Depressive personality is characterized by a pessimistic way of thinking and criticism of oneself and others. Depressive personality disorder (PDD) is often confused with dysthymia or depression. Learn about the diagnostic criteria for depressive personality, learn about effective treatments for depressive personality disorder.
What is depressive personality?
This type of personality disorder is characterized by a specific, pessimistic and depressive way of thinking, behaving and experiencing.
According to the DSM IV, depressive personalityis characterized by a generalized pattern of depressive thinking and behavior that appears in early adulthood. The manifestations of profound negativism include a belief in lack of self-worth, despondency, a critical attitude toward oneself, a tendency to ruminate, a negative attitude toward people, pessimism, and harsh judgments.
Diagnostic difficulties – depressive personality disorder
The diagnostic criteria for depressive personality disorder are not included in the DSM-V and ICD-10 diagnostic systems. Researchers recognize that depressive personality does not meet the requirements of a full-fledged diagnostic category, due to its very similar symptoms with dysthymia. In contrast, the DSM-IV authors considered depressive personality disorder a conditional diagnostic entity. Due to the lack of sufficient data, it was placed in the additional chapter “disorders requiring further research.”
The scientific community is divided over the diagnosis of this personality disorder. Despite the diagnostic difficulties described here, there is a documented group of patients who meet the diagnostic criteria for depressive personality while not meeting the other disorder.
Features of depressive personality
According to the DSM-IV criteria (classification of mental disorders), the most characteristic features of depressive personality are:
- Dominant feelings of depression and unhappiness rather than sadness.
- The cognitive profile is characterized by: pessimism, criticism and a negative attitude towards the self and the world.
- In core beliefs, themes of worthlessness, incompetence, irrelevance and ineptitude dominate.
- Deep feelings of guilt and regret.
- Chronic anhedonia, lack of feeling pleasure.
- A tendency to worry and dwell on problems.
- Low self-esteem.
- Difficulties that are ageist in nature, e.g., suppression of emotions.
- Lack of tolerance of one’s own failures.
- Sometimes submissiveness (docility, submission to rules).
Differential diagnosis. Depressive personality and dysthymia
The biggest diagnostic challenge is distinguishing dysthymia from depressive personality. Both diagnoses are characterized by low self-esteem and feelings of hopelessness. According to researchers, fixed and generalized psychological symptoms such as negativism, pessimism and self-criticism play a greater role in depressive personality. In the case of dysthymia, lowered mood is more noticeable and in depressive personality, chronic anhedonia is more prominent.
What is life like for those suffering from depressive personality disorder?
People with a depressive personality often feel sadness or remorse, but they are less likely to experience feelings of anger or rage. Situations that are most likely to cause anger in other people will mainly lead to more sadness in people with DZO. People with depressive personality disorder always hold a grudge against themselves for their failures. They blame themselves for every mistake, often truly believing they are bad people.
They have tremendous feelings of guilt, often about things that are beyond their control. They often dwell on past mistakes and failures, seeing the future in black colors.
Patients with depressive personalities are as unforgiving of others as they are of themselves. They are usually disliked and lead a solitary lifestyle. Sometimes they judge people harshly, pointing out their mistakes and shortcomings.
People who are affected by depressive personality disorder are often unable to function in their leisure time. They are unable to experience relaxation, which can increase feelings of isolation from other people.
People who suffer from depressive personality disorder usually do not take leadership positions in a group. They are inclined to follow someone else. They are usually characterized by a lack of assertiveness, passivity and criticism of others. Typically, such people have difficulty advancing at work.
It is also possible to distinguish several positive traits found in people with depressive personality. They are often meticulous and thorough in carrying out assigned tasks. They are conscientious and treat assigned tasks responsibly. Thanks to their criticality, they often correctly assess the risks of the planned activity.
Depressive personality – test
Find out to what extent you exhibit traits of depressive personality. Remember that the test is only an indication, for a proper diagnosis refer to a specialist.
- Your typical mood is sadness and you do not feel joy? Yes/No
- Do you have a pessimistic attitude toward yourself and the rest of the world? Yes/No
- Are you prone to feelings of guilt and remorse? Yes/No
- Are you critical of yourself and others? Yes/No
- You have low self-esteem and your self-concept, is based on a belief of worthlessness? Yes/No
- Do you often overthink and worry, even about things beyond your control? Yes/No
- Do you have an evaluative attitude toward others? Yes/No
If the answers to five or more questions are “yes” and the symptoms persist for two years or longer, it is worthwhile to consult a psychiatrist, psychologist or psychotherapist.
Where does depressive personality disorder come from?
However, there are several possible causes associated with depressive personality disorders. One supposes that they may be one of the mildest forms of unipolar mood disorders, or they may be the beginning of a depressive disorder. Another hypothesis is that it is a specific form of personality disorder, as a subtype of dysthymia, or one of the dimensions of personality.
Both psychosocial and biological factors, such as neurotransmission disorders, can contribute to the onset of depressive personality. Depressive personality disorder can also be triggered by a history of psychiatric disorders, past traumatic experiences, or chronic stress. Parents who have adopted an overly punitive attitude or lack of interest in their child’s life can also have an impact on their child’s development of depressive personality disorder in the future.
How to recognize depressive personality disorder? Dysthymia or perhaps depression?
Depressive personality disorder is sometimes very often confused with dysthymia, and it also happens to be confused with depression. It is important to remember that depressive personality and depression are two different concepts. Depression is a more severe, intense disorder with a shorter duration (episode), while depressive personality disorder is characterized by a chronic, milder depressive mood that lasts for a longer period of time. Pharmacotherapy is also very often introduced for depression.
Dysthymia is a chronic mood disorder with less intense but persistent depressive symptoms. Depressive personality disorder, on the other hand, is a more deeply rooted, persistent pattern of negative thinking and behavior that is part of a person’s personality. Treatment of dysthymia focuses on alleviating the symptoms of depression, while treatment of depressive personality disorder requires long-term therapy aimed at changing patterns of thinking and behavior.
Given the symptoms of either depression or dysthymia, depressive personality disorder is often downplayed. However, it should be remembered that these disorders significantly reduce the quality of life and hinder the daily functioning of the person who suffers from them. However, it should be noted that a tool has emerged to help professionals identify depressive personality disorders.
How does depressive personality affect relationships and daily life?
A depressive personality can affect many areas of your life – from relationships with loved ones, to functioning at work, to everyday minutiae. Below you will find the most important aspects that can also affect you.
Family and partner relationships
If you have depressive personality traits, you may find that building and maintaining close relationships can sometimes be a challenge for you. You may often experience feelings of guilt or a belief that you don’t deserve support and understanding. Sometimes you avoid sharing your feelings with your partner or family, fearing that you will be misperceived or judged.
Sometimes you may have difficulty appreciating the small gestures of loved ones – not because you don’t notice them, but because of your inner criticism and focus on your own imperfections. This can lead to misunderstandings, feelings of loneliness or distance in relationships. Remember that your emotions and needs are important, and building openness step by step is possible.
Functioning at work
At work, people with depressive personality often show great conscientiousness, responsibility and accuracy. You may notice in yourself that you take assigned tasks very seriously, do not underestimate details and try to anticipate risks. These are valuable qualities that employers appreciate.
At the same time, you may have difficulty accepting praise, getting promoted or taking on leadership roles. You may find it easier to follow others than to lead a team. There is also often a fear of being judged or a fear of making a mistake, which can result in being overly critical of yourself and others. You may feel less comfortable in competitive environments, which doesn’t mean you don’t have valuable competencies.
Social interactions and everyday situations
A depressive personality may make you avoid social situations or feel out of place in them. You may find it difficult to relax at gatherings with friends or family, and leisure time doesn’t always bring relief. Sometimes you interpret even neutral events in a negative way, which reinforces feelings of alienation and loneliness.
Often people with a depressive personality do not take the initiative in a group, preferring to listen rather than speak, and their critical mind makes them focus on shortcomings – both their own and those of those around them. This can lead to withdrawal from relationships and even isolation.
Positives in daily functioning
It is worth remembering that your attentiveness, reliability and empathy can be a tremendous support to others. Thanks to your sensitivity, you often notice the needs of loved ones and are ready to help. Your caution and realistic approach to life make you able to accurately assess risks and avoid rash decisions.
You don’t have to always be a leader or the soul of the company to have an important place in your family, work and group of friends. Your qualities can be your strength if you learn to use them in a supportive way – for yourself and others.
Cognitive behavioral therapy (CBT) for depressive personality disorder
Currently, psychotherapy is the only appropriate form of help for treating personality disorders. Psychotherapy, especially evidence-based psychotherapy, namely cognitive-behavioral therapy and schema therapy, is recommended as a treatment method. Cognitive-behavioral therapy is one of the most effective treatments for depressive personality. It allows a person with depressive personality disorder to understand and change negative and harmful patterns. The patient and the therapist work together to identify the thoughts that contribute to depressive personality disorder. And in the next step, they work together to try to modify them. The personality disorder sufferer learns new ways of reacting as well as acting. The overall goal of this therapy, is for the person with depressive personality to reevaluate his own beliefs.
Beck’s depressive triad
Beck’s depressive triad, formulated by American psychiatrist Aaron T. Beck, is a key element in understanding the mechanisms of depression and its impact on a person’s life. It consists of three main components: negative perceptions of self, the world and the future. These three components are closely linked to the experience of loneliness and self-esteem, affecting people of all ages.
- Negative self-perception
The first component of the triad is negative self-image. People experiencing depressive symptoms or suffering from a depressive personality often see themselves as worthless, inadequate and unattractive. This negative self-perception can lead to:
- Lowered self-esteem
- Social withdrawal
- A deepening sense of loneliness
- Negative perception of the world
The second element of the triad is a pessimistic view of perceptions of reality and the world around them. Sufferers often interpret neutral or positive events in a negative way. This can lead to:
- Avoiding social interaction
- Perceiving other people as a threat
- Exacerbating feelings of alienation and loneliness
- Negative perceptions of the future
The third element of the triad is pessimistic expectations about the future. People ą often see no hope for improving their situation, which can lead to:
- A lack of motivation to change
- A sense of hopelessness
- A deepening sense of loneliness and isolation
Key goals of CBT therapy
- Work on reducing belief in negative beliefs about oneself and others.
- Interactions, related to a more balanced and positive image of oneself and the world.
- Minimize the formulation of pessimistic interpretations of events and forecasts, a negative view of the future.
- Increase awareness of current moments, mindfulness techniques.
- Work on reducing the search for negative feedback
- Minimize behaviors that sustain negative beliefs.
- Work on minimizing worry.
Depressive personality disorders present diagnostic challenges. They are often very difficult to diagnose and are confused with other disorders such as depression or dysthymia. Personality disorders reduce the quality of life for many people, often leading to isolation. When persisting, they can promote the onset of other co-occurring disorders. Therefore, if you suspect you have a depressive personality, you should consult a specialist as soon as possible. Remember, personality disorders can be effectively treated.
Bibliography:
- T Denise D. Davis, Arthur Freeman, Aaron T. Beck. Cognitive therapy for personality disorders. WUJ 2016
- K. Huprich. What Should Become of Depressive Personality Disorder in DSM-V? Feb 2009 HARVARD REV PSYCHIAT
- M. Bagby, A. G. Ryder, D. R Schuller. Depressive personality disorder: A critical overview Jun 2003
- 4. S.K. Huprich. Depressive personality disorder: theoretical issues, clinical findings, and future research questions Sep 1998 CLIN PSYCHOL REV