WoTC may be treading an insensitive line concerning mental illnesses when it comes to describing "madness."  The Dungeon Master’s Guide has a section dedicated to short-term "madness," long-term "madness," and indefinite "madness."  However, the use of these terms seems unnecessary as it's really a table of effects including paralysis, incapacitation, fright, "babbling" (inability to speak/spellcast), disadvantage on ability checks, a charm-like effect, pica, stun, and unconsciousness.

On one, hand, portrayals of "madness" have some history with horror tropes, however, it seems that as we understand more about how labels have the potential to stigmatize, WoTC (and those who write about their products) might want want to reconsider how they portray mental illnesses in their materials.  It seems that it is unnecessary to label a group of imposed effects by this term.

No matter what it is, you have to call it something, and no matter what you call it, someone will take offense.

It accurately fits the term's definition. There is nothing to change.

Poetic language unavoidably blurs lines, and any attempt to clarify those lines undermines its narrative value. A perfectly accurate/sensitive story can not exist, and each storyteller must choose which compromises they are willing make.

The implications of morality in a game like this, is a massive subject unto itself.

A line typically gets drawn when a specific minority is unduly targeted, such as in the case of the controversial depiction of the Vistani in Curse of Strahd, which is based upon stereotypes surrounding the Roma people.

I'll expand on my view.

People can be offended by anything. You have to think about how justified that offense is. There's a difference between something actually being offensive, and somebody choosing to be offended. 

What if somebody is offended by violence in D&D - should we remove all combat from all current and future editions? What if people are offended by tall people RPing as Dwarves and Halflings or as one gender RPing as another? Should the game invent rules to say you shouldn't do this? Should they prevent this and only have "humans" as a playable race/species/lineage/ancestry/whatever? 

If somebody is offended by magic in games (and that was actually a real thing, part of satanic panic in the 80s), do we remove all spellcasters and magic from the game?

Just because somebody is offended, isn't really enough. People can choose to be offended by all sorts of things. The rest of us shouldn't have to cater our entire existence to them. There are, indeed, people who actively choose to be offended by things and play it up more for the sake of the ego fulfilment in making others feel bad or having to change to the way they want you to live/play/speak. 

So, is "madness" offensive? No. It's just a catch-all term to depict a variety of mental effects. That's the term in real-life and the term in this game. As a person with multiple mental health issues that have had severe impacts on all aspects of my life, am I offended by this term? No. It's not an insult. It's not derogatory. It's a harmless term, it's very fitting, and personally I find it more endearing than some alternatives (like 'batshit cray-cray", which I also find funny, rather than offensive, but that's more of a 'me' thing). 

Just because we have issues doesn't mean we're fragile little snowflakes. I'm ok if I have a little madness in my brain. The world is mad, anyway, there's even a song saying so. 

I can understand the kneejerk reaction and frustration with those who demand changes on the grounds of 'I'm offended' rants, often baseless. 

However, the OP isn't delivering this as a demand. They're suggesting something - it is a question, an invitation of thought. And this is not wrong, nor should it be discouraged. Questioning the norms and given is a gateway to progress. In this instance, I do not believe a fight for change is needed, but I can understand the desire to question. Where things genuinely are offensive then yes, something should change. Sometimes a new normal is needed for social growth and that cannot happen if the current norm is never questioned.

So while I disagree with the invited premise, I respect and admire the invite being made. There is no need for any hostility towards the OP. 

Personally I think it would be far more offensive to call madness “mental illness” or something like that. The Lovecraftian madness of the game is not meant to reflect real-world mental illness: it’s meant to be a little campy and, well, fictional. But I do think we should be careful not to blur the lines between classic horror “madness” and actual mental illness, because that can be hurtful, uncomfortable, and unfun. And we should make sure we’re not using madness to make fun of mental illness, intentionally or otherwise.

Quote from NaivaraArnuanna >>

Personally I think it would be far more offensive to call madness “mental illness” or something like that. The Lovecraftian madness of the game is not meant to reflect real-world mental illness: it’s meant to be a little campy and, well, fictional. But I do think we should be careful not to blur the lines between classic horror “madness” and actual mental illness, because that can be hurtful, uncomfortable, and unfun.

 Yeah, pretty much this.  And D&D's madness is an optional rule that can easily be left out of a game if players are uncomfortable with such things.

Quote from Vince_Snetterton >>

For all the dancing, I will make this simple: If this someone stated on, say a Warhammer fan site, that they found the extreme violence mixed with some religious aspects offensive, what do you think the reaction of the players or the game designers would be. Or if someone was furious with the sexism and violence in Grand Theft Auto, what would be the response?

How is D&D any different?

You did not respond to any one of my points in my previous post. Strike One for bad faith arguing was your original post in this thread's ad hominems and strawmen, Strike Two was you not responding to a single one of my points (which is a cop out) and continuing to argue. I am arguing in good faith, so I will answer your question (but tweaked a bit, because you changed the topic): How is "Madness" in D&D any different?

1. Warhammer, like D&D, is a TTRPG that highly relies on combat mechanics in its core. Neither I nor anyone else on "my side" in this argument have ever advocated for getting rid of violence in D&D, Warhammer 40k, or Grand Theft Auto. Violence is very much a part of their identity, and the games would be near unrecognizable without violence being a part of them. The "Madness" system in D&D, however, is not engrained in D&D's core identity. It's not a major part of the game. The Madness system is in the DMG, and there are very few circumstances in a typical game where it would come up (again, there are outliers, such as in the Out of the Abyss campaign). By and large, if the Madness system was removed from D&D, most D&D campaigns wouldn't change all that much, if they were to change at all. The same cannot be said for the combat system of D&D, Warhammer, or GTA. 

2. HOW SOMETHING IS DEPICTED IN MEDIA AFFECTS HOW PEOPLE THNK OF AND RESPOND TO IT IN THE REAL WORLD. I am capitalizing this because it was a major part of my previous post in this thread, and you ignored it entirely. What has the potential to do more harm a) allowing players to kill fantasy creatures in a make-believe fashion or b) depicting mental illness as something caused mainly by evil magic and demons, causing victims of it to have comically random effects, and insane people in the adventures mainly being villains? Does A or B have more potential to do harm?

It's clear to me that the latter is the one with the potential to do more harm. Video games don't make people more violent, so neither does D&D. However, how mental illness is depicted in the media (including D&D) does affect the real world. 

Again, chill. Your argument's foundation is riddled with logical fallacies (I've managed to pick out ad hominems, appeal to consequence, appeal to tradition, bulverism, strawmen, and a bunch of red-herrings). You're in the wrong, like everyone is sometimes, and it's okay to admit that. (I don't even care so much about you admitting that as I care about making you stop derailing the discussion. Simply walking away would be enough.)

Given their durations, short and long term madness are more akin to being dosed with psychoactive drugs than any actual mental illness. The indefinite madness options could plausibly be fit into DSV-IV, but I'm not sure why that's a problem? It's not like 'madness' is an actual diagnosis in modern medicine.

The "Madness" described in the DMG is of the Lovecraftian, mind-corrupting sort.  or at least it's intended to be.  In this instance, I believe the term is safe to use as most folks should understand that the 'madness' being portrayed here isn't mental illness, but is instead the result of what amounts to a metaphysical attack on the mind and possibly soul of the creature suffering the madness.  It is a wound in the psyche rather than commentary on reality, and those sorts of wounds can cause behaviors which some unfortunate people might play as depressingly similar to real-world conditions.  That is a table-by-table issue that should be addressed and resolved respectfully, but 'Madness' as a trope and a tool is too useful to too many games to ignore completely.  Nor can I come up with a better term for it.

Cybermind is very much correct, however - these are absolutely the sorts of questions folks should be asking, and Helhawke asked it in the proper way.  I'm glad to participate in the discussion, and ask that those with no interest in a civil discussion of how madness may be best addressed in the game can please go elsewhere.  We don't need to rehash months-old arguments on why being offended is offensive here.  This is a good thread asking a pertinent question the proper way - let's engage with it properly too, shall we?

It is worth noting that concerns about insensitive treatment of mental illness usually involves one of two things, neither of which D&D does:

1. A claim that a given condition produces behaviors that are outside of the definition of the illness.
2. Disputes about whether something should even be considered a mental illness.

D&D 'madness' doesn't name types of madness, it just describes the behaviors that it causes, so it can't fall afoul of (1). It could in principle fall afoul of (2), but that's just a matter of severity, any of those behaviors would be considered pathological if taken to a sufficient extreme.

Quote from Third_Sundering >>

Quote from Vince_Snetterton >>

For all the dancing, I will make this simple: If this someone stated on, say a Warhammer fan site, that they found the extreme violence mixed with some religious aspects offensive, what do you think the reaction of the players or the game designers would be. Or if someone was furious with the sexism and violence in Grand Theft Auto, what would be the response?

How is D&D any different?

You did not respond to any one of my points in my previous post.

 Am I the only one wondering which previous post you are referring to?

Quote from Wysperra >>

Quote from Third_Sundering >>

Quote from Vince_Snetterton >>

For all the dancing, I will make this simple: If this someone stated on, say a Warhammer fan site, that they found the extreme violence mixed with some religious aspects offensive, what do you think the reaction of the players or the game designers would be. Or if someone was furious with the sexism and violence in Grand Theft Auto, what would be the response?

How is D&D any different?

You did not respond to any one of my points in my previous post.

 Am I the only one wondering which previous post you are referring to?

It was post #8, taken down by moderation. 

Considering the number of users in this thread that I happen to know either:

• Actually live with one or more mental disorders (the current preferred clinical term).
• Are sensitive to and supportive of matters related to mental disorders in either their personal communities or this comunity.

And considering how many of them are on the side of this conversation saying that this is not a problem and doesn’t represent squat all to do with real life..

And considering that I am am one of them, take it from me: This is in no way representative of nor related to any real world issue, nor is it offensive to people who live with mental disorders.

In fact, this conversation is more offensive than the use of the term “Madness” in the DMG.

If anyone here does not have any mental disorders and feels like being offended on my behalf, don’t. Go find some other cause to martyr yourself for, your services are not required in this matter.

I hope this helps.

So this is a very, very, very sensitive topic and I'm not a very sensitive man, but I'm gonna take a stab at it and first off will commend Yurei on a tactful approach.

To set the record straight, I am a cis white male with no mental conditions.  I'm as plain toast as you can get on 99% percent of most spectrums.  That being said, my D&D table is about as diverse as they come.  Half Men, Half Women, Two People of Color, three on depression meds, and the vast majority doesn't identify as straight.  I'm the minority.

We're all friends outside of D&D, so we argue and fight and sometimes lines are crossed.  What matters is how the table addresses it.  What matters is how we treat the people, and most important to recognize the validity of their feelings.  

It's always about the intent of the argument when you are very good friends.  When you aren't friends, the intent is lost and now you make assumptions.  Case in point, this thread.  There are voices in this thread that people have strong feelings both for and against, and that will alter their perception of the words.  Regardless of how well intentioned.  

Transitioning, Twitch recently banned the word Blind in stream titles because it was "insensitive to viewers without sight".  The concept of blind playthroughs is something in the video game community has existed since video games came out, but now they want to be called first time playthroughs.  I don't think that's the right play, and I feel the same way with "Madness".

In general, I'm okay with it.  There are certain things on the madness table that kind of set off alarm bells to me though:

The character feels compelled to repeat a specific activity over and over, such as washing hands, touching things, praying, or counting coins. - This is an actual mental disorder.  I would never present this in my game. 

The character experiences uncontrollable tremors or tics, which impose disadvantage on attack rolls, ability checks, and saving throws that involve Strength or Dexterity. - Actual mental disorder, would never do it.

These aren't the only ones, these are just some of the easier to recognize ones.

The indefinite "madness" table that adds a flaw to your character?  Those are ok.  Your character experienced a life changing event and altered their behavior.   Makes total sense.

I think if some of the ones that were closer to real life mental disorders were taken out, and changed with short term, medium term and long term flaws?  It'd be a much better table.

It appears that the OP is suggesting that WOTC should remove even the potential of this situation from happening.

This isn't what they are stating at all.  Wizards is definitely trying to clean up a LOT of the horrible stuff in previous editions, the blatant racism, the misogynistic treatment of women, the stupid stereotypes, but at the end of the day its up to a table to police their game.   I'm NOT going to sit at a table where someone is going to exhibit the above behavior...but it exists, and that's what D&D is for that person.  I don't have to like it, I won't condone it, but that person will.  Wizards, sadly to me in that case, accomplished what they wanted with another customer.  That's because Wizards can't police every table and nor should it.  This discussion, and what this discussion SHOULD be about is the perception of the word, their thoughts and how to maybe bring about positive change.

It was post #8, taken down by moderation. 

Final thought.  If it was taken down, it obviously was a topic that shouldn't be discussed.

As much as people may disagree, mental illness is a grey area. There are a few lines you don't want to cross when it comes to these things. First, portraying mental illness as a triviality, or even worse, as a gift is going to alienate those who actually suffer with it. The madness rules, as currently written, are a bit awkward in relation to the first, because the indefinite madness descriptions border on comedy, and player portrayals of madness are frequently trivializing. I'd also like to throw in there that Lovecraft was a supreme *******. I, for one, would love it if cosmic horror were to finally advance beyond him, but we're still stuck in the age of cyclopean tentacles and whatnot.

Quote from IamSposta >>

Considering the number of users in this thread that I happen to know either:

• Actually live with one or more mental disorders (the current preferred clinical term).
• Are sensitive to and supportive of matters related to mental disorders in either their personal communities or this comunity.

And considering how many of them are on the side of this conversation saying that this is not a problem and doesn’t represent squat all to do with real life..

And considering that I am am one of them, take it from me: This is in no way representative of nor related to any real world issue, nor is it offensive to people who live with mental disorders.

In fact, this conversation is more offensive than the use of the term “Madness” in the DMG.

If anyone here does not have any mental disorders and feels like being offended on my behalf, don’t. Go find some other cause to martyr yourself for, your services are not required in this matter.

I hope this helps.

 
I'd respectfully ask that you don't position yourself as the spokesperson for those suffering with mental illness. There are certainly aspects of 5e's "madness" that may be perceived as insensitive to reasonable people.