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People on the DFM spectrum typically experience chronic feelings of sadness and depression that persist even when things are going well. According to the Darwinian evolutionary model, these individuals are oriented to the pain polarity and tend to behave in a passive, giving-up manner. As with the others, the spectrum has three levels, with varying degrees of intensity and breadth of depressive symptoms.

Mild dejected personalities are common among people who tend to see life pessimistically and problematically. Forlorn personalities are at a moderate or abnormal level, incorporating self-denigration and a belief that the future will be as sad and forsaken as the past. Melancholic personalities are at the pathological level, characterized by pervasive and persistent disconsolation and depression.

In psychopathology, some people consider depression to be as common as the common cold, making it difficult to distinguish from normal sadness or dejection. Whether it’s an endogenous disease process, an extreme variant of unhappiness caused by environmental circumstances, or both, is unclear. Additionally, it’s uncertain whether depression shows periodicity or is a continuous process, or whether it’s an intrinsic part of a personality pattern or an episodic clinical syndrome.

The DSM-IV Personality Work Group discussed the construct of a Depressive Personality Disorder and concluded that it should be included as an enduring type of psychological disorder. It exhibits early onset, demonstrates a relatively stable and long-term course, and displays many features across diverse situations over time.

In previous versions of the DSM, the dysthymic disorder was introduced as a construct for a personality variant of depressive character. However, it was recognized that the criteria for dysthymia emphasized mood symptomatology rather than a diverse set of personality traits. Furthermore, the symptoms were largely somatic or vegetative rather than cognitive or interpersonal in nature. The self-defeating/masochistic disorder was introduced to achieve these goals, but it was dropped from the most recent manual.

Criteria were provisionally introduced for a purer or prototypal variant of a melancholic personality disorder, from which Millon develops the DFM spectrum. (Millon 2011 754-755)

Polarities

We can observe a significant representation of both the preservation polar extreme and the accommodating ecological adaptation style. This indicates that the individual is overly concerned with pain and suffering and has essentially given up, accepting continuing misery as inevitable. Although these patterns share similarities with the avoidant spectrum personality, there are notable differences. Both personality disorders exhibit an adaptive focus on preservation and pain reduction, while neglecting the potential pleasures and joys of life.

However, in the ecological adaptation, the avoidant personality actively seeks to minimize pain by anticipating and avoiding the possibility of suffering. In contrast, the melancholic no longer attempts to evade the anguish and despair of life, having accepted it as inevitable and insurmountable. The melancholic individual remains passive, resigned to the distressing realities they have experienced, no longer attempting to avoid it but instead surrendering to it. (766)

Trait Domains

Emotional Expression: Disconsolate: The disconsolate emotional expression of DFM personalities is strikingly evident. Their posture and demeanor project an intense sense of melancholy and despair. They speak in a somber and mournful tone, conveying a deep sense of grief and sadness. Their voices sound unenthusiastic and discouraged, painting a visual image of hopelessness and misery.

DFM individuals exhibit a marked lack of initiative and spontaneity, often relying on prompting to communicate. They offer little information on their own and tend to repeat themselves. Their speech is slow and hesitant, and their movements are sluggish and lethargic. Even those prone to agitation and irritability exhibit a noticeable reduction in purposeful or intentional behaviors (Huprich, 2005). Their actions seem to be in slow motion. (766-767)

Interpersonal Conduct: Defenseless: DFM personalities are often seen as vulnerable and defenseless, constantly seeking reassurance and protection from others. They may behave in one of two ways: either passively withdrawing from others or becoming needy and demanding in their quest for affection and loyalty. The goal of their behavior is to elicit nurturant responses from others, and they recruit family and friends to provide these assurances of their worth and value. While their complaints and moods may serve as an excuse to avoid responsibility, their sense of helplessness and worthlessness is genuine and apparent to all.

DFMs often express anger and resentment in subtle or oblique ways, fearing that overt hostility will lead to rejection. They may overplay their helplessness to evoke guilt in others and create discomfort as others attempt to meet their seemingly justified need for care and nurturance. While they crave the love and support of others, they fail to reciprocate in ways that gratify or reinforce positive relationships. Their clinging behaviors, self-preoccupation, and devious coping mechanisms may eventually lead to annoyance and exasperation from others. When they fail to receive the sympathy they desire, they may turn inward, plagued by guilt and self-reproach. Overall, DFM personalities convey a constant sense of vulnerability and neediness, always seeking to be protected and nurtured by those around them. (767-768)

Cognitive Style: Pessimistic: DFMs have a pessimistic cognitive style, perceiving life in the darkest manner and expecting the worst to happen. They tend to interpret events in the most negative way, feeling discouraged and bleak, and believing that their future holds no promise. They are preoccupied with their own problems, obsessively worrying about their misfortunes from the past and present. DFMs often imagine unrealistic solutions involving some magical event or omnipotent force, but deep down, they feel little hope that their situation will improve. Their communications with others are typically stereotypical and lack color.

Although they may attempt to fight back depressive feelings by consciously diverting their thoughts away from their negative moods, these new thoughts often prove equally troublesome. They tend to reactivate and brood over minor past incidents and dwell only on the painful and distressing aspects of life, while ignoring any positive or pleasurable experiences. DFMs believe that their present state is irreversible and that optimism is just an illusion. They adopt a helplessness-hopelessness outlook, assuming that they are unable to help themselves and unlikely to receive outside help.

Despite enduring an astounding degree of misfortune, as long as there is hope, most personalities can endure and persevere. However, the pessimistic schemas that shape DFMs’ thoughts generate increasing levels of hopelessness, preventing them from imagining or planning any conditions that could improve their situation. DFMs often feel trapped in a never-ending cycle of despair, where life appears to create an ever-deepening well of hopelessness. (768)

Self-Image: Worthless: DFMs tend to have a deep sense of worthlessness and inadequacy. They often feel guilty for lacking praiseworthy qualities or achievements and judge themselves as valueless, inadequate, and unsuccessful in all aspects of a meaningful life. Minor failures can trigger a more severe state of disconsolation, and harmless critical remarks can intensify their sense of worthlessness. Even when things are going well, DFMs still feel deficient in qualities like popularity, intelligence, and physical appeal. They tend to blame themselves for circumstances that have no connection to them, and they fear making decisions or taking the initiative. Some DFMs reach such a low level of self-denigration that they begin to pity themselves, which can lead to constructive outcomes or self-destructiveness. While there is a possibility for inner salvation and renewal, there is also a significant risk of self-destructiveness during these times. (769)

Intrapsychic Content: Forsaken: The term intrapsychic content refers to a collection of unspoken beliefs about the nature of significant others and life in general. These unconscious assumptions shape how individuals interpret the fleeting events of everyday life. Intrapsychic content comprises personal expectations and assumptions that selectively interpret and integrate significant experiences, and it includes unspoken rules and dispositional inferences that accurately interpret observations, but can also erroneously distort them.

In the world of cognitive modes (Millon, Millon, & Davis, 1994), these dispositional sets are related to schemas and are largely conscious. However, there is an unconscious matrix of schemas that refers to significant intrapsychic structures. These structures selectively categorize and evaluate experiences below the level of awareness. When speaking of intrapsychic object-representations, we refer to these unconscious schemas, which have a tendency to mold perceptions and cognitions in line with inner templates that were formed earlier in life. These templates may remain inactive for periods of time but become prominent when stimulated by relevant experiences.

In the case of DFM individuals, these templates saturate ongoing experiences and thoughts with a pessimistic and negative tone. The content of their inner world appears devitalized, depleted, or jettisoned. It seems to lack the richness or joyful elements that characterize healthy psychological functioning. Memories of past good experiences, happy memories, and feelings of fulfillment appear to have been withdrawn from memory, leaving a sense of being forsaken, abandoned, or bereft. The depressive feeling associated with forsaken intrapsychic content may leave the individual feeling discarded and cast off. (769)

Intrapsychic Dynamics: Asceticism: The primary goal of DFM individuals is to fulfill their belief in experiencing penance and deprivation of life’s pleasures. Through this mechanism, they manipulate their inner world to achieve self-denial, self-punishment, and self-torment. This leads to a repudiation of pleasurable memories, and harsh self-appraisals that transform them into their opposite.

DFMs allow themselves minimal, if any, pleasure and constantly appraise their actions to determine whether they deserve more joy and satisfaction than they have attained. They feel that they deserve less rather than more, and may even give up on themselves completely, leading to self-abdication and resignation from life. In a sense, they have adopted a mechanism of ‘playing dead’ to remain alive and avoid total annihilation by suicide, which is always looming. (769-770)

Intrapsychic Architecture: Depleted: The intrapsychic architecture of DFM individuals appears weakened and vulnerable to stress, resulting in depleted coping methods and impoverished dynamic strategies. The forces that maintain psychic cohesion seem to have lost their focus and vigor. Consequently, the individual displays a diminished capacity to initiate action or regulate internal impulses and conflicts.

To protect against these feelings of inner ineffectuality, DFMs try to keep their distressing emotions at a minimum level, ignore their origins, and keep them out of awareness. By structuring the inner world in this manner, they may minimize the experience of psychic pain and isolate their affect so that they manifest only the overt appearance and complaints of depression, without experiencing its emotional undertone. However, this defensive maneuver may lead to self-destruction and suicide.

Drained of feeling and life, these individuals may conclude that there is little meaning to life and that they can no longer control or direct it. They may see suicide as a means to regain the feeling of competence and autonomy. The occasionally observed phenomenon of improved mood just prior to taking one’s own life is related to this defensive maneuver. However, it is important to note that suicide more commonly occurs when these individuals seek to escape from painful or humiliating life circumstances. (770)

Mood/Temperament: Depressed: DFMs are typically characterized by a persistent, pervasive dysphoric state, with low spirits, a woeful and joyless mood, and a tendency towards self-denigration and habitual gloom. These features have become intrinsic parts of their personality structure, and may persist at a moderate level of severity, remitting only rarely. Although some subtypes may emphasize one or another aspect of the depressive constellation of symptoms, such as sadness, anguish, irritability, guilt, or emptiness, it is clear that these patients have a diminished interest in life, few appetites for joy and closeness, and little enthusiasm for relating, eating, sexualizing, or playing. Their temperamentally-based inertia and sadness may undermine whatever capacity they may have had to smile and enjoy the humor and pleasures of life.

The belief that there are physiological underpinnings to this temperamental disposition is reinforced by the variety of vegetative functions they display, such as lowered metabolic rates and slowed gastrointestinal functions. Common complaints include difficulty in sleeping, early morning awakening, fatigue, diminished libido and appetite, as well as various bodily aches and pains. For some, dysregulation of the hormonal substrates of mood may lead to brief periods of euphoria and increased social drive, almost to the point of hypomania. However, more often than not, these personalities display a persistent dysthymic or melancholic temperament. (770-771)

Variants

Theorizing about DFM personalities has a rich and long history. Some individuals exhibit their depressive mood with dramatic gestures and pleading commentary, while others are demanding, irritable, and cranky. Some express their thoughts in passive, vague, and abstract philosophical terms, while others seem lonely, quietly downhearted, solemnly morose, and pessimistic. Despite these variations, all individuals with DFM personalities exhibit self-deprecatory comments, apathy, and marked discouragement and hopelessness. While others may offer sympathy and support, these reassurances provide only temporary relief from the prevailing mood of dejection.

Oldham and Morris (1995) described these individuals as having a “Serious” personality style, writing, “Serious men and women suffer no illusions. They don’t hitch their wagons to a star, count their chickens before they’re hatched, sing that life is just a bowl of cherries, or don rose-colored glasses to paint their existence in a more beguiling hue. Even when things are not so pleasant, they see them as they are.” While the current culture tends to favor individuals who “think positive” and look on the bright side, individuals with a Serious style do not necessarily fit that image. However, they have the ability to carry on in even the worst of circumstances, making them a no-nonsense, just-do-it personality style that can help everyone to survive in harsh climates.

Voguishly Dejected Personality: Some DFM personalities have a tendency towards vanity and voguishness. To these personalities, suffering is viewed as noble, providing a sense of uniqueness and elitism. They find refuge in philosophical musings about the bitterness of life. Some voguish dejected personalities have a preoccupation with aesthetics, adopting a style of dress and living that complements their unhappy moods. They engage in discussions about their existential sadness or the sense of alienation that we all feel in this age of mass society, using fashionable language to connect with others and gain a sense of belonging during their moments of isolation.

These individuals exhibit histrionic and, to a lesser extent, narcissistic personality traits. Their use of sophisticated language on current topics allows them to rationalize their personal emptiness and confusion while maintaining their appeal to “interesting” people. By adopting popular modes of disenchantment, they reinstate themselves as participants in an “in” group and draw attention to themselves. These feeble signs of social attachment provide a means of overcoming their foreboding and disquiet, as well as their deep sense of loss and isolation. However, if their expressions of connectedness fail to fulfill their attachment needs, they quickly withdraw and replace them with soulful declarations of guilt and hopelessness.

Voguish individuals tend to be cautious and keep their distance from problematic situations. They try to avoid troublesome relationships, preferring to arrange their lives to ensure a good measure of social order. They are upset by the actions of others and concerned that close relationships are neither genuine nor durable, and that joy will be ephemeral. They believe that life is most gratifying when approached with optimism and prudence, avoiding mistakes, and acting levelheaded and judicious.

Life experiences have sensitized voguish individuals to depend on themselves in looking after their needs. They anticipate that others will not be as considerate as they would like and are distrustful of those who are not supportive. Consequently, they have learned not to be drawn into the concerns and wishes of other people. Their independence reflects a belief that life is likely to go better by acting in a self-determined and self-interested way, rather than by assuming that others will act supportively and generously of their own accord.

Voguish individuals are primarily prompted by inner beliefs of an intuitive and unconventional nature, leaning towards transcendent, speculative, and socially idealistic insights regardless of their popularity or likelihood of future acceptance. They find human conflict in the outside world to be both disagreeable and upsetting. They desire social harmony but are not likely to seek a high degree of accuracy in decoding the complexities and dynamics of inner life, both within themselves and others. They are not keen observers of others’ actions or their dispositions and emotions.

Despite possessing a complex inner life, they cover it up and deny it, being reluctant to express their convoluted thoughts and troubling emotions, even to long-term friends. However, this rich inner world may be associated with a basis for creative imagination and for flashes of creativity and inspiration.

Voguish individuals may also be well-informed, diligent, motivated students and achievers who exhibit both creativity and perfectionism. Their troubled inner processes may have blended well in school with their tendency to be thoughtful, orderly, persistent, and conscientious. They are highly individualistic, attempting in less problematic times to place their beliefs and values at the forefront of their thinking. They fit these beliefs and values together into a coherent, internally consistent view of life that is sustainable over time. (773-774)

Despairingly Dejected Personality: The Despairingly Dejected Personality is characterized by a sense of social frustration and difficulty in feeling understood, leading to public withdrawals, moodiness, and discontent. This personality may seem forlorn and indifferent to their surroundings and may fade into the background in social, professional, and family relationships. They often lack confidence and view themselves as uninteresting, devaluing their own achievements. Despite their reserved and taciturn manner, they are likely to have an active imagination and complex inner thoughts.

They tend to be cautious and distance themselves from problematic situations, seeking security and psychic stability. They plan strategies to circumvent difficulties and seek to control the events of their lives. They have become self-focused and independent as they anticipate that others may not be as considerate as they would like. They are curious about the inner workings of the mind and emotions and perform best when faced with practical or immediate tasks that require their attention. However, they strongly dislike being tied to conventional schedules or routines.

Although this personality may become engrossed in their interests and desire to achieve goals as quickly as possible, this behavior can lead to potentially problematic outcomes. They may feel overwhelmed and fail to follow through with their plans. Despite their difficulties, the Despairingly Dejected Personality remains strong and continues to seek ways to make their life more tolerable, striving to be prudent and sensible in their actions. (774-775)

Ill-Humored Forlorn Personality: The Ill-Humored Forlorn Personality is characterized by a persistent sense of discontent, often accompanied by complaints, irritability, and a negative outlook on life. This personality type, first described by Kraepelin and Schneider, tends to have hypochondriacal preoccupations and periodic expressions of guilt and self-condemnation. They have a habit of acting out their conflicts and ambivalent feelings, resulting in extreme vacillations between bitterness and resentment, on the one hand, and self-deprecation on the other.

Self-pity and bodily anxieties are common in this personality type and may serve as a basis for distinguishing them from other depressive types. While not always gloomy, they find little pleasure in life and appear content with nothing. They direct their ill disposition against themselves rather than others, exhibiting a mood composed of irritability, anxiety, and self-flagellation. There is a self-tormenting quality to their behavior, with an annoying insistence that others hear their complaints and troubles.

As described by Kretschmer, individuals with an Ill-Humored Forlorn Personality appear cold, selfish, irritable, and critical, rejoicing in the failures of others and never anticipating or wishing others the rewards and achievements of life. Empirical and clinical studies suggest that the characteristics of this personality type interweave with those of negativistic personalities. (775)

Self-Derogating Forlorn Personality: The self-derogating forlorn personality is characterized by feelings of helplessness and futility in the face of responsibilities and the possibility of social abandonment. These individuals typically respond to the loss of a significant person with severe dejection or even a psychotic depression. Anticipation of abandonment may prompt them to openly admit their weaknesses and shortcomings as a means of gaining reassurance and support. They often express guilt and self-condemnation to deflect criticism from others, transforming threats into comments of reassurance and sympathy. These personalities typically contain their anger to avoid provoking the retribution of abandonment, turning inward any aggressive impulses they feel and discharging them through self-derisive comments and verbalizations of guilt and contrition. This tactic not only tempers others’ exasperation but also prompts them to respond in ways that make the person feel redeemed, worthy, and loved.

The self-derogating personality allows these individuals to gain a measure of control over their feelings of loss and anger by diminishing their own self-worth and taking out their hatred on themselves. Through their self-derogation, they seek redemption and absolution for their past behaviors and forbidden inclinations, soliciting support and nurturance from others. This style also serves as a devious means of venting hidden resentment and anger. The self-derogating forlorn personality is characterized by a fusion of depressive and masochistic features, as described by Kernberg (1988) and others.

However, these maneuvers become problematic as the self-derogating forlorn personality becomes increasingly dismayed and disillusioned, aware of having wasted much of their life and missing opportunities. The sense of worthlessness intensifies, preventing the patient from exploring their life wisely and finding a better route to make life more worthwhile. The individual’s own actions diminish whatever hopes they may have had, leading to a sense of loss for what might have been and self-alienation. This often leads to a depressive paralysis in which the person is unable to function. (778)

Morbidly Melancholic Personality: The morbidly melancholic personality is characterized by a deep paralysis of action that often overlaps with Axis I clinical depressions. These individuals experience intense emotions, in contrast to the emotional flatness seen in some schizoids. They exhibit profound gloom and dejection, often slumping with furrowed brows, stooped bodies, and heads turned away from others. Physical symptoms like weight loss and a haggard appearance are common, as are disturbed sleep and a growing dread of the new day. Their verbalizations often convey a sense of impending disaster, feelings of helplessness and guilt, and a resigned acceptance of their hopeless fate.

The dependent personality is often intertwined with this personality disorder, as these individuals feel incompetent and incapable of coping with their current state. Their withering self-contempt and obsessive pessimism lead them to see only the worst in themselves and the world around them. They feel like outcasts and sacrificial victims, forever suffering the consequences of their own actions and the whims of fate. This unrelenting despair permeates every aspect of their being, draining hope and leaving them in a persistent state of despondency and helplessness. (779-782)

Despairingly Melancholic Personality: These personalities often have traits of avoidant personalities, creating a pattern of characteristics that reflect the features of both. They often exhibit intense feelings of despair, vacillating between fretfulness and confusion at one time, and dysphoria and despondency the next. They tend to hold on to their grievances and may not express their displeasure and vexation openly. Instead, they may turn their irritability and disillusionment inward, manifesting as despondency and self-disaffection. These shifting and vacillating moods may help relieve their tensions momentarily but ultimately become increasingly self-destructive. They struggle to gain a clear hold on their feelings, and their self-destructive acts may be expressed directly through violent suicide or indirectly through severe alcohol or drug abuse. As they feel that nothing in life can ever become rewarding again, they feel compelled to express their deeply pessimistic view of both life and themselves. They often feel defeated and helpless and may conclude that they must rid themselves of the inescapable suffering they experience.

For the despairingly melancholic, suicidal acts are considered seriously as a way to solve all of one’s problems and eliminate one’s painful existence. While not generally done for attention by this personality, self-destruction is used to punish others for not having cared enough. Self-destruction and suicide are their only perceived ways to demonstrate control over their own lives. (782)