Depressive personality: causes, symptoms, risk factors

Surely at some time you have thought that in life there are people who always tend to see things in a particularly negative way. They breathe pessimism, sadness, despondency and fatalism, and it seems almost impossible to get them to see things a little less bleak.

They see the future in such a negative way that they can even infect you with their pessimism and hopelessness.. And it seems that the positive things that happen to them in life have little importance, they always see something negative in it, as if they were wearing glasses with an exclusive filter to perceive dark clouds and sadness.

What happens to these kinds of people? Do they suffer from major depression constantly? Do they have a persistent depressive disorder? Is being depressed a personality trait?

In this article we are going to talk about depressive personality disorder (PDD), which does not appear in current classifications such as the DSM-5 or the ICD-10, but it has been studied for many years by renowned authors such as Kraepelin (1896), Schneider (1923), Millon (1994) and Beck (1979).

Depressive personality disorder according to Theodore Millon

According to Theodore Millon, depressive personality disorders (what Millon calls the "surrender pattern") fall under Pleasure Difficulty Personalities. According to Millon, depressed people have a series of Personality traits in common, which can be manifested and described at different levels:

1. behavioral level

Expressively downcast, appearance and state convey hopeless helplessness. Interpersonally defenseless: due to the feeling of vulnerability and lack of protection, you will beg others to take care of you and protect you, fearing abandonment. He will seek or demand guarantees of affection, perseverance and dedication. They tend to be introverts, so they may have trouble finding a partner. When they find, they become very dependent on her.

2. phenomenological level

They are cognitively pessimistic: they show defeatist, fatalistic and negative attitudes in almost everything. They always expect the worst. You interpret the events of life in the most bleak way possible, and you feel hopeless because things are never going to get better in the future.

His self-image is "useless." They judge themselves as insignificant, useless, incapable, worthless to themselves or to others. They feel guilty for not having positive traits. Abandoned object representations: early life experiences are lived empty, without richness, without joyful elements.

3. intrapsychic level

• asceticism mechanism: believes that he must do penance and deprive himself of the pleasures of life. He rejects enjoyment, and also criticizes himself a lot, which can lead him to self-destructive acts.

• diminished organization: impoverished coping methods.

4. biophysical level

Melancholic state of mind: crying easily, sad, embarrassed, surly, worried and with a tendency to ruminate ideas. They tend to feel grumpy. They get angry with those who try to exaggerate the good at the expense of the realistic.

Clinical characteristics according to the DSM-IV-TR (APA, 2000):

In 1994, the APA introduced the term "Depressive Personality Disorder" in the DSM-IV in the appendix of Personality Disorders Research Criteria. According to the DSM-IV-TR (APA, 2000) the fundamental characteristics of depressive personality disorder (PDD) consist of:

• An ingrained pattern of depressive behaviors and cognitions.
• They see the future negatively, doubt that things will get better and anticipate the worst. They show defeatist and fatalistic attitudes.
• They are very serious, they lack a sense of humor, they do not allow themselves to enjoy or relax in their day to day.
• As for his physical appearance, it often reflects his downcast state of mind. Slumped posture, psychomotor retardation, and depressed facial expression are often visible.
• They look sad, discouraged, disappointed, and unhappy.
• Their self-concept centers on beliefs of worthlessness and inadequacy, and they have low self-esteem.
• They are self-critical, they frequently underestimate themselves.
• tend to rumination and constant worries.
• They are pessimists.
• They feel helpless and helpless.
• They criticize and judge others negatively.
• They tend to feel guilt and remorse.
• Passive, with little initiative and spontaneity.
• They require the love and support of others.
• The symptoms do not appear exclusively in the course of major depressive episodes and are not better explained by the presence of a dysthymic disorder.

differential diagnosis

People with depressed personality are at high risk of major depressive disorder or persistent depressive disorder (formerly known as "dysthymia"). It must be clarified that persistent depressive disorder is transitory, can be caused by a stressful stimulus and appear at any time, while that major depressive disorder is stably linked to personality and interferes in most areas of the subject's life over time. In other words, the symptom picture is permanent and causes clinically significant distress or social or occupational impairment.

Much of the controversy surrounding identifying depressive personality disorder as a separate category is the lack of utility in differentiating it from dysthymia. Besides, it has been suggested that depressive personality disorder can be confused and overlap with other personality disorders (dependent, obsessive compulsive and avoidant).

Causes

What are the causes of depressive personality disorder? We will emphasize the environmental factors that seem to be related to this disorder, since the biological influences are not entirely clear (Millon & Davis, 1998):

1. Deficient emotional attachment in childhood

If the child does not experience unequivocal signs of acceptance and affection during childhood, feelings of emotional detachment, insecurity and isolation can form.. These children lack experiences of affection and closeness with their parents, who tend to be distant and indifferent. Children tend to give in to the search for parental emotional support, learn to make few demands on their environment, and develop feelings of helplessness and hopelessness.

2. helplessness

The child, who in the future will be a depressed adult, is humiliated in childhood by his father, who usually makes him feel useless, preventing him from developing feelings of competence and trust. Children learn that they do not know how to function well on their own, and they begin to believe that they will never have that ability, so they feel deeply hopeless.

3. Reinforcement of sadness as an identity

Expressions of sadness and helplessness serve to attract attention, thus getting others to give them love and signs of affection that they need so much.. In this way, they get reinforcements for their depressive behavior. This can be a double-edged sword, because while it may work in the short term, in the long run term what is achieved is that their environment gets tired of their depressive behavior and they end it avoiding.

4. Disparity between what is and what should have been

Constantly feeling unloved, useless, and inadequate, the person with depressive personality disorder finds differences between what was supposed to be and what it actually is. Many times this disparity is born from the unrealistic expectations placed by the parents on the child. From this disparity are born feelings of emptiness and hopelessness.