Dependent Personality Disorder
Dependent personality disorder is a psychiatric condition marked by an overreliance on other people to meet one’s emotional and physical needs.
Personality traits are enduring patterns of perceiving, relating to, and thinking about one's environment and oneself that are exhibited in a wide range of social and personal contexts. Only when personality traits are inflexible, maladaptive, and cause significant functional impairment or subjective distress are they considered personality disorders. The essential feature of a personality disorder is a continuing pattern of inner experience and behavior that deviates noticeably from the expectations of the individual's culture and is manifested in at least two of the following areas: cognition/thinking, affectivity/emotional expression, interpersonal functioning, or impulse control.
This persistent pattern is inflexible and pervasive across a broad range of personal and social situations, and leads to clinically significant distress or impairment in social, occupational or other important areas of functioning. The pattern is stable and of long duration, which means its onset can be traced back to at least adolescence or early adulthood. This pattern is not better accounted for as a manifestation or consequence of another mental disorder and is not due to the direct physiological effects of a substance (such as drug abuse, medication, exposure to a toxin) or a general medical condition (such as head trauma).
Dependent personality disorder is described as a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior as well as fears of separation. This pattern begins by early adulthood and is present in a variety of contexts. The dependent and submissive behaviors are designed to elicit caregiving and arise from a self-perception of being unable to function adequately without the help of others.
Individuals with dependent personality disorder have great difficulty making everyday decisions (such as what shirt to wear or whether to carry an umbrella) without an excessive amount of advice and reassurance from others. These individuals tend to be passive and allow other people (often a single other person) to take the initiative and assume responsibility for most major areas of their lives. Adults with this disorder typically depend on a parent or spouse to decide where they should live, what kind of job they should have, and which neighbors to befriend. Adolescents with this disorder may allow their parent(s) to decide what they should wear, with whom they should associate, how they should spend their free time, and what school or college they should attend.
This need for others to assume responsibility goes beyond age-appropriate and situation-appropriate requests for assistance from others (such as the specific needs of children, elderly persons, and handicapped persons). Because they fear losing support or approval, individuals with dependent personality disorder often have difficulty expressing disagreement with other people, especially those on whom they are dependent. These individuals feel so unable to function alone that they will agree with things that they feel are wrong rather than risk losing the help of those to whom they look for guidance. Individuals with this disorder have difficulty initiating projects or doing things independently.
They may go to extreme lengths to obtain nurturance and support from others, even to the point of volunteering for unpleasant tasks if such behavior will bring the care that they need. Individuals with this disorder feel uncomfortable or helpless when alone, because of their exaggerated fears of being unable to care for themselves. When a close relationship ends (such as a breakup with a lover or the death of a caregiver), individuals with dependent personality disorder may urgently seek another relationship to provide the care and support they need. They are often preoccupied with fears of being left to care for themselves.
People with this disorder do not trust their own ability to make decisions and feel that others have better ideas. They may be devastated by separation and loss, and they may go to great lengths, even suffering abuse, to stay in a relationship. They may tend to belittle their abilities and frequently refer to themselves as "stupid." Other symptoms include:
- Difficulty making decisions without reassurance from others
- Extreme passivity
- Problems expressing disagreements with others
- Avoiding personal responsibility
- Avoiding being alone
- Devastation or helplessness when relationships end
- Unable to meet ordinary demands of life
- Preoccupied with fears of being abandoned
- Easily hurt by criticism or disapproval
- Willingness to tolerate mistreatment and abuse from others
Complications of this disorder may include depression, alcohol and drug abuse, and susceptibility to physical, emotional and sexual abuse.
The cause of this disorder is not known. The disorder usually appears in early adulthood. Individuals who experienced chronic physical illness or separation anxiety disorder in childhood or adolescence may be at higher risk of developing dependent personality disorder.
The estimated prevalence of this disorder in the general population is less than one percent. More women than men have been found to have dependent personality disorder.
Psychotherapy is the preferred form of treatment for people with dependent personality disorder. Cognitive-behavioral therapy focuses on patterns of thinking that are maladaptive, the beliefs that underlie such thinking, and resolving symptoms or traits that are characteristic of the disorder—such as the inability to make important life decisions or the inability to initiate relationships. Improvements are usually seen only with long-term therapy or treatment.
Medication may be helpful to treat any other underlying conditions. Certain types of drugs, such as antidepressants, sedatives, and tranquilizers are often prescribed for patients with dependent personality disorder to treat co-occurring conditions.
- American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
- National Institutes of Health
- National Library of Medicine
Last reviewed 03/06/2018