Review
The standard psychological questionnaire for depression doctors have given me is the PHQ-9. It names a symptom, and for each symptom it gives four possible responses in severity. The responses are worth points, the points are totaled, and the final score is supposed to be indicative of how severe a person’s depression is.
This is what it looks like:
According to Wikipedia, the final score indicates the following:
To be perfectly blunt, while I suppose this functions for doctors to get an idea of where their patient is at, it’s absolute garbage for giving the patient a sense of how depressed they are. Knowing how many times in the last two weeks you’ve felt ‘down, depressed, and hopeless’ isn’t super helpful when you’re trying to understand - or worse, explain to someone else - what it’s like in your head.
To that end I’ve been slowly developing my own sense of how depressed I am at any given time, and it’s based on a percentage scale.
The Scale
When trying to understand my own depression, I eventually came to the conclusion that, when depressed, I am not (in reality) the person I see myself as. I have a self-image, a conception of what I’m supposed to be like, and my depressed self isn’t it.
The key insight, however, was that there is a sense in which the person I am while depressed is a fraction of the person I identify as. My depression lessens me, but how much it lessens me is quantifiable.
Granted, it’s still self-reported so it’s not exactly an objective measurement, but neither is the PHQ-9.
If my depression lessens me, then I can get a feel for what percentage of myself I am at any given time - and that provides a reasonable sense for how depressed I currently am.
The scale runs from 0% to 100%, where 0% is ‘I am so utterly not myself that life does not feel worth living’ and 80% is ‘basically normal’. I can’t speak for others, but even when I’m not depressed at all I’m still not totally the person I want to be, which is why ‘normal’ is 80%. 100%, here, means something along the lines of ‘completely self-actualized, utterly myself in all the ways that matter’. I sincerely doubt that there are many (or plausibly any) people who spend all their time at 100%.
The scale in summary:
One of the most interesting parts of moving around this scale is that I’ve started to get a sense for what percentage certain feelings, behaviors, and cognitive abilities correspond to (for me). For instance, at 10% I’m too empty to even be particularly sad, and at 60% I can write nonfiction but not fiction (whereas I can write both at 80%).
0-10%
This is the realm of the living dead. When I am a single digit percentage of myself, life does not feel worth living and there is nothing to be done. I would be beset by despair, ennui, heartbreak and loss - if I could feel anything other than the grey blank soulless fog that consumes every waking moment with its quiet unfeeling dread.
Emotionally, I’m dead inside. I feel nothing. Sometimes that’s not so bad - there’s no anxiety either - but on the whole it’s an awful experience.
Cognitively, I’m substantially handicapped. My memory is bad, I can barely learn anything new, and I can only follow instructions.
Personally, I have no agency or initiative. I’m not making plans, I’m not pursuing goals, I’m just trying to make it from one minute to the next.
Luckily I’ve rarely spent any time here; I tend to bottom out around 15%.
10-20%
This is as low as I tend to go, and it’s very very unpleasant. 15% feels like I’m a vague shadow of the person I ought to be, and the contrast is cruel in how it highlights what I’m lacking. I can barely perform my activities of daily living (showering, brushing teeth, going to work, etc.), but they tend to suffer greatly in quantity or quality.
I can’t do any real writing of quality, and I find myself rereading and rewatching books and movies instead of seeking out new content, finding comfort in the familiar and predictable. I have little desire for novelty; new feels scary, and I don’t think I can handle it.
Emotionally, I’ll get little blips of feeling here and there, positive and negative, but things are mostly numb. I don’t have much anxiety, but that’s mostly because I don’t care enough about anything to be anxious about it.
Cognitively, I feel like a moron, like I’m operating 20-30 IQ points below where I ought to be. I can solve straightforward problems if they’re put right in front of me, but anything that involves creativity, learning, adaptation, improvisation, etc. is beyond me.
Personally, I have just enough agency to continue existing plans and commitments, but zero initiative to change anything or take on new ones.
20-30%
There is something to be said for not being at the bottom anymore - for being able to look down from where you are, instead of only up. At this percentage range I gain a little more of myself back, enough to start thinking about the future and things I may want the future to involve.
Emotionally, I can have peaks and troughs of emotion now, which isn’t necessarily a good thing. While there is a nonzero amount of happiness to be found when with friends, given the general state of my life while at this percentage there’s a lot more reason to be sad than happy.
Cognitively, I struggle to learn and problem solve, although not quite as much as before. Thinking feels like wading through quicksand, and not-thinking is always easier.
Personally, the embers of agency and initiative have returned, but it’s mostly just enough to realize when I’m not using them, as opposed to being able to exercise them in full.
30-40%
At 30-40% there’s a step change in my cognition. I’m not firing on all cylinders, not even close, but I’m no longer quite so useless either. A modicum of problem-solving ability has returned, and with it the motivation to start cleaning up all the messes that have been accumulating in my depressed state. I’ll vacuum, clean the bathroom, start making plans with friends, workout, etc.
Emotionally, I have a more positive affect and outlook. My recovered ability to solve problems leads to more optimism about things getting better. On the other hand, I can now feel anxiety, sadness, and grief, still partially numbed but getting stronger.
Cognitively, I am no longer just an instruction-executor. I can think about possible solutions, try new things, and seek help where needed. I’m still not particularly quick or efficient and everything still seems complicated and difficult, my memory still isn’t the greatest, but I can at least pursue avenues towards success.
Personally, I can take certain initiatives and feel more agentic. I can start to think about my goals and ambitions, not in the abstract, but in concrete plans to accomplish them.
40-50%
Halfway to normal, this range feels great on the upswing and terrible on the downswing. I have an actual emotional range, and even if it’s still dominated by negative emotions that’s still sometimes a relief after the grey abyss of lower percentages. I can start picking up longer-term goals and carrying on with them. I start to feel like being productive again, in a ‘how can I be spending my time to actually move my life forward’ kinda way (as opposed to the ‘I am a useless sack of garbage who never gets anything done, I should be doing something instead of watching another clip on YouTube’ kind of way).
Emotionally, I’ve regained the full palette of emotions, but not the full intensity. Feelings are still subdued and dull, but they’re there.
Cognitively, I can think and plan and act, although higher levels of creativity and ingeniousness are still offline. I can write nonfiction but not fiction.
Personally, I can make progress on existing goals, but I’m still not ready to start new ones. I can be more organized and focused than at lower percentages, but I’m still not spending my time wisely or reliably exercising my agency.
50-60%
In this range I’ve got most of the basic pieces of being a person available to me. Full emotional intensity doesn’t arrive until 80%, and the highest levels of cognition and creativity are still offline, but I can function, do my job, make plans with friends, and take care of myself. Pleasure can be had again in little things, like a walk outside or a hot shower. Anxiety, while present and powerful, isn’t dominant.
Emotionally, things are dull but not faint. Sharp edges are blunted, but I can introspect on emotions and do a decent job of identifying what I’m feeling.
Cognitively, I’m still lacking the relentless pursuit of answers that categorizes a determined problem-solver, but things are in general doable. I can learn and retain information. I can contribute.
Personally, I can start to look ahead, start to think about optimizing my life, maybe use trigger-action plans to start making or breaking habits. I’m not in control yet, not fully exercising my agency, but the flywheel is spinning.
60-70%
This might be a normal bad day for me. I’m not really at my best (or even my ordinary), but it’s close enough for most purposes. I imagine this range is common for most people if they got a bad night’s sleep or are run-down by long-term stressors.
Notable, at this percentage I start to get some of the downsides of being fully myself. Anger, anxiety, pride - they’re all well available and coloring my judgement in this range, whereas at lower ranges they tend to be suppressed.
Emotionally, I can feel powerful emotions again, which can be destabilizing, especially if I’m not used to them. I’m more sensitive to my emotions as well, especially when they’ve been dulled for so long.
Cognitively, things are a little fuzzy, but that’s about it. It’s the kind of penalty you take for not sleeping enough, not the 30-IQ point drop I get hit with at the lowest percentages.
Personally, I’m not firing on all cylinders, but most of them are up and running. I can make, keep, and execute plans, be social, start projects, etc.
70-80%
This is average, what a normal not-depressed me is like. I feel things, I know things, I act and think and learn and grow. I’m far from perfect, but if I can be 80% of my ideal self, I call that a good day. I can write nonfiction and fiction, read new books and seek out new experiences. I feel a desire to expand my horizons. I can handle my life.
Emotionally, I’ve got the full range and full intensity. I can introspect and meditate on my emotions, I can feel them, I can go outside and bask in the warmth and the sunlight and feel that the world is a beautiful place. I can also get angry, spiteful, and vengeful, which aren’t feelings you think you’ll miss until you can’t have them anymore.
Cognitively, this is my baseline, what I expect from myself on an average day. I can take the initiative, learn new things, solve problems, hunt down solutions and answers wherever they may be hiding, etc.
Personally, this is the level of agency I’m used to. I’m far less burdened by the choice paralysis I experience at lower percentages; I can be decisive and tactical. I can play on hard mode, although not for extended periods of time.
80-90%
This is what a great day feels like, with the wind at your back and clear skies before me. I get done everything I need to with time to spare. I suffer little to no anxiety or akrasia. I don’t even notice the small chores that keep the world turning - doing the dishes or driving places (I’m not generally a fan of driving). I’m as social as I want to be, and I feel like things are looking up.
Emotionally, I’m optimistic. The little voices that whisper anxiety in my ear are so quiet I can’t even hear them. Fears seem unfounded, pointless - what’s there to be afraid of?
Cognitively, things are easy. In the same way that we experience ‘becoming physically stronger’ as ‘weights get easier to lift’, I experience this percentage as ‘problems are easier to solve’. My brain just does a lot of the work without having to be forced; paths to solutions are explored with ease, and setbacks don’t interrupt my flow state.
Personally, I feel like I can take on the world, or at least my little corner of it. I feel capable of anything I set my mind to - not because my ambitions are easy, but because I’m capable of improvising and adapting and overcoming whatever challenges crop up. I have faith in my own agency and personhood.
90-100%
I don’t know about other people, but to me, this is the realm of the mythical.
To be so utterly, authentically oneself without burden or restriction or weight is a rare thing. It happens, but it’s a thing of moments, of precious instances when a challenge is risen to or burden overcome.
It’s the moment in a competition when I pull a solution out of my ass that even I didn’t think I were capable of, the time when I mustered the courage to talk to my idol or ask out the person I liked. It’s working on an impossible problem with friends and colleagues and solving it. It’s the feeling of the sun on my face when I’m done with final exams and there’s nothing ahead of me but freedom and time, a road stretching endlessly on, bursting with possibility and rapture in the sheer joy of opportunity.
It’s happened to me before - I’ve been 100% of myself before - but it’s rare. I sometimes wonder if there are people who truly live at this level, and what their lives must be like.
Emotionally, this is the feeling of aliveness that books talk about but that rarely feels real, like the first time a character rides a dragon. It’s excitement, it’s anticipation for the future to get here because I’m open to it all, the good and the bad, with the confidence that the good will be great and the bad will be manageable. Anxiety here is just the butterflies you savor before the start of the game, and despair is a distant, fuzzy memory.
Cognitively, my brain is a well-oiled machine, firing on all cylinders, computing paths and strategies and solutions as fast as I need it to, faster than language can express. I can make snap decisions and judgement calls with confidence and clarity. Nothing is insurmountable.
Personally, I am the master of my fate. I am the captain of my soul. There is nothing that feels like it’s beyond me, no human scope from which I am excluded. I dare do all that may become a man, who dares do more is none.
Conclusion
While I hope that this scale and this way of thinking can be useful to others, I don’t necessarily expect it. My brain and my depression are the way they are, and work the way they work; other people’s experiences will be different.
That said, I do think that there is utility to this framework. I’m starting to get a feel for what each percentage feels like, and what to expect from myself at different percentages. Sometimes, understanding something can be a balm by itself; few things are so frightening as uncertainty.