Stop Calling Your Boss "Psycho": Why Ableist Language at Work Hurts More Than You Think

It's a scene that's all too familiar: after a tough day at work, while unloading over a glass of happy hour wine with coworkers, the complaints start rolling out. Your boss is a total psycho. That HR lady is crazy. Sheila's new counterpart is an absolute narcissist.

At Girlboss, we talk a lot about building workplaces that actually work for women. And part of that conversation, one we don't have often enough, is about the language we use when we're frustrated. Because if you haven't been the one venting like this, you've almost certainly heard it in the last week. Or day. Or hour.

These terms, borrowed from psychology and casually weaponized as insults, get thrown around with the regularity of breathing. And while the conversation around the word "crazy," which is used disproportionately against women, has grown louder in recent years, we're still a long way from retiring it.

The effects of this kind of language, often called ableist language, reach further than most of us realize. Beyond the misogyny baked into words like "crazy," casually misusing clinical terms like "psycho" and "insane" reinforces a mental health stigma our culture urgently needs to dismantle.

In 2024, more than 23% of U.S. adults experienced a mental illness, and the words we use at work shape whether those people feel safe enough to say so.

As Dr. Lauren Harb, a clinical psychologist at Silver Lake Psychotherapy, puts it: "The misuse of clinical terminology leads to widespread misunderstanding about what certain diagnoses actually look like, as well as shame about getting a mental health diagnosis."

What We Actually Mean When We Say “Psycho”

Psychosis, the clinical term "psycho" is shorthand for, describes very specific symptoms that are almost always a far cry from the behavior someone is trying to describe when they call a coworker that name. Your supervisor curtly asking you to file a report on time does not qualify as psychopathic behavior.

"In my experience, it's usually an attempt to describe a person whose behavior is out of the ordinary," says Dr. Harb. "People are often talking about someone who is having difficulty regulating their emotions or remaining calm during conflict."

The potential for harm runs deeper than most expect. "A diagnosis is really meant to help understand a person's set of symptoms and deliver the most appropriate treatment," she says. "Using mental health terminology to describe unremarkable, everyday behavior minimizes the severity of certain disorders that really do require clinical attention."

It’s Not Just “Crazy” and “Psycho” Anymore

The conversation has evolved, and so has the language. In 2026, "so autistic," "totally ADHD," and "she's so OCD about her Slack notifications" are just as common in office chitchat as the terms this article originally named.

Neurodivergence is increasingly part of how people understand themselves at work, and much like microaggressions, the harm in these throwaway phrases often isn't intended. That doesn't make it land any differently for the person on the receiving end.

Disability justice activist Lydia X. Z. Brown, who has spent years raising awareness around ableist violence as a systemic issue, puts it plainly: "Much of the time, people who do this aren't having conscious thoughts demeaning people with psychosocial disabilities. Nevertheless, they are exemplifying a socially pervasive belief system that only some people's minds are healthy, valuable, worthy, or desirable."

Brown also points to something easy to miss: using this kind of shorthand to dismiss a coworker often lets the real problem off the hook. "Because of ableism, it's easier to scapegoat disability rather than naming actual problems like unchecked aggression, willful lack of empathy, racism, or misogyny." Calling someone "crazy" is a conversation-ender. It explains nothing and solves even less.

Why the Workplace Is Where This Matters Most

The stakes are particularly high at work. While 72% of workers report being comfortable supporting a coworker's mental health, 42% still refrain from discussing their own mental health concerns, and the language floating around in team chats and hallways is a big part of why. If someone with depression, anxiety, OCD, or ADHD hears their diagnosis used as a punchline in a Monday morning debrief, the message is clear: this isn't a safe place to be honest about that.

If you've ever felt the weight of masking something difficult at work, this piece on managing anxiety in meetings is worth bookmarking. And if you've ever wondered whether your workplace is adding to the problem rather than helping, the answer might start with the words used in the room.

What to Say Instead

Swapping out ableist language doesn't mean tiptoeing around conflict or softening your complaints. It just means being more precise. More often than not, the clinical label is doing the work of describing something much more specific, and naming that thing directly is actually more useful.

If you're not the one using the language but you're in the room when someone else does, that's a moment too. You don't have to deliver a TED talk. Something as simple as "what do you mean by that?" is often enough to interrupt the reflex and open a better conversation.

For more on navigating difficult workplace dynamics, our guide to dealing with toxic coworkers has practical scripts worth having in your back pocket.

Change Is Possible, and It’s Already Happened Before

It's easy to feel like language is impossible to shift. But it isn't. The use of "gay" and "retarded" as casual stand-ins for something bad or confusing was completely normalized not that long ago. Their retreat from everyday use didn't happen overnight, and it's still uneven. But it happened, driven by exactly the same forces at play here: people deciding the words weren't acceptable anymore and saying so out loud.

The same shift is underway now. It just requires noticing your own habits, and speaking up when you notice them in others. That's not a small thing. At work, where language shapes who feels seen and who doesn't, it might be one of the more meaningful ones.

For a deeper look at how mental health and women's experiences at work intersect, NAMI's resources for women and mental health are a genuinely useful starting point. And if you want to go further on the language piece specifically, the Autistic Self Advocacy Network's guide to ableism is written by and for disabled people, which makes it worth reading.

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