Dependent personality disorder is a mental health condition that is characterized by a pervasive, excessive need to be taken care of, leading to submissiveness and clinging behaviors.
People with dependent personality disorder do not think they can take care of themselves and use submissiveness to try to get other people to take care of them.
Doctors diagnose dependent personality disorder based on specific symptoms, including a person's need to be taken care of and fear of having to take care of self.
Psychotherapy that focuses on examining fears of independence can help.
Personality disorders are mental health conditions that involve long-lasting, pervasive patterns of thinking, perceiving, reacting, and relating that cause the person significant distress and/or impair the person's ability to function.
People with dependent personality disorder want to be taken care of and are extremely anxious about taking care of themselves. To get the care they want, they are willing to give up their independence and interests. They thus become excessively dependent and submissive.
Dependent personality disorder occurs in less than 1% of people in the United States. It is diagnosed more often in women, but some studies suggest it affects both sexes equally.
Other disorders are also often present. People often also have one or more of the following:
A depressive disorder such as major depressive disorder or persistent depressive disorder
Another personality disorder (such as borderline or histrionic)
Causes of Dependent Personality Disorder
Information about what causes dependent personality disorder is limited. Factors that may contribute include
Cultural factors
Negative early experiences
An inborn tendency to be anxious
Traits that run in families (such as submissiveness, insecurity, and self-effacing behavior)
Symptoms of Dependent Personality Disorder
Need for care
People with dependent personality disorder do not think they can take care of themselves. They use submissiveness to try to get others to take care of them.
People with this disorder typically require much reassurance and advice when making ordinary decisions. They often let others, often one person, take responsibility for many aspects of their life. For example, they may depend on their spouse to tell them what to wear, what kind of job to look for, and with whom to associate.
People with dependent personality disorder tend to interact socially with only the few people they depend on. When a close relationship ends, people with this disorder immediately try to find a replacement. Because of their desperate desire to be taken care of, they may not be discriminating in choosing a replacement.
People with dependent personality disorder have an excessive fear of abandonment by those they depend on, even when there is no reason to.
Excessive submissiveness
Because people with dependent personality disorder fear losing support or approval, they have difficulty expressing disagreement with others. They may agree to something they know is wrong rather than risk losing the help of others. Even when anger is appropriate, they do not get angry at friends and coworkers for fear of losing their support.
People with dependent personality disorder go to great lengths to obtain care and support. For example, they may do unpleasant tasks, submit to unreasonable demands, and even tolerate physical, sexual, or emotional abuse. Being alone makes them feel extremely uncomfortable or afraid because they fear they cannot care for themselves.
Lack of confidence
People with dependent personality disorder consider themselves inferior and tend to belittle their abilities. They interpret any criticism or disapproval as proof of their incompetence, further undermining their confidence.
Lack of independence
Because people with dependent personality disorder are sure that they cannot do anything on their own, they have difficulty starting a new task and working independently. They avoid tasks that require taking responsibility. They present themselves as incompetent and in need of constant help and reassurance. When reassured that a competent person is supervising and approving of them, people with dependent personality disorder tend to function adequately. However, they do not want to appear too competent lest they be abandoned. As a result, their career may be harmed. They perpetuate their dependency because they avoid learning the skills of independent living.
Diagnosis of Dependent Personality Disorder
A doctor's evaluation, based on standard psychiatric diagnostic criteria
Doctors usually diagnose personality disorders based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed, Text Revision (DSM-5-TR), the standard reference for psychiatric diagnosis from the American Psychiatric Association.
For doctors to diagnose dependent personality disorder, people must have a persistent, excessive need to be taken care of, resulting in submissiveness and clinging behavior, as shown by at least 5 of the following:
They have difficulty making daily decisions without an excessive amount of advice and reassurance from other people.
They want to have other people be responsible for most important aspects of their life.
They have difficulty expressing disagreement with others because they are afraid of losing support or approval.
They have difficulty starting projects on their own because they are not confident in their judgment and/or abilities (not because they lack motivation or energy).
They are willing to go to great lengths (for example, do unpleasant tasks) to obtain support from others.
They feel uncomfortable or helpless when they are alone because they fear they cannot take care of themselves.
When a close relationship ends, they feel an urgent need to establish a new relationship with someone who will provide care and support.
They are preoccupied with fears of being left to take care of themselves.
Also, symptoms must have begun by early adulthood.
Treatment of Dependent Personality Disorder
Cognitive-behavioral therapy
Psychodynamic psychotherapy
The general principles for treatment of dependent personality disorder are similar to those for all personality disorders.
Psychodynamic psychotherapy and cognitive-behavioral therapy that focus on examining fears of independence and difficulties with asserting themselves can help people with dependent personality disorder.
Whether medications are useful is unclear. Sometimes antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may be used to treat depression and anxiety.
