We talk about mental health more than ever, but the language we should use remains a vexed issue.

Should we call people who seek help patients, clients or consumers? Should we use “person-first” expressions such as person with autism or “identity-first” expressions like autistic person? Should we apply or avoid diagnostic labels?

These questions often stir up strong feelings. Some people feel that patient implies being passive and subordinate. Others think consumer is too transactional, as if seeking help is like buying a new refrigerator.

Advocates of person-first language argue people shouldn’t be defined by their conditions. Proponents of identity-first language counter that these conditions can be sources of meaning and belonging.

Avid users of diagnostic terms see them as useful descriptors. Critics worry that diagnostic labels can box people in and misrepresent their problems as pathologies.

Underlying many of these disagreements are concerns about stigma and the medicalisation of suffering. Ideally the language we use should not cast people who experience distress as defective or shameful, or frame everyday problems of living in psychiatric terms.

Our new research, published in the journal PLOS Mental Health, examines how the language of distress has evolved over nearly 80 years. Here’s what we found.

Generic terms for the class of conditions

Generic terms – such as mental illness, psychiatric disorder or psychological problem – have largely escaped attention in debates about the language of mental ill health. These terms refer to mental health conditions as a class.

Many terms are currently in circulation, each an adjective followed by a noun. Popular adjectives include mental, mental health, psychiatric and psychological, and common nouns include condition, disease, disorder, disturbance, illness, and problem. Readers can encounter every combination.

These terms and their components differ in their connotations. Disease and illness sound the most medical, whereas condition, disturbance and problem need not relate to health. Mental implies a direct contrast with physical, whereas psychiatric implicates a medical specialty.

Mental health problem, a recently emerging term, is arguably the least pathologising. It implies that something is to be solved rather than treated, makes no direct reference to medicine, and carries the positive connotations of health rather than the negative connotation of illness or disease.

Arguably, this development points to what cognitive scientist Steven Pinker calls the “euphemism treadmill”, the tendency for language to evolve new terms to escape (at least temporarily) the offensive connotations of those they replace.

English linguist Hazel Price argues that mental health has increasingly come to replace mental illness to avoid the stigma associated with that term.

How has usage changed over time?

In the PLOS Mental Health paper, we examine historical changes in the popularity of 24 generic terms: every combination of the nouns and adjectives listed above.

We explore the frequency with which each term appears from 1940 to 2019 in two massive text data sets representing books in English and diverse American English sources, respectively. The findings are very similar in both data sets.

The figure presents the relative popularity of the top ten terms in the larger data set (Google Books). The 14 least popular terms are combined into the remainder.

Several trends appear. Mental has consistently been the most popular adjective component of the generic terms. Mental health has become more popular in recent years but is still rarely used.

Among nouns, disease has become less widely used while illness has become dominant. Although disorder is the official term in psychiatric classifications, it has not been broadly adopted in public discourse.

Since 1940, mental illness has clearly become the preferred generic term. Although an assortment of alternatives have emerged, it has steadily risen in popularity.

Does it matter?

Our study documents striking shifts in the popularity of generic terms, but do these changes matter? The answer may be: not much.

One study found people think mental disorder, mental illness and mental health problem refer to essentially identical phenomena.

Other studies indicate that labelling a person as having a mental disease, mental disorder, mental health problem, mental illness or psychological disorder makes no difference to people’s attitudes toward them.

We don’t yet know if there are other implications of using different generic terms, but the evidence to date suggests they are minimal.

Is ‘distress’ any better?

Recently, some writers have promoted distress as an alternative to traditional generic terms. It lacks medical connotations and emphasises the person’s subjective experience rather than whether they fit an official diagnosis.

Distress appears 65 times in the 2022 Victorian Mental Health and Wellbeing Act, usually in the expression “mental illness or psychological distress”. By implication, distress is a broad concept akin to but not synonymous with mental ill health.

But is distress destigmatising, as it was intended to be? Apparently not. According to one study, it was more stigmatising than its alternatives. The term may turn us away from other people’s suffering by amplifying it.

So what should we call it?

Mental illness is easily the most popular generic term and its popularity has been rising. Research indicates different terms have little or no effect on stigma and some terms intended to destigmatise may backfire.

We suggest that mental illness should be embraced and the proliferation of alternative terms such as mental health problem, which breed confusion, should end.

Critics might argue mental illness imposes a medical frame. Philosopher Zsuzsanna Chappell disagrees. Illness, she argues, refers to subjective first-person experience, not to an objective, third-person pathology, like disease.

Properly understood, the concept of illness centres the individual and their connections. “When I identify my suffering as illness-like,” Chappell writes, “I wish to lay claim to a caring interpersonal relationship.”

As generic terms go, mental illness is a healthy option.

Nick Haslam, Professor of Psychology, The University of Melbourne and Naomi Baes, Researcher – Social Psychology/ Natural Language Processing, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Have you ever noticed changes in your eating habits when you are sad, bored or anxious?

Many people report eating either more, or less, as a way of helping them to cope when they experience difficult emotions.

Although this is a very normal response, it can take the pleasure out of eating, and can become distressing and bring about other feelings of shame and self-criticism.

Adding to the complexity of it all, we live in a world where diet culture is unavoidable, and our relationship to eating, food and body image can become complicated and confusing.

Emotional eating is common

“Emotional eating” refers to the eating behaviours (typically eating more) that occur in response to difficult emotions.

Research shows around 20% of people regularly engage in emotional eating, with a higher prevalence among adolescents and women. In a study of more than 1,500 adolescents, 34% engaged in emotional eating while sad and 40% did so while anxious.

Foods consumed are often fast-foods and other energy-dense, nutrient-poor convenience foods.

Stress, strong emotions and depression

For some people, emotional eating was simply a habit formed earlier in life that has persisted over time.

But other factors might also contribute to the likelihood of emotional eating. The physiological effects of stress and strong emotions, for example, can influence hormones such as cortisol, insulin and glucose, which can also increase appetite.

Increased impulsivity (behaving before thinking things through), vulnerability to depression, a tendency to ruminate and difficulties regulating emotions also increase the likelihood of emotional eating.

So what do you do?

First, know that fluctuations in eating are normal. However, if you find that the way you eat in response to difficult emotions is not working for you, there are a few things you can do.

Starting with small things that are achievable but can have a huge impact, such as prioritising getting enough sleep and eating regularly.

Then, you can start to think about how you handle your emotions and hunger cues.

Expand your emotional awareness

Often we label emotions as good or bad, and this can result in fear, avoidance, and unhelpful coping strategies such as emotional eating.

But it’s also important to differentiate the exact emotion. This might be feeling isolated, powerless or victimised, rather than something as broad as sad.

By noticing what the emotion is, we can bring curiosity to what it means, how we feel in our minds and bodies, and how we think and behave in response.

Tap into your feelings of hunger and fullness

Developing an intuitive way of eating is another helpful strategy to promote healthy eating behaviours.

Intuitive eating means recognising, understanding and responding to internal signals of hunger and fullness. This might mean tuning in to and acknowledging physical hunger cues, responding by eating food that is nourishing and enjoyable, and identifying sensations of fullness.

Intuitive eating encourages flexibility and thinking about the pleasure we get from food and eating. This style of eating also allows us to enjoy eating out with friends, and sample local delicacies when travelling.

It can also reduce the psychological distress from feeling out of control with your eating habits and the associated negative body image.

When is it time to seek help?

For some people, the thoughts and behaviours relating to food, eating and body image can negatively impact their life.

Having the support of friends and family, accessing online resources and, in some instances, seeing a trained professional, can be very helpful.

There are many therapeutic interventions that work to improve aspects associated with emotional eating. These will depend on your situation, needs, stage of life and other factors, such as whether you are neurodivergent.

The best approach is to engage with someone who can bring compassion and understanding to your personal situation, and work with you collaboratively. This work might include:

• unpacking some of the patterns that could be underlying these emotions, thoughts and behaviours
• helping you to discover your emotions
• supporting you to process other experiences, such as trauma exposure
• developing a more flexible and intuitive way of eating.

One of the dangers that can occur in response to emotional eating is the temptation to diet, which can lead to disordered eating, and eating disorder behaviours. Indicators of a potential eating disorder can include:

• recent rapid weight loss
• preoccupation with weight and shape (which is usually in contrast to other people’s perceptions)
• eating large amounts of food within a short space of time (two hours or less) and feeling a sense of loss of control
• eating in secret
• compensating for food eaten (with vomiting, exercise or laxatives).

Evidence-based approaches can support people experiencing eating disorders. To find a health professional who is informed and specialises in this area, search the Butterfly Foundation’s expert database.

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If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14, or the Butterfly Foundation on 1800 ED HOPE (1800 33 4673).

Inge Gnatt, PhD Candidate, Lecturer in Psychology, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.