From Tweets to Tears: Unravelling the Rhetoric-Depression Nexus among Malaysian Youth through Discourse Analysis Method

From Tweets to Tears: Unravelling the Rhetoric-Depression Nexus among Malaysian Youth through Discourse Analysis Method | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article From Tweets to Tears: Unravelling the Rhetoric-Depression Nexus among Malaysian Youth through Discourse Analysis Method Marlina Jamal, Malini Ganapathy, Ai Lin, Debbita Tan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8975779/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract The current study explores the relatively underexamined domain of Malaysian Twitter users aged 18 to 35 by investigating the relationship between rhetorical structures and depressive symptoms as expressed through everyday digital health communication practices. Employing a discourse analysis approach, the study analyses a selected dataset of tweets published between March 2022 and June 2022, taking into account Malaysia’s cultural and linguistic specificities. The findings reveal that users experiencing depressive moods frequently employ rhetorical strategies such as repetition, metaphor, imagery, hyperbole, personification, parallelism, and simile to articulate emotional distress and negotiate meaning in online spaces. These rhetorical patterns function as communicative resources through which individuals express despair, seek validation, and cope with personal struggles within an informal health communication environment. The study demonstrates how social media serves not merely as a platform for emotional expression but as a space where mental health experiences are linguistically constructed and shared. Beyond contributing to knowledge on social media language as an indicator of mental health, the findings offer practical implications for policymakers, mental health practitioners, and campaign designers by highlighting the importance of aligning youth-centred mental health messaging with naturally occurring rhetorical practices. Overall, the study contributes to a deeper understanding of Malaysian youths’ emotional well-being in the digital era by bridging rhetoric and mental health through a health communication lens, and underscores the potential of social media platforms as sites for early identification, communicative engagement, and support for individuals experiencing depression. mental health depression rhetoric discourse analysis NRC Emotion Lexicon Tweets health communication INTRODUCTION According to the World Health Organization (WHO, 2004), mental health is a state of well-being in which individuals realize their own abilities and contribute to their communities. It is integral to overall health, defined in at least three ways: the absence of disease, a state enabling the full performance of bodily functions, or a balance within oneself and with the physical and social environment (Sartorius, 2002 ). Mental health signifies the ability to form and maintain relationships, fulfill social roles, manage change, and effectively express and regulate emotions such as sadness. It fosters a sense of worth, control, and comprehension of internal and external functioning. The Society for Health Education and Promotion Specialists (SHEPS, 1997) emphasizes positive self-perception, joy, love, and the ability to cope with adversity. The Mental Health Foundation (MHF, 2008) underscores mental health's influence on self-perception, life outlook, and coping mechanisms during challenges. The intricate relationship between physical and mental health highlights mental health as a state of equilibrium where individuals are at peace with themselves, capable of social functioning, and adept at meeting basic and higher-order needs. In 2020, mental health conditions were projected to be the second most prevalent health concern in Malaysia after heart diseases. A national survey by the Malaysian Ministry of Health revealed a staggering increase in mental health conditions, with one in three Malaysian adults aged 16 and above (29.2%) experiencing such conditions—almost tripling from 11.2% in 2006. The states of Sabah, Kelantan, Kuala Lumpur, and Sarawak exhibited the highest prevalence. Among Malaysian youth aged 13 to 17, one in five grappled with depression, two in five experienced anxiety, and one in ten was diagnosed with stress. Alarmingly, 10.1% of youths reported attempting suicide. Depression, a prevalent mental disorder, manifests as a depressed mood, loss of interest, feelings of guilt or low self-worth, disrupted sleep or appetite, low energy, and poor concentration. These symptoms can become chronic, impairing individuals' ability to fulfill daily responsibilities. Depression, ranging from mild to severe, affects all age groups and backgrounds. According to a World Health Organization-sponsored study, approximately 9% of individuals in India reported experiencing an extended period of depression in their lifetime, with nearly 36% suffering from Major Depressive Episode (MDE). MDE involves sadness, loss of interest, feelings of guilt or low self-worth, disrupted sleep or appetite, low energy, and poor concentration, in addition to a pervasive sense of depression. Depression transcends gender, age, and backgrounds, affecting individuals universally.. Language and Depression Depression undeniably shapes individuals' emotions, thoughts, and communication patterns (American Psychiatric Association, 2013 ). In the realm of language, the impact of depression on linguistic style is primarily elucidated through cognitive mechanisms (e.g., Beck, 1976 ; Clark & Beck, 1999 ), where depressed individuals often demonstrate heightened negative thinking and self-focus. Aligned with these cognitive models, theories of social integration/disengagement (e.g., Durkheim, 1951 ) propose patterns where suicidal individuals withdraw from social engagement. These underlying mechanisms, in turn, manifest in language through increased self-focus, social disengagement, and the expression of negative emotions (Chung & Pennebaker, 2007 ; Tausczik & Pennebaker, 2010 ). In line with established theoretical frameworks (e.g., Beck, 1976 ; Clark & Beck, 1999 ), recent literature provides insight into the linguistic trends of depressed individuals, particularly concerning pronoun and emotion word usage. Various studies indicate heightened usage of first-person singular pronouns in the writings of suicidal individuals (Fernandez-Cabana et al., 2013 ; Stirman & Pennebaker, 2001 ) and depressed individuals compared to those who have never experienced depression (Rude et al., 2004 ). Additionally, increased use of negative emotion words is observed (Baddeley, Daniel, & Pennebaker, 2011 ; Rodriguez, Holleran, & Mehl, 2010 ). Building on prior findings (e.g., Rude et al., 2004 ; Stirman & Pennebaker, 2001 ), cognitive models of depression (e.g., Clark & Beck, 1999 ) depict depressed individuals as inclined toward self-focus, with heightened depression correlating with increased self-focus. As anticipated, negative affect predicts the utilization of negatively focused emotional language, emphasizing the significant role of negative affect in the use of negative emotion words. Exploratory analyses further indicate that depression predicts the use of third-person singular pronouns ("he" or "she" pronouns). Given the connection between negative affect and depression in the current study, it is conceivable that individuals experiencing depression or negative affect engage in a form of "other talk" as a mechanism for self-regulation or distraction from negative feelings. The use of these third-person pronouns may serve as a marker of attentional focus as individuals attempt to regulate or divert attention from unpleasant feelings. Negative affect appears to underlie this potential phenomenon, as momentary negative affect predicts the use of both singular and plural forms of third-person pronouns. Moreover, the study reveals distinctions in specific linguistic and paralinguistic patterns between individuals with mental health issues and those without. Importantly, linguistic markers offer predictive insights into mental disorders. These findings suggest the potential application of automated language pattern detection for early diagnosis and the ongoing monitoring of high-risk populations. Automated detection of language patterns could prove instrumental in advancing early intervention strategies and improving mental health outcomes. Past Studies Speech and language processing undergoes significant influence in the context of depression (Bernard et al., 2016 ; Zayts-Spence et al. 2023 ). Examining the linguistic dimensions of speech, Smirnova et al. (2013) demonstrated that individuals with depressive conditions exhibit distinctive patterns in stylistic and grammatical aspects of language. Content analysis techniques applied to text or recorded samples by other researchers identified specific parts of speech serving as markers of emotional states (Pennebaker et al., 2003 ). Previous studies on linguistic patterns in individuals with depression consistently reveal heightened usage of first-person singular pronouns, an elevated frequency of words carrying negative meanings (Bernard et al., 2016 ), and a prevalence of self-focused language (Jarrold et al., 2011 ). Understanding linguistic indicators can be enriched through Peirce's index paradigm (Atkin, 2013 ). Extending Peirce's index theory to markers in speech, Laver & Trudgill (1979) established a link between markers in speech and personal characteristics. In the context of language, the practical implications of depressive mood on linguistic style are predominantly explained by cognitive mechanisms (Beck, 1976 , 1986). Self-focus and increased negative thinking are recognized as prominent characteristics of depression (Jarrold et al., 2011 ; Romero, Sanchez, & Vazquez, 2014; Watters & Williams, 2011). Recurrent depressive episodes underscore poor cognitive functioning abilities, primarily driven by cognitive inhibition. Årdal & Hammar ( 2011 ) emphasize that cognitive inhibition is a pivotal aspect of depression, persisting during acute recurrent depressive episodes and enduring even after a decade, evolving into an irreversible phenomenon. The intricate relationship between language and executive functioning has also been explored previously. Harciarek & Cosentino (2013) and Ye & Zhou (2009) investigated this relationship by assessing speakers' selection of appropriate words to convey concepts or thoughts. However, their findings offer limited exploration of this potentially complex relationship. Additionally, neuroscience approaches speech and language processing during major depressive disorder episodes. Abdullaev, Kennedy & Tasman ( 2002 ) underscored the massive alterations in the neural circuitry of language processing during episodes of major depressive disorder. Discourse Analysis Discourse, as succinctly defined by Brown & Yule ( 1983 ) and Cook ( 1989 ), is essentially language in use. This definition leads to the understanding that discourse analysis involves the examination of language in use, specifically the set of norms, preferences, and expectations that link language to its context. It can also be viewed as the organization of language beyond the sentence levelb (Stubbs, 1983 ). Discourse analysis proves to be a valuable technique for delving into the intricate relationship between language and mental health. It provides essential insights into linguistic indicators associated with mental health disorders, encompassing vocabulary changes and metaphorical language employed by individuals to articulate their experiences (Rude et al., 2004 ). Notably, studies by Savekar et al. (2019) underscore the significance of discourse analysis in uncovering how language can either stigmatize or contribute to self-stigmatization related to mental health. Additionally, it aids in understanding the social frameworks that either perpetuate or combat such stigma. De Chaudhary et al. (2013) further emphasize that discourse analysis elucidates how language serves as a coping mechanism, shedding light on the problematic rhetorical and narrative devices individuals employ when discussing their mental health (Argaman, 2010 ; Trifu et al., 2017 ; Al-Mosaiwi & Tombstone, 2018). Moreover, exploration of language use and its connection to social support demonstrates how discourse analysis can identify the ways in which social networks communicate mental health issues (Smirnova, 2013 ). These insights provide a comprehensive understanding of the impact of social support and interpersonal connections on mental health outcomes. Analyzing linguistic structures reveals how these variables influence language usage within the mental health context by situating verbal expressions within cultural and societal norms, underscoring the importance of grasping this intricate connection (Boyd & Pennebaker, 2017 ). Discourse analysis serves as a versatile lens for exploring the intricate interplay between language and mental health. Insights gleaned from analyzing the discourse of individuals experiencing depression can be instrumental for researchers in developing customized communication plans, evaluating the effectiveness of anti-stigma initiatives, and enhancing therapeutic communication to deliver improved interventions for those grappling with mental health issues. Rhetorical Structures In discourse analysis, rhetorical structures elucidate how language components are arranged and organized in written or spoken communication to effectively convey meaning. Rhetorical analysis serves as a valuable tool for understanding a person's cognitive state, as speech structure is intricately linked to cognitive processes (Mann & Thompson, 1988 ). Departures from conventional rhetorical patterns can signify cognitive shifts, providing insights into an individual's mental state. For instance, in clinical psychology, researchers investigating language indicators of cognitive decline, as seen in conditions like Alzheimer's disease, have delved into the rhetorical structures of affected individuals (Nicholas et al., 2017 ). Similarly, examining rhetorical patterns in individuals under stress or in emotionally charged circumstances may reveal changes in how their minds and emotions process information (Bhatia & Ritchie, 2013 ). Thus, comprehending rhetorical structures in discourse analysis not only aids in understanding the core organization of language but also serves as a valuable tool for evaluating cognitive processes in various contexts. An integral aspect of unraveling the intricate link between language and mental health involves studying rhetoric as a tool for expressing a person's mental condition. Sorenson ( 2014 ) contends that rhetorical choices, including the use of self-deprecating humor, recurrent self-deprecation, and a focus on existential issues in speech, might indicate underlying depressed moods. In a similar vein, Pennebaker et al. ( 2003 ) highlight that a person's rhetoric could signal increased worry if it emphasizes first-person pronouns and emotive language while lacking optimistic, future-focused words. These rhetorical devices not only illuminate internal emotional battles but also underscore how language serves as an expressive representation of individuals' mental states. Rhetoric may also exhibit changes in a person's mental condition during recovery from a traumatic incident. Transitions from initial shock and detachment to acceptance and post-traumatic development can be identified through narrative and language analysis. Providing assistance and implementing interventions tailored to evolving mental health needs necessitates an understanding of how people use language to convey these shifts. The study of rhetoric's role in expressing mental states provides a comprehensive understanding of how language evolves into a medium through which individuals not only express their emotions but also manage their psychological well-being. METHODOLOGY The study employed a qualitative methodology, utilizing samples of Tweets for data collection. Discourse analysis was employed as the approach to analyze the chosen samples. The following research tools were utilized: Twitter Application Programming Interface (API): The Twitter API, a paid programming tool, facilitated access to Twitter data, allowing the retrieval of Tweets based on specific key phrases and demographic data. This tool is commonly used by researchers to access available data, and organizations such as the United Nations have employed it to identify misinformation related to public health (Twitter Inc., 2020). DSM-5 (Diagnostic and Statistical Manual of Mental Disorders): This manual, published in 2018, is a widely utilized resource by mental healthcare providers for diagnosing various mental illnesses, including depression (American Psychiatric Association, 2020). It offers a standardized vocabulary for researchers examining mental health concerns. Sample Selection For sample selection, the criteria sampling approach was employed, which involves selecting cases meeting predetermined criteria of importance (Patton, 2004). The research was conducted in two parts to analyze language patterns indicative of sadness among Malaysian Twitter users aged 18 to 35. Using the Twitter API, the initial step involved selecting Twitter users and tweet collections in English that met the specified criteria. Only Malaysians aged 18 to 35 were included in the sample, with other demographic variables such as gender, race, and religion excluded. A total of 24 Tweets published between March 2022 and June 2022 were selected, using random timeline sample based on recommendations by Lin (2013). The streaming support and data-fetching application utilized the Twitter API to filter tweets and users. The selection of prospective users who exhibited signs of depression was based on the most common English terms used by individuals diagnosed with depression, as outlined in the DSM-5 (American Psychiatric Association, 2018) (Refer to Table 1 ). This ensured a focused and relevant sample for the analysis. In summary, the study employed a robust qualitative methodology, leveraging discourse analysis and utilizing the Twitter API alongside the DSM-5 to gather and analyse relevant Tweets from Malaysian users within the specified age range exhibiting language patterns indicative of sadness. Table 1 Most common English terms relating to depression (DSM-5) overwhelmed exhausted distressed anxiety Anxious worried lonely sad empty tired demotivated insomnia cry nervous low Desperate discouraged depressed (verb) depressed (noun) depression RESULTS AND DISCUSSION The collected Tweets, retrieved through the Twitter API, provide a unique glimpse into the language patterns exhibited by individuals expressing signs of depression, as guided by the DSM-5 criteria. This section attempts to unravel the intricate threads of language to discern the rhetoric that mirror the complex interplay between mental health and expression. Use of Repetition The usage of repeating words or phrases in the utterances of depressed teenagers might provide information about their emotional state and mental processes. Repetition may be an effective language tactic for emphasising the intensity of emotions or reinforcing certain views. Example 1 nothing has improved my depression more than money. nothing comes close The repeating of "nothing" emphasises a feeling of despair and the conviction that money is the primary cause of their depression. The recurrence emphasises the absence of alternatives or sources of improvement, as well as the apparent futility of finding treatment from their emotional problems. Example 2 Mental health is real. Depression is real. Suicide is real. In this case, the repetition of "real" emphasizes the urgency and validity of the issues being addressed. It serves to validate the existence of mental health struggles, emphasizing the seriousness of depression and the harsh reality of suicide. The repetitive use of "real" may also reflect a desire for acknowledgment and understanding from others, as if attempting to break through potential skepticism or stigma surrounding these topics. When individuals repeat certain phrases or words, it can be indicative of their emotional state, the significance they attribute to specific ideas, or an attempt to make others understand the gravity of their experiences. It may also be a reflection of the limited cognitive flexibility that can accompany depressive states, where negative thoughts and beliefs become entrenched and dominate one's mindset. Use of Hyperbole Hyperbolic language is often employed to intensify the emotional impact of the statement, emphasizing the severity of the feelings or experiences. Example 3 "All the hell (betrayal from friends, family, self-sabotage,…" In this example, the use of "all the hell" is a hyperbolic expression that amplifies the perceived intensity of the negative experiences. It suggests that the person is overwhelmed by a multitude of challenging situations, such as betrayal from friends and family, as well as engaging in self-sabotaging behaviours. The hyperbole communicates a sense of hopelessness and despair by portraying the circumstances as an all-encompassing, insurmountable ordeal. Example 4 "I don't know what happened but it feels like a switch was flipped and now my brain wants to pop. Depression has been really bad last couple days. Stoppp" The example above is hyperbolic in describing the sudden and intense escalation of mental distress. The use of "wants to pop" conveys a vivid and extreme image, emphasizing the overwhelming pressure or turmoil the person is experiencing. The addition of "Stoppp" at the end further accentuates the plea for relief or cessation of the distressing thoughts and emotions. In both examples, hyperbole serves to emphasize the emotional weight of the experiences and feelings being conveyed. It can be a way for individuals to express the intensity of their struggles, seeking understanding, empathy, or support from others. Use of Simile The utilization of simile, a figure of speech involving the comparison of one thing with another using "like" or "as," lends a metaphorical richness to the expression of complex emotions, particularly within the realm of mental health. Employing similes in articulating the nuanced experiences of depression can offer readers a deeper understanding of the intricate nature of the condition. Example 5 "Depression is an emotion (and a nervous system state). Why should it be medicated?" In this instance, the simile is implicit in comparing depression to an emotion while also asserting its status as a nervous system state. The use of the simile serves to convey the multifaceted nature of depression, likening it to the realm of emotions while also acknowledging its physiological underpinnings. This comparison encourages contemplation on whether treating depression solely as an emotion adequately addresses its complexity. Example 6 "Depression is an amalgamation of built up feelings that change the entirety of you." The simile here lies in the comparison of depression to an "amalgamation of built-up feelings." This vivid imagery suggests that depression is not a singular emotion but rather a complex fusion of various emotional states that collectively alter one's entire being. The simile emphasizes the transformative and pervasive impact that depression can have on an individual's identity and emotional landscape. Example 7 "If depression is physically visible, it’s like cancer. Even with a lot of money and therapy/meds, they may not help. In essence, even if you seek help, one may not get better, or may be in and out. It’s difficult." In this example, the simile likens a physically visible manifestation of depression to cancer. This comparison draws parallels between the challenges associated with both conditions, emphasizing the potential resistance to treatment despite financial resources, therapy, and medications. The simile underscores the difficulty and unpredictability of the healing process, suggesting that seeking help may not guarantee a straightforward trajectory toward improvement. The use of simile contributes to a nuanced exploration of depression, allowing readers to connect with the subject matter on a more emotive level. Similes facilitate a deeper comprehension of the intricate aspects of depression by drawing parallels with familiar experiences, ultimately enriching the narrative and fostering empathy among readers. Use of Personification Personification involves attributing human characteristics to non-human entities, which can provide a vivid and relatable portrayal of emotions or experiences. Example 8 "Banana is a happy fruit. Eating just one can help relieve irritable emotions, anger and or depression." In this example, personification is applied to the banana by describing it as a "happy fruit." By attributing the emotion of happiness to the banana, the individual imparts a positive quality to the fruit, suggesting that consuming it can have a beneficial impact on the consumer's emotional well-being. This personification serves to create a more engaging and relatable image, fostering a connection between readers and the idea of finding emotional relief through a simple act like eating a banana. Example 9 "It looks like myself when I put on makeup. Depression." In this instance, personification is subtly applied to the concept of depression by suggesting that it has a visual resemblance to the speaker when they applying makeup. By personifying depression, the individual gives it a tangible presence and appearance, making it more relatable to the reader. The comparison to the act of putting on makeup adds a layer of complexity, potentially implying that, like makeup, depression can alter one's external presentation while leaving the internal struggles hidden. Personification, in both examples, brings a creative and humanizing element to the descriptions, enhancing the reader's ability to connect with the emotions or concepts being conveyed. It allows for a more nuanced and evocative exploration of the subject matter, contributing to a deeper understanding of the complex interplay between emotions and external stimuli. Use of Parallelism Parallelism is a rhetorical device in which elements within a sentence or across multiple sentences are grammatically and structurally similar in form. It serves to create balance and rhythm, emphasizing particular ideas or creating a sense of cohesion. Example 10 "The hardest part remains: the depression," The phrase "The hardest part remains" sets the stage with a specific structure, indicating that something challenging endures. The subsequent clause, "the depression," parallels the initial structure, maintaining a consistent pattern. This uniformity in structure creates a symmetrical and rhythmic quality, drawing attention to the significance of the statement. The use of parallelism reinforces the idea that the most difficult aspect, the enduring challenge, is encapsulated in "the depression." By structuring the sentence in this way, the ongoing nature of the struggle is emphasized, portraying it as a constant and unyielding presence. This construction intensifies the impact of the statement, highlighting the persistent nature of the difficulty faced. The repetition of a consistent grammatical pattern contributes to the overall impact of the sentence, making it more memorable and effectively conveying the ongoing nature of the challenge posed by depression. Use of Metaphor Metaphors are commonly used for their ability to evoke vivid images and emotions and often resonate with individuals on a personal level, making the communication more relatable. Example 11 ur not going goblin mode. u have untreated depression In this example, a metaphor is employed to convey the idea that the individual is not fully embracing a particular state or mode of being, described as "goblin mode." Instead, the metaphor suggests that the person is experiencing untreated depression. The term "goblin mode" is used metaphorically to represent a state of being or a specific set of behaviors. While the exact meaning may vary based on the context and individual interpretation, it generally implies a withdrawal from social interactions, self-care, or a general decline in mental and emotional well-being. The metaphor creates an imaginative and somewhat playful image of a goblin-like state, providing a relatable shorthand for a range of negative experiences. The metaphor is then linked to a more explicit and serious concept, revealing that what is colloquially referred to as "goblin mode" is, in fact, a metaphorical expression for untreated depression. This connection brings depth and gravity to the metaphor, transforming it from a playful or abstract idea into a representation of a significant mental health concern. Example 12 depression was like perpetually drowning for me Comparing depression to drowning, adds depth and complexity to the description. Drowning is not only a vivid image but also a metaphor for the suffocating and overwhelming nature of depression. The metaphorical layer allows for a nuanced understanding of the emotional pain, creating a bridge between a concrete, physical experience and the abstract realm of mental health. Use of Imagery Imagery enables a more profound connection between the writer and the reader, fostering empathy and understanding by drawing upon universally recognizable experiences and emotions. Example 13 "I won't go into details but depression was like perpetually drowning for me," The imagery of "perpetually drowning" creates a powerful visual representation of the emotional struggle associated with depression. It reflects an invitation to imagine the sensation of being submerged, struggling for breath, and experiencing a constant state of distress. This visual element contributes to a more tangible and relatable understanding of the emotional weight carried. The reader may instinctively sense the pressure on the chest, the struggle for air, and the overwhelming feeling of being engulfed by an unseen force. This multisensory engagement enhances the impact of the statement, allowing the reader to empathize more deeply with the author's emotional state. The concept of drowning is one that many people can relate to on a visceral level, even if they have not experienced depression in the same way. It goes beyond merely describing depression and invites the reader to emotionally connect with the author's struggle. The choice of the word "perpetually" suggests a relentless and ongoing battle, emphasizing the chronic and enduring nature of the emotional turmoil. CONCLUSION The articulation of emotions, particularly in the context of mental health, often relies on rhetorical patterns that extend beyond traditional discourse. Depressed individuals frequently employ linguistic devices such as metaphor, imagery, hyperbole, and parallelism to convey the complexity of their experiences. The presented examples showcase the nuanced ways individuals express the impact of depression through language. Metaphors for example, serve as a potent vehicle for expressing the intricate nature of depression. Imagery, vividly depicted through metaphors like "goblin mode" or "perpetually drowning," allows for a more profound connection between the speaker and the audience. By likening depression to tangible experiences, whether it be a transformative state or an engulfing struggle, metaphors create a bridge between the abstract and the concrete, enhancing understanding and empathy. Hyperbolic language, such as "nothing comes close" or "like cancer," amplifies the emotional weight attached to depression. Parallelism, as observed in statements like "the hardest part remains: the depression," contributes to the rhythmic balance of expressions. These rhetorical devices serve to emphasize the severity and persistence of the emotional challenges, providing a nuanced portrayal of the mental health struggles faced by individuals. The prevalence of these rhetorical patterns in expressions of depression has significant implications for mental health discourse. Beyond clinical language, metaphor and vivid imagery offer a means of conveying the subjective and often isolating experiences associated with depression. This communicative approach has the potential to destigmatize discussions around mental health, fostering more empathetic conversations. The universality of rhetorical language extends its impact beyond specific cultural or linguistic contexts, making it a valuable tool in global mental health awareness. Moreover, the incorporation of hyperbole and parallelism adds layers of emotional intensity and rhythm, contributing to a more resonant and memorable communication of depressive experiences. Beyond its linguistic and rhetorical significance, the findings of this study may be understood as a form of health meaning-making enacted through everyday digital communication. The rhetorical strategies identified such as metaphor, imagery, hyperbole, repetition, and personification function not merely as expressive devices, but as communicative tools through which individuals interpret, negotiate, and make sense of their mental health experiences within a public yet semi-anonymous online space. In this regard, Twitter operates as an informal health communication environment where users articulate distress, seek validation, and construct shared understandings of depression outside institutional or clinical settings. These findings carry important implications for mental health messaging and campaigns, suggesting that effective mental health communication should resonate with the lived rhetorical patterns used by youths themselves, rather than relying solely on clinical or medicalised language. For practitioners and mental health professionals, heightened sensitivity to metaphorical and affect-laden language in social media discourse may support earlier identification of psychological distress and inform more empathetic, youth-centred intervention strategies. Recognising rhetoric as a communicative bridge between emotional experience and health understanding underscores the potential of discourse-informed approaches in strengthening mental health awareness, outreach, and support initiatives in digitally mediated contexts. As we navigate the evolving landscape of mental health awareness, a deeper exploration of these rhetorical patterns can offer valuable insights. Continued research into the effectiveness of metaphorical language and its reception within diverse audiences can inform more inclusive approaches to mental health communication, breaking down barriers and fostering a shared understanding of the multifaceted nature of depression. This study therefore demonstrates how discourse-analytic insights can contribute meaningfully to health communication research by foregrounding the ways mental health is linguistically negotiated, shared, and understood in everyday digital interaction. Declarations Author Contribution Marlina Jamal dealt with primary writing and analysis. Malini Ganapathy and Debbita Tan Ai Lin are involved in data verification, and also proofing of the article. ACKNOWLEDGEMENT This work is supported by the Ministry of Higher Education Malaysia through the Fundamental Research Grant Scheme (FRGS/1/2020/SSI0/USM/01/1). 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SHEPS, London Smirnova D (2013) Language Phenomenon in the Diagnostic Criteria of Mild Depression. P.2.b.060. Eur Neuropsychopharmacol 23(2):S354–S355 Sorenson B (2014) To Thine Own Self Be Cruel: an Analysis of the Use of Self-Deprecating Humor as a Rhetorical Strategy by Figures in Positions of Authority . Theses and Dissertations. 129. https://ir.library.illinoisstate.edu/etd/129 Stirman SW, Pennebaker JW (2001) Word use in the poetry of suicidal and non-suicidal poets. Psychosom Med 63:517–522 Crossref. PubMed. ISI Stubbs M (1983) Discourse Analysis. Basil Blackwell, Oxford Tausczik YR, Pennebaker JW (2010) The psychological meaning of words: LIWC and computerized text analysis methods. J Lang Social Psychol 29:24–54 Crossref. ISI Trifu RN, Nemeș B, Bodea-Hațegan C, Cozman D (2017) Linguistic indicators of language in major depressive disorder (MDD). An evidence-based research. J Evidence-Based Psychotherapies 17(1):105–128. 10.24193/jebp.2017.1.7 World Health Organization (2004) Promoting mental health: concepts, emerging evidence, practice (Summary Report). World Health Organization, Geneva Zayts-Spence O, Edmonds D, Fortune Z (2023) Mental Health, Discourse and Stigma. BMC Psychol 11(1):1–5 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 09 May, 2026 Reviewers agreed at journal 20 Apr, 2026 Reviewers agreed at journal 21 Mar, 2026 Reviewers invited by journal 18 Mar, 2026 Editor assigned by journal 02 Mar, 2026 Submission checks completed at journal 02 Mar, 2026 First submitted to journal 26 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8975779","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":609971588,"identity":"738de6aa-0545-4d27-bc27-7edffd892a2b","order_by":0,"name":"Marlina Jamal","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAArElEQVRIiWNgGAWjYBACxgYg8cCAgYGfNC0JQC2SDSRZlQDEBgeIVc087fCzDwkFd+SNb6Q/3cCYc5gIh81OM56RYPDMcNuNHLMbjNuI0pJgDPTLYUagFjZitaR/Bmmx3zwj/RmxWnLAtiRukEgg2mE5xSAtyTPOvDG7kbgtnbAWw9npmxk+/Dls298OdNjHbdZEaGlA5iUwNBPWIo/GryOsZRSMglEwCkYcAAAUZD/YVXAHSwAAAABJRU5ErkJggg==","orcid":"","institution":"Universiti Sains Malaysia","correspondingAuthor":true,"prefix":"","firstName":"Marlina","middleName":"","lastName":"Jamal","suffix":""},{"id":609971591,"identity":"d8bdd206-cd63-4f96-a64c-7576926c0846","order_by":1,"name":"Malini Ganapathy","email":"","orcid":"","institution":"Universiti Sains Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Malini","middleName":"","lastName":"Ganapathy","suffix":""},{"id":609971597,"identity":"3ecababa-78d5-4499-9925-a4638b6f44c6","order_by":2,"name":"Ai Lin, Debbita Tan","email":"","orcid":"","institution":"Universiti Sains Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Debbita","middleName":"Tan Ai","lastName":"Lin","suffix":""}],"badges":[],"createdAt":"2026-02-26 09:10:01","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8975779/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8975779/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106959371,"identity":"3d61e356-961b-465f-9860-c49523155333","added_by":"auto","created_at":"2026-04-15 09:07:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":539281,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8975779/v1/696d1230-cd3f-4bfe-9e8f-40bb388763e0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"From Tweets to Tears: Unravelling the Rhetoric-Depression Nexus among Malaysian Youth through Discourse Analysis Method","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eAccording to the World Health Organization (WHO, 2004), mental health is a state of well-being in which individuals realize their own abilities and contribute to their communities. It is integral to overall health, defined in at least three ways: the absence of disease, a state enabling the full performance of bodily functions, or a balance within oneself and with the physical and social environment (Sartorius, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). Mental health signifies the ability to form and maintain relationships, fulfill social roles, manage change, and effectively express and regulate emotions such as sadness. It fosters a sense of worth, control, and comprehension of internal and external functioning. The Society for Health Education and Promotion Specialists (SHEPS, 1997) emphasizes positive self-perception, joy, love, and the ability to cope with adversity. The Mental Health Foundation (MHF, 2008) underscores mental health's influence on self-perception, life outlook, and coping mechanisms during challenges. The intricate relationship between physical and mental health highlights mental health as a state of equilibrium where individuals are at peace with themselves, capable of social functioning, and adept at meeting basic and higher-order needs.\u003c/p\u003e \u003cp\u003eIn 2020, mental health conditions were projected to be the second most prevalent health concern in Malaysia after heart diseases. A national survey by the Malaysian Ministry of Health revealed a staggering increase in mental health conditions, with one in three Malaysian adults aged 16 and above (29.2%) experiencing such conditions\u0026mdash;almost tripling from 11.2% in 2006. The states of Sabah, Kelantan, Kuala Lumpur, and Sarawak exhibited the highest prevalence. Among Malaysian youth aged 13 to 17, one in five grappled with depression, two in five experienced anxiety, and one in ten was diagnosed with stress. Alarmingly, 10.1% of youths reported attempting suicide.\u003c/p\u003e \u003cp\u003eDepression, a prevalent mental disorder, manifests as a depressed mood, loss of interest, feelings of guilt or low self-worth, disrupted sleep or appetite, low energy, and poor concentration. These symptoms can become chronic, impairing individuals' ability to fulfill daily responsibilities. Depression, ranging from mild to severe, affects all age groups and backgrounds. According to a World Health Organization-sponsored study, approximately 9% of individuals in India reported experiencing an extended period of depression in their lifetime, with nearly 36% suffering from Major Depressive Episode (MDE). MDE involves sadness, loss of interest, feelings of guilt or low self-worth, disrupted sleep or appetite, low energy, and poor concentration, in addition to a pervasive sense of depression. Depression transcends gender, age, and backgrounds, affecting individuals universally..\u003c/p\u003e\n\u003ch3\u003eLanguage and Depression\u003c/h3\u003e\n\u003cp\u003eDepression undeniably shapes individuals' emotions, thoughts, and communication patterns (American Psychiatric Association, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). In the realm of language, the impact of depression on linguistic style is primarily elucidated through cognitive mechanisms (e.g., Beck, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e1976\u003c/span\u003e; Clark \u0026amp; Beck, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e1999\u003c/span\u003e), where depressed individuals often demonstrate heightened negative thinking and self-focus. Aligned with these cognitive models, theories of social integration/disengagement (e.g., Durkheim, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e1951\u003c/span\u003e) propose patterns where suicidal individuals withdraw from social engagement. These underlying mechanisms, in turn, manifest in language through increased self-focus, social disengagement, and the expression of negative emotions (Chung \u0026amp; Pennebaker, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Tausczik \u0026amp; Pennebaker, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). In line with established theoretical frameworks (e.g., Beck, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e1976\u003c/span\u003e; Clark \u0026amp; Beck, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e1999\u003c/span\u003e), recent literature provides insight into the linguistic trends of depressed individuals, particularly concerning pronoun and emotion word usage. Various studies indicate heightened usage of first-person singular pronouns in the writings of suicidal individuals (Fernandez-Cabana et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Stirman \u0026amp; Pennebaker, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2001\u003c/span\u003e) and depressed individuals compared to those who have never experienced depression (Rude et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). Additionally, increased use of negative emotion words is observed (Baddeley, Daniel, \u0026amp; Pennebaker, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Rodriguez, Holleran, \u0026amp; Mehl, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBuilding on prior findings (e.g., Rude et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Stirman \u0026amp; Pennebaker, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2001\u003c/span\u003e), cognitive models of depression (e.g., Clark \u0026amp; Beck, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e1999\u003c/span\u003e) depict depressed individuals as inclined toward self-focus, with heightened depression correlating with increased self-focus. As anticipated, negative affect predicts the utilization of negatively focused emotional language, emphasizing the significant role of negative affect in the use of negative emotion words. Exploratory analyses further indicate that depression predicts the use of third-person singular pronouns (\"he\" or \"she\" pronouns). Given the connection between negative affect and depression in the current study, it is conceivable that individuals experiencing depression or negative affect engage in a form of \"other talk\" as a mechanism for self-regulation or distraction from negative feelings. The use of these third-person pronouns may serve as a marker of attentional focus as individuals attempt to regulate or divert attention from unpleasant feelings. Negative affect appears to underlie this potential phenomenon, as momentary negative affect predicts the use of both singular and plural forms of third-person pronouns. Moreover, the study reveals distinctions in specific linguistic and paralinguistic patterns between individuals with mental health issues and those without. Importantly, linguistic markers offer predictive insights into mental disorders. These findings suggest the potential application of automated language pattern detection for early diagnosis and the ongoing monitoring of high-risk populations. Automated detection of language patterns could prove instrumental in advancing early intervention strategies and improving mental health outcomes.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePast Studies\u003c/h2\u003e \u003cp\u003eSpeech and language processing undergoes significant influence in the context of depression (Bernard et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Zayts-Spence et al. \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Examining the linguistic dimensions of speech, Smirnova et al. (2013) demonstrated that individuals with depressive conditions exhibit distinctive patterns in stylistic and grammatical aspects of language. Content analysis techniques applied to text or recorded samples by other researchers identified specific parts of speech serving as markers of emotional states (Pennebaker et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). Previous studies on linguistic patterns in individuals with depression consistently reveal heightened usage of first-person singular pronouns, an elevated frequency of words carrying negative meanings (Bernard et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), and a prevalence of self-focused language (Jarrold et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Understanding linguistic indicators can be enriched through Peirce's index paradigm (Atkin, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Extending Peirce's index theory to markers in speech, Laver \u0026amp; Trudgill (1979) established a link between markers in speech and personal characteristics.\u003c/p\u003e \u003cp\u003eIn the context of language, the practical implications of depressive mood on linguistic style are predominantly explained by cognitive mechanisms (Beck, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e1976\u003c/span\u003e, 1986). Self-focus and increased negative thinking are recognized as prominent characteristics of depression (Jarrold et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Romero, Sanchez, \u0026amp; Vazquez, 2014; Watters \u0026amp; Williams, 2011).\u003c/p\u003e \u003cp\u003eRecurrent depressive episodes underscore poor cognitive functioning abilities, primarily driven by cognitive inhibition. \u0026Aring;rdal \u0026amp; Hammar (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) emphasize that cognitive inhibition is a pivotal aspect of depression, persisting during acute recurrent depressive episodes and enduring even after a decade, evolving into an irreversible phenomenon. The intricate relationship between language and executive functioning has also been explored previously. Harciarek \u0026amp; Cosentino (2013) and Ye \u0026amp; Zhou (2009) investigated this relationship by assessing speakers' selection of appropriate words to convey concepts or thoughts. However, their findings offer limited exploration of this potentially complex relationship. Additionally, neuroscience approaches speech and language processing during major depressive disorder episodes. Abdullaev, Kennedy \u0026amp; Tasman (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2002\u003c/span\u003e) underscored the massive alterations in the neural circuitry of language processing during episodes of major depressive disorder.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDiscourse Analysis\u003c/h3\u003e\n\u003cp\u003eDiscourse, as succinctly defined by Brown \u0026amp; Yule (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e1983\u003c/span\u003e) and Cook (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e1989\u003c/span\u003e), is essentially language in use. This definition leads to the understanding that discourse analysis involves the examination of language in use, specifically the set of norms, preferences, and expectations that link language to its context. It can also be viewed as the organization of language beyond the sentence levelb (Stubbs, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e1983\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDiscourse analysis proves to be a valuable technique for delving into the intricate relationship between language and mental health. It provides essential insights into linguistic indicators associated with mental health disorders, encompassing vocabulary changes and metaphorical language employed by individuals to articulate their experiences (Rude et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). Notably, studies by Savekar et al. (2019) underscore the significance of discourse analysis in uncovering how language can either stigmatize or contribute to self-stigmatization related to mental health. Additionally, it aids in understanding the social frameworks that either perpetuate or combat such stigma. De Chaudhary et al. (2013) further emphasize that discourse analysis elucidates how language serves as a coping mechanism, shedding light on the problematic rhetorical and narrative devices individuals employ when discussing their mental health (Argaman, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Trifu et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Al-Mosaiwi \u0026amp; Tombstone, 2018).\u003c/p\u003e \u003cp\u003eMoreover, exploration of language use and its connection to social support demonstrates how discourse analysis can identify the ways in which social networks communicate mental health issues (Smirnova, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). These insights provide a comprehensive understanding of the impact of social support and interpersonal connections on mental health outcomes. Analyzing linguistic structures reveals how these variables influence language usage within the mental health context by situating verbal expressions within cultural and societal norms, underscoring the importance of grasping this intricate connection (Boyd \u0026amp; Pennebaker, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDiscourse analysis serves as a versatile lens for exploring the intricate interplay between language and mental health. Insights gleaned from analyzing the discourse of individuals experiencing depression can be instrumental for researchers in developing customized communication plans, evaluating the effectiveness of anti-stigma initiatives, and enhancing therapeutic communication to deliver improved interventions for those grappling with mental health issues.\u003c/p\u003e\n\u003ch3\u003eRhetorical Structures\u003c/h3\u003e\n\u003cp\u003eIn discourse analysis, rhetorical structures elucidate how language components are arranged and organized in written or spoken communication to effectively convey meaning. Rhetorical analysis serves as a valuable tool for understanding a person's cognitive state, as speech structure is intricately linked to cognitive processes (Mann \u0026amp; Thompson, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e1988\u003c/span\u003e). Departures from conventional rhetorical patterns can signify cognitive shifts, providing insights into an individual's mental state.\u003c/p\u003e \u003cp\u003eFor instance, in clinical psychology, researchers investigating language indicators of cognitive decline, as seen in conditions like Alzheimer's disease, have delved into the rhetorical structures of affected individuals (Nicholas et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Similarly, examining rhetorical patterns in individuals under stress or in emotionally charged circumstances may reveal changes in how their minds and emotions process information (Bhatia \u0026amp; Ritchie, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Thus, comprehending rhetorical structures in discourse analysis not only aids in understanding the core organization of language but also serves as a valuable tool for evaluating cognitive processes in various contexts.\u003c/p\u003e \u003cp\u003eAn integral aspect of unraveling the intricate link between language and mental health involves studying rhetoric as a tool for expressing a person's mental condition. Sorenson (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) contends that rhetorical choices, including the use of self-deprecating humor, recurrent self-deprecation, and a focus on existential issues in speech, might indicate underlying depressed moods. In a similar vein, Pennebaker et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2003\u003c/span\u003e) highlight that a person's rhetoric could signal increased worry if it emphasizes first-person pronouns and emotive language while lacking optimistic, future-focused words. These rhetorical devices not only illuminate internal emotional battles but also underscore how language serves as an expressive representation of individuals' mental states.\u003c/p\u003e \u003cp\u003eRhetoric may also exhibit changes in a person's mental condition during recovery from a traumatic incident. Transitions from initial shock and detachment to acceptance and post-traumatic development can be identified through narrative and language analysis. Providing assistance and implementing interventions tailored to evolving mental health needs necessitates an understanding of how people use language to convey these shifts. The study of rhetoric's role in expressing mental states provides a comprehensive understanding of how language evolves into a medium through which individuals not only express their emotions but also manage their psychological well-being.\u003c/p\u003e"},{"header":"METHODOLOGY","content":"\u003cp\u003eThe study employed a qualitative methodology, utilizing samples of Tweets for data collection. Discourse analysis was employed as the approach to analyze the chosen samples. The following research tools were utilized:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTwitter Application Programming Interface (API): The Twitter API, a paid programming tool, facilitated access to Twitter data, allowing the retrieval of Tweets based on specific key phrases and demographic data. This tool is commonly used by researchers to access available data, and organizations such as the United Nations have employed it to identify misinformation related to public health (Twitter Inc., 2020).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eDSM-5 (Diagnostic and Statistical Manual of Mental Disorders): This manual, published in 2018, is a widely utilized resource by mental healthcare providers for diagnosing various mental illnesses, including depression (American Psychiatric Association, 2020). It offers a standardized vocabulary for researchers examining mental health concerns.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e\n\u003ch3\u003eSample Selection\u003c/h3\u003e\n\u003cp\u003eFor sample selection, the criteria sampling approach was employed, which involves selecting cases meeting predetermined criteria of importance (Patton, 2004). The research was conducted in two parts to analyze language patterns indicative of sadness among Malaysian Twitter users aged 18 to 35.\u003c/p\u003e \u003cp\u003eUsing the Twitter API, the initial step involved selecting Twitter users and tweet collections in English that met the specified criteria. Only Malaysians aged 18 to 35 were included in the sample, with other demographic variables such as gender, race, and religion excluded. A total of 24 Tweets published between March 2022 and June 2022 were selected, using random timeline sample based on recommendations by Lin (2013).\u003c/p\u003e \u003cp\u003eThe streaming support and data-fetching application utilized the Twitter API to filter tweets and users. The selection of prospective users who exhibited signs of depression was based on the most common English terms used by individuals diagnosed with depression, as outlined in the DSM-5 (American Psychiatric Association, 2018) (Refer to Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). This ensured a focused and relevant sample for the analysis.\u003c/p\u003e \u003cp\u003eIn summary, the study employed a robust qualitative methodology, leveraging discourse analysis and utilizing the Twitter API alongside the DSM-5 to gather and analyse relevant Tweets from Malaysian users within the specified age range exhibiting language patterns indicative of sadness.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMost common English terms relating to depression (DSM-5)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eoverwhelmed\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eexhausted\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003edistressed\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eanxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAnxious\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eworried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003elonely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003esad\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eempty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003etired\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edemotivated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003einsomnia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ecry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003enervous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003elow\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDesperate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ediscouraged\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003edepressed (verb)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003edepressed (noun)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edepression\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"RESULTS AND DISCUSSION","content":"\u003cp\u003eThe collected Tweets, retrieved through the Twitter API, provide a unique glimpse into the language patterns exhibited by individuals expressing signs of depression, as guided by the DSM-5 criteria. This section attempts to unravel the intricate threads of language to discern the rhetoric that mirror the complex interplay between mental health and expression.\u003c/p\u003e\n\u003ch3\u003eUse of Repetition\u003c/h3\u003e\n\u003cp\u003eThe usage of repeating words or phrases in the utterances of depressed teenagers might provide information about their emotional state and mental processes. Repetition may be an effective language tactic for emphasising the intensity of emotions or reinforcing certain views.\u003c/p\u003e\n\u003ch3\u003eExample 1\u003c/h3\u003e\n\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003enothing has improved my depression more than money. nothing comes close\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe repeating of \"nothing\" emphasises a feeling of despair and the conviction that money is the primary cause of their depression. The recurrence emphasises the absence of alternatives or sources of improvement, as well as the apparent futility of finding treatment from their emotional problems.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eExample 2\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eMental health is real. Depression is real. Suicide is real.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn this case, the repetition of \"real\" emphasizes the urgency and validity of the issues being addressed. It serves to validate the existence of mental health struggles, emphasizing the seriousness of depression and the harsh reality of suicide. The repetitive use of \"real\" may also reflect a desire for acknowledgment and understanding from others, as if attempting to break through potential skepticism or stigma surrounding these topics.\u003c/p\u003e \u003cp\u003eWhen individuals repeat certain phrases or words, it can be indicative of their emotional state, the significance they attribute to specific ideas, or an attempt to make others understand the gravity of their experiences. It may also be a reflection of the limited cognitive flexibility that can accompany depressive states, where negative thoughts and beliefs become entrenched and dominate one's mindset.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eUse of Hyperbole\u003c/h2\u003e \u003cp\u003eHyperbolic language is often employed to intensify the emotional impact of the statement, emphasizing the severity of the feelings or experiences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eExample 3\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"All the hell (betrayal from friends, family, self-sabotage,\u0026hellip;\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIn this example, the use of \"all the hell\" is a hyperbolic expression that amplifies the perceived intensity of the negative experiences. It suggests that the person is overwhelmed by a multitude of challenging situations, such as betrayal from friends and family, as well as engaging in self-sabotaging behaviours. The hyperbole communicates a sense of hopelessness and despair by portraying the circumstances as an all-encompassing, insurmountable ordeal.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eExample 4\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"I don't know what happened but it feels like a switch was flipped and now my brain wants to pop. Depression has been really bad last couple days. Stoppp\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThe example above is hyperbolic in describing the sudden and intense escalation of mental distress. The use of \"wants to pop\" conveys a vivid and extreme image, emphasizing the overwhelming pressure or turmoil the person is experiencing. The addition of \"Stoppp\" at the end further accentuates the plea for relief or cessation of the distressing thoughts and emotions.\u003c/p\u003e \u003cp\u003eIn both examples, hyperbole serves to emphasize the emotional weight of the experiences and feelings being conveyed. It can be a way for individuals to express the intensity of their struggles, seeking understanding, empathy, or support from others.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eUse of Simile\u003c/h2\u003e \u003cp\u003eThe utilization of simile, a figure of speech involving the comparison of one thing with another using \"like\" or \"as,\" lends a metaphorical richness to the expression of complex emotions, particularly within the realm of mental health. Employing similes in articulating the nuanced experiences of depression can offer readers a deeper understanding of the intricate nature of the condition.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eExample 5\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"Depression is an emotion (and a nervous system state). Why should it be medicated?\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIn this instance, the simile is implicit in comparing depression to an emotion while also asserting its status as a nervous system state. The use of the simile serves to convey the multifaceted nature of depression, likening it to the realm of emotions while also acknowledging its physiological underpinnings. This comparison encourages contemplation on whether treating depression solely as an emotion adequately addresses its complexity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eExample 6\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"Depression is an amalgamation of built up feelings that change the entirety of you.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThe simile here lies in the comparison of depression to an \"amalgamation of built-up feelings.\" This vivid imagery suggests that depression is not a singular emotion but rather a complex fusion of various emotional states that collectively alter one's entire being. The simile emphasizes the transformative and pervasive impact that depression can have on an individual's identity and emotional landscape.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eExample 7\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"If depression is physically visible, it\u0026rsquo;s like cancer. Even with a lot of money and therapy/meds, they may not help. In essence, even if you seek help, one may not get better, or may be in and out. It\u0026rsquo;s difficult.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIn this example, the simile likens a physically visible manifestation of depression to cancer. This comparison draws parallels between the challenges associated with both conditions, emphasizing the potential resistance to treatment despite financial resources, therapy, and medications. The simile underscores the difficulty and unpredictability of the healing process, suggesting that seeking help may not guarantee a straightforward trajectory toward improvement.\u003c/p\u003e \u003cp\u003eThe use of simile contributes to a nuanced exploration of depression, allowing readers to connect with the subject matter on a more emotive level. Similes facilitate a deeper comprehension of the intricate aspects of depression by drawing parallels with familiar experiences, ultimately enriching the narrative and fostering empathy among readers.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eUse of Personification\u003c/h2\u003e \u003cp\u003ePersonification involves attributing human characteristics to non-human entities, which can provide a vivid and relatable portrayal of emotions or experiences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eExample 8\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"Banana is a happy fruit. Eating just one can help relieve irritable emotions, anger and or depression.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIn this example, personification is applied to the banana by describing it as a \"happy fruit.\" By attributing the emotion of happiness to the banana, the individual imparts a positive quality to the fruit, suggesting that consuming it can have a beneficial impact on the consumer's emotional well-being. This personification serves to create a more engaging and relatable image, fostering a connection between readers and the idea of finding emotional relief through a simple act like eating a banana.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eExample 9\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"It looks like myself when I put on makeup. Depression.\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIn this instance, personification is subtly applied to the concept of depression by suggesting that it has a visual resemblance to the speaker when they applying makeup. By personifying depression, the individual gives it a tangible presence and appearance, making it more relatable to the reader. The comparison to the act of putting on makeup adds a layer of complexity, potentially implying that, like makeup, depression can alter one's external presentation while leaving the internal struggles hidden.\u003c/p\u003e \u003cp\u003ePersonification, in both examples, brings a creative and humanizing element to the descriptions, enhancing the reader's ability to connect with the emotions or concepts being conveyed. It allows for a more nuanced and evocative exploration of the subject matter, contributing to a deeper understanding of the complex interplay between emotions and external stimuli.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eUse of Parallelism\u003c/h2\u003e \u003cp\u003eParallelism is a rhetorical device in which elements within a sentence or across multiple sentences are grammatically and structurally similar in form. It serves to create balance and rhythm, emphasizing particular ideas or creating a sense of cohesion.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eExample 10\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"The hardest part remains: the depression,\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThe phrase \"The hardest part remains\" sets the stage with a specific structure, indicating that something challenging endures. The subsequent clause, \"the depression,\" parallels the initial structure, maintaining a consistent pattern. This uniformity in structure creates a symmetrical and rhythmic quality, drawing attention to the significance of the statement. The use of parallelism reinforces the idea that the most difficult aspect, the enduring challenge, is encapsulated in \"the depression.\" By structuring the sentence in this way, the ongoing nature of the struggle is emphasized, portraying it as a constant and unyielding presence. This construction intensifies the impact of the statement, highlighting the persistent nature of the difficulty faced. The repetition of a consistent grammatical pattern contributes to the overall impact of the sentence, making it more memorable and effectively conveying the ongoing nature of the challenge posed by depression.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eUse of Metaphor\u003c/h2\u003e \u003cp\u003eMetaphors are commonly used for their ability to evoke vivid images and emotions and often resonate with individuals on a personal level, making the communication more relatable.\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eExample 11\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eur not going goblin mode. u have untreated depression\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn this example, a metaphor is employed to convey the idea that the individual is not fully embracing a particular state or mode of being, described as \"goblin mode.\" Instead, the metaphor suggests that the person is experiencing untreated depression. The term \"goblin mode\" is used metaphorically to represent a state of being or a specific set of behaviors. While the exact meaning may vary based on the context and individual interpretation, it generally implies a withdrawal from social interactions, self-care, or a general decline in mental and emotional well-being. The metaphor creates an imaginative and somewhat playful image of a goblin-like state, providing a relatable shorthand for a range of negative experiences.\u003c/p\u003e \u003cp\u003eThe metaphor is then linked to a more explicit and serious concept, revealing that what is colloquially referred to as \"goblin mode\" is, in fact, a metaphorical expression for untreated depression. This connection brings depth and gravity to the metaphor, transforming it from a playful or abstract idea into a representation of a significant mental health concern.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eExample 12\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003edepression was like perpetually drowning for me\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003eComparing depression to drowning, adds depth and complexity to the description. Drowning is not only a vivid image but also a metaphor for the suffocating and overwhelming nature of depression. The metaphorical layer allows for a nuanced understanding of the emotional pain, creating a bridge between a concrete, physical experience and the abstract realm of mental health.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section3\"\u003e \u003ch2\u003eUse of Imagery\u003c/h2\u003e \u003cp\u003eImagery enables a more profound connection between the writer and the reader, fostering empathy and understanding by drawing upon universally recognizable experiences and emotions.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eExample 13\u003c/h2\u003e \u003cp\u003e \u003cem\u003e\"I won't go into details but depression was like perpetually drowning for me,\"\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThe imagery of \"perpetually drowning\" creates a powerful visual representation of the emotional struggle associated with depression. It reflects an invitation to imagine the sensation of being submerged, struggling for breath, and experiencing a constant state of distress. This visual element contributes to a more tangible and relatable understanding of the emotional weight carried. The reader may instinctively sense the pressure on the chest, the struggle for air, and the overwhelming feeling of being engulfed by an unseen force. This multisensory engagement enhances the impact of the statement, allowing the reader to empathize more deeply with the author's emotional state.\u003c/p\u003e \u003cp\u003eThe concept of drowning is one that many people can relate to on a visceral level, even if they have not experienced depression in the same way. It goes beyond merely describing depression and invites the reader to emotionally connect with the author's struggle. The choice of the word \"perpetually\" suggests a relentless and ongoing battle, emphasizing the chronic and enduring nature of the emotional turmoil.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe articulation of emotions, particularly in the context of mental health, often relies on rhetorical patterns that extend beyond traditional discourse. Depressed individuals frequently employ linguistic devices such as metaphor, imagery, hyperbole, and parallelism to convey the complexity of their experiences. The presented examples showcase the nuanced ways individuals express the impact of depression through language.\u003c/p\u003e \u003cp\u003eMetaphors for example, serve as a potent vehicle for expressing the intricate nature of depression. Imagery, vividly depicted through metaphors like \"goblin mode\" or \"perpetually drowning,\" allows for a more profound connection between the speaker and the audience. By likening depression to tangible experiences, whether it be a transformative state or an engulfing struggle, metaphors create a bridge between the abstract and the concrete, enhancing understanding and empathy. Hyperbolic language, such as \"nothing comes close\" or \"like cancer,\" amplifies the emotional weight attached to depression. Parallelism, as observed in statements like \"the hardest part remains: the depression,\" contributes to the rhythmic balance of expressions. These rhetorical devices serve to emphasize the severity and persistence of the emotional challenges, providing a nuanced portrayal of the mental health struggles faced by individuals.\u003c/p\u003e \u003cp\u003eThe prevalence of these rhetorical patterns in expressions of depression has significant implications for mental health discourse. Beyond clinical language, metaphor and vivid imagery offer a means of conveying the subjective and often isolating experiences associated with depression. This communicative approach has the potential to destigmatize discussions around mental health, fostering more empathetic conversations.\u003c/p\u003e \u003cp\u003eThe universality of rhetorical language extends its impact beyond specific cultural or linguistic contexts, making it a valuable tool in global mental health awareness. Moreover, the incorporation of hyperbole and parallelism adds layers of emotional intensity and rhythm, contributing to a more resonant and memorable communication of depressive experiences.\u003c/p\u003e \u003cp\u003eBeyond its linguistic and rhetorical significance, the findings of this study may be understood as a form of health meaning-making enacted through everyday digital communication. The rhetorical strategies identified such as metaphor, imagery, hyperbole, repetition, and personification function not merely as expressive devices, but as communicative tools through which individuals interpret, negotiate, and make sense of their mental health experiences within a public yet semi-anonymous online space. In this regard, Twitter operates as an informal health communication environment where users articulate distress, seek validation, and construct shared understandings of depression outside institutional or clinical settings. These findings carry important implications for mental health messaging and campaigns, suggesting that effective mental health communication should resonate with the lived rhetorical patterns used by youths themselves, rather than relying solely on clinical or medicalised language. For practitioners and mental health professionals, heightened sensitivity to metaphorical and affect-laden language in social media discourse may support earlier identification of psychological distress and inform more empathetic, youth-centred intervention strategies. Recognising rhetoric as a communicative bridge between emotional experience and health understanding underscores the potential of discourse-informed approaches in strengthening mental health awareness, outreach, and support initiatives in digitally mediated contexts.\u003c/p\u003e \u003cp\u003eAs we navigate the evolving landscape of mental health awareness, a deeper exploration of these rhetorical patterns can offer valuable insights. Continued research into the effectiveness of metaphorical language and its reception within diverse audiences can inform more inclusive approaches to mental health communication, breaking down barriers and fostering a shared understanding of the multifaceted nature of depression. This study therefore demonstrates how discourse-analytic insights can contribute meaningfully to health communication research by foregrounding the ways mental health is linguistically negotiated, shared, and understood in everyday digital interaction.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eMarlina Jamal dealt with primary writing and analysis. Malini Ganapathy and Debbita Tan Ai Lin are involved in data verification, and also proofing of the article.\u003c/p\u003e\u003ch2\u003eACKNOWLEDGEMENT\u003c/h2\u003e \u003cp\u003eThis work is supported by the Ministry of Higher Education Malaysia through the Fundamental Research Grant Scheme (FRGS/1/2020/SSI0/USM/01/1).\u003c/p\u003e\n\u003ch3\u003eDECLARATION OF ETHICS\u003c/h3\u003e\n\u003cp\u003eThis study analysed publicly available Twitter posts and did not involve direct interaction with human participants. Only open-access content was collected via the Twitter API. Usernames and identifying details were removed to ensure anonymity. As no private data or human subjects were involved, informed consent was not required.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbdullaev Y, Kennedy BL, Tasman A (2002) Changes in neural circuitry of language before and after treatment of major depression. Hum Brain Mapp 17(3):156\u0026ndash;167. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/hbm.10060\u003c/span\u003e\u003cspan address=\"10.1002/hbm.10060\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Mosaiwi M, Johnstone T (2018) In an absolute state: Elevated use of absolutist words is a marker specific to anxiety, depression, and suicidal ideation. 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BMC Psychol 11(1):1\u0026ndash;5\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":false,"email":"","identity":"sn-social-sciences","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"","title":"SN Social Sciences","twitterHandle":"","acdcEnabled":false,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"VoR Journals","inReviewEnabled":false,"inReviewRevisionsEnabled":false},"keywords":"mental health, depression, rhetoric, discourse analysis, NRC Emotion Lexicon, Tweets, health communication","lastPublishedDoi":"10.21203/rs.3.rs-8975779/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8975779/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe current study explores the relatively underexamined domain of Malaysian Twitter users aged 18 to 35 by investigating the relationship between rhetorical structures and depressive symptoms as expressed through everyday digital health communication practices. Employing a discourse analysis approach, the study analyses a selected dataset of tweets published between March 2022 and June 2022, taking into account Malaysia’s cultural and linguistic specificities. The findings reveal that users experiencing depressive moods frequently employ rhetorical strategies such as repetition, metaphor, imagery, hyperbole, personification, parallelism, and simile to articulate emotional distress and negotiate meaning in online spaces. These rhetorical patterns function as communicative resources through which individuals express despair, seek validation, and cope with personal struggles within an informal health communication environment. The study demonstrates how social media serves not merely as a platform for emotional expression but as a space where mental health experiences are linguistically constructed and shared. Beyond contributing to knowledge on social media language as an indicator of mental health, the findings offer practical implications for policymakers, mental health practitioners, and campaign designers by highlighting the importance of aligning youth-centred mental health messaging with naturally occurring rhetorical practices. Overall, the study contributes to a deeper understanding of Malaysian youths’ emotional well-being in the digital era by bridging rhetoric and mental health through a health communication lens, and underscores the potential of social media platforms as sites for early identification, communicative engagement, and support for individuals experiencing depression.\u003c/p\u003e","manuscriptTitle":"From Tweets to Tears: Unravelling the Rhetoric-Depression Nexus among Malaysian Youth through Discourse Analysis Method","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-23 14:13:20","doi":"10.21203/rs.3.rs-8975779/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-09T15:36:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281746982213905767180028443894055561296","date":"2026-04-20T04:05:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180200975294697155910959493704813451287","date":"2026-03-21T08:36:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-19T03:32:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-02T09:55:06+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-02T09:54:14+00:00","index":"","fulltext":""},{"type":"submitted","content":"SN Social Sciences","date":"2026-02-26T08:52:06+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":false,"email":"","identity":"sn-social-sciences","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"","title":"SN Social Sciences","twitterHandle":"","acdcEnabled":false,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"VoR Journals","inReviewEnabled":false,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4b11fd3c-f2f8-448c-ac3c-f6d28f52442f","owner":[],"postedDate":"March 23rd, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-09T15:36:03+00:00","index":74,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-23T14:13:20+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-23 14:13:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8975779","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8975779","identity":"rs-8975779","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}