Bob
Senior Member
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- 16,455
- Location
- England (south coast)
I haven't read any depression literature, so I'm not familiar with the arguments for and against the HADS questionnaire.
But even in science (or especially in science) common sense needs to be used.
Common sense means to use common logic to assess a situation, to get the best result.
When my ME symptoms are at their worst, and I'm exhausted, with severe malaise, I will not answer positively to any of the HADS questions. But this has nothing to do with depression. I suppose it could be correct to say it's related to distress, for want of a better word, or physical stress.
When someone has a severe bout of flu, they would also answer negatively to all the HADS questions. But it's nothing to do with psychological depression. It's to do with the physical distress of feeling severely physically ill.
If someone is in severe pain, all the time, then it's not likely that they are going to feel 'cheerful' all the time. If someone is too exhausted to crawl to the toilet, or to make a sandwich, and is flat out on the sofa all day, then their 'appearance' is the last thing on their mind. If someone has been suffering from significant cognitive impairment for months on end, has a constant head ache, feels constantly cognitively ill-at-ease, and has partially lost their memory, has suddenly become disabled, and has lost their job and their social network, then perhaps they might struggle to 'laugh and see the funny side of things' very often. But that doesn't mean they are depressed. It just means there's not a lot to laugh about.
I cannot see how the HADS questionnaire can possibly distinguish between depression and the stresses and limitations of living with a severely incapacitating illness.
HADS:
I still enjoy the things I used to enjoy
I can laugh and see the funny side of things
I feel cheerful
I feel as if I am slowed down
I have lost interest in my appearance
I look forward with enjoyment to things
I can enjoy a good book or radio or TV programme
But even in science (or especially in science) common sense needs to be used.
Common sense means to use common logic to assess a situation, to get the best result.
When my ME symptoms are at their worst, and I'm exhausted, with severe malaise, I will not answer positively to any of the HADS questions. But this has nothing to do with depression. I suppose it could be correct to say it's related to distress, for want of a better word, or physical stress.
When someone has a severe bout of flu, they would also answer negatively to all the HADS questions. But it's nothing to do with psychological depression. It's to do with the physical distress of feeling severely physically ill.
If someone is in severe pain, all the time, then it's not likely that they are going to feel 'cheerful' all the time. If someone is too exhausted to crawl to the toilet, or to make a sandwich, and is flat out on the sofa all day, then their 'appearance' is the last thing on their mind. If someone has been suffering from significant cognitive impairment for months on end, has a constant head ache, feels constantly cognitively ill-at-ease, and has partially lost their memory, has suddenly become disabled, and has lost their job and their social network, then perhaps they might struggle to 'laugh and see the funny side of things' very often. But that doesn't mean they are depressed. It just means there's not a lot to laugh about.
I cannot see how the HADS questionnaire can possibly distinguish between depression and the stresses and limitations of living with a severely incapacitating illness.
HADS:
I still enjoy the things I used to enjoy
I can laugh and see the funny side of things
I feel cheerful
I feel as if I am slowed down
I have lost interest in my appearance
I look forward with enjoyment to things
I can enjoy a good book or radio or TV programme