Dependent Personality Disorder
Dependent personality disorder (DPD) is a type of anxious personality disorder. People with DPD often feel helpless, submissive or incapable of taking care of themselves. They may have trouble making simple decisions. But, with help, someone with a dependent personality can learn self-confidence and self-reliance.
OVERVIEW
What is dependent personality disorder (DPD)?
Mental health experts describe personality as a person’s way of thinking, feeling and behaving. A personality disorder affects the way people think or act, making them behave differently over time.
Dependent personality disorder (DPD) is one of 10 types of personality disorders. Dependent personality disorder usually starts during childhood or by the age of 29.
People with DPD have an overwhelming need to have others take care of them. Often, a person with DPD relies on people close to them for their emotional or physical needs. Others may describe them as needy or clingy.
People with DPD may believe they can’t take care of themselves. They may have trouble making everyday decisions, such as what to wear, without others’ reassurance.
Statistics show that roughly 10% of adults have a personality disorder. Less than 1% of adults meet the criteria for DPD. More women than men tend to have DPD.
SYMPTOMS AND CAUSES
What causes dependent personality disorder (DPD)?
Mental health experts haven’t figured out what causes DPD. They believe it results from a mix of genetics, environment and development. Experts have found DPD is more likely in people with particular life experiences, including:
Abusive relationships: People who have a history of abusive relationships have a higher risk of a DPD diagnosis.
Childhood trauma: Children who have experienced child abuse (including verbal abuse) or neglect may develop DPD. It may also affect people who experienced a life-threatening illness during childhood.
Family history: Someone with a family member who has DPD or another anxiety disorder may be more likely to have a DPD diagnosis.
Certain cultural and religious or family behaviours: Some people may develop DPD due to cultural or religious practices that emphasize reliance on authority. But passivity or politeness alone is not a sign of DPD.
What are the symptoms of dependent personality disorder (DPD)?
Someone with dependent personality disorder may have several symptoms, including:
Avoidance of personal responsibility.
Difficulty being alone.
Fear of abandonment and a sense of helplessness when relationships end.
Oversensitivity to criticism.
Pessimism and lack of self-confidence.
Trouble making everyday decisions.
DIAGNOSIS AND TESTS
How is dependent personality disorder (DPD) diagnosed?
Your healthcare provider does a physical exam to understand if another condition could be causing symptoms. A mental health provider makes the DPD diagnosis.
A mental health provider will talk with you about your past mental health history. Questions may include how you feel, any other mental health concerns and any substance use problems. The provider compares your answers to factors listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
For a diagnosis of DPD, a provider will look for five of the DSM-5 diagnostic criteria. These factors include:
All-consuming, unrealistic fear of being abandoned.
Anxious or helpless feelings when alone.
Inability to manage life responsibilities without seeking help from others.
Problems stating an opinion out of fear of loss of support or approval.
Strong drive to get support from others, even choosing to do unenjoyable things to get it.
Trouble making everyday decisions without input or reassurance from others.
Trouble starting or completing projects because of a lack of self-confidence or ability to make decisions.
Urge to seek a new relationship to provide support and approval when a close relationship ends.
MANAGEMENT AND TREATMENT
How can I manage or treat dependent personality disorder (DPD)?
A mental health provider can help you manage DPD. You may have psychotherapy (talk therapy) such as cognitive-behavioural therapy (CBT). This care teaches you new ways to handle difficult situations. Psychotherapy and CBT can take time before you start to feel better.
With psychotherapy and CBT, your provider guides you to improve your self-confidence. You’ll work to become more active and self-reliant. Your provider will also talk to you about finding more positive relationships. A positive, meaningful relationship can build self-confidence and help you overcome some of the symptoms of DPD.
PREVENTION
Can dependent personality disorder (DPD) be prevented?
You may not be able to prevent DPD. But treatment can help people at risk for developing the disorder find ways to avoid or handle difficult situations.
Some studies have shown that healthy relationships may help prevent the child from developing DPD later in life. If a child has even one strong relationship with a friend, parent or teacher, it can counter others’ harmful effects.
OUTLOOK / PROGNOSIS
What is the outlook for someone with dependent personality disorder (DPD)?
Someone with DPD can live an emotionally healthy life if they receive treatment from a mental health provider. Learning new ways to cope with difficult situations can make a difference in their overall outlook.
People who don’t get treatment may be at risk for depression and anxiety. Without treatment, a person may misuse substances and develop problems such as drug addiction or alcoholism. Without treatment, people are more likely to stay in unhealthy or abusive relationships. If you or someone you know is in a dangerous or abusive relationship, contact 1800 RESPECT on 1800 737 732 This service offers free, confidential support. Advocates are available 24 hours a day, 365 days a year.
This article was first published in November 2020 on my.clevelandclinic.org The contact number was updated in April 2021.
When should I see a healthcare provider about dependent personality disorder (DPD)?
Your healthcare provider can help you decide if you need to see a mental health professional. Some reasons to talk about your mental health with your provider include:
Frequent feelings of anxiety.
Irritability or moodiness.
Loss or change in appetite.
Persistent negative thoughts about yourself.
Trouble concentrating.
Jumping from relationship to relationship.
Dependency is on a scale where some feel more or less dependent than others. We are all dependent to some extent, and more or less within certain times of our lives. It is considered Dependent PD when it fills the diagnostic criteria and this only applies to those that experience it at high levels. Even if your levels of dependence aren’t that high, it can be useful to seek help from a psychologist to understand the effects on your life and to learn how to become more independent in general.