Dysthymia, personality disorders and the MBTI

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 I had been diagnosed with Dysthymia (Persistent Depressive Disorder) in the past and was reluctant to accept the diagnosis. Even though I have spent most of my life dealing with depressive like symptoms, for some reason I refused to identify with the label completely. In the past, when a teenager and young adult, I experienced mostly depression and occasionally brief(~4 hr) euthymic/hypomanic periods. As I have stated in my about section, I experienced severe depression in the morning and euthymia/hypomania in the evening with quite a regularity. Many clinicians would describe this as diurnal variation in the context of a mood episode but I am not so sure.

In my mind over identifying with the depressive symptoms didn’t make sense since along with a depressed temperament I experienced many physical symptoms that suggested something other than temperamental problems. I have rarely read about people with Dysthymia mentioning much in the way of physical problems(insomnia/over sleeping,lack of appetite, fatigue). There seemed to be much more of a focus on how they felt emotionally and most of them identified strongly with being depressed for as long as they could remember. I however identified to quite a degree with the brief euthymic/hypomanic periods when I was quite productive and when I had no physical problems.

The other day though, I came across a Youtube video on the topic of INFP and the MBTI. In the video the person described a personality type that describes me when depressed and consequently I could identify with it to quite a degree. This made me ponder the difference between personality and Dysthymia. This topic has been debated for quite some time. In the past a Depressive personality type was accepted but once Prozac was introduced and successfully treated Dysthymia that changed. The DSM doesn’t have a label of Depressive Personality Disorder anymore but Persistent Depressive Disorder(Dysthymia) still remains. Despite the change the debate about a depressive personality hasn’t been resolved entirely. Many psychologist still view depression as more of a character flaw while psychiatrists are more open to the idea that there is something biological. The following excerpt supports my contention that my form of depression is more biological in nature and doesn’t overlap with Depressive Personality Disorder.

Many researchers believe that depressive personality disorder is so highly comorbid with other depressive disorders, manic-depressive episodes and dysthymic disorder, that it is redundant to include it as a distinct diagnosis. Recent studies however, have found that dysthymic disorder and depressive personality disorder are not as comorbid as previously thought. It was found that almost two thirds of the test subjects with depressive personality disorder did not have dysthymic disorder, and 83% did not have early-onset dysthymia.(Wikipedia)

I still tend to favor the idea of a biological explanation but have not entirely excluded the idea that a depressive personality might exist. This has been supported to a minor degree by an individual studying the MBTI and mood disorders named Janowski. He found depressed people tended to prefer introversion, feeling, and perceiving. Another small survey on McMan’s Depression and Bipolar Web found that most people with bipolar disorder identified with INFX as a MBTI type.

Unipolar Depressed patients were significantly more often Introverted, Sensing, Feeling, and Perceiving single-factor types respectively, and Introverted-Sensing-Feeling-Perceiving, and Introverted-Intuitive-Feeling-Perceiving four-factor types. The male Introverted-Sensing-Feeling-Perceiving four-factor type was the most dramatically over-represented.(Janowsky DS, 2002)

My conclusion from this small amount of information is that there might be an association between MBTI type and Depressive Personality Disorder but not so much with Dysthymia which has more of a physical basis. Hopefully more research will illuminate the debate regarding personality and clinical depression.

 

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