Depressive Personality Disorder

The Depressive Personality Disorder is not yet recognized by the DSM Committee. It makes its appearances in Appendix B of the Diagnostic and Statistical Manual, titled "Criteria Sets and Axes Provided for Further Study." It is not clear in what way is the Depressive Personality Disorder different to other depressive illnesses, such as Dysthymic Disorder.

The Depressive has pervasive and continuous depressive cognitions (thoughts) and behaviors. They manifest themselves in every area of life and never abate. The patient is gloomy, dejected, pessimistic, overly serious, lacks a sense of humor, cheerless, joyless, and constantly unhappy. This dark mood is not influenced by changing circumstances.

The Depressive's self-image is distorted: he holds himself to be worthless, inadequate, a loser. His sense of self-worth and his self-esteem are invariably and unrealistically low. This borders on self-hatred and self-abnegation. The Depressive chastises himself unnecessarily. His inner dialog (sometimes verbalized) is derogatory towards his self, blaming and self-critical. Freud called this inner judge the Superego. The Depressive's Superego is sadistic, unrelenting, unforgiving, self-denigrating, and, ultimate hatefully self-destructive. Dimly aware of this semi-suicidal streak, Depressives are naturally anxious and prone to excessive worrying and brooding.

The Depressive extends this propensity to humiliate and punish to his nearest and dearest. His masochism is complemented by equally exacting sadism. He is negativistic, passive-aggressive, critical, judgmental, and punitive towards others. Such recurrent outbursts are followed by feelings of remorse and guilt, often coupled with maudlin and prostrate apologies.