Dependent Personality Disorder Signs And Symptoms
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Dependent Personality Disorder (DPD) is typified by a widespread and pervasive need to be taken care of, potentially leading to submissive, dependent behavior and fears of separation from loved ones. It often begins in childhood or early adulthood and is typically present in social and personal contexts. The dependent and submissive behaviors often arise from a self-perception of the inability to function adequately without the help of others.
While approximately 10% of adults have been diagnosed with a personality disorder in the US, fewer than 1% are diagnosed with DPD. The disorder is marked by a poorly developed identity, poor self-esteem, poor self-appraisal, unusually high levels of intimacy with caregivers, anxiousness, and separation insecurity.
Potential causes of DPD
Experts have been unable to pinpoint a specific cause of DPD, but it most likely comes from a mix of environment, genetics, and developmental influences. For example, people with DPD may have a family with DPD (or another disorder with similar symptoms), a history of childhood trauma, or a history of abusive relationships.
Diagnostic criteria
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) provides a set of criteria for all personality disorders. For a diagnosis of dependent personality disorder (DPD), the individual must present five (or more) of the following criteria:
Difficulty making everyday decisions without excessive involvement and reassurance from others (usually a caregiver or loved one). These decisions can be anything from what to eat and what to wear to when to sleep. This happens not because they are physically or mentally disabled but because they often believe that they can’t care for themselves appropriately.
The individual has an intense need for others to take responsibility for significant issues in their life. Examples include an adult who depends on parents, partner, or friends to pick out where they should live, or a high school graduate who allows their parents to decide if they are going to college or not, what they should apply for in college, how they should act in school and so on. This must happen continuously in several areas of life for it to be taken as a symptom.
Trouble disagreeing with people due to a baseless fear of losing appreciation or approval. Some people with DPD may go out of their way to avoid conflict to please those they depend on. Out of fear that their caregivers might leave them, they’ll often agree or comply with their wishes, even if it’s harmful or undesirable.
They have trouble creating or initiating something by themselves because of perceived inadequacy in judgment and capability. People with DPD may have difficulty starting or maintaining a task or project on their own. They might believe they are not good or smart enough, so they wait for others to initiate projects. They are sometimes able to do well with what they consider “adequate supervision.”
The individual displays excessive effort to obtain nurturance and appreciation from other people, often to their detriment. People with DPD sometimes go to great lengths to seek care from the people around them. They might agree to do unpleasant tasks or tolerate abusive behaviors to obtain that care.
Feelings of helplessness or discomfort when left alone. People with DPD may feel very helpless when left alone, with heightened fears that they may be unable to care for themselves.
An urgent need for new relationships when a relationship ends. When a relationship with a caregiver ends, a person with DPD will sometimes immediately seek another caregiver or someone they can “depend” on. They quickly seek to fill the space left by the previous caregiver. For example, someone with PDP may immediately seek a partner to fill the role of a former partner or family they once depended on to control their life.
Excessive fear of responsibility to care for themselves. Individuals with Dependent Personality Disorder may worry continuously that they will one day be left alone to care for themselves. Even if they are being cared for in a safe environment, they may experience fear due to the unrealistic worry that their present caregiver will leave them alone.
Other characteristics of DPD
People with DPD may sometimes display other behaviors and characteristics that aren’t necessarily criteria for diagnosis. Some include:
Pessimism and self-doubt to the point where people with DPD may belittle their own abilities and assets. They may refer to themselves as “stupid” or make other disparaging remarks.
People with DPD tend to take criticism and disapproval poorly, using it as “proof” that they are worthy, and they consequently may lose faith in their abilities.
People with this disorder sometimes find it difficult to work where they are not dependent on a superior. They may require their superior to tell them what to do and may be unable to work where independence is the norm.
They may avoid responsibility and may pass over promotions to positions where responsibility is required to the extent that it’s detrimental to their growth in the workplace.
Social relations are often limited to the few people on whom they are dependent and perhaps these people’s group of friends.
Comorbidity and similarities to other personality disorders
There are several disorders that are common comorbidities with DPD. For instance, depressive disorders such as persistent or major depressive disorder often accompany DPD. Anxiety disorders or alcohol use disorders are also sometimes associated with DPD. Some phobias are present as a comorbid disorder along with DPD as well. Social phobia is common, and agoraphobia is sometimes associated with Dependent Personality Disorder.
Although DPD has some similar symptoms to these disorders, it doesn’t necessarily indicate an official comorbidity. It’s important to obtain an official diagnosis from a mental health professional.
Other personality disorders
Other personality disorders may be confused with DPD because they have certain features in common.
Dependent personality disorder and borderline personality disorder are commonly characterized by the fear of abandonment. However, people with borderline personality disorder tend to react to abandonment with feelings of emotional emptiness, rage, and demands. Individuals with DPD usually react with increasing appeasement and submissiveness and urgently seek replacement relationships to provide caregiving and support.
Dependent personality disorder and histrionic personality disorder are often characterized by a strong need for reassurance and approval. People with histrionic personality disorder may flirt excessively with multiple people to get the attention they need or desire. At the same time, those with dependent personality disorder usually focus on a few caregivers with whom they are self-effacing and docile.
Dependent personality disorder and avoidant personality disorder are characterized by feelings of inadequacy, hypersensitivity to criticism, and a need for reassurance. People with avoidant personality disorder tend to avoid and withdraw from relationships until they are certain they will be accepted. In contrast, people with dependent personality disorder usually have a pattern of seeking and maintaining connections with others whom they deem important.
Treatment options for BPD
Even though psychotherapy is essential for the treatment of DPD, because of its nature, some people experiencing the disorder may be reluctant to speak with a therapist. Issues around availability, scheduling, and finances may also present barriers to seeking treatment.
With the rise of online therapy, many people have a better opportunity to overcome those barriers than seeing a therapist in the office. BetterHelp offers a wide variety of licensed mental health professionals trained in treating personality disorders and other mental disorders, such as depression, anxiety, trauma, and more. Online therapy is as effective as in-person therapy for many conditions and concerns, and you can speak with a professional from the comfort of your home at any time that fits your schedule via phone, text, video chat, and online messaging.
If intense feelings of inadequacy and dependency on others are interfering with your daily functioning, it may be time to speak to a mental health professional. If you know someone who seems to fit the criteria of DPD, they may need you to help them take the first step to getting help.
Takeaway
There are many circumstances when a person may show traits similar to those of dependent personality disorder, but don’t necessarily qualify for an official DPD diagnosis. For instance, in some cultures, dependent behaviors are a socially and culturally acceptable norm. Similarly, some religions require submissive behavior from certain individuals in the household.
Some people may also show DPD traits when involved in a dominant behavioral system with a hierarchy dictated by behaviors of power and subordination. These behaviors may be inflexible, maladaptive, and persistent enough to cause problems in daily life, including significant functional impairment or subjective distress to the individual.
DPD and other personality disorders are most commonly treated with psychotherapeutic methods such as CBT (cognitive behavioral therapy) and/or a regimen of medications to treat the feelings of depression and anxiety that may accompany them.
What are the five signs of bipolar?
It's important to note that bipolar disorder exists on a spectrum, with different subtypes (e.g., bipolar I, bipolar II) and variations in symptom severity. Each person's experience with the condition is unique, and the following may emerge in differing frequency and intensity, but there are several common signs that may signal when an individual is developing bipolar disorder:
Severe mood swings, including manic or hypomanic episodes (high mood, increased energy, impulsivity) and depressive episodes (mental dullness, low mood, hopelessness, decreased energy).
Manic symptoms like excessive energy, euphoria, increased self-esteem, reduced need for sleep, racing thoughts, rapid speech, impulsivity (reckless behavior like excessive spending or risky sexual encounters), and difficulty concentrating.
Bipolar depression symptoms such as prolonged sadness, loss of interest in previously enjoyed activities, fatigue, changes in appetite and weight, difficulty sleeping or oversleeping, feelings of worthlessness or guilt, and thoughts of death or suicide.
Cycling between manic episodes and depressive episodes. The frequency and duration of these episodes can vary from person to person.
Impairment in an individual's ability to function in relationships, work or school, and overall quality of life.
Can you test yourself for bipolar?
While there are bipolar tests one can take to determine if they have symptoms of the disorder, there are other mental health conditions with similar symptoms. This is why consulting with a mental health professional is vital for an accurate diagnosis and the right treatment plan.
With that in mind, a quick internet search for bipolar disorder test or mood disorder questionnaire can help you find a bipolar test online to talk with your mental health provider.
Am I bipolar, or is it normal?
"Normal" thoughts, emotions, and behaviors are subjective. What one person perceives as "normal" may not be for another. However, there are trademark characteristics associated with bipolar disorder that may not qualify as typical for most. For example, it's normal for most to experience changes in mood in response to different situations, but dramatic shifts between manic and depressive episodes may be a sign of the disorder.
How do you test if someone is bipolar?
To test accurately for bipolar, a doctor will interview the patient about their symptoms, most specifically about how they feel before, during, and after an episode. They may look for signs of self-harm and/or suicidal ideation and behaviors. They'll also likely ask about a family history of mental illness or bipolar disorder. Depending on the symptoms, a doctor will conduct a physical exam and possibly request blood testing to rule out a physical condition.
How do I know if I'm slightly bipolar?
There is a condition called cyclothymia, often considered a milder form of bipolar disorder. Its symptoms involve fluctuations in mood alternating between periods of hypomania and other periods of extreme depression— but unlike bipolar disorder, these changes can happen in short, spontaneous bursts.
Determining whether an individual is "slightly bipolar" or has cyclothymia requires a diagnostic exam administered by a mental health professional. Assessment will likely involve the same testing, interviews, and physical screening given for bipolar disorders.
At what age does bipolar start?
It's possible for symptoms of bipolar to emerge at any age, but the average age of onset for bipolar type-1 is 12-24, but it is older for patients of bipolar type-2.
Can you go undiagnosed with bipolar?
Bipolar disorders are sometimes misdiagnosed or completely undiagnosed; some people live with it for years before receiving proper treatment. While it is possible to go undiagnosed, unaddressed cases may experience significant difficulties in daily functioning and impairment in well-being.
What triggers bipolar disorder?
Possible triggers for a bipolar episode include:
Extreme or prolonged stress. (Both "good" and "bad" stress)
Some types of hormonal changes
Physical illness or injury
Drug or alcohol use
Sleep disruptions
Nutritional deficiencies
Weather/climate changes
What is commonly mistaken for bipolar?
Research suggests that as much as 76.8% of people in outpatient treatment did have bipolar but received a different diagnosis or did not have it but received a positive diagnosis. This large number is typically because its symptoms overlap with several other mental health conditions, including:
Depression
Anxiety disorders
Personality disorders
Obsessive-compulsive disorders
Schizophrenia
What does undiagnosed bipolar look like?
When bipolar disorder is left undiagnosed and untreated, its symptoms may increase in severity and progress into other conditions like anxiety disorders, drug use disorders, psychosis, and eating disorders. It can also significantly negatively impact interpersonal relationships and functioning in a work or school environment and even result in suicide or suicidal ideation.
If you or a loved one are experiencing suicidal thoughts, reach out for help immediately by contacting the National Suicide Prevention Lifeline at 988 or 1-800-273-TALK (8255).
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