On Being Mad and Politically Incorrect

Patient Expert

"Our perhaps understandable modern need to dull the sawtooth edges of so many of the afflictions we are heir to has led us to banish the harsh old-fashioned words: madhouse, asylum, insanity, melancholia, lunatic, madness. But never let it be doubted that depression in its extreme form is madness." - William Styron, Darkness Visible: A Memoir of Madness

What is wrong with using the word "madness?" I ask because over the years I have received several indignant emails from people insisting that I stop using the word in the title of my Web site, Wing of Madness. According to them, I'm adding to the stigma surrounding mental illness and am being politically incorrect to the extreme.

One woman admitted in her email that she wasn't depressed, which made me wonder why she had appointed herself the guardian of the mentally ill. It reminds me of the man who started to berate me for parking in a handicapped space without a handicapped hang-tag before I pointed out to him that I have a handicapped license plate (for my MS). He said he was just looking out for my interests. Gee, thanks fella, how about you don't until you know what you're talking about?

When I received the first email I was taken aback. I wondered if there was some truth to it. Given that I often rail against the stigma surrounding mental illness, the last thing I want to do is to add to it. After some thought, I recalled two things. One was why I used that title to begin with. When I read Darkness Visible, one passage in particular resonated with me: "I couldn't rid my mind of the line of Baudelaire's, dredged up from the distant past, that for several days had been skittering around at the edge of my consciousness: 'I have felt the wind of the wing of madness.'"

The second thing I thought about was that one of the reasons it took so long for me to realize that I was depressed was, along with the dryness of the symptoms lists I ran across, the pallid nature of the word depression. As Styron says, depression is ""used indifferently to describe an economic decline or a rut in the road, a true wimp of a word for such a major illness"preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control." It never seemed to apply to the despair and hopelessness I often felt and the occasional mental freefall into darkness.

We use language to diminish or soften things that frighten us. A doctor will tell you that you're going to "feel some discomfort" instead of telling you that something's going to hurt like hell. "Depression" is somewhat ambiguous and definitely clinical in tone and makes the disease less frightening. "Madness," however, doesn't diminish or cover up the disease in any way - just the opposite. The rawness and power of the word lays it bare and leaves no doubt as to what we are talking about.

See, I don't think the word itself is the problem. I think the problem is that some people can't deal with the reality of depression, or what it can be for many of us. It's much easier to attack the political correctness of the word than to acknowledge that depression can be terrifying enough to burst out of the confines of even the most dry, clinical word we can apply to it.

I like to face things head-on, stare them in the face and see them for what they are. So if you want to sugarcoat your depression, that's up to you, but I prefer mine straight up and sugar-free. I have been made mad in the past by my illness, and I'm not going to pretend otherwise.