Dependent personality disorder (DPD) is one of the most commonly diagnosed mental health disorders. It is a condition in which people depend on others too much to meet their physical and emotional needs. While there is no known direct cause for DPD, it is thought that the disorder may be a result of a mix of environmental, genetics, temperamental, and developmental factors.
It tends to start in young adulthood and is common for both men and women to have. It is thought to develop from different factors, like childhood trauma, abusive relationships, and family history.
Individuals with DPD spend a great deal of time and effort trying to please others. They tend to display as passive, needy, and clingy. They also have a fear of separation and are hypersensitive to rejection. DPD falls under the category of personality disorders. These disorders are long-lasting, inescapable patterns of thinking, reacting, perceiving, and relating, causing the person intense distress. They also can impair a person’s ability to function on a daily basis. As a mental health illness, it is one that is not all that common but does affect a percentage of the US population.
There are three clusters of personality disorders:
Cluster A – This is characterized by appearing odd or eccentric.
Cluster B – This is characterized by seeming to be emotional, dramatic, or erratic.
Cluster C – This is characterized by seeming to be anxious and/or fearful.
DPD is a Cluster C personality disorder.
The National Institute of Mental Health (NIMH) relays from a 2003 report that the prevalence of any personality disorder in the general population was 9.1 percent. The same report states that only 39 percent of those received treatment, and 22.6 percent also have any substance use disorder.
So, how will you know if you have DPD?
Symptoms of DPD
DPD has many characteristics or symptoms to know. A person with DPD may exhibit some or all of them. They are:
- Not being able to make everyday decisions, such as what to wear or what to eat, without getting guidance from others
- An inability to be alone
- Avoids personal responsibility or adult responsibilities by acting helpless; depends on others to make decisions for them, such as what job to take.
- Lack of self-confidence and is pessimistic.
- Intense fear of abandonment and a feeling of helplessness when a relationship ends.
- Oversensitivity to criticism
- Pessimism and lack of self-confidence
- Truly believing they can’t take care of themselves without help
- Avoids disagreeing with other people due to fear of losing approval or support
- Takes mistreatment and abuse from other people
- Oversensitive to criticism
- Feels an intense fear of abandonment, helplessness, and devastation when a relationship ends
- Doesn’t want to start new projects due to lack of self-confidence
- Puts the needs of others and caregivers above their own
- Tends to be naive and fantasizes.
A DPD Diagnosis
Healthline explains what is involved in a DPD diagnosis. First, your doctor will give you a physical exam to see if there is a medical reason for your symptoms. If not, they will refer you to a mental health professional who will ask you several questions about how you feel and if you have any other mental health issues, such as anxiety or depression. They also may inquire about any substance abuse problems.
They will take your answers and compare them to the list of factors as indicated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the defining guide for making a diagnosis. The mental health provider will look for five diagnostic criteria among these:
- Helpless or anxious feelings when alone
- Unrealistic and all-consuming fear of abandonment
- Cannot manage life responsibilities without getting guidance from others
- Difficulty making everyday decisions without guidance or reassurance from others
- Afraid to state an opinion for fear of losing approval or support
- Strong urge to seek support from others, even when it means doing something unpleasant to get it.
- Not being able to start or complete projects due to lack of self-confidence or the inability to make decisions.
- Strong urge to seek a new relationship to have that support and approval when a close relationship ends
Complications of DPD
Complications of DPD
An individual with DPD lives in constant fear of being abandoned by those whom they are dependent on. They may go to great lengths to prevent that from happening, such as acting submissive, ill, or needier. As such, this can cause physical and psychological complications in their lives. The person with DPD may have anxiety issues and depression. They might also cause undue extreme stress on themselves and those they depend on. This could lead to frustration and resentment from the ones who help the person with DPD.
If DPD is not treated, the individual may be prone to other mental health disorders, such as panic disorder, obsessive-compulsive disorder, phobia, and substance use disorder. Another serious complication of DPD is the possibility of being abused by the person or people the individual is most dependent on. Early diagnosis and treatment are encouraged.
What Does DPD Look Like?
An individual with BPD will seem needy and clingy to those they are dependent on. They will ask for constant feedback or guidance for many things, like where to live, what groceries to buy, if they should go someplace, etc. The person will also avoid any personal responsibility. They will also seek a new relationship when a close one ends so that they are not alone.
Someone with BPD may also be full of self-doubt and very critical of themselves, says Psych Central. In addition, they might dodge work responsibilities because they doubt they can complete them or do them well. The person with DPD is more likely to avoid social activities, and they may show the world that they are worthy but inwardly feel not worthy.
What Happens If BPD Is Not Treated?
If left untreated, DPD can result in feeling more anxious and depressed. It could also lead to self-medicating with alcohol or drugs, which only provides brief relief. An individual with DPD who does not seek treatment may also be at risk of being in an abusive relationship. They expend a great deal of energy trying to please the other person and might not realize they are not being treated with love or respect. They may also become suicidal if they think the other person will leave and not come back.
There are some situations where DPD might be present with other mental health disorders. If left untreated, the person with these mental health conditions could develop phobias.
Substance abuse is another possibility for the person with DPD and any other co-occurring disorders. It is possible that drugs and alcohol can soothe or ease symptoms. However, the more a person uses these substances, the better the possibility that their system will become tolerant to the substances, and more of them will be needed to feel the same effects as when they originally started abusing them. This process eventually develops into addiction.
Is DPD Preventable?
There are ways to prevent DPD in adults, but first, we must understand what could cause it to occur. Dependency starts in young children, and particularly when they experience separation anxiety when a parent leaves, even for a short time. Children feel distressed when the parent is not close and become afraid when left alone. If their separation anxiety is not resolved, it may cause the child to develop attachments to other people. Some adults with DPD struggled with separation anxiety as a child, as Psychpoint shares.
They also note that someone with chronic illness may also have DPD. The individual with a chronic illness could be struggling by feeling inadequate and insecure. They often are dependent on the help of others to take care of everyday needs and for their emotional well-being causing low self-esteem and self-worth.
Depending on someone else to care for them can lead to developing a dependent personality. They might feel like they cannot survive without the help and support of someone else. Desperation and emotional distress grow if they feel they will be left alone.
If the symptoms of DPD begin in children, they should be addressed as soon as possible. An adult or parent should teach positive coping skills, which help the child develop a good sense of self-esteem. As adults, they will then be less affected by rejection and be more resilient.
It is essential to help children and adults practice self-esteem. Confidence-building exercises are also useful. A strong, healthy, and positive self-image bolsters the individual and increases their sense of self-worth.
As adults, DPD can be treated. Treatment is most beneficial in a residential care setting where there are no distractions or obstacles to overcome.
Is DPD Curable?
Dependent personality disorder is not a curable condition. However, it can be treated. There are several therapies that are beneficial for the person with DPD. These are:
Social skills training: This training involves teaching the individual how to understand verbal and non-verbal cues in social situations, how to carry a conversation, and how to communicate assertively. It might include role-playing, receiving feedback and is usually part of other types of therapy.
Cognitive behavioral therapy: This type of therapy is very useful for many mental health conditions. It helps the individual learn how to change the way they think about themselves or any damaging or negative thoughts and beliefs. It helps the individual build self-confidence and be more independent.
Therapy sessions may include exercises to help with:
- Learning how to be comfortable with and enjoy your own company
- Finding and practicing new ways learning how to handle the fear of being alone
- Learning decision-making skills, self-sufficiency skills, and practicing being more assertive
Treatment for DPD
As mentioned before, cognitive behavioral therapy is one of the primary types of treatment for DPD, as noted by GoodTherapy. When it is combined with existential therapy, the person with DPD will learn how to manage life in the present moment.
The primary focus of existential therapy is that the person with DPD does not feel in control of their life. They feel hopeless and powerless, which causes them to direct personal responsibility to others. Existential therapy will help the individual be in the present moment, not later in the future. This type of therapy focuses on helping the individual see new choices and opportunities in their lives. It also helps them explore who they really are and to find their true selves.
When combined with CBT, the individual will learn how to recognize and change negative or damaging thoughts and actions and learn to live in the moment while finding new positive choices in their life. Both therapies combined encourage the person to change and see the more realistic experiences they have with others. The individual with DPD will participate in activities like problem-solving skills, role-play scenarios, journal writing, and practice safe risk-taking in therapy and out of it.
The Differences Between BPD and DPD
There are keen differences between borderline personality disorder (BPD) and dependent personality disorder (DPD). Both disorders have some same characteristics, such as loneliness, avoiding responsibility, and having trouble maintaining relationships. People with either disorder may not handle rejection well. However, the differences are that those with BPD can experience impulsivity, rage, and aggression. There is only black in white in the world, no gray areas. They may also engage in self-harm and be reckless, as noted by Verywell Mind. Someone with BPD will have unstable moods, act impulsively, and be involved in unstable personal relationships. They tend to push people away rather than cling to them as the person with DPD does. A person with BPD will also have intense outbursts of anger or trouble controlling their anger. They may go to extreme lengths to avoid abandonment-real or imagined.
DPD and Substance Abuse
An individual with DPD may feel like they need something to ease their feelings of rejection or abandonment, like alcohol or drugs. While these substances may ease their symptoms temporarily, the person will feel physically poor when the effects of the drugs or alcohol wear off. This can lead to depressive thoughts and negative feelings about themselves. Regular use of drugs or alcohol can lead to addiction.
Drugs and alcohol might interfere with DPD treatment due to that therapy focuses on addressing the underlying mental health disorders, like anxiety and depression. If a person with DPD is taking antidepressant or anti-anxiety medication, alcohol use can be risky because it is a depressant affecting the central nervous system. Prescription drugs usually act slower than illicit substances and could take several weeks before the person begins to feel the wanted relief. In this case, the individual may take more of the drug to experience the intended relief. Abuse of the drug then becomes a problem that needs to be addressed.
Non-Medical Opioid Use and DPD
Addiction is the chronic use of substances despite the negative consequences. The National Institute on Drug Abuse (NIDA) states from a report that “people with a mental, personality, and substance use disorders were at an increased risk for non-medical use of prescription opioids.” Abusing opioids to ease symptoms of DPD leads to an opioid use disorder (OUD), overdose, and potentially death. Opioids obtained nefariously, such as those bought on from dealers, may be cut with ingredients that can cause severe illness and cause a fatality, such as fentanyl.
NIDA also shares that 43 percent of people in addiction treatment for non-medical use of prescription painkillers have symptoms of or are diagnosed with a mental health disorder, including anxiety and depression. These two mental health conditions are common with people with DPD. It is essential to not self-medicate with prescription opioids, alcohol, or other drugs, like marijuana.
A 2017 article from European Psychiatry states that “diagnoses of PD seem to increase vulnerability to other pathologies, including substance abuse and addiction.” It also indicates other studies have estimated that “between 65% and 90% of subjects treated for substance abuse or dependence has at least one concomitant PT (personality disorder). “
In addition, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that an analysis from substance use counselors found that the “prevalence of PDs (personality disorders) among people with SUDs to be wide-ranging and extremely high, varying from about 35 percent to 65 percent. It also indicates that PDs could be possible “in as much as 24 percent of people with alcohol use disorder in the general population.”
Alcohol abuse is common in people with personality disorders, and the prevalence of alcoholism ranges from 22 percent to 78 percent, according to research on the topic from Greece.
Treatment for Co-Occurring Disorders: DPD and Substance Use
People with co-occurring disorders of dependent personality disorder and substance use disorder will find that both disorders are treatable. Vista Pines Health, a mental health treatment center in Pembroke Pines, Florida, provides treatment and evidence-based therapies that can help you or the one you love learn how to manage DPD without misusing or abusing substances.
If you have been using alcohol or drugs to ease your symptoms, you may need to undergo detox. Detox is provided at Arete Recovery, our sister facility of addiction treatment. Here, you will be medically monitored as your body works through the process of getting rid of all the toxins in your system. Medical personnel will administer any needed medications and liquids to ensure you are comfortable and medically stable.
Once detox is complete, you will undergo an assessment to determine what your level of addiction is and what co-occurring disorders you may have, such as DPD, anxiety, or depression. A treatment plan will be developed with your input. You will have the opportunity to move to Vista Pines Health, where you will receive the very best care and therapies for DPD and addiction.
You may choose our inpatient treatment program, where you will stay on-site as you work through your disorder and learn how to manage them. You will feel at home in comfortable surroundings while receiving high-quality structured care. Therapies and other sessions with a counselor you might engage in are:
- Process group therapy
- Mindfulness-based therapy
- Emotion-focused therapy
- Solution-focused therapy
- Motivational enhancement
- Relapse prevention
- Family dynamics
We also have gender-specific group therapy.
Addiction and DPD are treatable disorders. You can learn coping strategies that will bolster your self-image, self-confidence and help you to become the unique individual you are. It’s time to take care of yourself first, before anyone else, and show the world the new you.
Why Vista Pines Health?
Vista Pines Health is located in sunny South Florida and is near major airports and nearly all of the main interstate highways. As a Delphi Behavioral Health facility, we always exceed medical standards. We are accredited by the Joint Commission and maintain low client-to-staff ratios so that you will never feel lost in the crowd. You will receive all the attention you need during your care for your mental health disorder. We understand that each person in our care is an individual with individual needs.
If you are thinking about Vista Pines Health for your substance use and mental health needs, our capable and caring staff can work with you to find transportation, review your insurance to see what is covered and what isn’t, and find options to pay for services that insurance does not. The cost of treatment should not be an obstacle to seeking and obtaining treatment for mental health and addiction treatment.
If you have questions, we are available to speak with you. Just give us a call.