PERSONALITY DISORDERS
Personality disorders are long-term patterns of behavior and inner experiences
that differ significantly from what is expected. They affect at least two of these
areas: Way of thinking about oneself and others. Way of responding emotionally.
The term “Personality Disorder” suggests that something is off with a person’s
personality. However, it actually refers to a category of psychiatric conditions
marked by rigid, unhealthy patterns of thinking, feeling, and behaving that impact
how someone interacts with the world. These patterns often result in difficulties in
personal relationships, making it hard for people with untreated personality
disorders to maintain fulfilling, stable connections with others. Relationships they
do form are usually filled with conflict and issues.
Being diagnosed with a “personality disorder” does not mean a person’s
personality is fundamentally flawed or abnormal. In reality, these disorders are
relatively common and can be deeply distressing for those who experience them.
Studies indicate that approximately 10% of adults may be diagnosed with a
personality disorder (Torgersen, 2005).
Unlike disorders like epilepsy, which show a clear break from normal functioning,
personality disorders are variations of a healthy personality. Since everyone has a
personality, personality disorders are seen as unique forms of normal personality
traits, similar to how a square is a specific type of rectangle. To better understand
personality disorders, it is helpful to first explore the broader concept of personality
itself.
DSM-5 lists ten specific personality disorders: paranoid, schizoid, schizotypal,
antisocial, borderline, histrionic, narcissistic, avoidant, dependent and obsessive–
compulsive personality disorder. Here, we discuss about Dependent personality
Disorder.
Dependent personality Disorder
Dependent personality disorder (DPD) is a type of anxious personality disorder.
People with DPD often feel helpless, submissive and incapable of taking care of
themselves. They may have trouble making simple decisions. The condition is
treatable with psychotherapy (talk therapy). Medication may help as well.
Dependent personality disorder (DPD) is a mental health condition that involves an
excessive need to be taken care of by others. A person with DPD relies on people
close to them for their emotional or physical needs. Others may describe them as
needy or clingy. People with DPD believe they can’t take care of themselves. They
may have trouble making everyday decisions, like what to wear or what food to
eat, without others’ reassurance. They usually don’t realize that their thoughts and
behaviors are problematic.
DPD is one of a group of conditions called “Cluster C” personality disorders. They
involve feelings of anxiety and fear. Personality disorders are lasting patterns of
behavior that are out of touch with cultural norms (how we’re expected to act).
They start before adulthood — in childhood or adolescence. Personality disorders
cause distress for the person with the condition and/or those around them.
DIAGNOSTIC CRITERIA
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:
1. Has difficulty making everyday decisions without an excessive amount of
advice And reassurance from others.
2. Needs others to assume responsibility for most major areas of his or her life.
3. Has difficulty expressing disagreement with others because of fear of loss of
Support or approval. (Note: Do not include realistic fears of retribution.)
4. 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).
5. Goes to excessive lengths to obtain nurturance and support from others, to
the Point of volunteering to do things that are unpleasant.
6. Feels uncomfortable or helpless when alone because of exaggerated fears of
Being unable to care for himself or herself.
7. Urgently seeks another relationship as a source of care and support when a
Close relationship ends.
8. Is unrealistically preoccupied with fears of being left to take care of himself
or Herself.
CAUSES
Personality disorders, including Dependent Personality Disorder (DPD), are among
the least understood mental health conditions. However, researchers believe that
DPD may develop due to several contributing factors, such as:
Abuse history: Individuals with a background of abusive relationships are at
a higher risk of being diagnosed with DPD.
Childhood trauma: Children who have suffered abuse (including verbal
abuse) or neglect, as well as those who faced life-threatening illnesses
during childhood, may be more likely to develop DPD.
Genetics: Having a biological family member with DPD or another anxiety
disorder may increase the likelihood of developing DPD.
Cultural, religious, or family influences: In some cases, DPD may
develop as a result of cultural or religious practices that emphasize
dependence on authority figures.
DIFFERENTIAL DIAGNOSIS
Several other personality disorders also involve hypersensitivity to rejection, but they can be
differentiated from Dependent Personality Disorder (DPD) based on distinct features:
Borderline Personality Disorder: Individuals with this disorder are too fearful to submit to the
same level of control seen in DPD. Unlike those with DPD, individuals with Borderline
Personality Disorder alternate between submissiveness and intense, rage-driven hostility.
Avoidant Personality Disorder: While also characterized by fear, individuals with Avoidant
Personality Disorder are reluctant to submit to control as those with DPD. However, they tend to
withdraw until they feel certain they will be accepted without criticism, whereas people with
DPD actively seek and try to maintain relationships.
Histrionic Personality Disorder: People with Histrionic Personality Disorder seek attention,
unlike those with DPD, who primarily seek reassurance. However, individuals with Histrionic
Personality Disorder are more outgoing and attention-seeking, while those with DPD are
typically more reserved and shy.
It's also important to distinguish DPD from the dependency seen in other psychiatric conditions, such as
depressive disorders, panic disorder, and agoraphobia.
PROGNOSIS AND RISK FACTORS
The outlook for Dependent Personality Disorder (DPD) largely depends on whether it is treated.
If left untreated, DPD may lead to:
Development of additional mental health issues, such as depression or
substance use disorder.
Challenges in relationships.
A higher risk of experiencing physical, emotional, or sexual abuse.
Increased rates of suicidal thoughts and attempts.
It’s important to recognize that DPD is a mental health condition. Like all mental health conditions,
seeking help early can reduce its impact on your life. Mental health professionals can provide treatment
plans to help manage thoughts and behaviors.
Family members and loved ones of individuals with DPD often experience stress, depression, and
feelings of isolation. It’s essential to prioritize your own mental health and seek support if you’re
struggling with these symptoms.
TREATMENT PLAN
Cognitive-behavioral therapy
Psychodynamic psychotherapy
Possibly antidepressants
The treatment approach for Dependent Personality Disorder (DPD) generally follows the same
principles used for other personality disorders.
Psychodynamic psychotherapy and cognitive-behavioral therapy, which focus on addressing fears of
independence and challenges with assertiveness, can be beneficial for individuals with DPD. It's
important for clinicians to avoid fostering dependency within the therapeutic relationship.
There is limited evidence supporting the use of pharmacotherapy for DPD, and no placebo-controlled
studies specifically address the disorder.
Benzodiazepines are typically not prescribed for DPD, as patients with this disorder may be at a higher
risk for misusing medication.
CASE STUDY
This case study looks at the patient of a 27-year-old, white female named Sally. She works as an
administrative assistant whose work required extensive data entry. Sally’s mother used her network to
get this stable job for her daughter. Sally is consumed with pleasing her mother and even asks for her
mother’s advice on what to wear to the office each day. Sally consistently worries about pleasing others
and her colleagues at work, even at the expense to herself, which leads to the diagnosis of dependent
personality disorder. The degree to which her self-destructive passivity and compliance at work
stemmed from her early experiences within the family are unclear, but her parents’ overprotectiveness
likely played some role in the etiology of her personality pathology.
REFERENCES
Mark Zimmerman, MD, South County Psychiatry, Reviewed/Revised Sept 2023,
https://www.msdmanuals.com/professional/psychiatric-disorders/personality-disorders/dependent-
personality-disorder-dpd.
Cleveland Clinic, Reviewed on 09/28/2023,
https://my.clevelandclinic.org/health/diseases/9783-dependent-personality-
disorder.
Julie Manley, Lumen Learning, Retrieved on Jan 2025,
https://courses.lumenlearning.com/wm-abnormalpsych/chapter/dependent-
personality-disorder/.
American Psychiatric Association (2013), Diagnostic and statistical manual of
mental disorders (5th ed.), https://doi.org/10.1176/appi.books.9780890425596.
