Peer Reviewed
Feature Article Psychiatry and psychology
Making sense of the complex depressed patient. Part 2: temperament and personality factors
Abstract
Personality traits tend to be magnified in the presence of stress and depression – they ‘shape’ the presentation and add to the complexity of depressive episodes.
Key Points
- A person’s temperament and personality style affects onset and course of illness, including depression, in that person.
- People with some personality styles are very vulnerable to episodes of major depression as well as chronic low mood.
- The combination of the patient’s temperament and attachment style predict the best approaches to managing depressive episodes and the likely problems that may be encountered.
- Management of these depressions involves using a problem-based approach, identifying barriers, minimising harm and assessing the need and motivation for more long-term interventions.
- Antidepressants may be used to treat a depressive episode; assist with mood regulation, anxiety and aggression; and help patients cope with disintegration under stress.
- Case conferences, second opinions and supervision can all help to ‘lessen the load’. A team approach can be useful but requires an integrated management plan.
- Different attachment styles invoke different emotional reactions from clinicians. GPs should consider the sorts of patients likely to ‘push their buttons’ and the best ways of responding.
- Patients should be reappraised after the depression has lifted as some personality dysfunction may resolve and enduring traits may need addressing to diminish vulnerability to further episodes.
Purchase the PDF version of this article
Already a subscriber? Login here.