depression symptoms

How a Person Uses Language Can Be a Clear Sign of Depression Symptoms

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Here’s what you need to know.

From the way you move and sleep, to how you interact with people around you, depression changes just about everything. It is even noticeable in the way you speak and express yourself in writing.

Sometimes this ‘language of depression’ can have a powerful effect on others. Just consider the impact of the poetry and song lyrics of Sylvia Plath and Kurt Cobain, who both killed themselves after suffering from depression.

Scientists have long tried to pin down the exact relationship between depression and language, and technology is helping us get closer to a full picture.

Our new study, published in Clinical Psychological Science, has now unveiled a class of words that can help accurately predict whether someone is suffering from depression.

Traditionally, linguistic analyses in this field have been carried out by researchers reading and taking notes. Nowadays, computerised text analysis methods allow the processing of extremely large data banks in minutes.

This can help spot linguistic features which humans may miss, calculating the percentage prevalence of words and classes of words, lexical diversity, average sentence length, grammatical patterns and many other metrics.

So far, personal essays and diary entries by depressed people have been useful, as has the work of well-known artists such as Cobain and Plath. For the spoken word, snippets of natural language of people with depression have also provided insight.

Taken together, the findings from such research reveal clear and consistent differences in language between those with and without symptoms of depression.

Content

Language can be separated into two components: content and style.

The content relates to what we express – that is, the meaning or subject matter of statements. It will surprise no one to learn that those with symptoms of depression use an excessive amount of words conveying negative emotions, specifically negative adjectives and adverbs – such as ‘lonely’, ‘sad’ or ‘miserable’.

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. Researchers have reported that pronouns are actually more reliable in identifying depression than negative emotion words.

We know that rumination (dwelling on personal problems) and social isolation are common features of depression. 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?

Style

The style of language relates to how we express ourselves, rather than the content we express. Our lab recently conducted a big data text analysis of 64 different online mental health forums, examining over 6,400 members.

‘Absolutist words‘ – which convey absolute magnitudes or probabilities, such as ‘always’, ‘nothing’ or ‘completely’ – were found to be better markers for mental health forums than either pronouns or negative emotion words.

From the outset, we predicted that those with depression will have a more black and white view of the world, and that this would manifest in their style of language.

Compared to 19 different control forums (for example, Mumsnet and StudentRoom), the prevalence of absolutist words is approximately 50 percent greater in anxiety and depression forums, and approximately 80 percent greater for suicidal ideation forums.

Pronouns produced a similar distributional pattern as absolutist words across the forums, but the effect was smaller. By contrast, negative emotion words were paradoxically less prevalent in suicidal ideation forums than in anxiety and depression forums.

Our research also included recovery forums, where members who feel they have recovered from a depressive episode write positive and encouraging posts about their recovery.

Here we found that negative emotion words were used at comparable levels to control forums, while positive emotion words were elevated by approximately 70 percent.

Nevertheless, the prevalence of absolutist words remained significantly greater than that of controls, but slightly lower than in anxiety and depression forums.

Crucially, those who have previously had depressive symptoms are more likely to have them again. Therefore, their greater tendency for absolutist thinking, even when there are currently no symptoms of depression, is a sign that it may play a role in causing depressive episodes.

The same effect is seen in use of pronouns, but not for negative emotion words.

Practical implications

Understanding the language of depression can help us understand the way those with symptoms of depression think, but it also has practical implications.

Researchers are combining automated text analysis with machine learning (computers that can learn from experience without being programmed) to classify a variety of mental health conditions from natural language text samples such as blog posts.

Such classification is already outperforming that made by trained therapists. Importantly, machine learning classification will only improve as more data is provided and more sophisticated algorithms are developed.

This goes beyond looking at the broad patterns of absolutism, negativity and pronouns already discussed. Work has begun on using computers to accurately identify increasingly specific subcategories of mental health problems – such as perfectionism, self-esteem problems and social anxiety.

That said, it is of course possible to use a language associated with depression without actually being depressed. Ultimately, it is how you feel over time that determines whether you are suffering.

But as the World Health Organisation estimates that more than 300 million people worldwide are now living with depression, an increase of more than 18 percent since 2005, having more tools available to spot the condition is certainly important to improve health and prevent tragic suicides such as those of Plath and Cobain.

World’s First Clinical Trial Finds Diet Works for Depression.

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Pioneering research from the Land Down Under shows you how to get out from under your depression!

Felice Jacka PhD is a trailblazing researcher at Deakin University in Australia who is calling the world’s attention to the powerful impact of food on mood. On January 30, 2017, the journal BMC Medicine published her new randomized controlled study called The SMILES Trial. This groundbreaking research demonstrates for the first time that people with moderate to severe depression can improve their mood by eating a healthier diet.

You may be surprised to hear that this kind of study has never been done before, probably because you have read headlines in the past proclaiming that healthier diets decrease risk for depression. We have Professor Jacka and her team to thank for many of those hopeful headlines. Over the past seven years, she published numerous epidemiological (survey-based) studies suggesting that people who report eating an unhealthy diet are more likely to be depressed. However, since these studies were based on questionnaires and weren’t actual diet experiments, they didn’t have the power to PROVE that unhealthy diets CAUSE depression, and couldn’t prove that healthy diets could TREAT depression. These were simply educated guesses that hadn’t been tested in the real world yet. Until now.

Professor Jacka boldly went where no one has gone before: she tested her theories on actual people with clinical depression…and emerged victorious.

The Study

Professor Jacka’s team recruited 67 men and women with moderate to severe depression who reported eating a relatively unhealthy diet. Most were taking antidepressants and/or were in regular psychotherapy.

They put half of these depressed people on a modified Mediterranean diet (aka the “ModiMed” diet—more details below) and required them to attend dietary support sessions with a nutritionist.

The other half continued eating their usual unhealthy diet, but were required to attend social support “befriending” sessions.

Before and after the 12-week study, everyone’s depression symptoms were graded using several different tests. The test this research group chose to focus on was the MADRS scale (Montgomery–Åsberg Depression Rating Scale), which rates mood on a scale of 0 to 60, with 60 being the most severely depressed.

Adapted from Jacka FN et al 2017.
Source: Adapted from Jacka FN et al 2017.

After 12 weeks, people in the ModiMed diet group saw their MADRS scores improve on average by about 11 points. Thirty-two percent (10 out of 31 completers) had MADRS scores so low that they no longer met criteria for depression—remission!

People in the unhealthy diet group improved by only about 4 points on the MADRS test and only 8% (2 of 25 completers) achieved remission.

More happy details:

Calories were not restricted and body weight stayed about the same for everyone in the study, so people didn’t have to lose weight to feel better.

Surprisingly, the ModiMed diet cost about 19% less than the standard unhealthy diet.

The diet plan was apparently easier to stick to than the social support plan, since more people in the diet group (31 out of 33) made it all the way to the end of the study, compared to only 25 out of 34 people in the support group.

What is the ModiMed diet?

Suzi Smith, used with permission
Source: Suzi Smith, used with permission

Encouraged foods: whole grains, fruits, vegetables, legumes, low-fat/ unsweetened dairy, raw unsalted nuts, lean red meat, chicken, fish, eggs, and olive oil

Discouraged foods: sweets, refined cereals, fried food, fast food, processed meat.

Beverages: maximum two sugar-sweetened beverages per week and maximum two alcoholic drinks per day, preferably red wine.

So, what is so special about the ModiMed diet?

Well, THAT is the $64,000 question, and the answer is? We don’t know.

It could be that this diet was higher in some potentially magical ingredient like olive oil or nuts.

It could be that this diet was lower in some potentially evil ingredient like processed meat or refined carbohydrates.

It could be both.

My opinion, based on everything I know about food and the brain, is that this diet is better than the average diet because:

  1. It is extremely low in refined carbohydrates (sugar, flour, refined cereals, etc). These non-foods put your blood sugar, insulin, hormones, and neurotransmitters on a dangerous invisible roller coaster. This destabilizes mood and increases risk for insulin resistance, which causes brain damage over time.
  2. It contains plenty of natural fat and cholesterol, which the brain needs to function properly [in my opinion the ModiMed diet unnecessarily limits saturated animal fats].
  3. It is low in processed oils from seeds such as cottonseed, safflower and corn. These industrially-refined oils are very high in omega-6 fatty acids, which tilt the brain towards inflammation and away from healing.
  4. It contains animal sources of protein, which are rich in key brain nutrients such as iron, zinc, and vitamin B 12, and free of anti-nutrients, which interfere with protein and mineral absorption.
  5. It is based primarily on whole foods, which humans are well-adapted to eating.

Real Hope for the Real World

I LOVE this study, because it proves that the human brain cares deeply about what we eat. I wish ALL of all of my patients would try a healthy diet before trying a prescription medication. Don’t get me wrong—I prescribe medications every day and I have seen them work wonders. But clearly the most powerful way to fundamentally change your brain chemistry is through food, because that’s where the brain chemicals come from in the first place! I believe a healthy diet can in many cases reduce or eliminate the need for prescription medications.

With the exception of crisis situations and special barriers to dietary change, why not start by improving the quality of your diet? What do you have to lose? Healthy diets have no co-pays, no side effects, and are good for the whole body, not just the brain.

The bottom line is this: the ModiMed diet is clearly superior to a junky standard diet loaded with fast food, processed foods, and refined carbohydrates. It is also affordable and manageable in the real world!

Take a Bite Out of Your Depression!

For those of you who eat a low-fat, vegan, vegetarian, low-carb, or Paleo diet, this study cannot tell you whether or not the ModiMed diet is better for depression than your diet. Until we have studies that compare these diets to each other, the only way for you to know which diet works best for your mood is to compare them yourself.

For those of you who have tried a Mediterranean diet without success, there is still tremendous hope. There are other healthy changes worth trying—my two favorite recommendations being:

  1. Lowering overall carbohydrate intake, especially if you have insulin resistance.
  2. Removing grains and legumes, which interfere with the absorption of key nutrients the brain needs to work properly, such as iron and zinc.

For those of you who don’t care to try the ModiMed diet, there are MOUNDS of evidence incriminating the refined carbohydrates and industrially-produced foods that form the basis of our American diet. So, regardless of what is IN your favorite diet, make sure you get the junk OUT.

Your brain, your metabolism, and your whole body will be happier and healthier.

9 Surprising Depression Symptoms

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  • 1. You’re in pain.
  • 2. You’re busting out of your pants.

Most of us would recognize classic depression symptoms, with its heavy veil of sadness and hopelessness. But what if you just started getting stomachaches or were suddenly very snappy? Could you be depressed without knowing it? (Here are 5 strange, surprising depression triggers.)

“Depression doesn’t always look like debilitating sadness,” says Richard Kravitz, MD, MSPH, a professor of internal medicine at University of California, Davis, and an expert in identifying depression in primary-care settings. “Patients are reluctant to consider depression as a cause of their symptoms—in part because they may equate it with weakness, but also in part because they simply don’t associate those symptoms with depression.” (Looking to take back control of your health? Prevention has smart answers.

Accurately identifying the problem is key, he adds, because the sooner you get treatment, the easier it will be to return your happy, healthy self. Here are 9 surprising warning signs you don’t want to miss.

Antidepressant therapy linked to improved CV outcomes

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Antidepressant therapy may offer an additional benefit of reducing cardiovascular disease (CVD) risk in cardiac patients with depression, a study has shown.

“We hypothesised that taking both statins and antidepressants would reduce cardiovascular [CV] risk more than either medication alone,” said lead study author Dr. Heidi May of the Intermountain Medical Center Heart Institute in Salt Lake City, Utah, US. “- However, we found that the effectiveness of antidepressants and statin therapy to reduce death and incident CVD at 3 years varied by the severity of depression symptoms.”

Antidepression therapy did not improve CVD risk in patients with mild or no depression. However, Patients with moderate-to-severe depression who took antidepressants alone had a 53 percent lower risk of death, coronary artery disease (CAD), or stroke during the 3-year follow-up compared with no treatment. [ACC 2015 Scientific Sessions, Abstract 1178-111]

Of note, taking a cholesterol-lowering statin, either alone or with antidepressants, did not improve CVD risk (hazard ratio [HR], 0.83 and 0.97, respectively) in these patients.

“The take away [message] from this study is that screening and treatment of depression symptoms should be a high priority,” said May. “Focus is usually placed on traditional CV risk factors and unfortunately, depression is often overlooked. This study adds to the evidence that, when used properly, antidepressants can improve CV outcomes among those with depression symptoms.”

The researchers analysed the health records and rates of death,  CAD, and stroke of 26,828 patients with no known CVD or antidepressant use. A nine-question depression screening questionnaire was used to determine their level of depression.

While the study did not examine how antidepressants reduced CVD risk, May said the easing of depression could have possible downstream effects on behavioral change.

“For example, people who are having depression symptoms may not be as inclined to exercise, practice good health habits, or comply with health advice. Using an antidepressant to reduce depression symptoms might also help people to better take care of their heart health,” May said.

12 Foods To Eat When You’re Totally Stressed Out

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When work deadlines begin piling up and your social calendar is booked, the last thing you want to hear is to steer clear of the vending machine. Who has time for healthy eating? But when it comes to combating stress levels, what you eat may actually help relieve your tension. Indeed, some foods may help stabilize blood sugar or, better yet, your emotional response. Here, 12 foods to reach for when you’ve just about had enough.

AVOCADO

Green leafy vegetables.
leafy vegetables

It’s tempting to reach for a cheeseburger when stressed, but go green at lunch instead. “Green leafy vegetables like spinach contain folate, which produces dopamine, a pleasure-inducing brain chemical, helping you keep calm,” says Heather Mangieri, RDN, a spokesperson for the Academy of Nutrition and Dietetics. A 2012 study in the Journal of Affective Disorders of 2,800 middle-aged and elderly people and found those who consumed the most folate had a lower risk of depression symptoms than those who took in the least. And, a 2013 study from the University of Otago found that college students tended to feel calmer, happier and more energetic on days they ate more fruits and veggies. It can be hard to tell which came first — upbeat thoughts or healthy eating — but the researchers found that healthy eating seemed to predict a positive mood the next day.

Turkey breast.
You’ve probably heard that the tryptophan in turkey is to blame for that food coma on Thanksgiving. The amino acid, found in protein-containing foods, helps produce serotonin, “the chemical that regulates hunger and feelings of happiness and well-being,” Mangieri says. On its own, tryptophan may have a calming effect. In a 2006 study published in the Journal of Psychiatry Neuroscience, men and women who were argumentative (based on personality tests) took either tryptophan supplements or a placebo for 15 days. Those who took tryptophan were perceived as more agreeable by their study partners at the end of the two weeks compared with when they didn’t take it. (The study was funded by the Canadian Institutes of Health Research.) Other foods high in tryptophan include nuts, seeds, tofu, fish, lentils, oats, beans and eggs.

Oatmeal.
If you’re already a carb lover, it’s likely that nothing can come between you and a doughnut when stress hits. First rule of thumb: Don’t completely deny the craving. According to MIT research, carbohydrates can help the brain make serotonin, the same substance regulated by antidepressants. But instead of reaching for that sugary bear claw, go for complex carbs. “Stress can cause your blood sugar to rise, Mangieri says, “so a complex carb like oatmeal won’t contribute to your already potential spike in blood glucose.”

Yogurt.
yogurt

As bizarre as it may sound, the bacteria in your gut might be contributing to stress. Research has shown that the brain signals to the gut, which is why stress can inflame gastrointestinal symptoms; communication may flow the other way too, from gut to brain. A 2013 UCLA study among 36 healthy women revealed that consuming probiotics in yogurt reduced brain activity in areas that handle emotion, including stress compared to people who consumed yogurt without probiotics or no yogurt at all. This study was small so more research is needed to confirm the results—but considering yogurt is full of calcium and protein in addition to probiotics, you really can’t go wrong by adding more of it to your diet.

Salmon.
When you’re stressed, it can ratchet up anxiety hormones, such as adrenaline and cortisol. “The omega-3 fatty acids in salmon have anti-inflammatory properties that may help counteract the negative effects of stress hormones,” says Lisa Cimperman, RD, of the University Hospitals Case Medical Center and a spokesperson for the Academy of Nutrition and Dietetics. In a study funded by the National Institutes of Health, Oregon State University medical students who took omega-3 supplements had a 20% reduction in anxiety compared to the group given placebo pills. One 3-ounce serving of cooked wild salmon can have more than 2,000 milligrams of omega-3s, double the daily intake recommended by the American Heart Association for people with heart disease.

Blueberries.
“When you’re stressed, there’s a battle being fought inside you,” Mangieri says. “The antioxidants and phytonutrients found in berries fight in your defense, helping improve your body’s response to stress and fight stress-related free radicals.” Research has also shown that blueberry eaters experience a boost in natural killer cells, “a type of white blood cell that plays a vital role in immunity, critical for countering stress,” says Cynthia Sass, MPH, RD, Health’s contributing nutrition editor.

Pistachios.
pistachios

When you have an ongoing loop of negative thoughts playing in your mind, doing something repetitive with your hands may help silence your inner monologue. Think knitting or kneading bread—or even shelling nuts like pistachios or peanuts. The rhythmic moves will help you relax. Plus, the added step of cracking open a shell slows down your eating, making pistachios a diet-friendly snack. What’s more, pistachios have heart-health benefits. “Eating pistachios may reduce acute stress by lowering blood pressure and heart rate,” Mangieri says. “The nuts contain key phytonutrients that may provide antioxidant support for cardiovascular health.”

Dark chocolate.
Calling all chocoholics: a regular healthy indulgence (just a bite, not a whole bar!) of dark chocolate might have the power to regulate your stress levels. “Research has shown that it can reduce your stress hormones, including cortisol,” Sass says. “Also, the antioxidants in cocoa trigger the walls of your blood vessels to relax, lowering blood pressure and improving circulation. And finally, dark chocolate contains unique natural substances that create a sense of euphoria similar to the feeling of being in love!” Go for varieties that contain at least 70% cocoa.

Milk.
Fortified milk is an excellent source of vitamin D, a nutrient that might boost happiness. A 50-year-long study by London’s UCL Institute of Child Health found an association between reduced levels of vitamin D and an increased risk of panic and depression among 5,966 men and women. People who had sufficient vitamin D levels had a reduced risk of panic disorders compared to subjects with the lowest levels of vitamin D. Other foods high in vitamin D include salmon, egg yolks and fortified cereal.

Seeds.
pumpkin seeds

Flaxseed, pumpkin seeds and sunflower seeds are all great sources of magnesium (as are leafy greens, yogurt, nuts and fish). Loading up on the mineral may help regulate emotions. “Magnesium has been shown to help alleviate depression, fatigue and irritability,” Sass says. “Bonus: When you’re feeling especially irritable during that time of the month, the mineral also helps to fight PMS symptoms, including cramps and water retention.”

Avocado.
You can’t just reach for slice after slice of avocado toast during crunch time if you don’t want to gain weight, but this superfruit might help shut down stress-eating by filling your belly and making you feel more satisfied. In a 2014 study by Loma Linda University (which, full disclosure, was sponsored by the Hass Avocado Board), researchers had participants add half an avocado to their lunches, which reduced their desire to eat more by 40% for the three hours following the midday meal. That full feeling will make you less inclined to reach for unhealthy snacks when stress kicks in.

Cashews.
One ounce of the buttery nut packs 11% of the daily recommended value of zinc, an essential mineral that may help reduce anxiety. When researchers gave zinc supplements to people who were diagnosed with both anxiety symptoms (irritability, lack of ability to concentrate) and deficient zinc levels over a course of eight weeks, the patients saw a 31% decrease in anxiety, according to Nutrition and Metabolic Insights. This is likely because zinc affects the levels of a nerve chemical that influences mood. If you’re already getting enough zinc, then it may not help your mood to chow down on cashews (or other zinc-rich foods like oysters, beef, chicken and yogurt). But, cashews are also rich in omega-3s and protein, so they’re a smart snack no matter what.