The subject of mental illness is undoubtedly a nuanced one. We have come a long way from past demonized conceptions of it, but we still have quite a ways to go. We continue to throw around terms like "crazy," "hysterical," "psycho," and the like with little discretion. Many argue that the world has become too sensitive and that it is excessive to be concerned about those terms, but as a person who has thought at times she was going "crazy," I can attest that the images these words conjure up can be extremely harmful.
This is especially so given the context they are used in and the history they come from, particularly regarding gender. There are many problematic stigmas and histories that have shaped our perceptions and treatment of mental illness: race, socioeconomic status, age, etc. By focusing on gender, it isn't being asserted that those other factors don't matter. I am choosing to focus on just one of those aspects for the time being.
From its beginning, gender has played an enormous role in psychology.The archetype we know as an uptight woman just needing to be shown a "good time" by a man, dates all the way back to the height of the Greek empire and even back to ancient Egypt. This is what we have come to know as hysteria. The concept was primarily based on a uterus being out of sorts: placement being off, evil spirits inside it, or not wanting to have sex with a man (Tasca, Rapetti, Carta, & Fadda, 2012, The Greek World, para. 1). While it is true that sex releases feel-good chemicals in the brain that help to decrease the stress hormone cortisol, it is problematic that the same ailment of "hysteria" is never associated with men.
If a man showed symptoms that were characteristic of hysteria, physicians would consider it normal behavior (McVean, 2019, para. 8). Not only is this problematic where toxic masculinity is concerned, it's problematic that it was almost solely women being diagnosed with mental disorders. This is coupled with the issue that virtually all doctors were male until the 1800's. Essentially, it was male physicians diagnosing behaviors they didn't understand in females as serious mental disorders.
It might surprise you that hysteria was taken out of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders only in 1980 (McVean, 2019, para. 1). Hysteria is only one word, but it has a long and not-so-pleasant history. It is, by far, not the only term that is associated negatively with mental illness and gender.
The terms such as "knowing your place," "not putting up a fight," and "submissiveness" are extremely gendered. These were, and sometimes still are, considered feminine virtues. However, studies show that,
"These are the very same qualities that characterize depression and low social rank." - World Health Organization, 2019, p. 12.
It's sad to think how many women throughout time have been misdiagnosed with an illness simply for being a woman displaying emotion, but, what is scarier, is that the terminology associated with "proper" female qualities essentially conditioned women to develop depressive traits. It's an unfortunate irony that the qualities that seemed negative in women were deemed as mental illnesses, when in fact, behavior that actually constitutes depressive disorders was celebrated. As you can see, gender is inextricably connected to our perceptions of mental illness.
Take the word psycho for example: It is usually used to describe a deranged state of mind that renders a person little more than an animal and has acquired the connotation of being homicidal in Norman Bates proportions. However, it is probably used most often to describe obsessive overly-emotional girlfriends, which is conflicted in and of itself.
Have you ever heard of the term psycho boyfriend? I'm guessing not. There is a reason we find it comical: its uncommon use makes it seem ludicrous, even though obsessive and overly-emotional boyfriends certainly exist. There aren't many male associations we've made culturally with that term. The men we call psycho are extreme. The women that are called psycho are everyday females, quite the opposite of uncommon. We see this archetype again and again.
A woman's descent into insanity is a famous poetic and literary trope. When grief strikes a man, he is typically portrayed as an incensed crusader for revenge. When grief strikes a woman, she is typically dramatized as beside herself in sadness and agony, weeping and wailing for all to hear, and completely bereft of her faculties and health, such as being bed-stricken for inordinate amounts of time or aimlessly wandering and whispering incoherent babble. While these characteristics are common symptoms of various mental disorders, they almost always seem to be associated with being the "weaker vessel" as a woman. It originates from being a particular gender.
This has become such an accepted trope that is regarded as the rule, not the exception for our perception of mental illness:
Ophelia, Lady Macbeth, Bertha Rochester from Jane Eyre, Miss Havisham from Great Expectations, Stephen King's Carrie, etc. An unsettling amount of horror films are centered around a female who went mad in life and turned vindictive specter in death. We have learned to spot and fear women who are portrayed as "deranged."
Take Game of Thrones for example: Cersei and Daenerys, the two females with the largest roles in the series, are both considered "mad queens." They are incredibly dynamic characters, but once they have a large amount of power, they lose their sanity. This is seen in some of the men, but not to the devastating extent of the two queens murdering thousands of innocents to overthrow the other. Women are pitted against women with their acts of violence seeming more shocking because of how few associations we have culturally with women being violent. Even though violent women most certainly exist. Arguably, the two most complex female characters can't handle having power: Women aren't fit to rule. Although it might not have been the intended message, the evidence is uncomfortably there without being an overreach or a hyper-feminization of the material. It only leaves Sansa to rule sanely, but at the expense of finding her strength, as she implies, from being raped.
Typically, men were the ones who were associated extreme acts of violence when it comes to being mentally ill. These men had taken the revered masculine qualities that are associated with battle prowess and pushed them too far. This is seen in characters like Richard III, Ivan the Terrible, Vlad the Impaler, Caligula, Nero, Attila the Hun, the list goes on ("25 Most Evil People in History, 2010). Rather than being compared to "female madness," "male madness" was the exact opposite of what made a woman mad. In this light, men and women were not even viewed as comparable—it was not possible for a man to exhibit symptoms of a creature completely different from him. And, funnily enough, by asserting such a binary in gender, men could only be compared to themselves and, you guessed it, women. The idea of masculinity couldn't exist without having its counterpart.
As time has gone on, being called psycho or insane has involved into humiliating castration for men. Take Norman Bates, the subject of Psycho: He dressed up as his mother—a shocking and eery foundation for the film. Think of the psycho men that come to mind. They usually appear in the form of serial killers who have strange sexual frustrations, cannot perform sexually as "normal" men do, and have an abiding hatred for womankind because of past emasculating experiences. It originates from being associated with a weaker gender. It becomes menacing in the attempt to prove they are more powerful than that gender.
Both the feminized and over-masculinized tropes of male insanity are always in relation to society's idea of female insanity—they are a retaliation against being seen as "weak" or "womanly."
Here is where we can do something to change this narrative. We can expand our vocabulary. We can stop using offensive terms for mental illness to so frequently describe women. Being informed can only help us to understand others--and navigate in society--better. Instead of diagnosing others, we can learn to get to know others, their background, and the potential mental suffering they have had to endure.
Today, 1 out of every 6 women has been a victim of rape or attempted rape. ("Victims of Sexual Violence: Statistics"). This alone is frightening, but it is especially so when considering that people with mental illness are 10 times more likely to be victims of abuse ("Mental Health Myths and Facts"). This isn't to say that all women with mental illness will be raped or abused, but it does say a lot about how far we need to go in changing the perceptions we have of women and the dangers that are still present because of those perceptions.
Regardless of your gender identity, mental illness affects people from all sorts of walks of life. It is not just being overly emotional. The illnesses, and feelings associated with them, are as real as anything. It's only fair that we to get to know someone before we decide to describe them in weighty and offensive terms. The next time you catch yourself using any of the terms I've touched upon, it doesn't make you a bad person—those words have been very normalized in our society.
Perhaps, in that instance, it will provide an opportunity for change.
Tasca, C., Rapetti, M., Carta, M. G., & Fadda, B. (2012). Women and hysteria in the history of mental health. Clinical practice and epidemiology in mental health : CP & EMH, 8, 110–119. doi:10.2174/1745017901208010110