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With the recent suicides of the designer Kate Spade and chef Anthony Bourdain, attention in the scientific and medical community has turned to attempts to detect and diagnose depression early on. Unlike cancer and other diseases, there are no biological markers to prompt doctors that trouble might be brewing. Therapists mostly rely on patients’ self-reported assessments and their own observations, but both are still highly subjective. However, scientists are beginning to understand that language, both structural and stylistic, can serve as an early warning sign of depression.

It has been understood that people change the way they speak when they are depressed. Their speech tends to be more labored, monotone with many pauses and stops. There is a perception of difficulty to collect their thoughts and structure fluid sentences. But newer studies published this year highlight a new aspect of language as a clue for depression: word choices and particular sentence structures can prompt professionals to watch for severe depression and suicide. People who are depressed often use the pronoun “I” instead of “she/he” or “we”, indicating intense focus on self and detachment from the lives of others. In a recent research published online in the Journal of Personality and Social Psychology, researchers gave questionnaires to more than 4,700 participants in six locations in the U.S. and Germany. The participants were not given any restrictions, except to write about their lives. The results proved the hypothesis: not only did people who were depressed use negative and sad language, their writing featured mostly “I” and “me” pronouns.

In addition to extreme self-awareness and self-consciousness, depressed individuals also write in absolute terms presenting a perspective of either black or white choices with no in-between options. People who are depressed “don’t see subtleties, and we can see this in the words they use,” says James W. Pennebaker, professor of psychology at the University of Texas at Austin. They use absolute words like “must”, “completely”, “should”, and “always” leaving no room for errors or aberration from expectations. The researchers from the University of Reading in the U.K. used software to keep track of absolutist terms used by 6,400 members of the internet forum geared towards people seeking an outlet for anxiety, depression, and suicid, and compared this terminology to a number of control groups. They found that approximately 1.5-1.8% of words used by the members of the depressive and suicidal group were absolutist. While this may seem like an insignificant increase, in reality, it represents a 50% increase in the usage of such words over a control population. Absolute words aren’t necessarily bad for a healthy person who is capable of realizing that the outcome of the current particular situation doesn’t translate to all such situations. A depressed person seldom leaves room for “grey” outcomes, frequently thinking that everything must go just so and demanding that the surroundings, often out of their control, correspond to their views exactly. The more flexible a person is, the better he/she is able to cope with situations which deviate from expectations.

To help health professionals identify dangerous situations early on, the field of computer-assisted language analysis is steadily developing and will eventually aid in tracking language to pinpoint a depressive state more quickly and accurately. But until then, psychologist recommend that people pay as close attention to their language as they do to their thoughts. “Very often, what you say is what you internalize,” says Mr. Al-Mosaiwi, a Ph.D candidate in psychology at the University of Reading. He recommends replacing negative words with more neutral statements if a patient cannot muster a positive attitude. He urges everyone not to think and speak in absolute terms, and always leave room for outcomes not turning out exactly as planned. Other recommendations include keeping a journal and monitoring the usage of pronouns and language overall as well as involving family members in paying close attention to speech.

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