Is "Insane" Still Used To Describe A State Of Mental Health?

Medically reviewed by April Justice, LICSW
Updated October 17, 2024by BetterHelp Editorial Team

The term insane was used to describe mental illness over 100 years ago. However, it may still be used on a community level or in the media to describe someone unique or to insult someone you don't like. In some cases, people use it to describe themselves when they feel their actions go outside of the norm. If you are going through a stressful or busy time in your life, you might feel distracted or anxious. 

Although these feelings are normal, you might tell yourself, "I think I've lost my mind. I'm going insane." If you are concerned about your mental stability, you may wonder if you are living with a mental illness. Insanity is no longer used as a term in mental health settings, so having the correct terminology may help you move forward to receive the proper support and reduce stigmas surrounding mental health.

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The definition of "insane" 

Several words have evolved to carry different meanings and are used in conversation to convey different feelings. For example, saying, "This is driving me insane!" is different than calling another person insane for having a mental illness. In the second case, learning to be sensitive to mental health topics and approach them from a destigmatized lens can be essential. 

The history of the term insanity

"How do you know I'm mad?" said Alice.

"You must be," said the Cat, "or you wouldn't have come here."

-Lewis Carroll, Alice in Wonderland

According to the American Psychological Association, insanity is most often used as a legal term in trials to determine if the condition of a defendant's mind renders a person incapable of being responsible for their criminal acts. This term is no longer used in a medical sense. While the term is legal, people use the word insane in everyday language to denote someone eccentric or to describe themselves when feeling overwhelmed. 

Throughout history, as far as Biblical times, there was an acknowledgment that some individuals struggled to conform to social norms and conventions. Several labels have been applied to these people, including:

  • Mad 
  • Lunatic
  • Maniac
  • Possessed 

In Greek and Roman civilizations, behaviors that may be perceived as different in the present were perceived as signs of a special connection to the divine. If someone hallucinated, these civilizations did not believe they were mentally ill but "touched by the Gods." However, they did experiment with medical treatments for various delusions and other inappropriate public behavior.

At the other end of the spectrum, there have been cultures in which holding a controversial opinion was enough to be called "insane." In the 1970s, for example, the Soviet Union proclaimed that anyone who disagreed with their regime was mentally ill, leading to mass hospitalizations of Soviet dissenters.

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Is insanity a relative concept?

The definition of "insane" varies significantly depending on location, education, culture, and beliefs. There are several definitions, including a popular and oft-quoted one that is misattributed to Albert Einstein or Mark Twain: "The definition of insane is doing the same thing over and over and expecting different results." 

While this definition accurately describes dysfunctional behaviors that might accompany an eccentric personality, obsessive-compulsive disorder (OCD), or forms of frontal lobe brain injury, it is not a catch-all definition for "insane." 

In some situations, it may be desirable and healthy to repeat the same action. For example, if you practice a new skill or send out job applications, you may be doing yourself a service. 

This old popular saying may be catchy and comedic, but it may not help you determine a person's mental state. According to the Merriam-Webster Dictionary, there are three definitions of insanity, including the following:

  1. A severely disordered state of mind usually occurring as a specific disorder (outdated and stigmatizing)
  2. Unsoundness of mind or lack of the ability to understand that prevents one from having the mental capacity required by law to enter a particular relationship, status, or transaction or that releases one from criminal or civil responsibility (legal definition)
  3. Extreme folly or unreasonableness

According to these definitions, there are medical and legal forms of insanity, with the medical form being outdated and stigmatizing. 

Insanity as a legal defense

Insanity is now used as a legal term, not a psychological one. The legal definition supports understanding insanity as a defense in a US court of law. To meet the legal definition of insane, a defendant must prove that they were unable to tell the difference between right and wrong at the time a crime was committed due to the severity of their psychosis or another mental health symptom.

The insanity defense has existed since 1581. Over the years, governing bodies have been compelled to revise how insane could be used as a defense when heinous crimes are committed. In the US, the legal definition of insane has changed several times after the public felt it was applied too broadly or narrowly in specific cases. Judges are often skeptical of this defense, which is rarely used in courtrooms. When it is, states hold to the definition of being "unable to tell right from wrong." 

Moving past stigmatizing terms 

When discussing mental illness, terms are garnered from the Diagnostic and Statistical Manual of Mental Disorders (DSM), published and revised by the American Psychological Association. In the current version of the DSM, the DSM-5TR, there is no definition of "insanity" or condition with this label. 

When discussing mental illness, terms are garnered from the Diagnostic and Statistical Manual of Mental Disorders (DSM), published and revised by the American Psychological Association. In the current version of the DSM, the DSM-5TR, there is no definition of "insanity" or condition with this label. 

The word "insane" is no longer used in the mental health community. Contemporary therapists and psychiatrists take a person-centered approach, not labeling anyone with judgments but allowing individuals to form their own positive conclusions. 

Although stigma still exists around mental illness and psychology, society is moving away from words like "mad," "crazy," or "insane" in a professional context, prompting individuals to cease the use of the word on a community level. 

The word "insane" is no longer used in the mental health community. Contemporary therapists and psychiatrists take a person-centered approach, not labeling anyone with judgments but allowing individuals to form their own positive conclusions. 

Although stigma still exists around mental illness and psychology, society is moving away from words like "mad," "crazy," or "insane" in a professional context, prompting individuals to cease the use of the word on a community level. 

Signs of mental illness 

If you worry that you or someone you love might have a mental health disorder, there are a few warning signs you might look for: 

  • Withdrawing from social situations
  • Lacking interest in previously enjoyed activities 
  • Struggling to cope with day-to-day responsibilities
  • Expressing "strange" thoughts or delusional, exaggerated beliefs
  • Experiencing excessive nervousness or worry
  • Experiencing dramatic shifts in sleeping habits and appetite
  • Having sudden and dramatic changes in mood (highs and lows)
  • Showing apathy
  • Having difficulty with memory, concentration, and attention
  • Experiencing a long-term sad or low mood 
  • Showing extreme anger
  • Experiencing irritability

If you or your loved one shows any combination of these symptoms, it may be beneficial to reach out for support. If you feel shame about these symptoms, you're not alone. Some social stigmas may still be attached to mental illness, leading people to feel embarrassed and shameful after diagnosis. 

However, mental health treatment is available for those with multiple symptoms, and you don't have to be diagnosed to receive help. Over 41.7 million adults in the US see a therapist, and going to therapy is increasing in popularity. Finding a therapist you feel comfortable opening up with may help you cope with your symptoms and see that therapy is not shameful, embarrassing, or weak. You're not alone in seeing a provider. 

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Support options 

Some people turn online, searching for a convenient way to speak with a trusted therapist without leaving the comforts of home. Recent studies show that electronically delivered cognitive-behavioral therapy can reduce depression and anxiety symptom severity more effectively than face-to-face therapy. The analysis considered several randomized controlled study trials that evaluated the effectiveness of cognitive-behavioral therapy online. Researchers concluded that online therapy is more effective in all aspects of outcomes, including severity of symptoms, adverse outcomes, clinically relevant outcomes, global functionality, participant satisfaction, quality of life, and affordability. 

Meeting with an online counselor may allow you to receive emotional support from home. If you are considering online therapy, a platform like BetterHelp can connect you to thousands of licensed therapists offering compassionate, non-judgmental counseling services from professionals trained to help those living with mental illness. Encouraging people to seek support can be an expression of love and care. You're not insane if you reach out for help, and insanity is no longer a term used in mental healthcare. 

Takeaway

It might feel tempting to use "insanity" or "insane" to refer to others when you don't understand their behavior or why they feel how they do. However, history has shown carelessly using words like "insane" without knowing the true definition does more harm. Living a fulfilling life with a deeper understanding of yourself and others can reduce stigma and ensure everyone receives the support they need. If you're seeking guidance with a mental health challenge, consider contacting a licensed therapist for further compassionate advice and support.
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