The Relationship Between Personality and Depression
1. Introduction. Depression is a serious mental illness that has a negative impact on an individual’s mood, thoughts, physical health, and behaviour. It can lead to problems with work, school, and relationships. Personality is a set of characteristics that an individual has that makes them unique. It includes the way they think, feel, and behave. There are different theories about how personality develops. Some of these theories are:
The Psychoanalytic Theory: This theory was developed by Sigmund Freud. It suggests that personality is made up of three parts: the id, ego, and superego. The id is the part of personality that is responsible for our basic needs and desires. The ego is the part of personality that helps us deal with reality. The superego is the part of personality that internalizes society’s rules and values.
The Psychodynamic Theory: This theory was developed by Carl Jung and Erik Erikson. It suggests that personality is shaped by our early experiences with our parents and other important people in our lives.
The Behavioural Theory: This theory was developed by John B. Watson and B. F. Skinner. It suggests that personality is a result of the reinforcement and punishment we receive from our environment during our life.
2. Theoretical Orientations to Personality and Depression:
Different theoretical orientations to personality may have implications for understanding depression and its treatment outcome (Strakowski et al., 2002). In this section, we will review three different orientations to personality; psychoanalytic, psychodynamic, and behavioural perspectives on depression with a focus on their implications for understanding depression as a disorder of personality development or as resulting from specific personality types or traits (see Table 1 for a summary).
The Psychoanalytic Perspective: Freud’s psychoanalytic perspective on depression emphasised the role of unconscious processes in the development and maintenance of depressive symptoms (Freud, 1917). According to Freud, major depressive disorder (MDD) results when an individual cannot resolve the conflicting demands of the id, ego, and superego leading to feelings of guilt, anxiety, and worthlessness (Abramson et al., 1978). Freud believed that the ego’s defence mechanisms such as repression, reaction formation, and denial are used to protect the individual from the painful realities associated with unresolved conflicts between the id and superego (Abramson et al., 1978; Freud, 1917). These defence mechanisms are thought to be maladaptive because they prevent the individual from resolving the underlying conflict which leads to chronic or recurrent depressive symptomology (Abramson et al., 1978; Freud, 1917).
The Psychodynamic Perspective: Jung’s psychodynamic perspective on depression emphasises the role of early childhood experiences in shaping adult personality (Jung, 1916). According to Jung, MDD results when an individual cannot come to terms with unresolved childhood traumas such as abuse or neglect (Jung, 1916). These traumas lead to feelings of guilt, shame, and inadequacy which are thought to be subconsciously repressed by the individual in an attempt to protect themselves from further psychological pain (Jung, 1916). This repression is thought to be maladaptive because it prevents the individual from resolving the underlying conflict which leads to chronic or recurrent depressive symptomology (Jung, 1916).
The Behavioural Perspective: The behavioural perspective on depression emphasises the role of environmental factors in the development and maintenance of depressive symptoms (Watson & Skinner, 1930). According to the behavioural perspective, MDD is a result of negative reinforcement such as learned helplessness or punishment such as social isolation (Watson & Skinner, 1930). These environmental factors lead to feelings of hopelessness and worthlessness which are thought to be maintained by the individual because they provide a sense of relief from the painful reality of the situation (Watson & Skinner, 1930). This relief is thought to be maladaptive because it prevents the individual from resolving the underlying conflict which leads to chronic or recurrent depressive symptomology (Watson & Skinner, 1930).
3. Types of Personality Pathology Associated with Depression:
There are a number of personality disorders that have been found to be associated with depression. In this section, we will review three different types of personality pathology; covert narcissism, borderline personality disorder, and avoidant personality disorder with a focus on their implications for understanding depression as a disorder of personality development or as resulting from specific personality types or traits (see Table 2 for a summary).
Covert Narcissism: Covert narcissism is a type of personality disorder characterised by grandiose ideas and fantasies, a need for admiration and attention, and a lack of empathy for others (Gabbard, 2005). Individuals with covert narcissism are often extremely sensitive to criticism and have difficulty handling rejection (Gabbard, 2005). They may also have difficulty maintaining close relationships because they are afraid of being hurt or rejected (Gabbard, 2005). Covert narcissism has been found to be associated with depression, anxiety, and substance abuse (Gabbard, 2005).
Borderline Personality Disorder: Borderline personality disorder is a type of personality disorder characterised by impulsivity, emotional instability, and chronic feelings of emptiness and loneliness (American Psychiatric Association, 2013). Individuals with borderline personality disorder often have difficulty maintaining close relationships because they fear abandonment and may engage in self-destructive behaviours such as drug abuse or self-harm (American Psychiatric Association, 2013). Borderline personality disorder has been found to be associated with depression, anxiety, and substance abuse (American Psychiatric Association, 2013).
Avoidant Personality Disorder: Avoidant personality disorder is a type of personality disorder characterised by social anxiety, feelings of inadequacy, and avoidance of social interactions (American Psychiatric Association, 2013). Individuals with avoidant personality disorder often have difficulty maintaining close relationships because they fear rejection and may avoid social situations altogether (American Psychiatric Association, 2013). Avoidant personality disorder has been found to be associated with depression, anxiety, and substance abuse (American Psychiatric Association, 2013).
4. Treatments for Depression: Depression is typically treated with medication and/or psychotherapy. Medication is used to treat the symptoms of depression such as sadness, fatigue, and insomnia. Psychotherapy is used to treat the underlying causes of depression such as unresolved childhood trauma or negative reinforcement from the environment. There are a number of different types of psychotherapy that have been found to be effective in treating depression. In this section, we will review three different types of psychotherapy; cognitive-behavioural therapy, interpersonal therapy, and psychodynamic therapy with a focus on their efficacy in treating specific types of depression (see Table 3 for a summary).
Cognitive-behavioural therapy: Cognitive-behavioural therapy is a type of psychotherapy that emphasises the role of thoughts and behaviours in the development and maintenance of depression (Butler, Chapman, Forman, & Beck, 2006). Cognitive-behavioural therapy is focuses on identifying and changing negative thinking patterns and behaviours that contribute to the development and maintenance of depression (Butler et al., 2006). Cognitive-behavioural therapy has been found to be an effective treatment for depression, particularly when it is used in combination with medication (Butler et al., 2006).
Interpersonal therapy: Interpersonal therapy is a type of psychotherapy that emphasises the role of relationships in the development and maintenance of depression (Cuijpers et al., 2009). Interpersonal therapy focuses on helping the individual to develop and maintain healthy relationships with others as a way of treating the symptoms of depression (Cuijpers et al., 2009). Interpersonal therapy has been found to be an effective treatment for depression, particularly when it is used in combination with medication (Cuijpers et al., 2009).
Psychodynamic therapy: Psychodynamic therapy is a type of psychotherapy that emphasises the role of unconscious processes in the development and maintenance of depression (Leichsenring & Leibing, 2003). Psychodynamic therapy focuses on helping the individual to understand and resolve the underlying conflict that is causing their depression (Leichsenring & Leibing, 2003). Psychodynamic therapy has been found to be an effective treatment for depression, particularly when it is used in combination with medication (Leichsenring & Leibing, 2003).
5. The Outcome of Treatments in patients with Personality Pathology:
There is evidence to suggest that patients with personality pathology are less likely to respond to treatment for depression than patients without personality pathology (Gabbard, 2005; Leichsenring & Leibing, 2003; Torgersen, Kringlen, & Cramer, 2001). In general, patients with personality pathology are more likely to experience chronic or recurrent depressive symptoms despite treatment (Gabbard, 2005; Leichsenring & Leibing, 2003; Torgersen et al., 2001). This may be due to the fact that patients with personality pathology often have difficulty complying with treatment recommendations or may be resistant to change (Gabbard, 2005; Torgersen et al., 2001).
6. Conclusion. Depression is a serious mental illness that can have a negative impact on an individual’s mood, thoughts, physical health, and behaviour. It can lead to problems with work, school, and relationships. Personality is a set of characteristics that an individual has that makes them unique. It includes the way they think, feel, and behave. There are different theories about how personality develops. Some of these theories are:
The Psychoanalytic Theory: This theory suggests that personality is made up of three parts: the id, ego, and superego.
The Psychodynamic Theory: This theory suggests that personality is shaped by our early experiences with our parents and other important people in our lives.
The Behavioural Theory: This theory suggests that personality is a result of the reinforcement and punishment we receive from our environment during our life.
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