Dependent Personality Disorder (DPD) is a mental health condition characterized by a pervasive and excessive need to be taken care of, which leads to submissive and clinging behavior and fears of separation.
The diagnostic criteria for DPD are outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To meet the criteria for DPD, an individual must exhibit a pervasive pattern of the following:
- Submissive and Clinging Behavior:
- The person has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
- They need others to assume responsibility for most major areas of their life.
- Fear of Separation:
- They have difficulty expressing disagreement with others because of fear of loss of support or approval.
- They feel uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themselves.
- Subordination of Needs:
- They go to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
- Low Self-Confidence:
- They have difficulty initiating or doing things independently (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
- Reluctance to Make Decisions:
- They have difficulty starting projects or doing things on their own due to a lack of self-confidence in judgment or abilities.
- Preoccupation with Abandonment:
- They urgently seek another relationship as a source of care and support when a close relationship ends.
- Other Criteria:
- The submissive and clinging behavior is not solely focused on a specific person who is caring and supportive, as occurs in a separation anxiety disorder.
These symptoms must be persistent and pervasive across a variety of situations, leading to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Differential Diagnosis:
It’s important to differentiate Dependent Personality Disorder from other conditions that may present with similar features, such as:
- Borderline Personality Disorder: Both may involve fears of abandonment, but DPD lacks the impulsivity and unstable self-image characteristic of borderline personality disorder.
- Social Anxiety Disorder: DPD may involve fear of disapproval or criticism, but social anxiety disorder primarily centers around fear of negative evaluation in social situations.
- Avoidant Personality Disorder: While both disorders may involve interpersonal difficulties, DPD focuses more on a need for nurturance and support, whereas avoidant personality disorder involves fear of rejection and feelings of inadequacy.
Treatment:
Treatment for Dependent Personality Disorder typically involves psychotherapy, particularly:
- Cognitive Behavioral Therapy (CBT): Helps individuals challenge and change their maladaptive beliefs and behaviors.
- Psychodynamic Therapy: Focuses on exploring underlying unconscious conflicts and fostering self-awareness.
- Supportive Therapy: Provides validation and guidance in developing healthier coping strategies and assertiveness skills.
In some cases, medication may be prescribed to alleviate symptoms such as anxiety or depression, which can co-occur with DPD. Treatment approaches are tailored to the individual’s specific needs and severity of symptoms, aiming to improve overall functioning and quality of life.