I’m not a fan of scales. I find it strange that I dislike tools of measurement when I’m all about order and precision and symmetry in my day-to-day life. You’d think I’d have an affection.
The ones that sit on the ground and tell you how much you weigh and how you’re supposed to feel about yourself as a person get most of my ire; an eating disorder will do that. But I dislike other kinds of scales as well.
Likert and continuous scales make me roll my eyes and wrinkle my nose. If they have fewer than ten options they’re statistically invalid anyhow. Plus, they rarely feel personally applicable. The values they choose or the questions they posit feel irrelevant.
Likert scales are the ones often found on survey forms; they’re designed to measure how people feel about a thing. They’re made up of a series of questions and possible answers; ideally, they’ll have balanced responses spreading out from a neutral midpoint. Likert questionnaire response include phrases like: strongly disagree, disagree, no opinion, agree, and strongly agree. I usually look for the “don’t care, this question isn’t relevant, and you can’t figure me out this way” option.
Continuous ratings scales are very slightly different; they ask for a number from a continuum rather than an identification with a phrase. Unfortunately, I usually disagree with the markers they’ve used as their data points. No doctor, zero is not like stubbing my toe.
Both of these scales, Likert and continuous, are quantitative.
Quantitative rating scales try to capture subjective opinions with numbers. They’re designed to apprehend estimations of magnitude. However, rating scales can’t produce qualitative data, regardless of what their end-point labels are.
“While quantitative studies are concerned with precise measurements, qualitative studies are concerned with verbal descriptions of people’s experiences, perceptions, opinions, feelings and knowledge. Whereas a quantitative method typically requires some precise measuring instrument, the qualitative method itself is the measuring instrument. Qualitative data are less about attempting to prove something than about attempting to understand something.”[i]
In addition to being quantitative or qualitative, data can be objective or subjective. It seems to me that when trying to characterize something as personal and specific as mood, qualitative and subjective data would be the most useful.
But, if I have to use an ostensibly objective quantitative rating system, and it seems I must since doctors apparently prefer questions such as “on a scale of one to ten with one being x and ten being y, rate your pain, grief, depression, emotional distress, nausea, and so on” over listening to personal recitations, then I would like to suggest we convert to negative numbers in certain instances, such as when evaluating depression. A positive progression for a negative reality seems wrong.
When you’re struggling with something like depression, describing your mood as “plus ten” can seem a little obscene.
I also think the subjects of the questionings should get to establish the values for the scales. After all, my zero and ten are probably quite different from yours. Our preferred responses may not line up with the options an interrogator selects.
I’d rate my default mood a negative three on a continuous scale, current drop towards eightville notwithstanding. Consistent, low-grade depression is my new normal. I’ve pretty much given up on the idea of returning to zero. One of the problems with chronic, long-term depression is the longer it lasts, the harder it becomes to shake its hold entirely.
I’m a negative three on a scale where zero is neutral and negative ten is me standing on top of a feed silo getting ready to jump. Scales need to be personal.
All things considered, three isn’t too bad aside from the persistent apathy and moderate deadening. But it begs the question, what next? What does life lived at a negative three look like? How do I work that?
That’s the problem with these kinds of scales. They quantify and that’s it. Often my response to their conclusions is “so what?” More important than assigning a quantitative value is what happens next.
What happens next is acceptance.
Acceptance is not defeat. I’m not giving up nor am I ruling out the possibility of future changes. But things are as they are; we have to deal with what is. If I’ve learned anything over the last few years it’s that we can only live in the now, and we can only control a limited number of things. My neurochemistry is not in my control. Fashioning a more productive and satisfying life within the parameters of chronic depression is.
I’m depressed but I’m living. I have lists and plans to help keep me on track. I have friends and family I push myself to stay in touch with. When I get agoraphobic, I force myself to go out. But there’s been an element of waiting in everything I’ve been doing. A sense that I’m living the way I am and doing the things I do so I can get “better” and my real life can recommence.
That kind of thinking was common with my eating disorder too: my life isn’t now; “now” is a holding pattern. My life begins later, once everything is perfect.
Things are as they are. My depression is what it is. It is, in many ways, beyond my control. The things I do, the way I spend my time, the plans, the actions, none of these things are a stop-gap. Life isn’t something that shows up later when the work is done; life is now.
There’s a popular phrase in Stoic philosophy that often shows up in my readings. Amor Fati. A love of one’s fate. Basically, you have to love things as they are, not as you wish they might be.
Live your life like it’s your actual life because it is. There won’t be another.
I’d give that bit of philosophy a seven.
I’m “mostly satisfied” with it.