Dependent personality disorder is a psychiatric condition characterized by a persistent need for the person to be taken care of and a fear of being abandoned and separated from the partner, parent or other important people in their life.

People with DPD are typically submissive and display clinging behaviour toward people from those they fear being separated. Although the exact cause of DPD is unknown, A combination of psychodynamic, cognitive and behavioural factors might contribute to the development of this condition. The diagnosis of DPD is carried out using various diagnostic methods including, DSM-5.

People with dependent personality disorder are at risk of several mental and physical complications. Psychotherapy help individuals with DPD to become more active and independent. At present, dependent personality disorder impacts about 0.6 % of the general population and usually emerge in the teenage years or early adulthood. Studies indicate that the incidence of this condition is more common in females. The prevalence is highest among people in Asian countries like India and Japan.

Dependent Personality Disorder

 

Dependent personality disorder symptoms

Personality disorders are categorised into three distinct clusters based on their prominent characteristics.

  • Cluster A – people whose behaviour appears odd or eccentric
  • Cluster B – people who appear dramatic, overly emotional or erratic
  • Cluster C – people with anxiousness or fearful behaviour

Dependent personality disorder belongs to Cluster C personality disorder. Individuals diagnosed with this condition spend considerable effort trying to please others, and they overly focus on the fear of criticism, disapproval or abandonment. Common symptoms of individuals with DPD include,

  • Inability to make even small decisions without the advice of others
  • Avoidance of personal responsibilities by acting passive and helpless
  • Dependence on another person to make decisions of their day-to-day life
  • Deep fear of separation or abandonment and severe grief or helplessness when relationships end
  • Seek out another companionship immediately after the end of one relationship
  • Lack of self-confidence
  • Being on behalf of others without giving priority to one’s own needs
  • Difficulty expressing disagreement
  • Preoccupation with unrealistic extreme fears of being left to care for themselves
  • Feels uncomfortable and helpless when alone
  • Difficulties in the initiation of projects
  • Difficulties in completion of activities due to self-doubt
  • Frequent requests for reassurance

 

Dependent Personality Disorder Causes and risk factors

Healthy variants of the dependent are capable of showing genuine empathy for others. Unfortunately,sometimes these traits can gradually turn toward a disorder. As with other personality disorders, the exact cause of dependent personality disorder is not fully understood. It’s likely to be caused by a combination of biological, environmental, psychological and cognitive factors.

1.Parenting style

Studies have determined two parenting styles that cause high levels of dependency in children

Authoritarian parenting

A strict method of parenting that focus is mainly on obedience and control.

  • Prevent children from learning through mistakes
  • Punish children for failures
  • Ignore achievements

This kind of parenting style causes a high level of dependency and aggressive behaviours in children.

Overprotective parenting

Parents in this category have an intense focus on the well-being of their children. This parenting style involves,

  • Continuously checking on their child
  • Consistently invading their child’s privacy
  • Controlling social interactions of the child
  • Taking over essential responsibilities of child

Kids with protective parents are likely to be over sensitive adults. Furthermore, both parenting styles make children believe they cannot function without the help, guidance and support of others.

2.Traumatic life experiences

History of a traumatic childhood, family difficulties and sexual or verbal abuse may cause a chronic inability in a person to be independent

3.Biological factors

Certain traits related to dependent personality may be passed on to someone by their parents through inherited genes.

4.Abusive relationships

Any act of physical, emotional, sexual and financial abuse in a relationship seem to increase the risk of developing DPD

5.Gender

Males are less likely than females to develop DPD

 

Dependent Personality Disorder Complications

People with dependent personality disorder are at risk of developing the following complications.

  • Anxiety disorders
  • Depression
  • Phobias
  • Substance abuse
  • Impaired educational progress
  • Various illnesses from lowered strength of immunity in individuals with severe anxiety

Also, they are vulnerable to physical and verbal abuse due to difficulties in expressing disagreements.

 

Dependent Personality Disorder Diagnosis and tests

The diagnosis of dependent personality disorder is carried out according to DSM 5 diagnostic criteria. DSM-5, or the diagnostic and statistical manual of mental disorders, contains diagnostic criteria for mental health disorders. Hence, clinicians use this diagnostic method for an effective and accurate diagnosis of DPD.

To be diagnosed with DPD, at least five of the following eight symptoms should be present.

  1. Feeling uneasy about their daily decisions and need the approval of others.
  2. Rather have someone else plan out their future goals than have to decide of their own.
  3. Have trouble expressing their opinions and agree with others even if it is against their beliefs. The reason for this is, they fear the loss of support from others.
  4. Have difficulty completing projects on their own because they constantly feel their work is inadequate.
  5. Goes to excessive lengths ( even unpleasant tasks ) to obtain nurturance and support from others
  6. Feels discomfort and helplessness when alone by excessive fears of being unable to take care of themselves without help from others.
  7. After the end of one relationship, they jump into another one immediately without thinking.
  8. Constantly fear that they will be left alone and will have to live on their own.

After considering the above diagnostic method, your clinician will run several examinations and tests to identify other related medical complications caused by DPD.

He will  conduct a general physical examination to check,

  • Heart rate
  • Blood pressure
  • Temperature
  • Height and weight
  • Skin condition
  • Vision

 

Dependent Personality Disorder Treatment and medicine

Based on the examinations and tests, the clinician will recommend an appropriate treatment plan.

A patient can successfully recover through the collective help of doctors, therapists, partners and

friends. An effective treatment plan can allow a person who is prone to dependent personality disorder to learn more productive ways to actively dealing with the dependency.

Psychotherapy is the principal method of treatment for DPD. It is a type of counselling that helps the person with the disorder to learn healthy ways to cope with their behaviour. There are several approaches used in psychotherapy. Your therapist will observe your particular situation and determine the most suitable method for you. Here are some psychotherapy techniques effective in treating DPD.

  1. Cognitive behavioural therapy

An evidence-based treatment approach that restructures an individual’s thoughts, feelings and

behaviours to obtain more effective actions.

  1. Dialectical behavioural therapy

An evidence-based method that provides patients with new skills to manage emotional conflicts and fears.

  1. Psychodynamic therapy

One of the most effective approaches that require a long-term commitment of the patient and family members. This therapy method focus on the roots of the sufferer’s dependency issues and intense fear of abandonment.

  1. Interpersonal therapy

Focus on how dependency is connected to relationship issues and life-changing experiences

 

Medications

Antidepressants help address the underlying problems of this condition. Such as depression and anxiety.

 

Dependent Personality Disorder Coping and support

Learning healthy ways to cope with this condition can help avoid DPD triggers. Coping strategies may include,

  • Engage in activities that do not revolve around your significant other
  • Learn to manage fears by writing down your emotions
  • Become comfortable with spending time on your own
  • Practice decision-making skills
  • Try to boost your self-esteem by using your creativity
  • Find your ways to handle daily situations

Parents, loved ones, friends and co-workers can offer guidance and support by,

  • Understanding it’s not their fault
  • Encouraging them to take daily responsibilities
  • Encouraging them to express their true beliefs and ideas
  • Inviting them to talk whenever questions arise
  • Appreciating them when they complete tasks successfully

 

DPD Lifestyle and home remedies

Implementing the following changes in your lifestyle can help you during and after your recovery from the disorder

  • Be well aware of the disorder you have
  • Avoid alcohol and other recreational drugs
  • Find ways to handle fears and stress
  • Get enough sleep
  • Stick to your treatment plan
  • Put extra focus on self-care
  • Know your worth and remember to love yourself
  • Keep the balance between treating yourself and giving to others

 

DPD Prevention methods

  • Positive parenting solutions can help prevent the development of this condition.
  • Teaching new skills and behaviours
  • Encourage children to learn from mistakes
  • Use positive language
  • Allow children to solve problems by themselves
  • Appreciate small accomplishments
  • Avoid abusive relationships
  • Learn to deal with traumatic stress.

 

References

  • Handbook of personality disorders- Theory research and treatment. By W. John Livesly
  • Dependent personality disorder – A review of etiology and treatment. By Chasidy Faith
  • Dependent personality disorder effective time-limited therapy. By Robert F. Borntein

 

  • https://www.webmd.com/anxiety-panic/guide/dependent-personality-disorder
  • https://www.goodtherapy.org/learn-about-therapy/issues/dependentpersonality#:~:text=Psychotherapy%20is%20the%20primary%20treatment,engaging%20in%20more%20
    independent%20behaviors.