The language of mental health discourse in news media

A 500-word bylined story can quickly shift conversations and drive narratives, whether accurate or not. The topic of mental health continues to be shrouded in misunderstanding. To take a closer look at how highly-circulated news articles shape public perceptions of mental illness, I examined one year of news coverage of schizophrenia.

I analyzed archived articles from leading U.S. news media sources published between April 2021 and April 2022. What I found was a fascinating narrative underlined by metaphors that play a significant role in influencing how society views schizophrenia, a rare and highly stigmatized mental illness.

The theory of cognitive metaphors guided this investigation. It’s an ideology that explores how human brains use familiar descriptions of sensory systems (sight, smell, sound, etc.) to conceptualize more abstract experiences. Through the lens of this theory, I found that metaphors portraying the mental illness as a physical struggle against an unseen and violent enemy were most prevalent. Other descriptions of this disorder included metaphors of schizophrenia as a destructive entity that can kick in and shred a person’s pride and dignity, an overwhelming force fully engulfing and swallowing the person, a foundational collapse and breakdown of self, and an intensifying fire susceptible to unpredictable flare-ups.

Key conceptual metaphors identified in media portrayals of schizophrenia

“All my professional life, I have witnessed the despair of patients and their family members when confronted with the diagnosis of schizophrenia,” said Heinz Katschnig, psychiatrist and Professor Emeritus of Psychiatry at the University of Vienna, in a self-authored 2015 study published in the Journal of Evaluation in Clinical Practice.

“It is perceived as a virtual death sentence in terms of referring to a chronic, deteriorating, and incurable disease, to a ‘split personality’ implying unpredictability, and to symptoms of craziness, such as hallucinations and delusions, leading to dangerous behavior,” Katschnig said.

Cognitive metaphors for schizophrenia, some of which I identified in my investigation, often depict people living with schizophrenia as warriors in an ongoing fight or as helpless and perpetually trapped victims of their condition. These metaphors can, and often do, perpetuate stigma through language, but it's important to recognize that they likely stem from efforts to be inclusive of various experiences.

The metaphors I identified represent vivid conceptualizations of schizophrenia as a debilitating and distressing force, minimizing self-esteem, causing severe disruptions to daily living, and having a volatile nature. The common thread among all the metaphors I found is the portrayal of schizophrenia as a relentless and disruptive adversary. 

Distribution of themes in the 50 sample articles, highlighting predominant narratives

I discovered a prominent theme of dangerousness in descriptions of schizophrenia, accounting for 47.3% of the 50 stories analyzed, representing the emergence of a concerning trend of linking schizophrenia to destruction. Contrary to such common misconceptions, the majority of people living with schizophrenia are nonviolent, according to the U.S. Department of Health and Human Services, and their experiences are far more complex than often publicly described. 

Metaphors such as break, struggle, and shred were found, carrying with them a likelihood of fueling misconceptions and societal prejudices of the illness. I also found some other metaphors, including descriptions of individuals with schizophrenia being eroded by the disorder. This reductionist framing can perpetuate stigmatization and stunt efforts to foster empathy, understanding, and acceptance.

As a self-reflection activity, consider instances where everyday dialogue about mental health is riddled with metaphorical language along the same themes discovered in this study.

• Fire Metaphor: “It’s like her symptoms flare up out of nowhere, and everything feels unpredictable.”

• Violence Metaphor: "They snapped during the party; it’s scary how fast thing escalated."

• Loss Metaphor: "It feels like the person we knew is slipping away, piece by piece."

• Journey Metaphor: “Living with schizophrenia has so many ups and downs. It’s a long road with unexpected turns.”

There is a growing body of research shedding light on the intricate relationship between language and perception in shaping our understanding of mental illness. By exploring how news media convey information, we uncover the layers of stigma and misconception surrounding these conditions. My paper, "Framing Schizophrenia: Metaphors and Themes in U.S. Newspapers" was presented at the 16th biennial meeting of the High Desert Linguistics Society (HDLS) at University of New Mexico in November 2024. See the slideshow here.

Conclusions & Key Takeaways

• Media Reflects Society: Portrayals of schizophrenia mirror our engagement with complex topics.

• Metaphor Impact: Media metaphors shape everyday conversations, reinforcing or challenging biases.

• Language Awareness: Recognizing metaphors in discourse is crucial for understanding mental health perceptions.

• Larger Dialogue: These narratives influence public attitudes toward schizophrenia and mental health overall.

Suggested Readings & Sources

Conceptual Metaphor Theory

• Lakoff, G. & Johnson, M. (1980): Metaphors We Live By.

• Thibodeau, P. H. & Boroditsky, L. (2011): “Metaphors We Think With: The Role of Metaphor in Reasoning.”

Schizophrenia in Public Discourse

• Chopra, A. K. & Doody, G. A. (2007): “Schizophrenia, an Illness and a Metaphor.”

• Lampropoulos, D. et al. (2017): “Analyzing the Presentation and Stigma of Schizophrenia.”

Stigma and Mental Health

• Perlick, D. A. et al. (2001): “Stigma as a Barrier to Recovery.” Psychiatric Services.

Foundational Critique

• Sontag, S. (1978): Illness as Metaphor.