Dependent personality disorder (DPD) is a type of personality disorder that causes feelings of helplessness, submissiveness, wanting to be cared for, needing constant reassurance, and being unable to take everyday decisions without advice from others.
DPD is not very common−it is diagnosed in less than 1% of the US population. This personality disorder can be managed with talk therapy and antidepressant medications.
Please continue reading to learn more about dependent personality disorder, including the causes, DPD symptoms, and DPD treatment options.
What is Dependent Personality Disorder (DPD)?
Dependent personality disorder is a personality disorder characterized by feelings of helplessness, lack of confidence in your abilities, and an excessive need to be taken care of by others. This leads to submissiveness, clinginess, and inability to make ordinary decisions without reassurance and advice from others.
According to the American Psychiatry Association, there are 10 types of personality disorders that are grouped into three different clusters.
- Cluster A includes personality disorders in which a person has unusual thoughts and behaviors, for example, paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder.
- Cluster B includes personality disorders in which a person has dramatic thoughts and behaviors that keep changing, for example, antisocial personality disorder, borderline personality disorder, narcissistic personality disorder, and histrionic personality disorder.
- Cluster C includes personality disorders in which a person has anxious or fearful thoughts and behaviors, for example, obsessive-compulsive personality disorder, avoidant personality disorder, and dependent personality disorder.
Symptoms of Dependent Personality Disorder
Common symptoms and behaviors in people with dependent personality disorder (DPD) include:
Difficulty making decisions without reassurance
A person with dependent personality disorder may depend on their spouse or some other person with whom they have a close relationship to tell them how to behave in daily life, for example, what to eat, when to bathe, and who to be friends with. The affected person does not realize that these thoughts and behaviors are unusual or out of touch with cultural norms.
Excessive need for advice and support from others
A person with DPD may rely on others for advice and support in daily life and ordinary tasks. They may avoid learning the skills to live independently to perpetuate their dependency.
Fear of being alone
A person with DPD may interact socially with a limited number of people that they can depend on. If a close relationship ends, they typically find a replacement quickly, for fear of being alone. In the desperate need to be taken care of by someone, they may choose an inappropriate replacement for the person they were close to.
Intense anxiety about taking care of themselves
A person with dependent personality disorder tends to have excessive worry or fear about being able to take care of themselves. They may use submissiveness to get others to take care of them.
Difficulty being independent
A person with DPD may feel inferior to others and belittle their own capabilities. Any criticism from others is taken as proof of their incompetence, further undermining their confidence.
Avoiding personal responsibility
A person with dependent personality disorder may avoid starting new tasks, working independently, or taking responsibility. Rather than being embarrassed about their incompetence, they may be submissive to a competent person and let themselves be supervised. Their career may suffer because of fears of appearing too competent and being left to do things on their own.
Tolerance of mistreatment and/or abuse
People with dependent personality disorder often struggle to express disagreement with others for fear of disapproval. They may refrain from expressing anger, even when appropriate, because of worries about losing the support of family, friends, or coworkers. These individuals may even do unpleasant tasks, submit to unreasonable demands, and tolerate emotional, physical, or sexual abuse to ensure support and care from others.
Causes of Dependent Personality Disorder
Genetic Factors
Research suggests that having a biological family member with DPD or other anxiety disorders is a risk factor for developing this disorder.
Environmental and Development Influences
Researchers believe dependent personality disorder can be triggered by certain developmental and environmental influences such as:
- Traumatic experiences during childhood, for example, neglect or verbal, emotional, physical, or sexual abuse.
- Authoritarian or overprotective parenting styles.
- Cultural, societal, or religious practices that emphasize obeying authority figures.
Interactions Between Genetics and Environment
Researchers and scientists do not completely understand the cause of dependent personality disorder, but they believe it develops due to an interplay of genetic and environmental factors. For example, someone who was brought up by a parent with an anxiety disorder and consequently an overprotective parenting style may develop dependent personality disorder in early adulthood when they are forced to start making important decisions and living a more independent life.
Diagnosis of Dependent Personality Disorder
Mental health professionals diagnose DPD based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, (DSM-5). This handbook is an authoritative guide that contains descriptions of mental health conditions as well as the common symptoms and criteria for diagnosing mental disorders.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Criteria for DPD
A mental health professional can make a diagnosis of dependent personality disorder (DPD) if a person has a persistent and excessive need to be taken of, resulting in submissive and clinging behaviors and fears of separation. These symptoms should have begun by early adulthood and be demonstrated by:
- Difficulty making everyday decisions without inordinate amounts of advice and reassurance from others.
- The need to have others be responsible for important aspects of their life.
- Difficulty expressing disagreement with others for fear of disapproval.
- Problems with starting projects independently due to lack of confidence in their judgment and abilities (but not due to lack of energy or motivation).
- Willingness to go to great lengths to obtain support from others, including meeting unreasonable demands and doing unpleasant tasks.
- Feeling uncomfortable or helpless when alone with fears of separation and being unable to take care of themselves.
- Urgently needing to establish a new dependent relationship for care and support after a close relationship ends.
- Having unrealistic fears of being unable to take care of themselves or being abandoned.
The Importance of a Thorough Evaluation
Most people depend on others throughout life for comfort and support and also experience periods of lack of self-confidence. But that does not mean they have dependent personality disorder or need treatment for this mental health condition.
People with DPD have a persistent and excessive reliance on others. However, this complex condition can be difficult to diagnose because the affected person lacks insight and does not realize they have a problem.
A mental health professional can make a diagnosis of dependent personality disorder after a thorough evaluation and a series of interviews with the person and their loved ones.
Differential Diagnosis: What’s The Difference Between BPD and DPD?
Borderline personality disorder (BPD) is one of the most common types of personality disorders. However, it is different from DPD in some key aspects. People with BPD are unable to manage their emotions, especially anger, and are prone to impulsivity. They tend to have extreme mood fluctuations, for example, alternating between submissiveness and rage or hostility. However, people with BPD do not have intense fears that cause them to submit to control such as those with DPD.
Other personality disorders that share some common characteristics with DPD include:
- Avoidant personality disorder, which causes a person to withdraw from relationships until they are sure they will be accepted without criticism. In contrast, those with DPD try to maintain their relationships at all costs for fear of being alone.
- Histrionic personality disorder, which causes a person to be disinhibited and flamboyant and to seek attention from others rather. In contrast, those with DPD are constantly seeking reassurance from others.
Co-Occurring Disorders with DPD
Common co-occurring disorders with DPD include anxiety disorders, major depressive disorder, borderline personality disorder, histrionic personality disorder, and alcohol use disorder.
The presence of co-occurring disorders can complicate the diagnosis and treatment of dependent personality disorder. A psychiatrist or psychologist can make the diagnosis based on detailed interviews with family members and friends to obtain the person’s behavioral, relationship, and work history.
Treatment Options for Dependent Personality Disorder
Treatment of dependent personality disorder can be challenging because it involves breaking deep-rooted thinking and behavioral patterns. The mainstay of treatment for DPD is talk therapy and medications.
Cognitive-Behavioral Therapy (CBT)
Cognitive behavior therapy (CBT) is very effective in treating personality disorders, including dependent personality disorder. This is a type of psychotherapy in which a therapist works with you to identify negative thought patterns that affect how you think and act. During CBT sessions, people with DPD learn to recognize their dependency patterns and develop skills to become more independent.
The treatment duration with CBT is generally short-term, which works well for dependent personality disorder, because long-term therapy can cause a person with DPD to develop dependence on the therapist.
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+18442884672 Dialectical-Behavior Therapy (DBT)
Dialectical behavior therapy (DBT) uses CBT techniques and mindfulness practices. A therapist works with you to develop skills to regulate your emotions, tolerate distress, and improve interpersonal relationships. People with dependent personality disorder learn to cope with day-to-day life without being dependent on others by replacing unhealthy behaviors with healthy ones. Mindfulness, or being present in the moment, helps people with DPD control their worries.
DBT can be offered in individual and group sessions as well as online and telephone modes. It involves building a strong relationship with the therapist and can be a longer-term therapy modality that is offered for up to a year.
Psychodynamic Therapy
This is a form of psychotherapy in which you learn to recognize the unconscious mental processes that affect your behavior. The goal is to increase self-awareness and understand the influence of the past on your current behaviors. It can help people with dependent personality disorder examine the psychological roots of their thinking and behavior patterns and understand how they affect their present behaviors and relationships with others.
Role of Medications in Managing the Symptoms of Dependent Personality Disorder
There are no specific medications for treating dependent personality disorder. However, antidepressant drugs are sometimes prescribed to treat symptoms of depression and anxiety that are common in people with personality disorders. Anti-anxiety medications such as benzodiazepines (Valium, Xanax) are not typically used because people with dependent personality disorder are at a high risk of developing substance use disorders.
Building Independence and Self-Reliance
Some people fear that getting treatment for dependent personality disorder will turn the person into someone totally different and not “who they are.” However, the truth is that a combination of talk therapy, medications, and the support of loved ones can help a person with dependent personality disorder live a healthier, more moderate life, where they are not excessively dependent on others, and are a less extreme and more natural version of themselves.
Coping Strategies for Individuals with Dependent Personality Disorder
Tips for Managing Symptoms and Improving Quality of Life
People with dependent personality disorder can use the following strategies for developing decision-making and problem-solving skills and start living more independent lives:
- Examine your relationships with others and try to identify ways in which you depend on people you are close to. Try taking on one task at a time without the support of loved ones and doing it independently before attempting another task.
- Slowly start doing things alone, starting with easier challenges before moving on to more difficult ones. For example, start by deciding what to wear, then try going grocery shopping alone, and work your way up to eating a meal by yourself in a restaurant.
- Listen to your thoughts and feelings and observe how they affect your actions. Before seeking other people’s opinions or approval, stop to reflect on how you can start to trust your gut and have faith in your abilities to do tasks without others’ support.
- Get regular exercise to develop physical and mental resilience and feel stronger and more confident.
Importance of Building a Supportive Network
The symptoms of dependent personality disorder can range from mild to debilitating. Fortunately, treatments are available to help people with DPD live healthier lives. However, successful treatment of DPT involves professional psychotherapy and medications as well as the understanding and support of friends and family members. Given that DPD symptoms are intimately linked to people with whom the affected person has close relationships, the support of friends and family plays a vital role in helping individuals with dependent personality disorder live more independent lives.
How to Support Someone with Dependent Personality Disorder
Role of Friends and Family in DPD
If you suspect DPD in a loved one, for example, if they are excessively dependent and clingy and unable to do things on their own, consider talking to a mental health professional about the possibility of dependent personality disorder. People with DPD and other personality disorders are unaware that their thought patterns and behaviors are problematic. It is therefore up to family members and friends to recognize there is a problem and seek appropriate care.
Encourage Independence While Providing Support
If someone you love has been diagnosed with dependent personality disorder, start by paying attention to your own behaviors. Make small changes to avoid encouraging their dependence or taking on their responsibilities.
During professional mental health treatment for DPD, let the person know they are loved and supported. Offer to go with them to therapy sessions. Avoid sounding harsh or judgmental or trying to assign blame for their personality disorder.
Resources for Loved Ones and Caregivers
Managing a psychiatric condition can be an isolating and challenging experience for the affected person and their loved ones. There are peer support groups for people living with mental illnesses, including personality disorders and substance addictions. These support groups provide a safe and supportive place to share your thoughts, feelings, and experiences and get support and advice on mental health issues.
Long-Term Outlook of Dependent Personality Disorder
Prognosis and Potential for Improvement Through Treatment
Improvements in dependent personality disorder are usually only seen with long-term therapy. Left untreated, the disorder can lead to complications such as alcohol and substance abuse, anxiety and depression, suicidal ideation and attempts, and an increased likelihood of abuse.
Challenges and Successes in the Long-Term Management of DPD
According to mental health professionals, personality disorders, including dependent personality disorder, are some of the most difficult psychiatric disorders to treat. The affected person does not see their behaviors as being abnormal but instead feels these behaviors are acceptable and compatible with their personality, values, and way of thinking. For this reason, people with DPD are often resistant to seeking treatment.
However, long-term treatment for dependent personality disorder shows high rates of success with many people being able to achieve therapy goals. Evidence-based treatments, such as talk therapy, can successfully help people with dependent personality disorder recognize and change their behaviors, regulate their emotions (fear and anxiety), and develop self-reliance and independence.
Common Myths and Misconceptions About Dependent Personality Disorder and Factual Information
Myth: Dependent personality disorder affects women far more than men.
Fact: Studies show that DPD affects women and men almost equally, with an approximate 1% prevalence rate.
Myth: Dependent personality disorder only occurs in romantic relationships.
Fact: Dependence can develop on not just a romantic partner, but a parent, sibling, friend, or coworker.
Myth: Dependent personality disorder and co-dependency are the same thing.
Fact: DPD involves becoming dependent on others for decision-making, care, and support, with the underlying theme being “I need others.” Co-dependency involves placing others first and caring for their needs, with the underlying theme being, “I want to be needed by others.”
Myth: There is no cure for dependent personality disorder.
Fact: Treatment with psychotherapy and medications can help people with dependent personality disorder live healthier, more independent lives.
Final Thoughts: Dependent Personality Disorder is Treatable with Psychotherapy
Dependent personality disorder (DPD) is a mental health condition in which a person develops an excessive dependence on others to meet their physical and emotional needs. The exact cause of this personality disorder is unknown, but experts believe it is a combination of genetic and environmental factors.
Symptoms of DPD include being passive or submissive, having difficulty making daily decisions, and avoiding being alone, taking responsibility, or expressing anger or disagreement with others for fear of abandonment.
Talk therapy is considered the most effective treatment for dependent personality disorder. It can help individuals with this mental health condition become less dependent on others and live more independent lives. Medications may be prescribed to people with DPD to manage symptoms of depression and anxiety.
At Discover Recovery, we have a team of highly-experienced licensed psychiatrists and psychologists who offer a range of talk therapies for treatment of dependent personality disorder. Call us today or complete our assessment form to find out how we can help you or a loved one manage DPD symptoms.
