Depression and Personality Disorders

How is Depression Linked to Personality Disorders?

Depression is one of the most common mental health disorders in the world. In the U.S., about 6.7% of the adult population will experience an episode of depression in a given year. While there is no single cause of any mental health condition, a combination of different factors can increase a person’s risk of becoming depressed. Also, the symptoms of depression and comorbid conditions can worsen the effects of each. When it comes to the complex nature of personality disorders, it can be difficult for clinicians to differentiate between personality disorders and depression, and effectively treat both.

Depression and Personality Disorders

What is personality?

Personality is the way an individual thinks, behaves, or feels, and how those thoughts and behaviors make them unique from others. The personality is made up of inherent traits and characteristics. But individual experiences and the environment a person grows up in and lives in can shape and morph someone’s personality. This is especially true during a person’s infancy, the toddler years, and childhood. In most cases, the personality is stable, and the way someone thinks and behaves will stay the same over time. But trauma and genetics can change things.

What is a personality disorder?

A personality disorder is when the way someone thinks, feels, perceives, and behaves that deviates markedly from the norm, and these patterns cause distress in their relationships and ability to function. Deviation refers to the person’s cultural norms, and these disruptions in thinking and behavior must create patterns that last over a long period and be disruptive for it to be considered indicative of a personality disorder.

Personality disorders are long-term patterns and thoughts that significantly differ from what is considered expected behavior. It’s important to understand that trauma, grief, and even periods of depression can change a person’s behavior or perception. But these tend to go away over a period. What’s different with personality disorders is they are fixed, and the issues they cause will last for a person’s lifetime unless they get treatment for a mental health disorder.

There are ten individual personality disorders listed in the current DSM V. For a diagnosis, the abnormal patterns of behavior, perception, and thinking must start in the late teen years, or early adulthood and cause significant distress and problems in daily functioning. Some of the most significant issues that personality disorders cause will be present in the individual’s personal relationships. People with high-functioning personality disorders may do remarkably well in school or their professional lives. But they may exhibit a string of broken relationships or have difficulty forming close, healthy bonds with others because of an untreated personality disorder. Personality disorders influence the following patterns:

  • The way a person thinks about themselves and others
  • How that person responds to others and situations emotionally
  • How they relate to other people in their relationships
  • The way they control their behavior, both positive and negative

It is critical to understand that nearly everyone can exhibit the signs of a personality disorder at some point in their lives. The difference between transient, harmful behaviors and perception, versus a clinical personality disorder is the inflexibility of the person’s belief system and their subsequent responses.

What are the different types of personality disorders?

Personality disorders are broken down into three categories or clusters. There are cluster A, B, and C personality disorders. Clusters A and C are the least likely to cause significant impairment in a person’s life and relationships, although they will still cause varying degrees of distress for the patient and their loved ones. Cluster B personality disorders are some of the most distressing for both patients, their loved ones, and clinicians.

Cluster A personality disorders are often referred to as odd or eccentric personalities. These include paranoid personality, schizoid personality, and schizotypal personality disorders. People with these disorders tend to exhibit extreme social awkwardness, social isolation, and withdrawal.

Cluster B personality disorders are dramatic, erratic, and emotional disorders. They include borderline personality disorder, narcissistic, antisocial, and histrionic personality disorders. People with these types of personalities have difficulty controlling distressing feelings, thoughts, and acting out on those thoughts. These personality disorders are also the most likely to abuse drugs and alcohol, and to get into financial and legal trouble if untreated.

The final cluster C personality disorders are referred to as the anxious and fearful cluster. Avoidant personality, dependent personality, and obsessive-compulsive personality disorders make up this cluster. People with these personalities may have difficulty forming healthy bonds in close relationships. A preoccupation with rules, regulations, and orderliness in obsessive-compulsive personality disorder can cause alienation and isolation for sufferers.

How is depression linked to personality disorders?

The behaviors, feelings, and thoughts that are present in personality disorders are considered deviant and abnormal by societal standards. Erratic, rigid, and emotional behaviors that are associated with personality disorders will lead to severe issues with a patient’s relationships and ability to function in society. They are at increased risk of feeling guilty, or self-loathing because of their past behaviors and the consequences of their actions. For people with personality disorders, these feelings can either trigger depression symptoms or worsen them.

Also, the increased chances of a person, especially with a cluster B personality, turning to drugs and alcohol to cope can also trigger depression symptoms or make them worse. In some studies, more than half of patients admitted to hospitals for major depressive disorder meet the diagnostic criteria for at least one comorbid personality disorder.

What is the treatment for a personality disorder and depression?

Personality disorders require ongoing, intense cognitive behavioral therapy and dialectical behavioral therapy from an experienced therapist. It is also crucial that patients receive medication and therapy for clinical depression at the same time. Both personality disorders and clinical depression are lifelong, chronic conditions. But depression and personality disorders can be successfully treated and managed with customized and holistic treatment plans.

Treating both symptoms simultaneously is necessary for complete and successful management of mental health. Addressing only one issue at a time will never work. When one symptom is lessened, the other has the potential to also come down in severity. Treating depression with transcranial magnetic stimulation is an excellent option as to not interfere with the personality disorder with medications or other triggering stimuli.

Depression is one of the leading causes of disability around the world, and it’s becoming even more common. In a Boston University study, 1,441 participants answered questions about the impact of COVID-19 on their lives. The results showed that the number of adults who reported symptoms of depression climbed from 8.5% before the pandemic to 27.8% during the pandemic. Depression often exists with other mental disorders, making both conditions harder to diagnose and treat.

What Are Co-Occurring Disorders?


A co-occurring mental disorder, or comorbidity, exists when one individual has two different mental health conditions at the same time. Personality disorders, anxiety, and PTSD are some of the most frequently seen with depression. One condition may develop before the other condition, or as the result of it. Episodes of post-traumatic stress (PTSD) or the mood swings in borderline personality disorder, for example, may lead to depression.


Some combinations, such as depression and anxiety, are easy to recognize. Others, such as personality disorders, are more difficult because symptoms overlap with those of depression. It’s not unusual for one illness, especially when it’s a personality disorder, to go undetected.


What Is a Personality Disorder?

A personality disorder occurs when thoughts, emotions, and behavior deviate from the norms of society and cause ongoing problems in daily life. Unhealthy thought patterns often begin during the young adult or teen years and continue, although they may lessen in later years. One of the most disruptive is borderline personality disorder, a condition that results in anger, impulsivity, and severe mood swings.

Borderline personality disorder, which frequently occurs with depression, falls into four categories:

  • Discouraged
  • Petulant
  • Self-destructive
  • Impulsive

While there is no medication for treating personality disorder, drugs like antidepressants and mood stabilizers may help with symptoms. Care is usually ongoing and involves a team of medical and mental health professionals. Research has shown that transcranial magnetic stimulation, a relatively new technique, can be helpful in treating treatment-resistant depression and co-occurring disorders.

Transcranial magnetic stimulation is a non-invasive procedure that uses an electromagnetic coil to send quick pulses of magnetic energy that stimulate specific areas of the brain associated with depression and personality disorders. The magnetic field stimulates neurons, or brain cells, that are not functioning normally. Approved by the FDA, TMS treatments are administered in brief sessions over a period of 6 to 8 weeks. Side effects are minimal, and patients can return to work or school after each session.

Studies show TMS helps individuals with several disorders, including borderline personality and depression. A 2014 study showed improvement in emotional stability, organizational skills, and anger after 10 TMS sessions. In 2018, other research showed that TMS helped participants control anger, mood swings, and impulsive behavior.

We Can Help

If you have depression that occurs with another disorder or resists traditional treatments, transcranial magnetic stimulation offers new hope. Contact our experienced team at Pulse TMS to schedule an appointment today. You can also learn more by visiting our blog.