Depressed? Watch the words you use

Kinsale CBT therapist Linda Hamilton's Southern Star column exploring the link between language and depression.
Absolutist words like 'totally' and 'definitely' are associated with depression.

Last week's Your Mental Health column in The Southern Star column explored new research regarding the link between depression and the words people use in their everyday language. The column is reproduced below.

 

"Me”, “myself”, “I”, “always”, “definitely”, “totally” – these may sound like a bunch of harmless words, but they can actually be indicative of depressed thinking.

 

A new study has found depressed people use a lot more first-person singular pronouns – words like “me”, “myself” and “I” – and a lot fewer second- and third-person pronouns (“they, “them”, “she”). The study, which examined language used by over 6,400 members of different mental health online forums, also found absolutist words like “always” and “completely” were roughly 50 per cent more common in anxiety and depression forums than in non-mental health-related forums.

 

Frequent use of words like “I” and “me” indicate a person is more focused on themselves and less connected with others, which is what one generally expects to find with depression. Similarly, the usage of absolutist words is not surprising – after all, when you’re down, you’re more liable to think in a negative, black-and-white fashion.

 

However, we should be very careful of the language we use. The above traits are not simply a consequence of being depressed – they can be a cause of it. The researchers found the same kind of language was found in depression recovery forums. We know that people who have experienced at least one depressive episode are at greater risk of experiencing a relapse at some stage in the future. This tendency towards absolutist, self-focused thinking, the study suggests, may play a part in causing a depressive relapse.

 

Other studies have reached similar conclusions regarding the dangers of excessive self-focus, which is especially associated with social anxiety. In conversation, for example, you may find you are completely focused on yourself and on the impression you are leaving – so much so you barely take in what the other person was saying. Afterwards, you ruminate on your performance and engage in acute self-criticism that further dampens your mood. Rumination – going over things again and again, replaying negative events – has been linked to “increased sadness, distress and anxiety, reduced motivation, insomnia, and increased tiredness, self-criticism, pessimism and hopelessness”, to quote cognitive behavioural therapy (CBT) expert Dr Edmund Watkins (continued below...)

 

DEPRESSION AND SELF-FOCUS

It’s important to be self-aware, but an excessive focus on oneself should be avoided. You can end up living inside your own head and wrapped up in your own perceived troubles, the end result being you grow more distant and separate from those around you. Self-focus grows more acute when we are on our own or inactive, which is why behavioural activation – essentially, engaging in everyday behaviours and activities that keep us occupied and boost mood – has always been central to CBT treatment of depression. Immersing oneself in activities neuters the tendency toward self-absorption; its importance cannot be underestimated.

 

It’s similarly important to become conscious of absolutist thinking. Learning to spot and correct black-and-white, all-or-nothing thinking has always been a core part of CBT. Do you often use words like “always”, “never”, “impossible”, “terrible”, and “perfect”? Would a scientist use these words, or would they use more qualified language? Can you see how such words may be emotionally arousing and exaggerated?

 

All of us are occasionally absolutist in our thinking, especially when stressed or pressurised. The danger is when such language and self-talk becomes habitual and automatic. “Why do things always go wrong?”; “nothing ever works out”, “I’ll never get things right” – these kind of statements are as inaccurate and exaggerated as they are unhelpful.

 

BLACK-AND-WHITE THINKING

 In all areas of life, things are rarely black and white. It’s important to try and think in a more balanced fashion, to see the shades of grey. For example, ask yourself: is it true to say a part of your life may be difficult at the moment but it might get easier in the future? Can one aspect of your current life be stressful but other aspects be enjoyable? Can parts of an experience – for example, a night out or social engagement – be negative but other parts of it be OK? Can you be a pretty intelligent person and still do something stupid? 

 

Everyone can agree the answer to each of those four questions is “yes”. As I often say, better mental health isn’t about “positive” thinking – it’s about balanced, helpful thinking.