Dependent Personality Disorder

The dependent personality disordered individual suffers from a neediness that is marked by an over reliance on others. His or her emotional and physical needs are dependent on the people closest.

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 clothes to wear) without an excessive advice and reassurance from others. These individuals tend to be passive and allow other people (normally one 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 people to befriend. Adolescents with this disorder may allow a parent to decide the clothes to wear, with whom they should associate, how they should spend free time, and what school or college to attend.

Handing over responsibility is often beyond appropriate requests (such as the specific needs of children, elderly persons, and handicapped persons). These individuals seek support and approval, and therefore cannot express opinions or disagreement, especially with those 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 find it difficult to initiate projects or work 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.

This condition is inflexible, maladaptive, and can cause dysfunction and distress.

Symptoms

People with this disorder do not trust their own ability to make decisions and feel that others are more quipped. They may feel devastated by loss and separation, and they may even suffer abuse to stay in a relationship. They may belittle themselves and their abilities and frequently refer to themselves as stupid. Other Signs and symptoms, as cataloged by the DSM-5:

  • A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.

  • Needs others to assume responsibility for most major areas of his or her life.

  • Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Does not include realistic fears of retribution.)

  • Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).

  • Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.

  • Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.

  • Urgently seeks another relationship as a source of care and support when a close re­lationship ends.

  • Is unrealistically preoccupied with fears of being left to take care of himself or herself.

Causes

The cause of this disorder is unknown. The disorder usually appears in early adulthood. Individuals who experienced separation anxiety disorder or chronic physical illness in childhood or adolescence may be at higher risk of developing this disorder.

The prevalence of this disorder in the general population is estimated at less than 1 percent. More women than men have been found to have dependent personality disorder.

Treatment

People with dependent personality disorder should consider psychotherapy for treatment. Cognitive-behavioral therapy focuses on maladaptive thinking patterns, 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. This disorder often requires long-term therapy or treatment.

There may be other underlying conditions, so medication may be helpful. Antidepressants, sedatives, and tranquilizers are often prescribed for patients with dependent personality disorder to treat co-occurring conditions.

References

  • American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
  • National Institutes of Health
  • National Library of Medicine

Last reviewed 02/07/2019