When we refer to a person’s personality, we are essentially talking about the characteristics and behaviours that make up a person. This includes the person’s interests, emotions, thought patterns and values.1
A personality disorder is the expression of extreme personality traits.2 These traits result in a person thinking and acting in a way that goes against societal expectations. The extreme expression of these personality traits typically causes distress in the individual’s life, affects their daily life and can cause significant suffering. The behaviour demonstrated by a person with a personality disorder is a long-lasting, regular pattern, rather than a once-off occurrence.3
Navigating your way through life requires some level of dependency. At countless stages in life, you may find yourself relying or counting on people for certain things, however, dependent personality disorder is when an individual’s dependency on others is on the far end of the spectrum. People with dependent personality disorder tend to feel helpless, are generally overly submissive in their relationships and have trouble making simple decisions.4
This article will take you through some of the key characteristics of dependent personality disorder, how it is diagnosed, and some of the factors that increase an individual’s chances of developing this particular personality disorder.
Causes of dependent personality disorder
Personality disorders in general are quite complex and still not fully understood. The same is true for dependent personality disorder specifically, experts are not sure of the exact causes of it. However, there is a general understanding that several factors may increase a person’s likelihood of developing a dependent personality disorder. Current thinking surrounding dependent personality disorder places genetics as the main factor that influences the development of the personality disorder. Other factors include a person’s environment and their development.5
Signs and symptoms of dependent personality disorder
To be classified as a personality disorder, the behaviour exhibited by an individual has to have longstanding/long-term behaviour patterns that differ significantly from cultural expectations.
The pattern is seen in at least two of the following areas:
- Thinking about oneself and others
- Responding emotionally
- Relating to other people
- Controlling one's behaviour5
There are 3 groups that personality disorders may belong to, namely, cluster A, cluster B or cluster C. Dependent personality disorder belongs to cluster C which is the subgroup with disorders that highlight anxious or fearful behaviours. Other personality disorders in this group are avoidant personality disorder and obsessive-compulsive personality disorder.
The main characteristics of people with dependent personality disorder are extreme dependence on others and the extreme feeling of needing to be taken care of. These characteristics can be displayed through the following signs and symptoms:
- Clingy or submissive behaviour
- Afraid to provide self-care
- Struggles when left alone
- Has trouble starting or carrying out activities due to low self-confidence
- Difficulty making small decisions
- Fears disapproval- struggles to say no to others or disagreeing with others
- Oversensitivity to criticism
- Tolerates poor or abusive treatment, even when other options are available
- Transfers responsibility to others
- Sense of helplessness when a relationship ends and rushes to start a new relationship4, 6
Management and treatment for dependent personality disorder
Management and treatment of dependent personality order is centred around helping the individual build self-confidence by helping improve the way they think of themselves.7 Management also largely involves helping the individual learn how to form healthy relationships with other people. 2
A mental health provider can help you manage dependent personality disorder. They may offer advice and give you techniques that you can implement into your life to help increase your self-esteem and to handle various situations better. This can be done through cognitive-behavioural therapy (CBT). Your mental health provider will work on helping you to become more independent. They will also encourage you to form healthy, meaningful relationships with others as this can help you overcome some of the symptoms of dependent personality disorder.4
It is important to bare in mind that results are not instantaneous. Psychotherapy such as CBT works through progress, it will take some time before you start to feel better and see the impact of your CBT sessions in your daily life. It is important to build a solid foundation of healthy behaviours and ways of thinking that you can implement in your everyday life, and doing so takes time.
Dependent personality disorder may come with associated symptoms such as anxiety and depression. If this is the case for you, then your healthcare provider may prescribe medication for your anxiety and depression.
How is dependent personality disorder diagnosed?
When it comes to mental health-related disorders, a few of them have overlapping symptoms.8 Therefore, to ensure that the individual receives the most appropriate and effective treatment and management options, it is important to make an accurate diagnosis.
Dependent personality disorder is diagnosed by a mental health provider. They will ask you about your past mental health history and will ask about signs and symptoms you may be presented with and how these have affected your day-to-day life. Although extremely difficult, it is important to open up as much as possible so that your healthcare provider gets an accurate picture of what you are experiencing and how it is affecting you. This will help to reduce the chances of a misdiagnosis.
For a dependent personality disorder diagnosis, an individual should display an excessive need to be taken care of, which results in being extremely clingy and submissive. This will be shown through an individual having 5 or more traits from the DSM-5 diagnostic criteria. These could be any 5 of the following:
- All-consuming, unrealistic fear of being abandoned
- Difficulty making decisions without a lot of f reassurance and advice from others
- Anxious or helpless feelings when alone and struggling to take care of oneself
- Inability to manage life responsibilities without seeking help from others
- Difficulty disagreeing with others- struggles to state an opinion out of fear of losing support or approval
- Strong drive to get support from others, even choosing to do unenjoyable things to get it
- Trouble starting or completing projects because of a lack of self-confidence or ability to make decisions
- Urge to seek a new relationship to provide support and approval when a close relationship ends4,9
Who is at risk of dependent personality disorder?
As mentioned previously, although the cause of dependent personality disorder, as well as other disorders, is still not fully understood, some factors increase the risk of someone getting dependent personality disorder.
The environment you are currently in (if not yet an adult) or the environment you grew up in can be a contributing factor in why you have developed dependent personality disorder. The environment describes being put in situations where you have unfortunately experienced traumatic events such as:
- Abusive relationships
- Abandonment during childhood
- Other childhood trauma
Although these factors may increase your likelihood of developing dependent personality disorder, not everyone who experiences traumatic events goes on to develop a personality disorder. In the same respect, not everyone with a personality disorder has had a traumatic experience.
Having a relative, in particular, a first-degree relative with dependent personality disorder or another anxiety disorder increases your chances of developing it as well. This could either be from a genetic standpoint or learned behaviours and responses to some of the behaviours that your relatives may have displayed.10
Culture and Religion
Some cultures and religious practices that highlight the need to overly rely on authority may cause people to develop dependent personality disorder. However, passivity and politeness by themselves are not signs of dependent personality disorder.11
Can dependent personality disorder be prevented?
Since the cause of dependent personality disorder is poorly understood, it is hard to derive preventative measures from the available information . However, treatment such as CBT can help those at risk of developing dependent personality disorder to avoid developing thinking patterns that promote low self-confidence and over-reliance on others.
Some studies suggest that healthy, meaningful relationships may help prevent children from developing dependent personality disorders later in life. One good, strong, healthy relationship may counter the harmful effects of any other toxic relationship that the child may have.4.
How common is dependent personality disorder?
According to mentalhealth.org, approximately 1 in 20 people in the UK have a personality disorder. Of all the personality disorders from clusters A-C, dependent personality disorder according to cambridge.org is the least common accounting for 0.78% of all personality disorders.
When should I see a doctor?
If you exhibit some of the signs and symptoms mentioned in this article, then the best thing to do is to see your doctor or other primary care professional. Your healthcare provider will then refer you to a mental health professional if appropriate.
It is advised that you see a healthcare professional if you experience any of the following:
- Frequent feelings of anxiety
- Irritability or moodiness
- Loss or change in appetite
- Persistent negative thoughts about yourself
- Trouble concentrating4
Dependent personality disorder can cause anxiety and depression if left untreated. Therefore, if you do experience any of the previously mentioned symptoms, it is important to schedule an appointment with a healthcare professional as soon as possible.
Mental health professionals aim to assist you in finding ways that you can cope with difficult situations. For dependent personality disorder specifically, they aim to help you learn to become more self-confident and self-reliant. This in turn will hopefully reduce the distress you may be experiencing in your day-to-day life and reduce the amount of suffering experienced. Over time, with the help of your provider, you may start to feel better.6
Dependent personality is a cluster C personality disorder where individuals have a strong need to be taken care of and display extreme traits of submissiveness and clinginess. With the help of a mental health professional through interventions such as cognitive-behavioural therapy, individuals can learn healthy behaviours. Individuals with dependent personality disorder can learn how to form healthy relationships with others and improve their self-confidence and change their self-perception.
- American Psychological Association. Personality. American Psychological Association [Internet]. 2022; Available from: https://www.apa.org/topics/personality
- Ekselius L. Personality disorder: a disease in disguise. Upsala Journal of Medical Sciences [Internet]. 2018 Oct 2;123(4):194–204. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327594/
- Robitz R. What Are Personality Disorders? [Internet]. Psychiatry.org. 2022. Available from: https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
- Cleveland Clinic. Dependent Personality Disorder (DPD) | Cleveland Clinic [Internet]. Cleveland Clinic. 2017. Available from: https://my.clevelandclinic.org/health/diseases/9783-dependent-personality-disorder
- CEMM. Personality Disorders [Internet]. CEMM. 2023 [cited 2023 Feb 22]. Available from: https://www.cemm.af.mil/Programs/Mental-Health/Personality-Disorders/Risk-Factors-and-Causes/
- Mayo Clinic. Personality disorders - Symptoms and causes [Internet]. Mayo Clinic. 2016. Available from: https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463
- Ward RK. Assessment and Management of Personality Disorders. American Family Physician [Internet]. 2004 Oct 15 [cited 2023 Feb 23];70(8):1505–12. Available from: https://www.aafp.org/pubs/afp/issues/2004/1015/p1505.html#characteristics-and-management-strategies
- Ramsay G, Jolayemi A. Personality Disorders Revisited: A Newly Proposed Mental Illness. Cureus. 2020 Aug 9;12(8).
- Zimmerman M. Dependent Personality Disorder (DPD) [Internet]. MSD Manuals. 2021 [cited 2023 Feb 23]. Available from: https://www.msdmanuals.com/professional/psychiatric-disorders/personality-disorders/dependent-personality-disorder-dpd#v25247211
- Discovery Mood. Five Signs Your Anxiety May Stem From Your Family History [Internet]. Discovery Mood & Anxiety Program. 2019. Available from: https://discoverymood.com/blog/five-signs-anxiety-may-stem-family-history/
- Solmi M, Dragioti E, Croatto G, Radua J, Borgwardt S, Carvalho AF, et al. Risk and Protective Factors for Personality Disorders: An Umbrella Review of Published Meta-Analyses of Case–Control and Cohort Studies. Frontiers in Psychiatry. 2021 Sep 6;12.