Depression

/

Definition:

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Darkness of the Heart

People with Personality Disorders are often also diagnosed with depression resulting from mistreatment at the hands of others, low self-worth and sometimes the results of their own poor choices.

The common symptoms of depression include:

  • Loss of interest in normal daily activities
  • Feeling sad or down
  • Feeling hopeless
  • Crying spells for no apparent reason
  • Problems sleeping
  • Trouble focusing or concentrating
  • Difficulty making decisions
  • Unintentional weight gain or loss
  • Irritability
  • Restlessness
  • Being easily annoyed
  • Feeling fatigued or weak
  • Feeling worthless
  • Loss of interest in sex
  • Thoughts of suicide or suicidal behavior
  • Unexplained physical problems, such as back pain or headaches

Source: Mayoclinic.com

Depression symptoms can vary because people experience depression in different ways. For instance, a 25-year-old woman may not have the same symptoms as a 70-year-old man. Some people may have depression symptoms which are so severe it’s obvious something isn’t right. Others may feel generally miserable or unhappy without really knowing why.

When Personality Disorders and Depression Meet

People who suffer from personality disorders are particularly prone to depression because:

The disorder itself may produce irrational feelings of depression.
The consequences of poor choices made may result in regret and depression.

A Non (non-personality-disordered individual) may have trouble understanding the depressive symptoms of a Personality Disordered loved one because sometimes the depressive symptoms are a consequence of the disorder itself, and sometimes the depressive symptoms may be a reaction to their circumstances.

It can seem like the Personality Disordered person is being erratic or hard to “figure out”, which can lead a Non to conclude that the Personality Disordered individual is being insincere or manipulative.

While a person with a Personality Disorder may be very insincere or manipulative at times, they may also sometimes be genuinely, clinically depressed.

So sometimes the person with the personality disorder may be complaining about their situation because they are controlling you. Sometimes they may be complaining about their situation because they are really hurting. It’s a hard one to call, because if a Non reacts based on the way they were “last time”, this time it may be different.

What NOT to do:

  • Don’t try to “figure out” your loved one or write a script for your relationship. There’s no way to get inside their head and connect the dots for them. They won’t be wearing a T-shirt which tells you what their state of mind is.
  • Don’t expect you can ‘fix’ them - it’s not your job to program them back into happiness - any more than it would be your job to grant them sight if they were blind.
  • Do not ignore suicide threats or disclosures of suicidal feelings – call for appropriate assistance from the police, ambulance or mental health intervention team.

What TO Do:

  • Understand that your loved one has a Personality Disorder - and they have depression sometimes.
  • Read each situation with honest objectivity. Ask yourself, what do the facts of the situation call for? Who is being hurt? Who is hurting others? Who needs protection? Who needs to be left alone?
  • Put safety first. Survey the situation. Are there children being hurt? Are you being hurt? Are innocent bystanders being hurt? Is the Personality Disordered individual being hurt? If the answer is ‘yes’ to any of these questions, get help from either the police or mental health professionals as a matter of urgency. Remove yourself and any children to a place of safety.

Related Personality Disorders:

Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive-Compulsive

Comorbidity Between Personality Disorders and DSM-IV Axis I Disorders

67% of people who meet the DSM-IV criteria for a Personality DIsorder have been found in a 2007 study to also meet the criteria for at least one of the DSM-IV Axis I disorder. The table below shows the probability that a person who has been diagnosed with a personality disorder will also meet the criteria for each of the following Axis I disorders, as defined by the American Psychiatric Association's Diagnostic & Statistical Manual of Mental Disorders (DSM-IV).

Comorbidity is a psychological term used to describe the occurrence of more than one diagnosis in a single patient.

Axis I Disorder Comorbidity
Anxiety Disorders 52.4%
- Generalized Anxiety Disorder (GAD) 15.2%
- Specific phobia 23.4%
- Social phobia 26.3%
- Panic disorder 10.0%
- Adult separation anxiety disorder (ASAD) 8.9%
- Post Traumatic Stress Disorder (PTSD) 14.1%
Mood Disorders 24.1%
- Major Depressive Disorder (MDD) 13.4%
- Dysthymia 10.8%
- Bipolar I or II 8.1%
Impulse Control Disorders 23.2%
- Intermittent Explosive Disorder (IED) 15.9%
- Attention Deficit Disorder (ADD) 11.0%
Substance Abuse 22.6%
- Alcohol abuse or dependence 10.9%
- Drug abuse or dependence 5.6%
- Tobacco dependence 11.8%
Any DSM-IV Axis I Disorder 67.0%

Source: Lenzenweger et al, 2007 - DSM-IV personality disorders in the National Comorbidity Survey Replication

Note that although 67% of the people meeting the criteria for a personality disorder also meet the criteria for an Axis I disorder, the reverse is not true. Only 24.8% of people meeting the criteria for an Axis I disorder also meet the criteria for an Axis II personality disorder.