Dependent Personality Disorder


All human beings value connection and relationships with others. Being a social animal, forming connections, and sharing a bond with others are necessary for survival. In a relationship, whether formal or informal most individuals feel secure and safe in a cozy long-term bond with a partner; they feel supported and flexible. This helps increase emotional connection quality while having the freedom of individuality. However, when a person in any form of relationship starts to show an excessive need to be taken care of, clingy behavior may disrupt and cause impairments in a relationship with the fear of losing support, approval, and abandonment. Such complete emotional dependency impacting negatively on the area of an individual's life and relationships can be termed a disorder of personality.


What is Dependent Personality Disorder (DPD)?

A dependent personality disorder is a serious mental disorder that manifests itself as extreme neediness, fear of being rejected, and clingy behavior. Individuals with a dependent personality disorder may go to extreme lengths to remain in a relationship or under the support of others, and they may even tolerate the maltreatment of their partner. Personality disorders affect how an individual thinks, behaves, or acts over time. A dependent personality disorder falls under personality disorders characterized by anxious, fearful thinking or behaving.


People with dependent personality disorder feel an overwhelming need to offer care to others. They rely on individuals close to them for their emotional and physical needs. Therefore, been described as a needy or clingy person.

Individuals with DPD believe they are incapable of taking care of themselves and have trouble making decisions related to everyday life choices, such as needing constant approval and reassurance on matters like how to dress or behave, etc. This condition makes an individual deal with a feeling of insecurity and an increased need for assurance from others. People with this condition usually show the first symptoms between their early to mid-adulthood.

Impact of Others Lives on a Person with DPD

These individuals allow others to take the initiative and responsibility for most of their major aspects of life. For instance, adults with this disorder typically depend on their spouse or parents to decide where they should be living, the types of friends they should have, or/and what kind of career path and jobs they should maintain.

Adolescents with this disorder let their parents decide the smallest decisions, such as with whom they should hang out, what colleges to attend, or even the clothes they should wear. Individuals seek support and approval and cannot hold opinions of their own or express disagreements with those they rely on. They feel unable to be alone and look for guidance, and they may go to great lengths to gain support and nurturance. This disorder makes an individual feel helpless and uncomfortable and holds exaggerated fear of existing with the incapability of taking care of themselves. This personality condition is maladaptive, inflexible, and causes distress and dysfunctional life.

The Daily Life of an Individual with DPD

Dodging responsibilities at work, self-doubt, self-criticizing, declining social situations, hiding insecurities, and lack of self-worth and autonomy. Co-occurring mental conditions and complications that can cause disabilities in an individual's life with DPD are −


Symptoms

People with this disorder belittle themselves and their capabilities. According to DSM 5, signs and symptoms are −

  • Excessive need for being taken care of results in clingy behavior with fear of separation usually beginning with onset by early adulthood and present in various contexts by at least five or more of the following −
    • Faces difficulty making everyday life decisions without advice or nurturance from others.
    • Need others to take responsibility for most major areas of their life.
    • Difficulty in holding opinions and expressing disagreement with others.
    • Living with unrealistic fears of losing the support or approval of that individual.
    • Difficulty taking responsibility for doing their task as they lack self-confidence in their judgment.
    • Ready to go to great lengths to obtain support and do things for them, even if they are unpleasant.
    • Feeling helpless and alone due to intense fear of being incapable of caring for their own needs and themselves.
    • Seek relationships after relationships as a source of support after every breakup.
    • Unrealistically occupied with fears of being alone, left alone.

Compatibility and Living Pattern

Narcissistic, borderline, anti-social, and historic personalities fall under cluster B, where individuals are erratic and dramatic. Individuals with DPD feel withdrawn toward those falling under this cluster, giving in everything to fulfilling their needs and wants. DPD individuals Praise while putting their partner on a high pedestal and making them in charge of all the decisions revolving around their life. This results in helping DPD individuals receive that dependency by forming a symbiotic relationship.

Friendship with an individual suffering from DPD may follow a similar pattern to their romantic relationships, as the individual fears being alone, is needy, and does not disagree with their friend's opinions. They believe that doing so would not be helpful for them, as to obtain care and support from their friends, they need to accept what they want and are ready to go extreme to keep them happy and close.

Prevalence

In a study by Bornstein, R.F. in 1996 on the difference in gender of personality disorder and their prevalence rates, it was observed that 1% of the population suffered from DPD, and women received diagnoses significantly at higher rates than men. These variations in gender differences were obtained with different dependency measures and tools and using the multimodal approach for assessment.

Causes

Dependency disorder cause is not known specifically but believed that a combination of factors increases the risk of developing DPD.


Management and treatment

A treatment plan aims at stabilizing an individual's mood using psychotherapy, medication, and coping strategies that help develop skills to express any disagreement in productive ways and spend time independently and comfortably.

  • In psychotherapy, CBT helps improve self-confidence and makes them self-reliant and active. Short-term therapy with goals focused on behavior management for behaviors disturbing an individual's daily functioning. Strategies include assertiveness training, attitude formation, and perspective development. They help in overcoming and minimizing the side effects of medicines.
  • Group and Family Therapy encourage the healthy formation of a support system. Schema therapy has been proven useful in treating Cluster C personality disorders. The goal of schema therapy is to enable individuals to understand problematic patterns and coping strategies and modify them into healthy ones.
  • Medications such as anti-depressants and anti-anxiety can help with anxiety, panic, depression, etc., but they should be taken as a last option.

Conclusion

An anxious personality disorder called dependent personality disorder (DPD) makes individuals feel powerless, submissive, or incapable of caring for themselves. They have difficulty making simple decisions in their daily life. Therapy helps an individual focus on building coping mechanism that helps them with fears of being alone in decision-making, self-confidence, self-sufficiency, and being assertive. The cause of it is not known yet, but a variety of childhood experiences, genetic makeup, trauma, etc., all contribute to the onset of dependent personality disorder.

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Updated on: 13-Oct-2022

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