What is Dependent Personality Disorder?
Dependent Personality Disorder (also known as DPD or asthenic personality disorder) is characterized by a long-standing need to be cared for - and fear of being abandoned by - important individuals. This leads the person with Dependent Personality Disorder to engage in submissive, dependent behaviors that inspire caregiving behavior in others around them.
Those who suffer Dependent Personality Disorder are often plagued by self-doubt and pessimism. They tend to minimize their own abilities and strengths, consider themselves stupid, and appear clingy to those on the outside. People with Dependent Personality Disorder take criticism as evidence of their own worthlessness and, subsequently, lose faith in their abilities.
They may seek dominance and over-protection from others, which can cause problems at work if placed in positions of responsibility or decision-making. Likewise, the individual with Dependent Personality Disorder may limit friendships and other social obligations to those they trust and upon whom they can be dependent.
Symptoms of Dependent Personality Disorder:
Symptoms are similar to those of other personality disorders and may include:
- Unstable relationships
- Trouble making/keeping friends
- Unstable mood and/or angry outbursts
- Poor impulse control
- Social isolation
- Substance or alcohol abuse
- Need for instant gratification
Diagnostic Criteria For Dependent Personality Disorder via DSM-IV:
In order to meet the diagnostic criteria for Dependent Personality Disorder as set forth in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, DSM IV-TR, the individual must exhibit at least five of the following (in Axis II Cluster C):
- Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
- Needs others to assume responsibility for most major areas of his or her life.
- Has difficulty expressing disagreement with others for fear of loss of support or approval. Note: does not include realistic fears of retribution.
- Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
- Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
- Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for him/herself.
- Urgently seeks another relationship as a source of care and support when an established close relationship ends.
- Is unrealistically preoccupied with fears of being left to take care of him/herself.
It is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
The individual also must be over 18 years of age to be diagnosed with a personality disorder.
Questions Asked While Diagnosing Dependent Personality Disorder:
These are examples of questions asked during assessment of Dependent Personality Disorder:
- Do you worry about people in your life leaving you?
- Are you desperate to enter into a new relationship when another one ends?
- Is it hard to be alone?
- Do you pretend to agree with others when you don't agree?
- Do you need help to work on a project?
- Is it hard to express an opinion different from someone else's?
- Do you do unpleasant tasks for others so they will take care of you when you need it?
How Is Dependent Personality Disorder Diagnosed?
Diagnosis of a personality disorder is often performed not by a general practitioner or family doctor, but by a trained mental health professional. There are no blood tests, laboratory studies, or genetic tests that will provide a diagnosis of Dependent Personality Disorder.
Many people with personality disorders do not seek treatment until the disorder begins to significantly impact their life - often when a person is overly stressed or dealing with major life events.
A diagnosis of Dependent Personality Disorder is made by a psychologist or psychiatrist after carefully comparing a detailed life history with the symptoms and diagnostic criteria for the disorder.
Treatment Of Dependent Personality Disorder:
Goals for treatment of those with Dependent Personality Disorder are aimed at preventing further deterioration, regaining - and learning new - adaptive skills, and alleviating symptoms. Treatment should teach methods of managing stress and distress, improving interpersonal relationships and learning new stress-managing skills.
Treatment is generally focused upon teaching autonomy (the capacity for independence) and the ability to develop functional interpersonal relationships.
Psychotherapy is the treatment of choice for those with Dependent Personality Disorder - focused primarily upon specific and current life problems. Long-term therapy is contraindicated for those with Dependent Personality Disorder as it will reinforce the dependency of the individual with Dependent Personality Disorder upon a therapist.
Those with Dependent Personality Disorder are often needy - requiring attention, validation, and social contact. Someone who has Dependent Personality Disorder may want extra attention to be paid to their complaints (whatever they may be about).
A person with Dependent Personality Disorder will often appear outwardly compliant but be passive in their treatment. Therapeutic gains may be hard to attain because the person with Dependent Personality Disorder may only be passively compliant.
Therapists who work with Dependent Personality Disorder should be careful, as people with the disorder may become excessively dependent upon their therapist. This may threaten the therapeutic relationship between the client and the therapists, as the needs of the individual with Dependent Personality Disorder may overstep the limits of the patient/doctor relationship. Boundaries must be set and stuck to.
Medications are not appropriate for treating Dependent Personality Disorder, although they may be prescribed to address other psychiatric diagnoses. Individuals with Dependent Personality Disorder often abuse sedatives and anti-anxiety agents, so it is with great care that a physician should prescribe these drugs.
Group therapy may be helpful for those with Dependent Personality Disorder, if it is run by a moderator familiar with the disorder. Those with Dependent Personality Disorder must avoid using a support group as the only means of treatment as it may encourage further dependent behaviors and relationships.
Additional Resources For Dependent Personality Disorder:
Out of the Fog - provides information and support to the family members and loved-ones of individuals who suffer from a personality disorder.
National Mental Health Consumers Self-Help Clearing House - provides information, directory of services, publications, training packages and consultation to help individuals advocate for mental health reform and fight the stigma and discrimination associated with mental illness.
National Association of Mental Illness (NAMI) – the most formidable grassroots mental health advocacy organization in the country. NAMI is dedicated to improving the lives of individuals and families affected by mental illness by providing information, access to services, support and funding for research.
Psych Central Personality Disorder Support Groups – list of all personality disorder support groups on the internet and beyond.