I’ve heard the term mental illness for decades.  Does anyone know when it came into widespread use, and why
the term includes illness rather than disease?

cuchuflete - 02 September 2007 12:13 PM

I’ve heard the term mental illness for decades.  Does anyone know when it came into widespread use, and why
the term includes illness rather than disease?

the DSM-IV prefers “disorders” as in The Diagnostic and Statistical Manual of Mental Disorders .  I wonder whether or not this is so because of the controversy about whether the mind can be thought of as a biological organism which may be presumed when using words like illness and disease.

Illness, however, seems more abstract to me and less biological than disease.  But they seem to be used interchangeably.

In addition to what Oeco said, “disease” seems to me to be somewhat more stigmatizing.  The OED2 cites as one of its senses “3. fig. A deranged, depraved, or morbid condition (of mind or disposition, of the affairs of a community, etc.); an evil affection or tendency.” I think “illness” carries less of this connotation.

With all due respect to Oeco and Doc T, I don’t think either of those responses is particularly relevant to the question, which is not “what would be the most respectful and/or officially sanctioned way of referring to mental illness?” but “why do English speakers prefer mental illness to mental disease?” Unless y’all have discovered evidence that the average speaker of English consults the DSM or a manual of political correctness before using words, I think such considerations are beside the point.  Not that I have an answer myself, mind you; it’s a good and interesting question.

Mental disease has been used more than I would have thought:

1851 N. HAWTHORNE House of Seven Gables xv. 253 A mode of passion that, as often as any other, indicates mental disease.
1904 Lancet 27 Aug. 598/2 Scientific views regarding mental disease have..been undergoing great changes.
1946 Amer. Jrnl. Psychiatry 103 323/1 At the present time it cannot be said that we cure any of the more important and more fixed mental diseases.

But it’s certainly very rare by comparison with mental illness.  My best guess at the moment is that it’s a matter of rhythm: English has a strong preference for alternation of stressed and unstressed syllables, which is why the natural meter is iambic.

I don’t think either of those responses is particularly relevant to the question, which is not “what would be the most respectful and/or officially sanctioned way of referring to mental illness?” but “why do English speakers prefer mental illness to mental disease?”

I’ll accept the charge of thread hijacking for myself, but I think that Dr. T. replied directly to the question. I agree that disease is more stigmatizing and harsh and may be one reason why it’s avoided in common speech.  I don’t think that the use of disease is politically incorrect, just stigmatizing.

[edit] I also agree with Cuchuflete in his last post in WordReference Forum, that the preference for illness is old enough to pre-date the more recent penchant toward political correctness.

I don’t know if any dictionary agrees with me, but I’ve always felt that “disease” carries connotations of infectiousness (as in “viral disease” “sexually transmitted disease” or “water-borne disease”) that “illness” does not. If this isn’t purely an idiosyncrasy of my own, perhaps that’s the rationale behind the preference for “illness”.

As stated, the stigma attached is significant I think. People in treatment with mild mental problems (or voluntary patients such as tortured auteur Woody Allen - get a grip man!) are often called clients not patients.
The idea is to detract from their feelings of inadequacy or abnormality and if the client can’t see through this obfuscation they will surely find it reassuring.
Bipolar disorder sounds less forbidding to laymen than manic depression (both are loaded words) and involves less stigmatization.
This could be one of the few areas in which euphemism is to be welcomed at least as far the ‘self-esteem issues’ (sorry) of sufferers are concerned.
Cerebral health issues or emotional stability concerns - I’d prefer to be known to have these until I work out whether I am a sociopath or a psychopath ;)

In my mind “Mental Disease” is concatenated with “or Defect” and is legal or paralegal jargon. I cannot think of any reason other than TV for my thinking thusly.

Syntinen Laulu’s posting strikes an answering chord in me. “Disease” certainly carries the very unwelcome implication of infectiousness (remember “coughs and sneezes/spread diseases”?) and has (as several posters have noted) altogether a much nastier semantic load than “illness”. If I had to choose, I’d much rather be “ill” than “diseased”. And I’d sooner visit an ill friend than a diseased one, even if both were suffering from the same complaint ;-). Political correctness is neither here nor there. Nor is the dictionary meaning, nor the definition in a manual which mostly doctors read. And I don’t think languagehat’s observation about the rhythm is the answer either. The difference is in how the two words make people feel.

The OP spoke of “mental illness”. This idea carries such a huge load of negative connotations ("mad". “lunatic” . “crazy”.) that any step in the direction of reducing the associated stigma, by the use of euphemism, should be welcome, as venomousbede points out.

(Lionello’s thoughtful thought of the week: “Anybody who would consult a psychiatrist needs to have his head examined")

;-)

I agree that disease is more stigmatizing and harsh and may be one reason why it’s avoided in common speech.

Once again, I must insist that in my many years of studying common speech, I have never seen the slightest evidence that it has any concern for avoiding the “stigmatizing and harsh.” If mental illness were a specialized term used mainly by professionals, you would have a point, but it is a perfectly normal English expression, a step up from cracked, nuts, psycho, etc. but not at the level of refinement of, say, differently abled (where the desire to avoid offense is paramount, and the usage is correspondingly confined to the bien-pensant).  My relatives, when I was growing up, would say someone was “mentally ill” in the same way they’d say someone was “old” or “sick” or “crippled.” It is a normal, straightforward term, not a euphemism.

I also disagree with what seems to be the consensus about the relative merits of disease and illness—I don’t see either of them as stigmatizing or harsh—but as I say, that doesn’t seem relevant to me.

MENTAL ILLNESS:

a condition which causes serious abnormality in a person’s thinking or behaviour, esp. one requiring special care or treatment.

OED

MENTAL DISEASE:

Designating a temporary or permanent impairment of the mind due to inherited defect, injury, illness, or environment, usually needing special care or rehabilitation. Esp. in mental breakdown, deficiency, disease, disorder, incapacity, retardation, etc.; see also mental illness, sense 7.

MENTAL PATIENT:

a person under medical care for a mental illness

OED. BUT apparently not a person under medical care for a mental disease. We don’t call anyone a mental patient now, at least not in our PC world.  Now psychiatric patients suffer from mental illnesses/personality disorders/whatever, but not from mental disease.

The earliest OED citation of “mental illness” is 1971, but the earliest citation of “mental disease” is 1851.

edit before I read Dr T’s post:
I agree with SL and lionello - you don’t want to catch any disease, so you’d avoid contact with diseased people, though you wouldn’t object to having contact with ill people.

I stand by my original comment: I see “mental illness” as a somewhat formal term, at least in origin: one that’s in common use these days but, like so many other terms relating to psychology, made its way into the popular vocabulary from the lexicon of clinicians and specialists. 

Having said that, I have to concede that the earliest use cited in the OED is from Wuthering Heights, but that seems to have been something of a one-off, with no further examples for 75 years, and then we’re in the technical literature.  So I think its popular prevalence owes much to its preferred use by specialists.  Remember that, for instance, “retarded” is now a vernacular term (and even regarded as crude and offensive) but started out as a term used by professionals in lieu of blunter terms for mental impairment.

OTOH, I think your comment about meter is a valid one; “mental illness” rolls off the tongue more readily than “mental disease”, and that may well have played a role in the former’s prevalence.  OTOOH, “social” has the same meter as “mental”, and yet the prevailing term was “social diseases” not “social illnesses”.

Note: Eliza posted above while I was composing this, so I didn’t see her OED dates.  The online revision shows, as I noted, “mental illness” with one citation from the 19th century (Bronte 1847); the next is from 1922 (Jrnl. Royal Statist. Soc.).

No change in the earliest citation for “mental disease”.

further edited for typo

The practitioners went through a similar process: Mad Doctor, Alienist, Psychoanalyst, Psychiatrist.
Psychoanalysts are still Freudians and cling to their core beliefs. Psychiatrists deal with abnormal psychology

Young girls who frequent picture palaces
Have no use for psychoanalysis;
And though Dr. Freud
Gets very annoyed,
They cling to their long-standing fallacies.

(I may have posted this before. If so, my apologies --- though it’ll bear repeating)

The practitioners went through a similar process: Mad Doctor, Alienist, Psychoanalyst, Psychiatrist.
Psychoanalysts are still Freudians and cling to their core beliefs. Psychiatrists deal with abnormal psychology

Not quite right regarding psychiatrist. There are psychologists who deal with abnormal psych and psychiatrists who deal with normal psychologies.

The key difference is that a psychiatrist is a type of physician. A psychiatrist has an M.D. degree.

Mental Illness vs. Mental Disease

This is me laughing at you.
Your user name means ‘&^#$()ed up in the head’.
Peruvian Spanish?

I’ve met you before.

How much could an alpaca?
Not as much as a wood chuck!

Juggling three ping pong balls in a jar full of dill pickles that take up one 1/6th of the jar each.

Keep doing that for a while.

Dork.

By the way.

The walls are melting.