This chapter tackles the issue of language when writing about mental illness. Jamison writes that she had once received a very angry letter criticizing her for using the word madness in the title of a lecture she was slated to give. Though she was resentful of the letter, she acknowledges that it did push her to think about the kind of language we use when discussing these issues. “On the one hand,” she writes, “the pain of hearing these words, in the wrong context or the wrong tone, is sharp; the memory of insensitivity and prejudice lasts for a long time,” but on the other hand, she feels that rejecting specific terms “gives an illusion of easy answers to impossibly difficult situations and ignores the powerful role of wit and irony as positive agents of self-notion and social change” (180-81).

To illustrate, Jamison discusses the terminology for her own illness. Although she has used the term manic-depressive illness throughout the text, the official contemporary diagnosis, according to the DSM (at the time of her writing), is bipolar disorder. However, she feels that the term bipolar suggests a distinction between that disorder and simple depression “that is not always clear, nor supported by science,” and that it further “perpetuates the notion that depression exists rather tidily segregated on its own pole,” which “flies in the face of everything that we know about the cauldronous, fluctuating nature of manic-depressive illness” (182).