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Dependent Personality Disorder

Reviewed by Psychology Today Staff

An individual with dependent personality suffers from neediness that is marked by an over-reliance on others. His or her emotional and physical needs are dependent on the people to whom he or she is closest.

Dependent personality disorder is a pervasive and excessive need to be cared for 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 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 their free time, and what school or college to attend.

These individuals seek support and approval, and therefore cannot express opinions or disagreement, especially with those they are dependent on. They 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.

The 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 equipped. 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 their 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 themself.

  • 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 themself.

How does a person with dependent personality react when a relationship ends?

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.

Are dependent personalities drawn to narcissists or histrionic people?

Narcissistic, histrionic, borderline, or antisocial personalities fall under the Cluster B disorders. These people are more erratic and live for drama. People with dependent personalities are drawn to those with Cluster B disorders. The dependent person will give the Cluster B disordered person exactly what they need, praise and high regard. It becomes a type of symbiotic relationship where the Cluster B disordered person is in charge and makes all the decisions.

 

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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.

Is dependent personality a Cluster C disorder?

Yes, dependent personality disorder is a Cluster C disorder. Other Cluster C personality disorders include avoidant and obsessive-compulsiveness. For the most part, people who have a Cluster C disorder suffer from fearful or anxious thoughts and behavior.

Treatment

People with dependent personality disorder should consider psychotherapy for treatment. Cognitive-behavioral therapy focuses on maladaptive thinking patterns, the beliefs that underlie dependent 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 share power in relationships. This disorder often requires long-term therapy or treatment.

There may be other underlying conditions, therefore medication may be helpful. Antidepressants, sedatives, and tranquilizers are often prescribed for patients with dependent personality disorder who suffer 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 updated: 01/19/2022