else. People diagnosed with psychiatric disabilities, however, are ten times as likely to be victims of violent crimes. This is just one example of a big myth that persists about “people who are crazy.”

AsAs the month waned, I looked through all the instances of “insane” and “crazy” I’d tracked. I confirmed that my initial thesis wasn’t quite right; people weren’t using “insane” or “crazy” to say exclusively negative things. My finding overall was that people were using them to mean, well, anything. Sometimes even positive things.

Much in the manner of New England’s “wicked” or Northern California’s “hella” (which I grew up saying and still say) many usages of “insane” and “crazy” carried little meaning and only worked to accentuate whatever else the sentence was actually about. Altogether, these “insanes” and “crazies” are a broad spray of language, effectively meaningless.

There is a connection, I think, between these impossibly elastic terms and the relative lack of information most people have about the real situation for psychiatric patients in America. I don’t think most people have ever really thought about what it means in this country, today, to be told by a doctor “You are schizophrenic,” for example. Or to be, as my uncle also was at sixteen, tossed in a psychiatric cell and locked there, injected with you-don’t-even-know-what.

62. 10:15 am ad for blue bottle coffee “insane commitment to freshness”

63. 11:44 am friend describing book she’s writing “It’s crazy”

64. 12:03 adidas store window display copy: “crazy isn’t humble”

Once my book about Uncle Bob published, I traveled the country, speaking to groups about his story and what it has to teach us. After, I took questions. In those moments, I encouraged rooms of people to speak and ask openly about mental health, about madness. In this sense, my experiment was a sham, because on these occasions, I didn’t clandestinely reach for my phone. It would have been impossible to do so and hold a room’s attention, or carry on an intense one-on-one exchange.

But also, I reasoned, this kind of talk was different. Now we were in the realm of the literal, all of us together. People in bookstores, people in bars, at med schools, at a church. People who’d been diagnosed themselves with “schizophrenia” or something like it. People who worked variously in mental health. People who had family who’d been in the system. And, importantly: People who knew nothing about all this. People like I was before. People who say “insane” and “crazy” and think nothing about it.

I’ve had countless spectacular exchanges, both in person and online, with people of all of these persuasions. The ones that have surprised me the most have been from psychiatrists, who report that Bob’s story has opened their eyes about the very people they treat. The messages I’ve enjoyed most are ones from people who hear Bob’s story and are reminded of themselves.

Which is really the heart of the matter: There is not some vague concept called “mental illness” or “mental health.” There are people. Just people — many of whom are perhaps different than some mythological standard called normal. Many are individuals in the realest sense. Many are survivors of trauma. Many are members of groups already more vulnerable in our generally violent and bigoted society.

In my experience, it’s when we start listening to people with lived experience that we might begin to learn a better way forward, when it comes to the common goal of having better mental health care. Talking to a lot of people on all sides of these issues over the last decade, I’ve observed basically everybody wants better “mental health care.” A few very powerful forces, though, actively oppose this goal and so, as people also largely agree, things are instead mostly getting worse.

I’ve realized it’s very unwise to exclude people diagnosed with psychiatric disorders — or as many I’ve interviewed like to be called, “people with lived experience” — from our ideas about “mental health.” When such people are systematically silenced and ignored, I think, the general public is likeliest to be duped by industry and its propaganda. As Uncle Bob first helped me to understand, this is no small point.

A common misperception, I think, is that “mental health” is a niche or fringe topic, not something that does, to varying degrees, implicate and impact us all. As I say often, madness is a feature not a bug of the human condition. Whether or not you or your loved ones need “mental health care” today, the future is wide open. We’re already bound up in this, whether or not we’re aware. Noticing your own “insanes” and “crazies” can be a way of starting to tune in.

A friend recently called and explained that, given conversations we’ve had, he has been trying to remove words like “insane” and “crazy” from his own speech. He admitted it’s tough. He marveled at how much he’s noticing such language now. It’s everywhere, he said. It is, I said. But I am hopeful, as Uncle Bob was hopeful, that someday our ways will change.

Gay Mag

A new magazine from Roxane Gay offering some of the most…

Sandy Allen

Written by

Author of A KIND OF MIRRACULAS PARADISE (Scribner, 18) | Host of podcast MAD CHAT (www.madchatshow.com) | www.hellosandyallen.com | they/them

Gay Mag

A new magazine from Roxane Gay offering some of the most interesting and thoughtful cultural criticism to be found on the Web. Our first quarterly is coming in June 2019. We value deep explorations, timelessness, and challenging conventional thinking without being cheap and lazy.

Sandy Allen

Written by

Author of A KIND OF MIRRACULAS PARADISE (Scribner, 18) | Host of podcast MAD CHAT (www.madchatshow.com) | www.hellosandyallen.com | they/them

Gay Mag

A new magazine from Roxane Gay offering some of the most interesting and thoughtful cultural criticism to be found on the Web. Our first quarterly is coming in June 2019. We value deep explorations, timelessness, and challenging conventional thinking without being cheap and lazy.

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