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People with Depression Use Language Differently (theconversation.com)
269 points by toufiqbarhamov on Dec 31, 2018 | hide | past | favorite | 135 comments



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.


> 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.

An underrated piece of advice. Not to take at all away from what those with depression are suffering, but supporting a loved one with depression can be a tremendous task in itself, sometimes involving a lot of emotional abuse. Thanks for sharing.


Get professional help before it rubs off on your children. I grew up with anger/sensitivity/delayed development issues due to the non-stop theatrics of a depressed parent.


"Theatrics" may be the wrong word.


From experience, I’d describe it as an “emotional whirlwind”. The person suffering has a lasting, chaotic impact on the household. Similar to a whirlwind the very winds that start it can’t really be seen or predicted with ease.


I don't know man, maybe it is? Not the performance aspect, for sure. But isn't the purpose of drama heightened emotions?


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).


I'm afraid that I can't suggest anything. I can't recall whether or not I tried to suggest that my wife get help; it's been nearly two decades now. But I'm fairly confident that if I had, she would have misinterpreted that suggestion as a criticism of her. It was that difficult to have a conversation with her that didn't go off the rails. There was just no way I could have brought the subject up without her interpreting it as an attack.

What finally happened was that she recognized that her feelings towards our 2-year-old daughter weren't right. And, oddly enough, our dog. We had a fabulous, beautiful, well-trained Aussie, the best dog I've ever seen. My wife is a vet. When she started thinking of the child and the dog as both being problems in her life, that's when she recognized that she herself had changed for the worse, and realized she needed help.

There may be ways to go about intervening. Support groups with trained staff would probably be able to help. But I wasn't smart enough at the time to find one.


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.


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".


EQ isn't a real thing. https://news.ycombinator.com/item?id=14940184

And you by the way seem very apt in considering other people's emotions. This dilemma you're posing would be hard on anyone to navigate.


> 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).

Serious question, how did your team have that many people with these issues. I presume that presuming a standard distribution, every team would have certain number of people with certain mental health related issues, but if your team has more than others, then there must be some hiring heuristic which skewed things that way. Am I correct?


The organization doesn't normally fire people and these people had been working there for over a decade, some near 2 decades. Whatever hiring heuristics existed, I'd have to ask several generations of managers and directors prior to me.


I think you hit the head on the nail with describing someone in my life. I always thought it was deep-seated insecurities about their appearance causing this behavior, it very well may be but now it dawned on me that depression and insecurities may not be mutually exclusive and insecurities may stem from depression. Thanks for sharing.


Wow.. this is my wife right now. I feel like I cannot say anything around her because she will take it wrong way. We just watch TV and don't really talk. We may talk about paying bill or picking up groceries but nothing serious or something I really want to talk about.

I am not sure what my next steps should be.


Whether or not she will get help, you should. I would offer to go to couples' therapy. If she takes you up on that, terrific. But if she is not willing to go, you should find some emotional support for yourself.

My brother, who is a minister, has a saying that helps: "If I didn't break it, it's not up to me to fix it." Your first job is to see to your own emotional health. You can't make another person's decisions for them.


This reminds of Dido's song "Quiet Times", a song about dating someone with depression:

"Now I miss you,

Now I want you,

But I can't have you,

Even when you're here"

https://www.youtube.com/watch?v=SOd-rz8lDXQ


holy crap, i know this discernible lag and delay to hear how something is alternately interpreted than plainly and positively intended. thanks for writing this all down so clearly.


What treatment helped her the most?


SSRI's.


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.


I recommend you read the original studies on replication, and their primary coverage, rather than Taleb's slant that tends to be driven by his own issues.

It's not just psychological studies, it's a range of fields, from neuroscience to psychology to oncology. By a reading of that literature, you should be skeptical of most studies. In fact, if you were to caution someone about replicability, it might be just as accurate to frame it as "as a machine learning study, you should take its generalizability with a grain of salt given the specific data sources involved." Psychologists are the messengers; replicability studies are a natural offshoot of meta-analysis, which also has its modern origins in psychology.

Also, this study doesn't really claim any sort of causal anything. It's just reporting differences in language use. The primary application of something like this is screening. There are some implications about causal hypotheses (absolutist thinking is a classic target of cognitive-behavioral therapies, which do have a fair amount of experimental support), but this paper is pretty agnostic about that sort of thing.


IANAE, Perhaps experimental methods themselves aren't a good fit for Psychology, theoretical approaches may be better.


The trouble is we don't yet understand the human mind well enough to establish the basis for comprehensive theories. At this point we're still like monkeys randomly poking the keyboard of a computer to see what happens.


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.


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.


> identify or avoid methodological flaws like p-hacking,

It is not trivial to identify them. If it was then there would be no replication crisis. Avoiding is easy in theory: you need decide on math methods in advance. Generate random data before you start to gather real data, and write an R program to process this data. Test it, debug, and when you get real data just feed it to this program. Without changing the program. It is harder in practice though.

> understanding correlation vs causation

> I'd love more information on best practices especially for experimental design

I learnt it with experimental psychology. С. James Goodwin "Research in Psychology"[1], there are some specific psychological topics covered (you might not be interested in ethics of psychological research), there are not a word about chi squares or other math methods you mentioned (data processing is out of the scope of the book), but there are a lot about different experimental setups, with a lot of examples. IIRC there is discussion of p-hacking too.

I believe this book is a good read to anyone interested in design of experimental and/or correlational research methods in general, not just for psychologists.

[1] https://www.amazon.com/Research-Psychology-Methods-Design-8E...




There's something that I think is relatively simple - design experiments not to try to prove your hypothesis, but to disprove it. I'm not talking about hypothesis vs null hypothesis here, but the experimental design itself from which the data is collected. There are lots of good examples, and this study happens to be a particularly good one. It basically looked at new topics posted on a forum for e.g. suicidals and compared them to new topics on a forum for e.g. pensioners. The study found a selection of 19 'absolutist' words occurred more frequently on the forums for one group than the other. It should be self evident that there are a practically infinite number of potential confounding variables there.

In some cases confounding variables are impossible to escape, and you simply have to accept the fact that the science is going to be dodgy at best. But this is not really one of those cases. There are trivial and practically free ways you could really try to test the hypothesis that depressed individuals use absolutes more often than non-depressed. For instance, why not give them a prompt and have them write a brief 300 word story? And even better you can secretly prompt the individuals in a given direction with what seems like a free-form prompt to try to further reduce confounding issues.

As an example, "Write a brief persuasive piece with the premise being that green is a more pleasant color than red." It seems open form, but it's not-so-secretly directing people in a broad but common direction to try to give you decent samples of speech where you continue to remove as many confounding variables as possible. Even better in my study design is that, similar to a twin study, it doesn't actually matter if your prompt would inherently nudge people towards using e.g. absolutes more often since you're comparing two individuals in the same 'environment.' What matters is not the absolute (har har) difference, but the relative difference. Suddenly you have an experimental situation where you're controlling for as much as you can outside of the behavior of the individuals themselves. And it would be an extremely cheap study that could even be done remotely.

---

From a reader's perspective and not a researcher's there are a million tell tale signs of p-hacking. The biggest one is studies, like this, that intentionally expose themselves to confounding variables. The average phrasal composition of new post topics on any non-general topic is going to radically differ between sites. Not controlling for that is not sloppy. It's far worse than sloppy since there is absolutely no way these researchers could not have been entirely aware of this confounding issue. It was an intentional choice and that deserves scrutiny. Given the current state of social sciences, I am no longer inclined to offer the benefit of the doubt.

Other tell tale signs tend to be large numbers of variables, particularly when they are overly specific. With a large enough set of data you can find some commonality between any group of people. So for instance take a set of e.g. rich individuals and a set of non-rich individuals. If you just start collecting random data that could in no possible way be causal you'll eventually find a subset that, for whatever reason, holds. People who were born on a Wednesday, went to a school with 5 letters in its first name, and have an 'E' in their last name are 92.3% more likely to be wealthy than those that don't! Of course the variables will never be so absurd which can make it sound like implying a possible causal relationship is not so absurd. Again taking this study they chose 19 specific words to be used as their selection of absolutes, down from an original choice of some 300. And their criteria, even in what they acknowledge, is something that deserves substantial scrutiny. The worst part is that in cases like this you're also left just trusting the author that at no point did their selection process involve 'peeking' at whether the words would 'prove' their hypothesis. And once again, I'm no longer inclined to offer the benefit of the doubt in studies of this sort.

And there are countless other signs. Another one, for instance, is seemingly odd exclusions/inclusions in the data. For instance throughout this post I've stated that the study only considered new topics on the forums. And that's true. They chose not to consider responses for no legitimate reason. They state it was done "in the interest of simplicity and interpretability" which not only makes absolutely no sense, but introduces yet another potential confounding variables. Responses and original topics are going to have starkly different word choices.

It's hard to generalize but maybe the easiest way is to remove good faith from the picture, in a way take it as your own little personal null hypothesis. Do the decisions and design taken within a study lend themselves towards (or away) from a connection with good faith - a study confident in its hypothesis and seeking to test it as stringently and rigorously as possible to try to ensure its integrity? Or do the decisions and design within a study seem to indicate individuals more interested in simply obtaining publishable data as is often a means to an end of survival in the current state of academia today? A study more geared towards softly 'prodding' a hypothesis in a way likely to yield something that can be published? In many cases the answer there is immediately evident.


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.


In my personal experience, it's less an inability to connect to others, more an inability to take care of yourself in a sufficient way so you're comfortable enough to not feel like connecting w/ others will be further depleting.


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

Imagine that you're currently experiencing the worst headache you've ever had. Remember how focused you were on the pain and not much else? Now imagine that that headache is permanent and incurable. You might learn to regain some measure of normalcy but that internal pain is always there and demanding attention.

It seems reasonably likely that those unfortunate souls who suffer from chronic (physical) pain would also exhibit similar writing patterns for much the same reason.


I suspect (wildly guess, to be honest) that, like "cancer", "depression" (or even "Melancholic Major Depressive Disorder") is really a name we give to a collection of related diseases with similar symptoms. Teasing apart the various forms will likely improve treatment (and improve quality of studies).


Yeah I have known many depressed people and been depressed myself. It seems much more likely to be a symptom than a singular condition, considering how differently people seem to experience it (some with it channel it into being successful, others can’t even get out of bed) its comorbidities, etc paired with how wildly many semi-successful treatments there are (SSRIs, CBT, diet, supplements, exercising/losing weight)


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

Vitamin D does wonders.


Vitamin D is not a medication for depression.

Lack of vitamin D can cause depression but it does not “do wonders” for people suffering from depression.


Moving from Canada to California did a lot to help my depression. It's hard to not feel good on a beautiful sunny day


I'm happy that worked out for you. To be fair, however, moving from the US to Norway has done wonders to help with mine. But I understand that could easily be that outside stressors are different and I'm in a much more stable and healthy environment than I was previously. I'm also in a situation that I chose. All of it, all of my everyday life is in a situation I chose. I also rather like being an immigrant, it turns out. I'm going to guess you have some of these feelings too.

Not everyone can say that.

And as it turns out, my experience about beautiful days is different from yours. I find it is quite easy not to feel good on a beautiful day. Doubly so if you feel too ugly to go outside, better about yourself when you can wear a jacket, if you are in a bad situation, stressed, sick, stuck, and so on.


Seasonal Affective Disorder (SAD) is its own thing, and yes, bright sunlight or artificial sunlight is the primary treatment.


If your depression is caused by lack of vitamin D it stands to reason that vitamin D helps fighting it. But not every depression is caused by vitamin D deficiency, so it doesn't always do wonders


That may be true but studies have shown that most people in the US are deficient. Our indoor lifestyle is to blame, and vit D is not readily available in food as other nutrients are. It is either sun or supplements.


>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...


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



The graphs you link to show Vitamin D having "good" evidence of improving well-being, well above the "worth it" line.

But I would expect studies showing Vitamin D only effective in some cases of depression, just like Coffee is helpful in some cases of headaches. Depression seems much closer to being a symptom than to being a disease. So anything that fights a root cause of depression will only work for those people whose depression is caused by that specific root cause, and will have many people reporting it doesn't work for them at all.


The graph has Vitamin D listed multiple times, for multiple health issues. I don't doubt Vitamin D is good, but for mental health, it lists it in the lower half (below the "worth it" line) - in the category of "Slight" evidence.

No harm in taking it, given all the other health benefits. You have to take a ton of it before Vitamin D has harmful effects.


I would guess that most human health issues that are universal across the species have been discovered at this point. Vitamin C and Iodine deficiencies cause serious problems for all humans. Large studies that see some small effect are likely to be variance where a few people are have large positive effects and others not or even negative. That is your individual genetics and other factors are going to determine if some advice is useful for you. Listening to your parents and grandparents is probably more useful than reading almost all modern health studies.


[flagged]


Please don't degrade this site further by posting dross like this.


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.


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.


They're are clinics that administer mdma and psilocybin, they're know for basically resting the brains dopamine system https://medium.com/s/trips-worth-telling/i-reset-my-brain-wi...


Impressive job.

Medicine is sadly too focused about the average, if you fall off the side you'll have to walk the distance on your own. I think many (including me) have experienced that.

Good luck


An interesting route might be doing the wim hof method regarding upping your NE temporarily

https://m.youtube.com/watch?v=EWHRumILOOk

You can also email me for questions.

Full disclosure: I was a participant in one of the landmark studies on it: https://www.pnas.org/content/111/20/7379


i'm interested in this. do you have any other studies?


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.


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.


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

part of the problem is determining this



Just sent you an email from jessica{something_secret}@gmail.com


A nice observation. It's a fundamentally important and very practical part of what Buddhism teaches by the way.


I agree, which is why I aspire to live to the namesake of my username.

Metta: https://en.wikipedia.org/wiki/Mett%C4%81

Mage: my fantastical word for programmer or person who brings his ideas into reality (could also do wizard but mage sounds cooler).


Cool!


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


That's quite probably a high factor indeed. I often felt like the value of social groups is to smooth out emotions. When you're with people you are a lot less stuck in your own mind and somehow you don't pile up negative thoughts to the point of crippling darkness.

Also something I've noticed when trying to meditate (just cleansing my mind, nothing fancy). You can stop thinking and in a few minutes you'll feel just a little upbeat feeling, maybe fun ideas.

It's a bit odd and paradoxical but your best choice is not to listen to your negative ideas..


And if you do feel the need to engage, tell them:

"In time, come back when you have something good!"


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.


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


I view it as a probability spectrum. Prior default 10% this, 90% that... if you don't do anything you get that 90% outcome.. but you can act!!! And that increases the likelihood of the 10%. This means you need to apply Bayes Law to your thoughts. It also explains reality distortion fields etc...


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.


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.


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.


Seligman also teaches children to speak specifically about negative topics (2007 book, The Optimistic Child). His research says that a more optimistic speech pattern can be learned, where you actively reduce "always" sorts of words. He claims to have proven outcomes in reducing depression rates after several years.


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.


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.


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).


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...


"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... "


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.


You might want to get some tests done on your gut microbiome. Fiber is really important for long term health. Inability to digest fiber is often indicative of gut flora issues.


This. Dietary fiber is important to positive gut health (flax is a good place to start if you're interested). While cutting carbs and fiber in the short term may have some positive impact (maybe the OP was cutting out a lot of processed fiber/carbs) I can't imagine this is good in the long run. I'm, personally, surprised the conflated war on "carbs" is still a thing. You can't eat fruits and vegetables without carb intake. Not many people are going to claim the fiber and carbs in Kale is harming them detrimentally. Carbs are not the devil certain fad diets claim. The finger should be pointed at the type of food first by asking a question like: is it whole or processed. But lumping them all together is just spreading a lot of misinformation unfortunately.


What tests would you recommend, and what can be done if they show a problem?


Gojiman has some good information about this on his YouTube channel:

https://youtu.be/4VeRuSk76hE

If the tests do turn up any issues the treatment depends specifically on what the issues are.


Not sure why you're being downvoted. There's research indicating links between gut bacteria and (among others) mental health:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662178/

And of course one's gut bacteria culture heavily depends on what one eats.


Not downvoting as it’s still an interesting comment bringing personal insight.

This is an article about a different approach to detect/diagnose depression, and the first comment reads a lot like “this weird trick I used to beat depression”.

The “Not meaning to demean anyone's hard work with psychology, but” really doesn’t help. They found a way to beat their depression, what does it have to do with other people’s hard work in psychology ?


Well, the article and the research it discusses is exclusively focussed on language.

Of course, there are more factors to depression beyond just language. Your body's internal chemistry is also going to factor in.

You say cutting carbs and fibers from your diet helped you. It might help some other people as well. For yet another group of people with depression, such a change might not help at all.

There's no magic solution and there are many, many possible causes for why a person is suffering from depression.


My impression (from my wife who is in med school) is specific diet recommendations are very challenging to properly research and quantify for doctors. Sure we know certain things behave certain ways and some things are objectively bad, but it can be hard to recommend a scientifically back diet.

With the proper knowledge, it's relatively easy to identify diet deficiencies (e.g. low iron, calcium, or vitamin D levels) but it can be a lot harder to pinpoint excess as the body generally does a good job ridding itself of too much of something.

Effects of diets can also take years and years to study. Look at Keto. Lots of people are claiming to see great results from it. I've tried it myself and have seen the positive effects.

The problem is nobody knows what the long term effects of Keto will be. They look great in the short-term, like "curing" diabetes, but the long term results aren't so clear. There's a chance that a Keto diet (or any diet) could be placing significant unseen stress on the body.


If you want to run your own experiment try Whole 30.


Depression can be a symptom of Celiac disease and the effects you've seen from your diet change would be consistent with that...have you been tested for Celiac? Did/do you have any of the other symptoms associated with that condition?

If you haven't been tested, you should have your doctor get you the blood test since knowing for sure may point to other things (e.g. beer) that you should stay away from and may inform other medical decisions.


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


You could try some probiotics to see of it helps. Yogurt is particularly easy to integrate into a daily regimen if you don't want the pill forms, although the pills often have a broader variety of bacteria. See if that improves your carb sensitivity.


You should start paying close attention to the carbs. Also Cruciferois veggies can be rough on the stomach (bloating, gad). Just see hat you observe. Carbs get stored readily as muscle glycogen, so maybe something in that process is causing issues for you.


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


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.


> 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)


> 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.


That’s possible, I definitely shoot for low inflammation. I think it’s the foods themselves though because I’ve done calorie restriction with less optimal foods and if I have sugar my joints will hurt the next day.


No doctor would suggest "eliminating" fiber, a low fiber diet puts you at risk for developing a bunch of diseases. A no fiber diet sounds downright dangerous.

The composition of the elimination diet almost certainly has nothing to do with the resolution of symptoms, just the feeling of being in complete control. We know that people report a wide range of foods as "bad," and one person's "bad" foods are another person's "good" foods, so any particular suggestions are going to be useless. Its been my observation its entirely about perception, not anything to do with the foods they consider "bad," most people I know with extreme diets that have cured all sorts of illnesses actually eat foods that are on their "bad" list because they don't realize it can fit into their "bad" category.


here's the thing though, i've experienced the literal opposite of what you're talking about: adding fiber to my diet helped with mitigating my depression.

i think a lot of this kind of diet related advice is anecdotal and very person-specific. we should absolutely ask people to experiment with their diet more, but depending on the extent of their depression and the amount of flexibility they have in their lives (someone who works two jobs a day might find it difficult to find the energy to change their cooking/eating habits), this could be quite difficult for them

and its totally possible that a significant fraction (possibly even the majority) of people suffering from depression will see no major benefits to changing their diets.


No fiber? How do you poop??


But what do you eat? Mostly fat and protein?


Think about hunter gatherers during the Paleolithic period. Nuts, meat, fat, eggs, bone marrow, liver, berries etc.


100g Almonds carbohydrate 22g (and lots of paleo friendly fat and protein)

100g strawberries carbohydrate 8g (basically the rest of the weight is water)

These are hardly "not eating carbohydrates".

Also, considering any product of modern agriculture "paleolithic" is inaccurate. The almonds and strawberries differ greatly from the wild varieties available to primitive hunter-gatherers - largely because they have drastically increased carbohydrates - but even the chickens/turkeys/cows producing meat and eggs are very different from undomesticated animals.

Even kale and broccoli didn't exist before about 4000 years go.


Still better that consuming bread, sugar and alcohol. I didn't write that you should consume 100% prehistoric food.


But on that list are great sources for fiber and carbs, namely berries and nuts. So going by the assumptions that we should eat like the early humans did, it makes no sense to avoid fiber and carbs.


With respect, how should I think about them? Just dream up whatever I want? Okay. My Paleolithic people ate mostly fish, and supplemented with breadfruit and coconuts. Is that right? You don't have any idea, because you weren't there.

Also, WHICH Paleolithic people? I must imagine that those people ate varied diets that were contingent on their locality. People on the tundra would maybe not be eating so many nuts.

Encouraging people to construct their diet by imagining the past is a useless exercise.


You do not have to positively identify what they ate so much as identify what they did not eat. They did not eat canned food, microwave meals or McDonalds or soda/chips.

Does that help?


Or broccoli, cauliflower, kale, cabbage, etc.

Or any fruits or vegetables you can buy in any modern restaurants or stores.

Or meat from any domesticated animal.

Not sure that helps, frankly.


There was no single "Paleolithic diet," different peoples in different geologic areas ate different things in differing amounts.

Even if there was, the foods that existed in Paleolithic times no longer exist due to both natural genetic changes combined with selective breeding.


I wanted to try the paleo diet, but the supermarket was always sold out of mammoth, saber-tooth, and aurochs meat.


They would dig up roots and tubers as well.


What did you change in your diet?

Changing a diet seems like a hard thing to do while you are suffering from depression.


Diet changer here, the first rule of diet, before you even look at what you eat, is that you need to eat. I started eating breakfast consistently. Often eating filling food like leftovers.


I don't think this is necessarily true. For me, eating anything makes me slightly feel worse, either it's feeling a little tired or something else. That's why sometimes, I eat 2 meals a day and get all my calories (~3000 calories) in two meals.


And I feel at my best when I eat at most once a day (with regular fast days). When I eat all day I feel gross and sluggish.


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.


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...


I've always wanted to delve more into E-prime, general semantics after hearing about it in a lot of Robert Anton Wilson's lectures. Language definitely has an effect on the way we think and feel. I recently bought a book called 'The Tyranny of Words' by Stuart Chase that I need to find the time to read too.

Keep in mind that general semantics is mostly pseudoscience, or at least ont the fringe.


There's an enlightening discussion interweaved with clinical examples on the power of chanting, synchronised rituals, theatre and Neurofeedback (among many others) in treating trauma patients in The Body Keeps the Score by Bessel van der Kolk, which I highly recommend for going deeper into the points you mentioned.


As someone who has come out of depressiveness, for me it was mostly about physical factors in the end: routine, sleep, always eating regularly (breakfast!).

I don't know what to think about the mental factors. For me they seem to mostly be symptoms of a bad physical state.

Some approach to both worlds is needed: Also I needed that the absurdly negative voices in my head would shut up, when I was trying to sleep. Some of that was just healing over time, I think.


> Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy.

-- Thich Nhat Hanh


Sometimes we forget to smile, thanks for reminding us. :)

https://www.ncbi.nlm.nih.gov/pubmed/25139308


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.


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.




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