What Is Dependent Personality Disorder (DPD)?

Dependent personality disorder (DPD) is one of several personality disorders outlined in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). Someone with DPD has a pervasive and excessive need to be taken care of. The condition belongs to a group of personality disorders characterized by high levels of anxiety. 

Personality disorders can make having healthy relationships difficult and can be severe enough to impact functioning in daily life.

The symptoms of DPD can be challenging to manage. Personality disorders do not have an approved standard medication treatment, but therapy is often a crucial part of a treatment plan for DPD. When treated, there is a high chance of improvement for a person with this condition.

Here are a few more things that you should know about DPD, including its common symptoms and ways to cope.

Symptoms

Individuals with dependent personalities often rely on those they are close to for their emotional and physical needs. They tend to feel helpless and find it difficult to make everyday decisions as they may believe they are incapable of doing so alone.

Common symptoms of DPD include:

• Fear of being alone
• Avoiding taking initiative or responsibility
• Sensitivity to criticism
• Lack of opinions

Diagnosis

A primary care physician can do an initial screening for DPD, but they will need to refer you or your loved one to a licensed mental health professional for an official diagnosis. 

According to the criteria described in the DSM-5, a diagnosis of DPD will be made if five of the following eight symptoms are present:

• Unable to make everyday decisions without reassurance from others
• Allows others to make important decisions in their life
• Agrees with people even if they think that they are wrong; fears the loss of approval
• Difficulty initiating projects because of a lack of self-confidence
• Performs unpleasant and excessive tasks to obtain approval from others
• Dislikes being alone with feelings of helplessness
• Devastated when close relationships end and urgently seeks replacement
• Preoccupation with fears of abandonment and being left to care for themselves

Diagnosing personality disorders can be challenging because the clinical symptoms can overlap with those of other mental health conditions. For example, major depressive disorder shares some symptoms with DPD, which can lead to a person being misdiagnosed or undiagnosed.

A diagnosis is also complicated by high rates of comorbidity—the presence of two or more conditions at the same time—in people with personality disorders.

Patient Responsibility 

To help make sure that you get an accurate diagnosis, it’s important to have an open and full conversation about your symptoms with your healthcare provider. Giving your doctor this vital information will lower the chance of misdiagnosis and allow you to get treatment as soon as possible.

The exact cause of DPD is unknown, but the condition has been linked to different risk factors, including genetics, environment, and development.

For example, people with DPD are more likely than people without the condition to have experienced:

• Abusive relationships
• Childhood trauma
• Cultural or religious practices that emphasize reliance on authority

Treatment

Personality disorders do not tend to respond well to medication; however, medication might be part of your treatment plan if you have another mental health condition in addition to DPD.

Therapy

The main treatment for personality disorders is therapy. Several types of psychotherapy can be used to treat personality disorders.

Examples of some of the most common methods used are:

• Cognitive behavioral therapy (CBT): The goal of this type of therapy is to help people learn how to identify and change destructive or dysfunctional thought patterns.
• Dialectical behavior therapy (DBT): This type of CBT aims to teach people how to manage emotions more effectively, and be more mindful and effective in their relationships with others.
• Psychodynamic therapy: This method is a form of talk therapy that helps people better understand their underlying motivations.
• Family therapy: This type of therapy focuses on issues that specifically affect families’ mental health and functioning.

Causes

Medication

If someone with DPD also has another mental health condition, such as depression or anxiety, there are some medications that might be prescribed to help with their symptoms.

• Anti-anxiety medications: These can rapidly reduce the symptoms of anxiety and panic attacks. The most common type is benzodiazepines (a sedative).
• Antidepressants: The most commonly prescribed antidepressants for anxiety and depression are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Coping

Seeking professional support is very important if you have DPD. Learning to live and cope with your symptoms will also be a key part of your recovery.

Some elements of coping with DPD that you will work on include:

• Sticking with treatment: Make sure that you keep your appointments and therapy sessions. Do not stop taking medications without talking to your doctor.
• Knowing your triggers: Your therapist will help you identify the things that trigger your symptoms, as well as teach you strategies for dealing with triggering situations. Practicing these strategies will help reduce anxiety.
• Practicing self-care: Taking care of your body and your mind means doing things like getting enough sleep, exercising regularly, and eating a nutritious diet. It’s also important to avoid alcohol and other substances, which can exacerbate your symptoms.

How to Maintain Relationships With DPD

While there is nothing wrong with talking with the people in your life about decisions you make, if you have DPD, you may automatically turn to others for help.

If you feel incapable of doing anything alone, it can have a negative effect on your relationships with family, friends, partners, children, and coworkers. Part of your treatment will be developing skills to help you have healthy relationships with others.

Examples of things you might work on in recovery include:

• Practicing self-sufficiency and assertiveness skills
• Learning to cope with fears of being alone
• Practicing decision-making
• Becoming comfortable spending time on your own
• Learning to express disagreement in productive ways

Frequently Asked Questions 

How is DPD different from BPD?

Both borderline personality disorder (BPD) and DPD are characterized by a fear of abandonment. However, unlike in DPD where someone might react to this fear with submissive or clingy behavior, people with borderline personality disorder react to these experiences with symptoms of rage, impulsivity, and aggression, and tend to see the world as “black and white” with no middle ground.

A person with borderline personality disorder will also typically have a pattern of unstable and intense relationships.

What does treatment for dependent personality disorder look like?

For most people, therapy will be the main treatment for DPD. If you have comorbid mental health conditions, such as depression or anxiety, your treatment plan may also include medications. 

Can I have a healthy relationship with DPD?

It is possible to have healthy relationships if you have DPD. Part of your treatment plan will be developing strategies to help you maintain healthy relationships with the people in your life.

How reliable is the DSM? 

Using the DSM does not eliminate the risk of misdiagnosis. The diagnostic criteria in the DSM for DPD have not significantly changed since 1987.

The DSM is recognized as having increased the reliability of psychiatric diagnosis; however, there are still many factors that can impact reliability in a typical psychiatric interview.

According to some experts, the limitations mean that the reliability of psychiatric diagnoses is still relatively poor.

A Word From Verywell

Dependent personality disorder can have a negative effect on a person’s life—especially their relationships with others. However, a person can learn to have healthy relationships with the right treatment.

Talk therapy is usually the most effective way to help people with DPD. If you have DPD and another mental health condition, such as depression, your doctor might prescribe medications like antidepressants.

If a loved one has DPD, you can support them by encouraging them to express their feelings and opinions, and letting them make their own decisions.

Whether you have DPD or you love someone with DPD, joining a support group—whether in person or online—can also be helpful.