People with dependent personality styles or disorders often seek treatment for what they describe as depression or uncontrolled anxiety. But the underlying behaviors include difficulty making decisions and feelings of helplessness, loneliness, and abandonment. The anxiety appears to be part of this system, as the overall helplessness and dependence lead right into this.
Dependent personality disorder was poorly understood until Freud was conceptually able to place the genesis of this disorder, in part, into a specific developmental stage in terms of overindulgence during early life. In treating patients who present with depression symptoms and anxiety disorders, I stay alert to negative expressions such as "I can't," "I'll never be able to," "I'm no good at it," "You figure it out," or "I need help." Such statements lead me to think the culprit is dependency, rather than anxiety or depression.
Let me offer an example to see how one can create a goal-oriented plan for improvement. A nice young man in his mid-20s was referred by his family doctor for depression and "high anxiety." He was not doing well at work or socially. Some of his friends called him too needy. He was both depressed and anxious about his failures. At work, he could rarely find what he needed or got confused between incoming and outgoing material. Socially, he needed a lot of attention and was told by one date that he was depleting her "energy." He gave the impression of helplessness, lack of self-esteem, and inability to do things at all or well.
If dependency is the central issue, you must be willing to challenge the automatic negative thoughts you have about yourself and your abilities, and then take small steps to address the behaviors. Here's a roadmap for self-care I developed with this person. Although we worked on his dependent personality disorder together over the course of a year, you can try these same strategies on your own.
Step 1: Make a commitment to learning about your problem. Reflect on your childhood. Were you encouraged to tackle projects that were above your skill level? Or to take risks even though you might not succeed? Or was there someone always there hovering, someone to rescue you or to keep you from discomfort (i.e., someone was always there to turn the faucet off for you as a child)? How did those early experiences shape your adult behavior?
Step 2: Create a goal-oriented plan for improvement. Make a list of tasks at work and at home that feel overwhelming to you, or that fill you with dread or feelings of helplessness. Choose one on which to focus first. For example, let's say your coworkers complain that you can't seem to learn the all-in-one printing/fax machine. This is a good place to start practicing new patterns of behavior.
Step 3: Remind yourself that this process takes time. Remember that you will not instantly be able to change and improve. Are you willing to follow the process of taking charge of your dependency? Good. Are you open to the idea that you can learn from your mistakes? Good.
Step 4: Develop concrete strategies to tackle the problem. With the print/copy/fax machine example, you could get the instruction manual or call for technical help and learn it, rather than repeatedly ask coworkers to help you. You could take the tutorial that came with the machine or watch it online. You could come into work early or stay late, and practice using its functions in a low-stress environment. Each time you succeed, it reinforces positive behaviors. Each time you are not successful, ask yourself what you can do differently next time-and then do it.
If you're a person who feels helpless, inadequate, or afraid, know that your feelings of depression and anxiety can be greatly relieved or solved altogether by dealing with your dependency first, rather than focusing on the emotional condition that it's causing. Even though dependency problems can be serious, they are indeed rectifiable by making conscious, step-by-step changes in your behavior. Once you address dependency issues, you will feel calmer, happier, and more confident. Give it a try!
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Note: This blog aims to present psychiatric/psychological information to a general readership, offering insights into a variety of emotional disorders, as well as social issues that affect our emotional well-being. It includes the ideas and opinions of Dr. London and other leading experts. This blog does not provide psychotherapy or personal advice, which should only be done by a mental health care professional during a personal evaluation.