Don't ban the word
Why pre-diagnostic “I have depression” is valid under DSM-5
In DSM-5 there is a dedicated section on everyday self-identifications of symptoms and states, and their cultural specificity ("Cultural Concepts of Distress," pp. 749–759). It is a guide for the clinician to properly understand what a patient is trying to say.
From a practical standpoint, the popularization and dissemination of scientific knowledge improve health through: (a) timely consultation with a doctor, and (b) a more accurate description that the doctor can understand.
This is beyond dispute. In modern conditions, people mis-triage themselves as “I’ll just endure it” in 30–40% of cases, which seriously worsens their condition and ultimately increases the burden on the healthcare system. Popularization and education are considered necessary paths of prevention in modern medicine.
Words point to systems of concepts. Bringing the folk system of concepts closer to the scientific one is precisely the classical program of the Enlightenment. To forbid specific words — especially those used by specialists, on the grounds that they belong to some sacralized language — means, at best, constructing a parallel lexicon to reflect the same concepts. Or worse: constructing a new conceptual system, inevitably poorer.
Here is an example from another sphere: correct names for genitals are today considered appropriate and necessary in raising children. Here is a hand, here is an ear, here is a vulva1. This is not exposure to “sex”—it is simply the body they already own and have unrestricted access to.
Folk nosology will exist regardless of our wishes, because language itself is the basic human cognitive instrument. Encouraging the use of standard terminology structurally and semantically aligns everyday speech with scientific discourse, without changing the epistemological status of the message. For example: “I have nerves” (folk, a real example from DSM-5) and “I have depression” (pseudo-clinical) have the same status as self-narratives of distress.
In any case, symptoms are real as reported (this is an axiom), distress is real as reported, and the difference lies only in wording and categorization. The second way is better in many aspects, including accuracy and specificity: “nerves” covers a wide spectrum of manifestations, while “depression” is narrower, separating it, for instance, from “anxiety” or “outbursts of anger.” Such statements are still reports of symptoms, subject to further clarification. Yet using more precise terms from the outset, according to empirical studies, supports earlier diagnosis and facilitates it.
At the same time, the distinction between a narrative and a diagnosis is not lexical but epistemological. A word means something only through context. This is what is called the asymmetric dualism of the linguistic sign. The difference lies not in the letters that form the word, but in the context provided by the doctor’s seal.
Another example from elsewhere: “spectrum of a field” in a mathematical context means something very abstract, quite unlike what you probably thought. At the same time, Perls’ introduction of the concept of “field” in describing psychic dynamics has its own sense, different from that in physics.
One could object:
But people misuse “depression” all the time.
Yes, that is precisely the level of folk nosology. It is unavoidable, but conceptual clarification can be genuinely effective. A blanket prohibition—“don’t say that because it’s a diagnosis”—only worsens things and general well-being.
People often misuse vagina when they mean vulva. That’s anatomically incorrect - but still vastly better than avoiding the topic altogether or defaulting to euphemisms, distortions, or silence. Even misused clinical term is far better than any folk placeholder, far closer to productive, health-relevant communication. One would reasonably endorse it rather than gatekeep.