Living with dependent personality disorder can be a challenge and it’s understandable that many people find it difficult to manage. However, there are plenty of options for help, ways to cope and to live a happy, healthy life.
Dependent personality disorder (DPD) is a mental health disorder that affects a person’s ability to relate to other people and situations in a healthy manner. It particularly affects relationships due to a tendency for over-reliance on others. This dependency on other people can be linked with a lack of self-confidence in their own abilities.
Approximately one to two percent of the general population suffer from DPD. The disorder is diagnosed in females more than men, according to the American Psychiatric Association.
Research into dependent personality disorder is ongoing and there is not a definitive cause discovered yet. However, preliminary research has shown that people who suffered from separation anxiety disorder in childhood or adolescence or those who had a chronic physical illness in childhood, are at greater risk of developing DPD.
Research by The Cleveland Clinic found that one possible risk factor is very strict authoritarian or overprotective parenting.
People with dependent personality disorder typically have an excessive fear of being alone and struggle with independence.
Decision making is difficult and can be a source of great stress. A person with dependent personality disorder will rely on others to make decisions for them, whether it be a significant and life-changing decision, or a small, everyday choice.
An individual with DPD will usually have great difficulty in expressing their own opinion, especially if that opinion is in disagreement with others. Instead, they will vehemently agree, even at their own expense, for fear of disapproval, rejection, and abandonment.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), the diagnostic criteria for DPD is:
A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
-The individual has a hard time making everyday decisions without an abundance of advice and reassurance from others.
-The individual needs someone else to take over major areas of his or her life.
-The individual has a difficult time disagreeing with others due to his or her fear of losing support and/or approval.
-The individual has trouble doing anything on his or her own, due to a lack of self-confidence in their capabilities.
-The individual does whatever it takes to receive support and nurturance from other.
-The individual feels uncomfortable alone because he or she fears an inability to take care of himself or herself.
-The individual searches for another relationship for care when a close one ends.
-The individual unrealistically fears being abandoned to care for himself or herself.
Although often confused, there is a distinct difference between DPD and co-dependency. The main difference between the two conditions is that those with codependency have a strong desire to be depended on, rather than to depend on others.
It’s important to note that, unlike dependent personality disorder, codependency is not recognized as a disorder in the Diagnostic and Statistical Manual of Mental Disorders.
People with DPD are also likely to suffer from depression, anxiety and mood disorders. They are more likely to suffer from another personality disorder, such as borderline personality disorder or avoidant personality disorder.
Research has found that individuals with DPD are at high risk of suicidal thoughts and attempting suicide. Men diagnosed with the condition are especially high risk.
People with DPD may be more inclined to abuse alcohol and drugs. Research has found that 28.04% of people with DPD also suffer from alcohol dependency and 27.34% with drug dependency.
The American Psychological Association has advised that diagnosing children and adolescents with DPD should be done with great caution, if at all. This is because children are naturally dependent on others, such as parents, for support, safety, and emotional well-being.
A diagnosis should only be made when dependency is age inappropriate and unnecessary to welfare.
Mona is 32 years old and has been diagnosed with DPD. In a session with her therapist, she talks about her relationship with her partner and her extreme discomfort of being separated from him. She often becomes physically sick, vomiting, at the thought of being abandoned by him or the relationship ending.
Mona admits that the relationship is both verbally and physically abusive and that her partner has often cheated on her. Despite the relationship being unhealthy and to the detriment of her own well-being, Mona describes herself as helpless without him:
“I know I won’t actually die, but it often feels like it…I can’t live without him, that’s for sure. When he is gone, it’s like life switching from Technicolor to black and white.”
(Malignant Self-Love: Narcissism Revisited by Sam Vaknin and Lidija Rangelovska)
There are several risk factors that people living with DPD should be aware of. Firstly, that they may be more likely to become involved in an abusive relationship and steps should be taken to avoid this, such as working with a relationship therapist to learn about healthy relationships and boundaries.
Another serious risk for sufferers is that they may be more likely to self-harm and become suicidal. It may be a good idea to ask a doctor or therapist for a risk management plan, in case suicidal feelings and/or a desire to self-harm arises.
Doctors and psychotherapists may advise to avoid frequent alcohol consumption and drug use or to abstain altogether. This is due to the high-risk factor of becoming an addict or abuser, as well as the negative effect alcohol and drugs can have on mental health. Some medications may also react strongly to alcohol so be sure to follow medical advice carefully.
Smoking is also a high-risk behavior, with research finding that 53.68% of people with DPD also have nicotine dependency.
There are several medications that a doctor may use to help, depending on the patient’s physical health, as well as the individual symptoms and their severity. There is not currently one single medication that would work for everyone suffering from DPD. In fact, there are no FDA-approved medications for any personality disorder.
Factors such as other mental health conditions will need to be taken into consideration and are often the aspect that a doctor will focus on treating. For example, a patient with DPD may suffer from depression and so a doctor may prescribe an SSRI to treat that symptom. Equally, those who have anxiety or psychotic symptoms may be treated for those problems with the relevant medication.
Drugs such as antidepressants, tranquilizers, mood stabilizers, and sedatives are commonly prescribed for DPD.
As well as seeking psychotherapy and medical treatment, there are several recommended methods that people with DPD can carry out themselves. Always seek medical advice before trying any home remedy.
Many people suffering from mental health problems in general have found exercise helpful, particularly exercise that focuses on the mind as well as the body, such as yoga. Swimming, running and walking are often recommended as ways to help relieve depression and anxiety.
Gardening is an excellent alternative to more tradition exercise, as it is still an active activity and also encourages a more outdoor lifestyle.
Meditation, mindfulness, and aromatherapy can also be useful tools and are especially good for those who suffer from anxiety. Many places now offer short courses or classes in these areas and there are plenty of online resources available, including video tutorials.
Some psychologists recommend writing and self-reflection as an important tool for people with DPD. They believe that writing about your childhood experiences can allow you to analyze incidents from a new, more mature, perspective. This can lead to new insights and may help to ‘let go’ of the past. It is recommended that you talk to a therapist or doctor before trying this particular method.
It’s important to have an active role in your own care and to fully participate. Take time to learn about DPD and to attend therapy sessions and other medical appointments. Remember to take medication when prescribed and to follow the advice of medical professionals.
Creating an action plan could be an effective way to help manage the more severe behaviors caused by the disorder. For example, having an action plan in place in case of a desire to self-harm could be a good way to reduce the risk of actual self-harm.
An action plan can also be used as a daily preventative tool, by listing individual steps and tasks to carry out, with a goal of managing and minimizing symptoms long-term. Work with a doctor or therapist to create an action plan for use at home.
Some people use alternative and complementary medicines to manage DPD, such as herbal supplements, teas and flower infusions. Although there is no scientific consensus on the effectiveness of herbal or alternative medication, many people report benefits from using such treatments.
Doctor Philip Muskin, author of Complementary and Integrative Treatments in Psychiatric Practice, says that complementary and alternative medicine has a lot to offer when it comes to dealing with stress from personality disorders.
Finding a supportive doctor is the most important step as a good doctor can be key to getting all the help needed, both medically and emotionally. Ask your doctor to recommend an experienced therapist who has the best therapeutic treatment method for your symptoms.
As well as finding the right medical help, having a good support network is also essential when living with DPD. Whether it’s family, friends or a local organization, seek out a place to turn to in case of an emergency, as well as for general support.
Insurance providers have individual policies when it comes to personality disorders. Speak to your provider to find out exactly what medications and treatments are covered and ask for a copy of their policy.
Ask your doctor, therapist or a trusted organization to help you with this, if needed.
Overall, the most important feature to look for in a Licensed Mental Health Practitioner (LMHP) is that you feel comfortable with them. Most LMHPs have websites and social media where you can find reviews and learn about the experiences of other patients.
It’s best to discuss with your doctor about the right kind of treatment and therapist for you. However, psychotherapy is the most commonly recommended type of therapy for DPD and other personality disorders. To find a local psychotherapy practitioner, contact local or state psychological association.
It’s important to find the right therapist for you and part of that process is asking questions. You may have personal questions that you want to ask but there are some general questions you may want to ask. For example, ask if a therapist has treated people with DPD or other personality disorders previously and what sort of therapy they normally provide for that condition.
Feel free to ask about their educational background and training, as well as how long they have been at their current practice. A good therapist won’t mind providing you with their full background.
It’s also a good idea to ask about a therapist’s cancellation fee and policy, in case of an emergency in the future.
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
National Alliance on Mental Illness (NAMI) Helpline: 1-800-950-NAMI (6264)
Crisis Text Line: Text “home” to 741741
Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357)
National Institute for Mental Health: https://www.nimh.nih.gov/index.shtml
Mental Health America: http://www.mentalhealthamerica.net/
National Alliance on Mental Illness: http://www.nami.org/
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