Dependent Personality Disorder And Depression


Definition of dependent personality disorder (DPD)

Dependent personality disorder (DPD) is defined as a very strong and overwhelming need to be cared for, sometimes accompanied by worries of being abandoned, rejected, or disappointing others.

People who have this disorder may have been labelled as "clingy" or "needy." Others, may not experience ongoing self-doubt and are looking for solace or guidance.1

The history of DPD dates back well before the publication of the first volume of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It was frequently described in prior works as a symptom of dysfunction that originated in the Freudian oral stage of development. DPD has now developed from its historical foundations over various iterations of the DSM.3

Early DSM criteria highlighted that individuals with this disorder frequently require an excessive amount of direction or assurance from others. Because they are afraid of being disapproved of, they frequently let others make the most crucial decisions in their lives and agree with others even when they think they are wrong. To win over others' favour, they frequently offer to do things that are painful or demeaning. 

Eight areas are listed in the DSM-5 criteria for DPD. Problems starting anything without support from others, difficulty making routine decisions without assurance and advice from others, desire for others to take on responsibilities that they should be attending to, excessive need for other people's attention and support, feeling vulnerable and helpless when alone, openly and desperately seeking another relationship when one ends, and unrealistic preoccupation.2

Overview of depression in individuals with DPD

Dependent Personality Disorder (DPD) is a mental health disorder characterised by an overwhelming need for care, a fear of being alone and abandoned, and difficulties making decisions or taking charge of one's own life. DPD sufferers could also exhibit depressive symptoms.

In those with DPD, depression is a frequent co-occurring disorder. Feelings of melancholy, hopelessness, guilt, lack of enjoyment in activities, exhaustion, changes in eating or sleep patterns, and suicidal thoughts are all possible symptoms of depression. The person's fear of abandonment and reliance on others for emotional support may make these symptoms worse.

Individuals with DPD may find it challenging to get help or take action to change their circumstances if they are depressed. They could feel helpless or overburdened.

People with DPD and depression should consult a mental health expert for assistance. With the right care, people with DPD can learn to control their depressive symptoms and enhance their quality of life.1

Understanding dependent personality disorder

Symptoms of DPD

The following are possible signs of dependent personality disorder:

  • Having trouble making day-to-day decisions without assistance from others
  • Relying on others to handle important aspects of your life
  • Automatically agreeing with others 
  • Lacking the courage to start anything on your own 
  • Needing ongoing confirmation and support from others 
  • Feeling uneasy, nervous, bored, or powerless when alone 
  • A strong desire to resume dating after a relationship ends  
  • Separation anxiety1

Causes of DPD

The etiology of DPD has received very little empirical study. Family environment, social learning, severe childhood illness, and biological susceptibility have all been linked to its development. Along with these factors, specific early traumatic events, like child sexual abuse, are frequently mentioned in the literature. A developmental illness called separation anxiety disorder (SAD) has also been implicated as a risk factor for adult-onset DPD.3

Diagnosis of DPD

A mental health expert makes the diagnosis of personality disorders. They'll assess your case against the diagnostic standards for:

Personality disorders are typically diagnosed in adulthood since they are identified by enduring behavioural patterns.

One of the more contentious personality disorders in terms of sex, DPD is more typically diagnosed in individuals assigned female at birth (AFAB). Critics claim that therapists have a prejudice towards those AFAB and see this range of symptoms as more dysfunctional in them than in those assigned male at birth (AMAB).4

Depression in individuals with dependent personality disorder

Symptoms of depression in individuals with DPD

A frequent co-occurring disorder among people with DPD is depression. In people with DPD, depression symptoms can include:

  • Sadness, emptiness, or hopelessness
  • Losing interest in previously enjoyable activities
  • Guilt or worthlessness
  • Excessive or insufficient sleep changes in appetite or weight
  • Feeling worn out or low on energy
  • Having trouble focusing or making judgements
  • Suicidal or self-harming ideas

If you or someone you love is going through these symptoms, it is crucial to get expert assistance. Treatment and assistance from a mental health expert can help manage these symptoms and enhance the quality of life.1

Causes of Depression in individuals with DPD

Dependent personality disorder (DPD) patients may experience depression for a variety of reasons, including biological, environmental, cognitive, and social variables. Depression may be brought on by aberrant brain chemicals (i.e low levels of dopamine and serotonin) that are responsible for as well as a family history of the condition. 

Negative thought patterns can increase the symptoms of depression, which can also be brought on by trauma or stressful life events. Depression may also be exacerbated by difficulties in forming and sustaining supportive social relationships. Furthermore, excessive dependency on others and a fear of abandonment may keep people with DPD from receiving treatment in a timely manner, worsening their symptoms.1

Diagnosis of depression in individuals with DPD

Due to overlapping symptoms, diagnosing depression in people with DPD can be difficult. However, to enhance the patient's quality of life, accurate diagnosis and treatment are essential.

The process of diagnosing depression typically starts with a clinical interview in which a mental health practitioner inquires about the patient's symptoms, medical background, and depression-related circumstances.

To evaluate the signs of depression, anxiety, and other mental health issues, psychological tests may be utilised. It might also be useful to track patterns in the person's behaviour over time that might point to depression.

At least five of the symptoms listed below must persist for two weeks or longer to meet the diagnostic criteria for depression: decreased interest or enjoyment, changes in appetite, sleeplessness, psychomotor agitation or retardation, exhaustion, feelings of worthlessness, and a decreased capacity for mental and physical activity.

Accurate diagnosis and treatment of depression in people with DPD require a complete assessment by a mental health expert.6

Treatment of dependent personality disorder and depression

Psychotherapy options for DPD

It is advised to use psychotherapy, particularly cognitive-behavioral therapy (CBT), to treat DPD. The goal of CBT is to recognise and change harmful attitudes and behaviours that support DPD. 

It focuses on enhancing independence, boosting self-esteem, and building coping mechanisms. Another alternative is psychodynamic therapy, which focuses on underlying psychological problems that may be related to DPD.1

Medication options for depression

Depression can be successfully treated with antidepressant drugs such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). They function by raising the concentrations of specific neurotransmitters (i.e., serotonin, norepinephrine) that control mood in the brain. For maximum benefits, however, medication and psychotherapy should be combined. Before beginning any drug, it is crucial to speak with a healthcare provider.7

Self-help strategies for DPD and depression

Self-help techniques for depression and DPD include learning coping mechanisms, establishing social networks, and engaging in self-care. It can also be beneficial to learn stress-management strategies, set attainable goals, and confront unfavourable ideas. Good sleep habits and engaging in enjoyable activities like hobbies and exercise can enhance mental wellness. If symptoms continue or worsen, it is crucial to seek expert assistance.7

Prognosis and prevention

Outlook for individuals with DPD and depression

With the right care, people with depression and DPD can have a bright future. People with DPD and depression can benefit from psychotherapy, such as CBT and psychodynamic therapy, which can aid in coping skill development, self-esteem improvement, and increased independence. 

Although it should be taken in conjunction with therapy, antidepressant medication can be effective in treating depression. With the right care, people with DPD and depression can enhance their relationships, lessen symptoms, and live better. To avoid relapse, therapy should be continued even when symptoms have improved.3

Prevention strategies for DPD and depression

Addressing risk factors and fostering good coping mechanisms are important components of prevention efforts for depression and Dependent Personality Disorder. DPD risk can be decreased by strengthening one's sense of self, gaining more independence, and strengthening social ties. Depressive disorders can be prevented by developing good coping mechanisms like stress management and problem-solving techniques. 

To prevent relapse, it's critical to seek help as soon as you experience symptoms and to stay in therapy even after things get better. A balanced diet, regular exercise, and a restful night's sleep can all promote mental wellness.7


Depression and Dependent Personality Disorder (DPD) can be challenging to diagnose and treat, but accurate diagnosis and treatment can improve quality of life. Psychotherapy and medicine are available as treatment options, and improving independence and looking for early intervention if necessary are prevention tactics.


  1. Ramsay G, Jolayemi A. Personality Disorders Revisited: A Newly Proposed Mental Illness. Cureus [Internet]. [cited 2023 Jul 14]; 12(8):e9634. Available from:
  2. Furnham A. A Big Five facet analysis of sub-clinical dependent personality disorder (Dutifulness). Psychiatry Research [Internet]. 2018 Dec 1 [cited 2023 May 1];270:622–6. Available from:
  3. Disney KL. Dependent personality disorder: A critical review. Clinical Psychology Review [Internet]. 2013 Dec 1 [cited 2023 May 1];33(8):1184–96. Available from:
  4. Anderson KG, Sankis LM, Widiger TA. Pathology versus statistical infrequency: potential sources of gender bias in personality disorder criteria. J Nerv Ment Dis. 2001 Oct;189(10):661–8.
  5. Uguz F, Akman C, Sahingoz M, Kaya N, Kucur R. One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders. J Psychosom Obstet Gynaecol. 2009 Jun;30(2):141–5.
  6. Skodol AE, Gallaher PE, Oldham JM. Excessive dependency and depression: is the relationship specific? J Nerv Ment Dis. 1996 Mar;184(3):165–71.
  7. Dependent personality disorder (Dpd) - psychiatric disorders [Internet]. MSD Manual Professional Edition. [cited 2023 May 1]. Available from:
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Neha Minocha

Neha Minocha is a dentist from India and completed her Masters of Public Health from the University of York, United Kingdom, in 2022.

Her research interests include behavioral economics, health and social behavior, systematic reviews, qualitative research, mental health research, and epidemiology.

She is passionate about medical writing and advocating for mental health among young individuals. She is currently volunteering as a group facilitator for a mental health organisation and is an ambassador for Covidence.

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