
People with Depression Use Language Differently - toufiqbarhamov
https://theconversation.com/people-with-depression-use-language-differently-heres-how-to-spot-it-90877
======
GlenTheMachine
My wife has depression, and for the first several years of our marriage it was
undiagnosed and untreated. Her use of language is, to this day, the single
biggest thing I remember about that time.

She used absolutes a lot. Things were "terrible" or "horrible". The house was
"a disaster". It was never partly clean, or messy. It was either clean, or a
disaster.

But the biggest issue was that her perception of the world, including her
perception of what people were saying to her - what _I_ was saying to her -
was utterly skewed. Anything I said to her, she took in the worst possible
light. A compliment that could be shaded negatively, was. If I told her I
liked her dress, that was taken as my not liking her other clothes. If I told
her I appreciated something she did, that was taken as my not liking anything
else she did. Every once in a while I managed to figure out how to say
something that was so clear that it couldn't be misinterpreted, and when that
happened it was as if I were speaking Greek. The statement literally did not
make any sense in her mind. It was fascinating to watch; there was actually a
discernible lag as she processed, and figured out how to misinterpret,
anything I said.

It was as if she had her own private version of English, with her own
definitions, which were more black and white (and shaded towards the black)
than the vernacular version everyone else spoke. In order to speak with her I
had to become conversant in her version of the language.

After a while it really felt like she was gaslighting me. Anything I said or
did, she took in the worst possible way, and then blamed me for it. It took an
enormous amount of emotional fortitude to keep reminding myself that this was
fundamentally not my fault. I feel tremendously lucky that I didn't become
depressed myself.

Happily, she eventually did recognize that something was wrong and got help,
and is tons better today. Bit what they say about depression is completely
true: your mind is lying to you. I watched it happen. And the even more
fascinating thing is that, although she now recognizes she was depressed, she
still doesn't remember those times the way I do. Her memories are still
skewed.

If you are suffering from depression, please seek help. And if you are in a
relationship with someone suffering from depression, find emotional support.
It isn't your fault.

~~~
PakG1
I have seen this pattern multiple times in various people, most recently in
people who work under me. In those cases, I am not confident that I can
suggest that people seek help. Marriages are (hopefully) different in that
they are built on a foundation of love and trust (i.e. oh yeah, why did I
marry this person again? I really did love and trust this person, right? Maybe
I can still trust him/her?).

As a new manager who came in to manage a new team, I was completely clueless
about many of my team members' very personal emotional baggage (everyone had
different stories, but the key point is that everyone often made very negative
assumptions and interpretations). It would require immense effort to earn
their trust, but I had no idea at first. By the time I realized this baggage
existed, I was already the enemy, the horrible evil manager who just wanted to
fire everyone at the first opportunity; the only reason I hadn't succeeded is
because of insert-reason-here.

In that frame, if I were to suggest that someone seek help, I think it would
only be taken as a significant attack and increase the conflict? It's taken me
a few years to get to the point where my team no longer believes I'm trying to
fire them. I've been able to understand that they've all had various traumas
in their lives (it slips out when they're emotionally upset about things).

I'm glad that your wife was able to get better, and I hope that she'll
continue to get better. I wonder if anyone has any suggestions for how to make
the suggestion to seek help when you're the boss of the one who needs help.
Because I'm certainly no psychiatrist.

Similarly, random strangers who need help, perhaps they just needed that one
person to nudge them. But too scared of creating unnecessary drama instead of
having a positive impact. I guess the only easy thing to do is try to be kind
to people and let it go if it backfires. It's better to say it's not my job,
or it's better to be the Good Samaritan?

It doesn't help that my EQ is quite low (though it's higher than it used to be
at least).

~~~
DenisM
I suggest that you talk to a lawyer and/or HR before making any mention of
other employees's medical conditions to anyone.

Also, remember that you're a manager, not a doctor and not a friend. Getting
emotionally invested beyond your job role will hurt more than it will help.
There is only so much of you to go around, and without proper training in
handling this sort of problems you will run out of your own sanity in short
order.

~~~
salamanderman
100% agree, and there are legal ramifications given that you're their manager.
As always, the universal answer to everything in the workplace, "talk to HR".

------
man-and-laptop
Taleb claims that most psychological studies suffer from methodological flaws
like p-hacking. One should be very sceptical of these kinds of studies and how
you interpret them (correlation vs causation).

Psychology has recently experienced a replication crisis. More than half of
studies have failed to replicate, and those that have, have had lower effect
sizes.

Also, remember that there are lots of factors in a person's immediate
situation that affect how they act. You end up with a "curse of
dimensionality" problem, where it's impossible to isolate a general cause
that's not specific to a certain situation.

By the way, I'm not saying the result is wrong. I'm only urging caution. Don't
just believe something because "A study says..." or "Scientists say..."

____________________________________________

I noticed they did their study by comparing mental health forums to other
types of forums. That's an awfully specific situation. Let's say I had cancer,
and I were writing in a forum full of cancer sufferers, clearly I would use
more first-person pronouns, because _I 'm the cancer sufferer_.

~~~
Regardsyjc
Do you have any recommended books or resources by Taleb or another author on
how to identify or avoid methodological flaws like p-hacking, understanding
correlation vs causation, and more?

I'm currently taking a data science course on Udemy and learning about chi
squares, regression, and decision trees, but I'd love more information on best
practices especially for experimental design.

~~~
man-and-laptop
Taleb's book The Black Swan has sections comparing heavy-tailed prob.
distributions with thin-tailed prob. distributions. The thesis is that you
can't tell whether a distribution has fat tails until a fat-tailed event
happens (which he calls a black swan). Also goes into the flaws of using
induction, the flaws in ascribing causes when there are "silent witnesses",
and so on. I don't think there's any specific practical advice. It's more "If
you work in economics and other areas, your research may well be doomed."
Taleb's advice is often "Don't do this", instead of "Do this".

I'm reading Anti-Fragile now. Can't off the top of my head give you advice on
experiment design or statistics. [EDIT] It's more about designing systems that
benefit from the unpredictability of the world, instead of building systems
that are harmed by unpredictability. [EDIT] It's an important companion to his
previous book, because it gives positive advice on how to make decisions in a
world that isn't amenable to understanding because of complexity. It
effectively gives positive advice, instead of just negative.

There's also SITG that I'd like to read. And there's a "Technical Incerto"
which looks like a work-in-progress, but involves concrete statistics.

[edit] He's also tweeting the contents of a new Data Science course he's
teaching at NYU. Be warned that Taleb is a bit of an arsehole on Twitter.

------
el_cujo
So was their analysis of depressed people purely based on post/comments on
mental health forums? To me, it makes sense that if you were going to one of
these forums for the express purpose of getting help, of course you'd be using
first person pronouns and negative-words, I imagine a lot of the posts would
have something to the tune of "I've been feeling sad lately". Likewise, they
compare this to formerly-depressed people on a forum explicitly for positive
encouragement and found they used more positive-sounding words. The study
seems to me to be analyzing whether people stay on topic in these forums more
than saying anything about depressed people in general. While this would be
much more difficult to accomplish and probably isn't realistic, I think it
would be way more helpful to analyze how depressed people post on social media
or via text or other "normal" conversation rather than how they interact when
they go somewhere to talk about depression/being depressed.

------
chiefalchemist
> "More interesting is the use of pronouns. Those with symptoms of depression
> use significantly more first person singular pronouns – such as “me”,
> “myself” and “I” – and significantly fewer second and third person pronouns
> – such as “they”, “them” or “she”. This pattern of pronoun use suggests
> people with depression are more focused on themselves, and less connected
> with others."

Which raises the question: Is depression a symptom? The root "disease" being
the inability to connect / feel connected to others?

I suppose futher studies might be able to track language (as a proxy) over
time and shed light on correlation vs cause, etc.

~~~
orasis
When you’re unwell the focus is naturally more on the self than others.

Vitamin D does wonders.

~~~
BeetleB
>Vitamin D does wonders.

Except in studies, where it is still inconclusive.

For general supplement research, I tend to look at:

[http://informationisbeautiful.net/visualizations/snake-
oil-s...](http://informationisbeautiful.net/visualizations/snake-oil-
scientific-evidence-for-nutritional-supplements-vizsweet/)

~~~
byproxy
Interesting site. I generally read what Examine.com
([https://examine.com/supplements/vitamin-d/](https://examine.com/supplements/vitamin-d/))
has to say about a supplement.

~~~
DenisM
More specifically [https://examine.com/nutrition/vitamin-d-and-
depression/](https://examine.com/nutrition/vitamin-d-and-depression/)

------
mettamage
Regarding the pronouns: what I notice within myself is that when I nudge
myself to be more altruistic, in a giver's mindset or care more about others
then I feel often more good as opposed to when I think about myself.

I think it's because it's easier to get anxious about oneself compared to
anxious about someone else.

~~~
depressedthrow
I work in tech am i am depressed. I am unable to move and think, negative
thoughts amplifying in my mind till i lose my ability to think. I've no
motivation and energy, i don't even feel like eating.

Want to imagine how it feels? Think like a tube with end point A and B forming
a closed loop with amplifier between these points and negative thoughts are
injected into this closed loop, they amplify each time they pass through the
loop and after suddenly nothing makes sense.

No talk therapies, workout, yoga doesn't work in this case! I tried all these
popular cures fo depression.

I don't have any underlying trauma or abuse, i am not poor (who is poor in
tech?) with fulfilling life and my life doesn't suck! I've a boyfriend who
takes care of me, listens to everything i say and supportive family yet i
couldn't get myself out of it.

I've tried amphetamine, it works for me but i figured amphetamine works by
reving up the supply of dopamine and Norepinephrine.

I was sucidal, i overdosed on Amphetamine and nearly died.

Back from the hospital, i realized using amphetamine is a shotgun approach to
my issue.

Since the probability of two things happening, like Norepinephrine deficiency
and Dopamine deficiency is less than probability of one of the happening.

I went forward with my best guess that I've NE deficiency and i started taking
selective Pure norepinephrine reuptake inhibitors (NERIs)

I managed to take enough dose to bridge the dificiency gap then using a
spreadsheet, slowly lowered the doses over a span of 3 years in a hope that
body would increase its own supply to normalize the level.

Now, i am no longer depressed.

This is after a depression lasting a decade. And local health authorities seem
like they don't really wanna help you.

~~~
depressedthrow2
it's sad that this is a throwaway because i hope you see my comment. i suffer
from the same every day and my life doesn't move. i want to die every day.
please reach out with some sort of contact. im in toronto, i have no idea what
clinics or doctors or what to visit, i've never been to a doctor. email is in
profile, if anyone has any info i'd love to hear it.

~~~
cowb0yl0gic
I recommend that you first see any psychiatrist who has experience treating
depression (ask your primary care provider for a referral or find one online).
Think of depression like any serious medical condition; if you aren't
satisfied with a given provider or approach, then explore others.

~~~
depressedthrow2
>if you aren't satisfied with a given provider or approach, then explore
others.

part of the problem is determining this

------
Ihfhcub
One explanation is poor evaluation of evidence in their environment and
matching their past to their present environment. CBT deals with this. A black
and white way of thinking will lead to poor reasoning and misguided emotions
for their environment. Like a conspiracy theorist will distort evidence and
confuse the probabilities of unlikely events. They will take weak evidence and
deduce distorted statements about the world

~~~
insickness
Actually evidence shows that depressed people are more realistic about the
world than non-depressed people. The converse is true as well: people with
unrealistically high ambition tend to do far better than those with realistic
views.

~~~
xanipher
Depressive realism is still a strongly contested theory. There is also a lot
of evidence that depressed people rate themself worse than warranted.

------
zach43
One methodological issue that I can detect in this article is the choice of
forums used to draw their conclusions:

> We predicted and found that anxiety, depression, and suicidal ideation
> forums contained more absolutist words than control forums (ds > 3.14).
> Suicidal ideation forums also contained more absolutist words than anxiety
> and depression forums (ds > 1.71).

I have no knowledge of this field of research, but I'm trouble understanding
why its a significant result that self-oriented forums (like "anxiety,
depression, and suicidal ideation forums") have more self-oriented words and
absolutist words than the control forums (of which 'MumsNet' and 'StudentRoom'
are mentioned in the article). In the case of 'MumsNet' at least, you'd almost
certainly have a prevalence of second person pronouns.

~~~
xivzgrev
I’d agree with you, but you are comparing apples and oranges.

The selection you quoted focuses on absolute language eg always, never. But
the comparison you’re making is on pronoun choice eg I, you, they.

You do mention absolutist words but the selection you quoted doesn’t mention
pronouns so your critique shouldn’t either.

------
heyjudy
Yes. All-or-nothing, black-and-white thinking appears to be a cognitive
simplification that discards nuance in order to model the world more simply.
Being depressed takes more effort to think and do almost everything that
would/could be routine when not depressed, coupled with a mental fog and
internal disorganization that makes it more difficult to function normally.
This introduces both more errors and a propensity for drama in cases of being
wrong, which also often introduces an inflexibility, which leads to more
conflict with others. Overall, I'd say depression reduces critical thinking,
multi-model thinking and prioritization by making it easier to focus on edge-
cases and catastrophication (cognitive distortions).

------
MarkMc
Back in the 1980's Martin Seligman analysed the speaking styles of baseball
team members to determine if their optimistic/pessimistic attitude correlated
with success on the field. In his book "Learned Optimism" he claimed that this
kind of analysis had some predictive power in who would win the game.

~~~
pbhjpbhj
Cause or effect though? If you realise the other team are better than yours
you could talk realistically about the result and people might interpret that
as being negative. Et cetera.

~~~
sjg007
There's a phenomenon in sports and competitive environments that you rise to
the level of your competition. In those cases you could win with some luck or
strategy.

------
rbosinger
I can't wait until our internal email or chat flags me as depressed and I'm
forced to go on leave. Can you imagine? And then I call the bank and their
phone system decides I'm depressed and locks my accounts to protect me. And
then the men in the white coats come. There could be a Black Mirror episode in
this (if there isn't already).

~~~
brendanmc6
Sounds like some low hanging fruit for an API or SaaS product.

I'd hope the buyers would be healthcare professionals-- but like you've noted
the real markets might be a bit more unpleasant...

~~~
zild3d
"Hi, I'm Clippy! I noticed you used a lot of negative and absolute words in
your paper, here are some recommended psychiatrists near you... "

------
aszantu
Not meaning to demean anyone's hard work with psychology, but last year I
changed my diet and my depression went away almost completely. From routinely
wishing to be dead -> to walking a part of the camino trail in europe and
being able to hold a job. Turns out, that all symptoms return when I eat carbs
or fiber. But even after the depression gone away there are still some issues
in thinking and moving slowly, which could be addressed by therapy. But I'm
kinda mad that no doctor ever told me about diet and gut-brain connection.

~~~
gnulinux
I have a similar experience. When I start eating carbs (including fiber) I
start feeling sad, desperate, inactive etc. I did not stop eating carbs though
because I like experimenting with food (I spend months eating different diets)
and I don't think not eating carbs is healthy (even though it makes me feel
bad). So I still eat e.g. broccoli. Whenever I eat _any_ carb, I experience an
inflammatory response which I can tell from my skin being inflated, and I feel
ants and needles on my skin. [1] I did see doctor for these symptoms and since
they're very mild they usually say "meh, it's probably nothing". But I do
correlate it with eating carbs (e.g. I do not get the same response when I eat
chicken breast, or it's milder when I eat avocado).

[1]:
[https://en.wikipedia.org/wiki/Formication](https://en.wikipedia.org/wiki/Formication)

~~~
orasis
Same for me. Cutting carbs, dairy, and alcohol and I FEEL AMAZING. I think
vitamin D supplementation is also a big factor for me.

~~~
naasking
Sometimes that helps, but also consider whether cutting all those food sources
is actually putting you into a caloric deficit, and that's having the positive
effects you see (assuming you don't have a lactose intolerance of course).

Caloric restriction reduces inflammation, and chronic inflammation is a big
problem in the first world.

~~~
gnulinux
> putting you into a caloric deficit

No? I still eat the same amount of calories (~3000 calories a day, I'm a male
who works put regularly). There are more than enough non-carb sources to get
calories from (lean meats (chicken breast, turkey breast, pork), sea food,
avocado, nuts)

~~~
naasking
> There are more than enough non-carb sources to get calories

Sure, I just meant that most people are too quick to attribute causation when
they notice a correlation. Sounds like you track your calories, so that could
rule out caloric restriction.

------
Telos06
Cognitive Behavioral Therapy puts much emphasis on identifying and pushing
back against the "black and white" thinking behind such "absolute words".
Getting stuck in a false dichotomy of extremes is one of the more damaging
thought patterns.

------
azinman2
Note this is relative to an older specific analysis technique (LIWC) and on
Internet forums about depression/anxiety. Hard to interpret much about how
this generalized to, say, text messages to friends.

------
camillomiller
It would be then interesting to see if there is a scientific correlation
between changing one’s language habits and depression. I’ve always considered
the “start talking positive and things will go well” advice as shortsighted
and oversimplistic, but maybe there is indeed a correlation, and a positive
reinforcement through language is possible. Mantras and chants can have a
strong influence on our brain waves, so maybe there’s a way to leverage
positive language and repetition to ignite a change in the way we feel and the
way we think.

~~~
hliyan
My personal theory is that an absolutist vocabulary of thinking ("always",
"never", "very/extremely") diminishes the possibilities / opportunities
perceived by the person. This leads to a feeling of helplessness, which leads
to a lack of motivation, which in turn becomes a self-fulfilling vicious
cycle.

It's amazing what people go and achieve when they don't know it's
impossible...

------
atulatul
I also noticed use of passive voice more than active voice. Not sure if it
even has a correlation with depression or lack or control. Just noticed it.

[https://en.wikipedia.org/wiki/Active_voice](https://en.wikipedia.org/wiki/Active_voice)

[https://en.wikipedia.org/wiki/Passive_voice](https://en.wikipedia.org/wiki/Passive_voice)

------
ivoras
That's basically the original observation of NLP (no, not that one) - that
people often literally express their mental state through language on a non-
trivial level, and IMO still one of the better things which make it worth
studying.

Just find yourself a trainer who has a similar propensity for metaphysics as
you (which can range from 0 to all-in-new-age) since the field has diverged
into various interpretations.

------
slantaclaus
“This pattern of pronoun use suggests people with depression are more focused
on themselves, and less connected with others.“

I believe this is more of a symptom of excessive isolating behavior (an
arguable cause of depression) than it is a predisposition towards selfishness.

------
momentmaker
This reminds me of the first agreement in The Four Agreements by don Miguel
Luis.

"Be impeccable with your words."

The words manifest into thoughts which turn into physical form. The book
described words are akin to black magic.

------
salamanderman
Describes my speech and internal monologue patterns before I got medications
and therapy perfectly.

------
DoreenMichele
I'm basically currently losing my shit over my intractable personal problems
and the ways in which sexism help keep them intractable. So I don't think I
can be rational or socially acceptable at the moment.

 _However, we don’t know whether these findings reflect differences in
attention or thinking style. Does depression cause people to focus on
themselves, or do people who focus on themselves get symptoms of depression?_

My belief based on first-hand experience is that social factors drive some
people to this.

I'm very socially observant. I've apparently been casually announcing that
_the emperor has no clothes_ since I was about three years old. I often don't
realize I know someone's "secrets" that they imagine they have covered up very
successfully. When I casually remark on such things, it gets me hated on. No,
I will never ever ever ever be forgiven for it.

So, over the years, I have gradually worked at saying less about other people
because it's such a mine field. Talking about me and only me as much as I can
convinces other people I'm a narcissist, but it's less problematic than me
casually asking "The emperor? You mean the deluded naked guy whose delusions
everyone is feeding by going along with his bullshit claim that he has some
amazing new wardrobe? Is that the guy we're talking about?"

This is backed up by data. I mean, the fact that I only talk about me and
everyone hates me for it -- or, more accurately, everyone hates me and
identifying this habit is one of the excuses they use to justify it. When I
was on Metafilter, if you checked their infodump, I used "I" vastly more than
any runner up. And I was hated on, which was just a thing Metafilter chose to
do to certain people because the site has serious issues. When I joined, it
was policy for the mods to pin the drama on one person, blame them, tell them
you shut up and stop commenting and then let other people continue attacking
them under circumstances where they would get in trouble if they came back to
defend themselves. I quickly got on the short list of people where public bear
downs by multiple people were not only the norm, God help you if you tried to
defend them because that could mean you're next.

Depression is often a female issue and, on average, woman tend to be
(perceived as) more social. We get tasked with doing emotional labor and get
dismissed a lot and can't make as much money for the same job, etc. It's a
very crazy-making situation and it's common for therapists to offer women
medication instead of advice on how to stop being victimized.

I think most men don't really mean to victimize women, so it goes bad places
when women point fingers and blame men who are part of the problem. They feel
wrongfully accused. Doing so just makes the problem more intractable.

But trying to find the right words before you can speak to the problem winds
up being a silencing mechanism. It makes it extra hard to try to solve it at
all.

When every door slams shut in your face no matter what you do, it's hard to
not start thinking in absolutist terms of "always" and "never."

Even so, I think the absolutist terms are more likely linked to wonky brain
chemistry.

I have a medical condition. On bad days when I'm feverish, etc, I engage in
more absolutist language and I'm not rational.

My sons have learned to "not engage the crazy." I say something extreme and
irrational, they say "Mom, are you hungry? Are you thirsty? Are you warm
enough?"

Most of the time, when I'm irrational, getting me fed, hydrated and warm
results in me falling asleep in short order. Trying to argue with me about
crazy stuff I'm saying just puts out the fire with gasoline. Insisting on only
engaging me constructively is more effective.

They do sometimes rebut my irrational remarks, but they don't get dragged into
arguing it with me. I say "I have no friends" they say "That's not true." They
rebut it,but they dont get tired in it.

That seems to be a best practice that helps keep me grounded in reality
without pissing me off, fueling a sense of hopelessness and despair, etc.

Getting healthier and making my life work better has proven to be the best
solution. My mental health has gradually improved.

I still have days when the bullshit in the world that makes it seemingly
impossible for a woman to get anywhere just makes me postal. I'm there right
now. The past few days have been terrible in terms of my head space.

But most of the time, I'm overall more rational.

Most depressed people have serious intractable personal problems that no one
knows how to solve. Medicating their feelings ends up de facto being
dismissive.

Think of it like if Susan B Anthony were put on Valium and told "Women don't
need the vote. You're merely crazy. Here, take this. You'll feel better." No,
that's not going to figure the myriad problems that grow out of being
disenfranchised and disempowered and having no real say in your own life.

I think social factors fuel the use of first person pronouns. I think social
factors and brain chemistry fuel the use of absolutist terminology.

Both get better when the social factors driving it improve. The second seems
to also be helped by addressing physiological factors, like exhaustion.

/2 cents

------
sgt101
Some people, who are diagnosed, sometimes.

------
bequiet
What most people, including researchers, don’t get is that depression causes
distorted thinking. Black and white thinking is merely a symptom of the
disorder. CBT’s approach to depression is wildly inaccurate and damaging. If
you can change how you feel by changing your perspective you are NOT suffering
from clinical depression. You are at worst morose, lethargic, and unmotivated.
Depression includes those, but is much more; it calls itself apathy, but is
actually a survival mechanism unlike any other. Think of bipolar disorder.
Their range goes from -20 to 30 in terms of emotional intensity instead of 0 -
10 for normal people. Except our nervous system can’t really handle that kind
of intensity, so every manic episode MUST be followed by a depressive episode,
otherwise they would die. Or think of post-partum depression, a state in which
a mother’s body has been pushed to the extreme (8 on the pain scale, easily).
The body returns to a depressed state to survive until it has recovered.
Distorted thought patterns, lack of motivation, and sense of lethargy are
merely symptoms of this state.

~~~
sjg007
While interesting ideas, is there any evidence for any of your claims? In the
meantime CBT has been shown in clinical trials to be as effective as drugs
although not necessarily as fast acting. CBT has also been shown to last
longer.

