Mental Health : Markers of Concern from Students

I saw a brilliant musical performance this week, by a student whom I know has struggled over recent years, and who has seen counsellors for mental health issues on a regular basis.  The performance was so assured, so happy and so impressive; and when I offered congratulations as the end, I got a wonderfully warm and proud smile.  I also know that this particular student has been offered several university places, and that all is looking good for the upcoming IBDP exams.  So when I was speaking with that student's mother later, I remarked how it seemed things were going well.  Her wise response was a good reminder of things I know from my own family and personal experiences - that we should take nothing for granted; that despite outward appearance, it is very hard to know what's going on internally for anyone.  This mother was talking about her child, of course, but it made me reflect on how we can know what's happening for all our students in schools.

A recent conversation reminded me that our inner worlds
 may be very different to what we portray publicly.  

A lot of the time we rely on good relationships between students and teachers, and trust that issues will emerge.  Of course, some students - perhaps most often precisely those who need support - find it difficult to open up and admit vulnerability.  We are fortunate that in these cases friends often alert us that they are worried, but I have been wondering if there are signals that we should be looking out for.  This is a very well researched topic (see here for example), and signs such as withdrawal, apathy or increased nervousness are things all teachers look out for.

Researchers Al-Mosaiwi and Johnstone have, however, recently suggested that we should be looking at the language people use.  It'll come as no surprise that those with symptoms of depression use more negative adjectives and adverbs (such as lonely, sad or miserable); but more interestingly, it turns out that increased use of me, myself and I over they, them, he and she are are also giveaways.  The researchers argue that pronouns are actually more reliable in identifying depression than negative emotion words (perhaps because people with depression are more focused on themselves, and less connected with others), but the pragmatic teacher in me knows that I will never manage to spot which teenagers are naturally just a little self-focussed as a passing phase, and which are ones to worry about.

It seems, however, that a much better indicator of mental health issues is highly increased use of use of absolutist words such as always, nothing or completely.  The researcher found that the prevalence of absolutist words is approximately 50% greater in anxiety and depression forums, and approximately 80% greater for suicidal ideation forums.  This is a massive effect, and one that should be recognisable to teachers and parents if we listen carefully.   It fits with the idea that when we see a situation as permanent, and our problems as pervasive over all our experiences, that we are likely to experience  a challenge as a trauma.

The ways we use language non-consciously, as well as our
 intentional words can provide clues to our emotional balance.

An obvious question here is the familiar language-thought one: If we can help students avoid absolutist words, will that help those in distress?  The danger here of course is that we muddle up the causal relations; addressing symptoms (language) is not addressing root causes (mental distress).  It would be ridiculous to simply ask someone to stop using marker words and thereby think one has helped them.   That said, if we can help students see that the stories we tell ourselves matter a great deal, then we will be talking about avoiding a permanent and pervasive outlook  - and if we are successful that should mean that always, everywhere, never, completely, perpetually, invariably, forever, totally, ultimately will appear less in thinking - and hence, I guess, in language.  

There are no easy answers here; it is not  a magic recipe to ask questions like why do you say it will 'never' get better? or You say that about 'everyone'; so I wonder, is there anyone that does not apply to?  But questions like these do draw attention to the ideas of permanence and pervasiveness which is surely helpful.

I fear to stray into areas of counselling that are not my forte; the difficult, intense, highly-skilled and incredibly important work of counsellors can in no way be replaced by simple attention to language.  But awareness is surely valuable to both parents and teachers who need to be able to see below the public personas of teenagers.

Thanks to Gemma Dawson for some ideas here.

References
Al-Mosaiwi, M. (2018) People with depression use language differently – here’s how to spot it.  The Conversation.
Al-Mosaiwi, M. and Johnstone, T. (2018) In an Absolute State: Elevated Use of Absolutist Words Is a Marker Specific to Anxiety, Depression, and Suicidal Ideation. Clinical Psychological Science