Insights into Psychology

What Is… Dependent Personality Disorder

head with cogs inside

In this series, I dig a little deeper into the meaning of psychology-related terms.  This week’s term is dependent personality disorder.

Dependent personality disorder (DPD) falls within cluster C, the anxious/avoidant personality disorders, in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). People with DPD believe they’re unable to care for themselves, and behave submissively in an attempt to have others to take care of them and make decisions for them. This is different from actually requiring care due to decreased ability to care for oneself; DPD is about decreased perceived ability.

Symptoms

Symptoms in the DSM-5 include:

  • “A persistent, excessive need to be taken of, resulting in submissiveness and clinging”
  • Difficulty with daily decisions without +++ reassurance/advice from others
  • Needing others to take responsibility for most areas of their life
  • Reluctant to disagree with others out of fear of losing their approval
  • Difficulty initiating projects because they don’t trust their own judgment/abilities
  • Willing to go to significant/unpleasant lengths to get support from others
  • Feel helpless when alone due to fear of not being able to care for oneself
  • When one close relationship ends, there is a sense of urgency to find a replacement relationship
  • Unrealistic, excessive focus on the idea of not being able to take care of oneself

It’s perfectly normal to have some of these symptoms to some extent some of the time. It only rises to the level of a disorder when there’s a significant impact on overall functioning. Like any personality disorder, it starts to appear early and is well-established by adulthood, and is consistent over time.

It’s worth mentioning that dependency is not the same as codependency. Codependency is the need to feel that someone else depends on you. If I have a partner with an addiction and I feel the need to play the caregiver role for him, that’s codependency, whereas if he feels like he needs me to take care of him, that’s dependency.

Prevalence and risk factors

DPD occurs in less than 1% of the population. Symptoms are consistent across time and across situations. Some studies have shown that it’s more common in women than men, while others have shown it’s pretty much equal.

There’s no clear cause, but there appears to be a mix of biological and environmental factors that can contribute. Twin studies have suggested here is a heritable component. People with DPD often have a history of childhood abuse or neglect. Having overprotective or authoritarian parents is also a risk factor, as is a family history of anxiety disorders.

People with DPD commonly have another comorbid condition, such as depression, anxiety, alcohol use disorder, or another personality disorder. They may develop social phobia, as they don’t like to leave people and places that feel safe. They may also develop separation anxiety, as they feel abandoned when their support people aren’t present.

Treatment

Psychodynamic psychotherapy and cognitive behavioural therapy (CBT) can be helpful, although it’s important to avoid establishing dependency in the therapeutic relationship. There’s some indication that antidepressants may help somewhat. Benzodiazepines shouldn’t be used in this population due to the risk of developing an addiction.


I didn’t come across this very often as a nurse, if at all. People who were dependent, sure, but DPD, not much. I’m a very independent person, and even trying to conceptualize in my head what this might feel like just does not compute. It sounds like a very difficult way to go through life.

Is this something you’ve ever come across?

Sources

The Psychology Corner: Insights into psychology and psychological tests

The Psychology Corner has an overview of terms covered in the What Is… series, along with a collection of scientifically validated psychological tests.

Visit the MH@H Resource Pages hub to see other themed pages from Mental Health @ Home.

24 thoughts on “What Is… Dependent Personality Disorder”

  1. I’m not sure if I’ve ever encountered it, but when you mentioned neglect, that clicked in my mind as something that could definitely contribute to this disorder. I don’t have much direct experience with neglect, but for some reason, I can totally picture it leading to this issue.

    Hmm…. have I ever encountered DPD… I’m a bit dependent on my dad, but it’s actual dependency rather than the perceived kind. Like, for example, he has to get my prescriptions for me because I can’t handle going to the pharmacy. (When they ask for my birthdate, I feel that they’re being presumptuous. My birthdate3 is sacred and would let them see into my soul. All for meds!) But I can’t think of, like, if I’ve ever encountered anyone with this disorder! It must be rare indeed!

  2. I appreciate the clarity in this post, especially the concrete difference between dependency and codependency. It’s a difficult distinction to explain sometimes.

  3. I wonder how this changes during life as people age? I wouldn’t say it was DPD, but it did instantly make me think of this girl I new in school, a friend of mine. She was taller than me but she and her nan would ask me to walk by her house in the mornings to walk with her to school. This went on up to high school so around age 13. She would deflect all the time with homework and get me to help her. Anything she did, she made out like she couldn’t do and wanted me to do or help her with it.

    She was doted on by her mum and nan, who’d take her on holidays, buy more expensive things than my family could afford, ensure she’d picked up after school so she never walks on her own (wise, but she was still like this age 16). I think some dependency was nurtured by her family. She’d make me feel guilty if I didn’t help her and she could be pretty passive aggressive. Again, not DPD but it makes me wonder what she’s like now. I’ve no idea.

    You’ve covered this really well as always, Ashley. You should re-write all the psych textbooks I used to have in college & for my degree. xx

    1. Aw, thanks! ❤️

      That’s a really interesting story. Neglect probably messes kids up more, but sheltering a kid too much isn’t healthy either.

    2. This is what I was wondering: can this behaviour be trained into a child. Would a child with a parent with a proxy disorder like Munchausen develop these kinds of traits and responses?

      1. That’s a very interesting question. I couldn’t find anything that specifically linked those two, but it certainly seems like it would make sense.

  4. I need reassurance a lot. To be transparent. It’s just something I require. Thanks for sharing about this disorder. Though, too, I don’t think I have it. It was interesting reading about it.

  5. I’ve expressed my opinion on this one before. There are so many “disorders” in relation to personality that I am starting to wonder what is not a disorder? Do you know what I mean? There are submissive in BDSM world who are happy to be controlled all day long every day – lifestyle people. While I am personally far too independent to ever be a “lifestyle” slave, the last thing I think is “these people have a personality disorder” what I think is “wow, awesome for them that they recognized this need and found someone to control them who has just as much need in the opposite direction for total control of someone”. Yeah this makes me suspicious. What is a disordered personality in comparison to just a rebel, a kinky person, a passionate art person, etc. This makes me suspicious of all the personality disorder classifications.

    1. For something to be considered a personality disorder, it has to be an inflexible pattern that causes distress and/or impairs functioning. Leading an “alternative” kind of lifestyle is likely flexible, in the sense that it’s a conscious choice, and it doesn’t cause distress or impair someone’s ability to live their life the way they want to live it.

    1. It sounds like early relationships with caregivers has a big impact, and the person comes to see themselves as needy and helpless while attachment figures are seen as competent. Freud thought it was a fixation at the oral stage of psychosexual development.

  6. I suppose the perfect marriage would be when a DPD and a benevolent Codependent. I wonder how often this occurs. I suppose that two people who are not abusive would have a wonderful marriage if they needed each other for psychological fulfillment. It appears that those who have long enduring marriages must experience these feelings of dependency, especially as they get older. Where does normal end and abnormal begin in absence of some other regressive trait?

    1. I think to be diagnosed with DPD, or at least diagnosed appropriately, the dependence is to such an extreme that it makes it very difficult for them to maintain social relationships. My parents have been married almost 50 years and I would say they’re interdependent in quite a balanced way.

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