Depressive personality: causes, symptoms and risk factors.

There are individuals with a greater propensity to suffer from depression.

Surely you have ever 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 black.

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

What happens with this type of people? Do they constantly suffer from major depression, do they have a persistent depressive disorder, is being depressive a personality trait?

In this article we are going to talk about depressive personality disorder (DPD), which is not included in current classifications such as DSM-5 or ICD-10, but has been the subject of study over many years by such renowned authors 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 refers to as the "surrender pattern") fall under the umbrella of the Pleasure Difficulty Personalities. According to Millon, depressive persons have a number of personality traits in common, which can be manifested and described at different levels:

1. behavioral level

Expressively depressed, the appearance and state convey hopeless helplessness.. Interpersonally helpless: due to the feeling of vulnerability and lack of protection, he/she will beg others to take care of him/her and protect him/her, fearing abandonment. They will seek or demand guarantees of affection, constancy and dedication. They tend to be introverted, so they may have trouble finding a partner. When they do find a partner, they become very dependent on them.

2. Phenomenological level

They are cognitively pessimistic: they show defeatist, fatalistic and negative attitudes in almost everything. They always expect the worst. They interpret the facts of life in the most desolate way possible, and feel hopeless that things will never get better in the future.

Their self-image is "worthless". They judge themselves as insignificant, useless, incapable, of no value either 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

• Mechanism of asceticismThe asceticism mechanism: he 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 organizationimpoverished coping methods.

4. Biophysical level

Melancholic state of mind: easily tearful, sad, sad, saddened, sullen, worried and with a tendency to ruminate ideas. They tend to feel bad-tempered. They get angry with those who pretend to exaggerate the good at the expense of the realistic.

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

In the year 1994 the APA introduces in the DSM-IV the term "Depressive Personality Disorder" in the appendix of Research Criteria for Personality Disorders. According to the DSM-IV-TR (APA, 2000) the core features of depressive personality disorder (DPD) consist of:

• An entrenched pattern of depressive behaviors and cognitions.
• They view the future negatively, doubt that things will get better, and anticipate the worst. They show defeatist and fatalistic attitudes.
• They are very serious, lack a sense of humor, do not allow themselves to enjoy or relax in their daily lives.
• As for their physical appearance, it often reflects their depressed mood. The slumped posture, psychomotor retardation and depressed facial expression are often visible.
• They look sad, discouraged, disillusioned and unhappy.
• Their self-concept is centered on beliefs of worthlessness and inadequacy, and they have low self-esteem.
• They are self-critical, frequently self-deprecating.
• They tend to ruminate and worry constantly.
• They are pessimistic.
• 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 best explained by the presence of a dysthymic disorder.

Differential diagnosis

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

Much of the controversy regarding the identification of depressive personality disorder as a separate category is the lack of utility in differentiating it from dysthymia. In addition, it has been suggested that depressive personality disorder it has been suggested that depressive personality disorder may be confused and overlap with other personality disorders (dependent, obsessive compulsive, obsessive-compulsive). (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 and Davis, 1998):

Deficient childhood emotional attachment 2.

If the child does not experience unmistakable signs of acceptance and affection during infancy, feelings of emotional detachment, insecurity and isolation may develop.. These children lack experiences of affection and closeness with their parents, who are often distant and indifferent. Children tend to give up looking for parental emotional support, learn to make few demands on their environment and develop feelings of helplessness and hopelessness.

Helplessness

The child, who in the future will be a depressive adult, is humiliated in childhood by his father, who usually makes him feel useless, preventing him from developing feelings of helplessness and hopelessness.This prevents him/her from developing feelings of competence and confidence. Children learn that they do not know how to function well on their own, and 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 are used to attract attention, so that others give them much-needed affection and affection.. In this way, they get reinforcement for their depressive behavior. This can be a double-edged sword, because although in the short term it can work, in the long term what is achieved is that their environment gets tired of their depressive behavior and they end up avoiding it.

4. Disparity between what he is and what he should have been.

Constantly feeling unloved, worthless and inadequate, the person with depressive personality disorder finds differences between what he supposedly should have been and what he really is. and what he or she actually is. Often this disparity stems from unrealistic expectations placed on the child by the parents. This disparity gives rise to feelings of emptiness and hopelessness.