People with Depression Use Language Differently

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.

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..."

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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.

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.

> "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.

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.

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

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.

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).

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.

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).

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.

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.

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.

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.

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/Passive_voice

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.

“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.

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.

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

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

Some people, who are diagnosed, sometimes.

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.