Stigmatizing and Ableist Language: Alternatives and Best Practices

Language shapes how we understand one another and how we express respect, compassion, and care. The words we choose can either reinforce stigma or create space for dignity and belonging. This is especially important when we are talking about mental health, substance use, disability, and neurodivergence.

This guide offers alternatives to commonly used stigmatizing or ableist terms and highlights ways to use language that honors people’s full humanity and lived experiences.

Why Language Matters

Language holds power. Stigmatizing words can cause harm by reinforcing negative assumptions and making people feel unseen or devalued. Choosing language that is accurate, compassionate, and person-centered supports inclusion and respect for the full range of human experience.

The following examples include common terms that may perpetuate stigma, along with alternatives that foster connection and understanding.

Common Terms and Inclusive Alternatives

“Crazy”

This word is often used to describe ideas, behaviors, or emotions, but it can unintentionally reinforce stereotypes about mental health conditions, neurodivergence, or distress. Instead, choose words that more clearly describe what you mean.

• Instead of “Crazy Idea,” use:

  • Unconventional

  • Innovative

  • Radical

  • Out of the box

  • Wild

    
    

  Instead of “Crazy Behavior,” use:

  • Unusual

  • Unpredictable

  • Unexpected

  • Wild

    
    

  Instead of “Crazy Experience,” use:

  • Intense

  • Extreme

  • Extraordinary

  • Overwhelming

  • Wild

    
    

  Instead of “Crazy Situation,” use:

  • Surprising

  • Extraordinary

  • Astonishing

  • Unbelievable

  • Wild

    
    

  Instead of “Crazy Person,” use:

  • Person with unusual behavior

  • Person experiencing strong emotions

  • Individual with a unique perspective

  • Person exhibiting unpredictable actions

  
  

Mental Health and Neurodivergence

Instead of “Mentally Ill,” use:

• Person with a mental health condition

• Person experiencing mental health challenges

• Individual living with a mental health diagnosis

• Neurodivergent person (if they identify that way)

  
  

Instead of “Suffering from [condition],” use:

• Living with [condition]

• Managing [condition]

• Experiencing [condition]

• Navigating [condition]

  
  

Instead of “Self-harm / Self-mutilation,” use:

• Non-suicidal self-injury (NSSI)

• Self-injury

• Person who engages in self-injury

  
  

Instead of “High-functioning / Low-functioning,” use:

• Describe specific support needs (for example, “requires support with communication”)

• Neurodivergent person

• Autistic person or person on the autism spectrum (depending on preference)

Disability

Instead of “Handicapped / Crippled,” use:

• Person with a disability

• Disabled person (if they prefer identity-first language)

  
  

Instead of “Special Needs,” use:

• Person with a disability

• Person with additional needs

• Individual with support needs

• Disabled person (if they prefer identity-first language)

  
  

Instead of “Wheelchair bound” use:

• Wheelchair user

• Person who uses a mobility aid

Disability and neurodivergence are natural parts of human diversity. Using affirming language recognizes that the problem is not with the person but with the barriers and biases created by the world around them.

Substance Use

• Instead of “Substance Abuse / Substance Abuser,” use:

  • Substance use

  • Person who uses drugs

  • Person with a substance use disorder

    
    

  Instead of “Addict / Junkie,” use:

  • Person with a substance use disorder

  • Person with a complex or chaotic relationship with substances

  • Person who uses drugs

    
    

  Instead of “Alcoholic,” use:

  • Person with alcohol use disorder

  • Person with a complex or chaotic relationship with alcohol

    
    

  Instead of “Clean,” use:

• For toxicology results:

  • Tested negative

• When referring to an individual:

  • In recovery

  • Abstinent from substances

  • Not drinking or using substances

  • Not currently or actively using substances

    
    

Instead of “Dirty,” use:

• For toxicology results:

  • Tested positive

• When referring to an individual:

  • Currently using [name of substance]

  • Currently drinking or using substances

    
    

• Instead of “Non-compliant / Resistant / Unmotivated / Non-adherent,” use:

  • Not participating or not in agreement with the treatment plan

  • Opted not to

  • Has not begun

  • Feels ambivalent about change

    
    

  Instead of “Former Addict / Reformed Addict,” use:

  • Person in recovery

  • Person no longer using substances

    
    

  Instead of “Clean and Sober,” use:

  • In recovery

  • Abstinent from substances

    
    

  Instead of “Lapse / Relapse / Slip,” use:

  • Experienced a recurrence of use

  • Resumed or returned to use

    
    

The Importance of Person-First and Identity-First Language

Using person-first language such as “person with a disability” or “person with a mental health condition” emphasizes that someone is a person before any diagnosis or experience. Some people and communities prefer identity-first language such as “disabled person,” “autistic person,” or “mad person,” which expresses pride, community, and identity.

There is no single correct choice for everyone. The most respectful practice is to listen to how individuals describe themselves and follow their lead. Language evolves through lived experience and community use, not by outside labels.

Moving Toward a Culture of Respect and Belonging

Being intentional with language is not about being perfect. It is about striving for understanding and care. When we move away from stigmatizing or ableist language, we open the door to more compassionate and honest conversations.

By speaking with respect and curiosity, we help build a world where disabled, neurodivergent, and mad folks, as well as those navigating mental health challenges or substance use, can be met with dignity and belonging.

Inclusive language helps us remember that every person’s experience matters, and that connection and understanding begin with the words we choose.