Can Psychopaths be Depressed? (Yes & here’s why)

This blog aims to answer the question, “Can psychopaths be Depressed?”, and covers topics such as what is meant by the term psychopath, the signs and symptoms of depression, what research has to say about the prevalence of depression among psychopaths and what it looks like. Finally, this blog will shed some light on how to cope with depressive episodes.

Can Psychopaths be Depressed?

Yes, psychopaths can be depressed… However, how the symptoms of depression are manifested by psychopaths may differ from the normative experience of depression. One way of looking at psychopathy is through the psychodynamic lens, which states that few symptoms of psychopathy like antisocial behaviour are actually a defense against the feelings of depression. 

Before we dive into the aforementioned question, it is first important to fully understand such terms like psychopathy and depression. These terms are often widely misinterpreted as well as misused, and end up being represented as a mere slang. The gravity of these words, however, differs from the social media context they are highly popularised in. 

Describing Psychopathy

While there is no strict diagnostic definition of psychopathy in the DSM 5 (2013), or ICD 10 (2004), it is often used interchangeably with the diagnosis of Antisocial Personality Disorder (ASPD) in clinical as well as empirical fields. ASPD is characterised by a pervasive pattern of disregard for and violation of the rights of others1. It encompasses such traits as unlawful/ criminal behaviour, deceitfulness, impulsivity, high aggressiveness, disregard for the safety of others, irresponsible behaviour and/or lack of remorse or empathy. A more comprehensive dimensional approach of classifying psychopathy was given by Hare (2003)2 measuring psychopathy across the following factors: 

  • The callous, selfish, remorseless use of others
  • Interpersonal
  • Affective
  • A chronically unstable and antisocial lifestyle
  • Impulsive Lifestyle
  • Antisocial Behaviour

What seems to be common across these definitions are the traits like callousness, selfish behaviour, antisociability, lack of remorse or empathy, and interpersonal and affective disturbances. 

The Signs and Symptoms of Depression

Depression has been clinically defined as a prolonged and pervasive state of depressed mood, diminished interest and pleasure, appetite, sleep and weight related disturbances, feelings of worthlessness, excessive guilt and hopelessness 1,3

It is when these signs and symptoms cause clinically significant distress and malfunctioning in the individual’s social, personal or occupational life, for a prolonged period of at least 6 months that a clinical diagnosis can be given. It can occur through all age groups, and leads to a general displeasure and lack of interest in activities that were previously enjoyed. 

This lack of interest as well as pleasure out of activities may then lead to a vicious cycle of inability to perform routine tasks, or lack of focus/ attention, which perpetuates the feelings of worthlessness as well as hopelessness. Due to extensive research as well as clinical work into depressive disorders, various modules of treatment for the same with high efficacy are now available.

  • Mood related, i.e., feelings of sadness, irritability
  • Sleep disturbances
  • Appetite and weight related disturbances
  • Anhedonia, i.e., loss of interest in activities
  • Feelings of worthlessness
  • Excessive feelings of guilt
  • Suicidal thoughts or ideation

Depression among psychopaths: What it may look like!

What makes depression, and psychopathy seem somewhat contradictory are the factors such as guilt and remorse. While they are reported to be high in individuals suffering from depression, psychopathic behaviour has been characterised by a lack of such emotions. 

It is however important to note that the experience of depression may vary from person to person. While for one individual it might be manifested as sadness, for another, it may manifest as higher levels of irritability. Similarly, while one individual may experience loss of appetite and weight loss, another may experience the exact opposite. 

Thus, growing literature proves that depression is not merely a categorical disorder, but may be more dimensional in nature4. Further, a wide misconception about psychopaths is that they cannot feel any emotions. 

This is however, not true. While they may not feel guilt, remorse, fear or sadness they may be capable of experiencing emotions such as joy, surprise, disgust, and even anger7. They may also feel inferior to others, and react arrogantly in order to hide their true feelings8

Thus, to answer the question of whether psychopaths can be depressed, the answer follows similar lines. Yes, individuals scoring higher on psychopathy may experience depressive symptoms, but they may manifest differently than the normative populations 5

For instance, individuals scoring higher on psychopathy may manifest depression as a higher level of irritability or aggressive behaviour, as opposed to the pervasive feelings of sadness. 

Further, these differences may be explained from a psychodynamic point of view stating that the anti-social behaviour characteristic of psychopathy is in fact a means of coping, or defense against the underlying feelings of depression6

Another misconception about psychopaths that stems from generalisation of their portrayal in the media is that all psychopaths are violent and indulge in criminal behaviour. It is a vast over generalisation and may not always stand true, but instead only perpetuates stigma against those suffering from psychopathic personality disorders. 

Psychopaths can be productive members of the society, and may in fact work well in highly stressful situations due to their lack of ability to feel such emotions9. When we look beyond such stigmatising stereotypes, it might become easier to look at individuals suffering from psychopathic traits as being capable of suffering from signs and symptoms of depression. 

How to cope with depressive episodes:

Depressive episodes often get overwhelming, and it is important to consult your mental health advisor or general practitioner if you are suffering from symptoms of depression.

Strategies to cope with depression:

  • Setting tasks and to do lists for yourself & going through with them. 
  • Following sleep hygiene and trying to maintain a healthy sleep cycle
  • Getting enough exercise and eating right
  • Indulging in self care activities
  • Reaching out & having a support system

Conclusion

This blog addressed the question, “Can Psychopaths be Depressed?”. We saw what the terms psychopathy and depression meant, what the signs and symptoms of depression are, whether psychopaths are depressed & what are the signs of depression among psychopaths. Finally, the artilcle outlines some strategies to cope with depression. 

Frequently asked questions (FAQs): Can Psychopaths be Depressed

Can psychopaths feel regret?

Literature shows that while psychopaths may feel regret about poorly made choices, this regret may not always be functional, that is, it may not influence their future decisions or choices. 

Can psychopaths feel fear?

Looking at psychopathy from the psychodynamic perspective, it can be seen that they fear feeling or being inferior to others, and thus their outward arrogant behaviour is merely a reaction formation to cope with this fear.

Are there any causal links between psychopathy and depression?

A study on circadian preferences of those suffering from psychopathy and depression show that they share in common the preference of being what is commonly referred to as the night owl, due to greater emotional dysregulation, blunted affective rhythm, and reduced light exposure10

Are psychopaths killers?

The stereotype that psychopaths are violent is perpetuated by their portrayal in popular media. This portrayal is however not always accurate. Due to their criminal prone tendencies, they may be more likely to be found in criminal settings, but they are more likely to use manipulation and recklessness to get what they desire, instead of indulging in outright violence. 

Can psychopaths lead normal lives?

They lack the ability to feel certain emotions, but that does not deter all psychopaths to lead relatively normal lives. They may perform in highly stressful jobs well and become productive members of society, and may also maintain social relations due to their superficially charming nature.

What illness do psychopaths have?

The classification of psychopaths often becomes vague due to no clear cut definition of the same. Psychopaths can be defined as those individuals suffering from a severe form of Antisocial Personality Disorder. 

REFERENCES

1American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders- 5th edition. Washington DC: Author.

2Hare R.D., (2003) Hare Psychopathy Checklist-Revised, 2nd Edition (PCL-R). Pearson.

3World Health Organization. (‎2004)‎. ICD-10 : international statistical classification of diseases and related health problems : tenth revision, 2nd ed. World Health Organization.

4Stein, D.J., (n.d) Dimensional or categorical: different classifications and measures of anxietyand depression. Medicographia. 

5Williemsen, J., Vanheule, S., Verhaeghe, P., (2011) Psychopathy and lifetime experiences of depression. Criminal Behaviour and Mental Health. 21. 279-294.

6Howard, J., (1981) The expression and possible origins of depression in male adolescent delinquents. The Australian and New Zealand Journal of Psychiatry. 15. 311-318. 

7Freeman, R., (2013) Do psychopaths have emotions. Neuroinstincts. 

8Martens,W.H.J., (2014) The hidden suffering of the Psychopath. Psychiatric Times. 31(10).

 9The conversation (2018) Five things you didn’t know about psychopaths. 

10Haapanen, L., (2019) Psychopathy, Drepression Related to Chronotype Disposition. Psychiatry Advisor. 

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