Dependent Personality Disorder (DPD)

What is dependent personality disorder?

Dependent personality disorder is a fear-based disorder that leaves people unable to take care of themselves, often described by others as ‘clingy.’

A personality disorder changes the way someone thinks or behaves. Someone with DPD will struggle to think or behave independently and confidently without the support of others. They will often be hugely lacking in self-confidence, experiencing strong feelings of submissiveness, helplessness, need for reassurance, and an inability to make simple decisions. ^[1]

Symptoms of dependent personality disorder

DPD can be characterized by a wide range of symptoms, including:

• Difficulty or complete inability to make even small decisions
• Struggling to deal with criticism
• Fear of abandonment and rejection
• Difficulty being alone and will often experience anxious thoughts
• Requiring constant reassurance and lacking independence
• Passive behavior, such as avoiding expressing opinions, dealing with conflict or standing up for oneself
• Avoiding responsibilities
• Inability to deal with breakdowns or relationships
• Lack of self-confidence and oversensitivity to criticism
• Putting the needs of others above themselves and allowing themselves to be mistreated
• Feelings of anxiety, helplessness, submissiveness, and pessimism ^[4]

Causes of dependent personality disorder

Health experts are still unsure about the root causes of DPD, but several risk factors are known to increase likelihood or developing the disorder. These include:

• Childhood trauma or abusive upbringing
• History of neglect
• Abusive relationships
• Overprotective or authoritarian parents
• Family history of anxiety disorders or other types of personality disorders ^[4]

Diagnosing dependent personality disorder

To evaluate if someone is experiencing dependant personality disorder, a healthcare professional will most likely conduct the following assessments:

Physical exam - to determine if you have any other condition or physical illness that could be causing the symptoms. The exam may include regular checks of vital signs and blood tests to indicate any hormone imbalances.

Psychiatric assessment – A psychiatrist or psychologist will conduct an interview and ask you questions about your mental health history, substance abuse, and any other concerns. For a diagnosis of DPD, they will be looking out for five of the following Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria ^[1]:

• All-consuming, unrealistic fear of being abandoned
• Anxious or helpless feelings when alone
• Inability to manage life responsibilities without support 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

Prevention of dependent personality disorder

As with any personality disorder, it may not be possible to prevent DPD, but certain things that can help reduce the likelihood of developing it.

Supporting someone to learn practical and rational ways of dealing with difficult situations can be a beneficial way of counteracting the causes of DPD. Research has also shown that maintaining healthy childhood relationships with a friend, teacher, or relative, can help prevent someone from developing the disorder. ^[2]

Treatment for dependent personality disorder

Psychotherapy is the most common treatment for DPD and focuses on alleviating the symptoms rather than curing the disorder. The main aims of psychotherapy are to:

• Help someone become more independent, increasing their self-confidence and ability to make their own decisions
• Support them in learning ways to build and maintain healthy relationships

Specific forms of psychotherapy, like cognitive behavioral therapy (CBT), can be used to help people develop a new, more positive way of thinking about themselves. Assertiveness training can also be a valuable strategy to help someone build self-confidence.

Short-term therapy is often preferred, but as with any treatment plan, it can take time to see positive results. However, the relationship between patient and therapist must be carefully managed to avoid forming the same kind of dependence.

Healthcare providers may also use medication to treat people who experience mental health conditions related to DPD, like anxiety and depression. However, medication is considered a last resort as it doesn’t target the root issue of DPD. Furthermore, like with many prescription drugs, there is also a risk of patients with DPD becoming dependent on their medication, leading to misuse and addiction. ^[3]

Helping someone with dependent personality disorder

Supporting someone with dependent personality disorder can be challenging and complex, and doing your research on symptoms, diagnosis and treatment or consulting a medical professional for their advice can be a great place to start.

If you believe you or a loved one has DPD, gently voicing your concerns and offering to support them in seeking professional help can be invaluable, taking care to recognize the risk of over-attachment.

Encouraging them to seek help from a medical professional will give them the best chance of long-term recovery and make sure they receive the right support.

Although it may be difficult, it’s important to establish boundaries for your role as a support in their life. Be clear and assertive with the that limits you provide for support and don’t take on too much responsibility. This will, in turn, encourage them to become more independent and trust their own decisions and abilities. ^[5]

FAQs about dependent personality disorder

When do people usually develop dependent personality disorder?

DPD is usually known to begin in childhood or before age 29.

Are there any complications to DPD?

Failing to treat dependent personality disorder properly can lead to complications and other serious disorders. For example:

• Alcohol or substance use disorders
• Self-harm
• Major depression
• Suicidal behavior
• Emotional, sexual or physical abuse

What is the outlook for people with DPD?

If left untreated, dependent personality disorder can lead to an increase in symptoms and other serious disorders. However, with the right therapy or other treatment, those with DPD can learn to develop self-confidence and live a happy, independent life with healthy relationships.

Dependent personality disorder vs borderline personality disorder – What is the difference?

Both personality disorders can cause troubled relationships and unhealthy behaviors. However, the main difference is that borderline personality disorder is characterized by feelings of anger and aggression when faced with fears of abandonment, while those with DPD respond to these fears with submissiveness and helplessness.