Know if Someone Has a Dependent Personality Disorder

Dependent Personality Disorder is characterized by an excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. It is found in persons who have never been able to form a strong sense of self and who find purpose (and safety) living in the shadow of another. Often commencing in early adulthood (by which time the person should have a fairly stable sense of self), this condition can result in anxious, fearful, and insecure behavior than can prevent the sufferer from leading a full and fulfilling life. This tendency to "cling" can cause those targeted by the dependent individual to feel suffocated or — if being manipulative — to seek to control the sufferer's every move and thought. If you're concerned that someone you know might have dependent personality disorder, it is important to learn to spot the signs and to encourage the sufferer to seek help.

Steps

Assessing the Situation

1. Understand a possible cause of Dependent Personality Disorder. The person's Understand the Effects of Childhood Experiences may have laid the foundations for developing dependent personality disorder. Overly anxious or insecure parents are often the cause of a child's inability to individuate from them. If she was constantly punished or made to feel guilty for seeking independence as a child, she may feel that independent thought and action is a bad thing. While she ultimately needs to move on from her childhood experiences, recalling how they may have brought on her dependent personality can be helpful in elucidating the cause of her disorder.
   • If you can take the time to listen to her and gently ask questions about her childhood, a pattern of unhappy attachment might be revealed.
   • Note that there may be a combination of genetic, biological, and environmental factors that lead to this disorder.
2. Recognize the signs. You will need to look for five or more of the following characteristics to be able to draw an initial conclusion that someone might be suffering from Dependent Personality Disorder. The following traits in combination are indicative (although, to be sure, the sufferer will still need professional diagnosis):
   • Does he constantly experience difficulty in making everyday decisions? Needing an excessive amount of advice and reassurance from others before undertaking any task is a sign of deep dependence. However small these tasks may be, if he is unable to initiate or complete these tasks on his own, this is indicative.
     • Ask him these questions: Some people enjoy making decisions; others prefer to have someone they trust guide them; which do you prefer? Do you seek advice for everyday decisions? Do you often need help to get started on a project?
   • Does he allow other people to make decisions for him in areas that directly affect his life? Needing others to assume responsibility for most major areas concerning his life shows immaturity and a lack of understanding about the importance of self-responsibility.
     • Ask him this question: Do you find yourself in situations where other people have made decisions about important areas in your life, for example, what job to take?
   • Does he go to excessive lengths to obtain nurturing and support from others? This may even occur to the point of him doing unpleasant things.
     • Ask him these questions: Do you volunteer to do unpleasant things for others so they will take care of you when you need it? Are you uncomfortable when you are alone? Are you afraid you will not be able to take care of yourself? Do you worry about important people in your life leaving you?
   • Does he urgently seek another relationship as a source of care and support when a close relationship comes to an end? Does he jump into rebound relationships, for example, meaning he must find someone new to date quickly after a breakup? Does he feel helpless when alone because of exaggerated fears of being unable to take care of himself, whether financially, emotionally, or even physically?
     • Ask him this question: Have you found that you are desperate to get into another relationship right away when a close relationship ends? Even if the new relationship might not be the best for you?
   • Does he constantly have difficulty in expressing disagreement with others? If he fears disapproval, rejection and a loss of support from others, he will likely try too hard to please people. Note that this must exclude realistic fears of retribution.
     • Ask him these questions: Is it hard for you to express a different opinion from someone you are close to? What do you think might happen if you did? Do you often pretend to agree with others even if you do not? Why? Could it get you into trouble if you disagree?
3. Check additional criteria. Sometimes people seem like they have Dependent Personality Disorder when they really don't. If the above criteria are met, see if she also meets the following criteria before considering a diagnosis of dependent personality disorder. Note that if any of these are not met, she does not have dependent personality disorder:
   • Do her behaviors deviate significantly from the norms of her culture in at least two of the following areas:
     • Cognition (perceiving and interpreting things, people, and events, and forming attitudes and images of self and others).
     • Affect (range, intensity, and appropriateness of emotional arousal and response).
     • Control over impulses and gratification of needs.
     • Manner of relating to others and of handling interpersonal situations.
   • Do her symptoms manifest across a broad range of personal and social situations, not limited by specific triggers or situations? If so, her symptoms are considered pervasive, inflexible, and maladaptive.
   • Do her symptoms of dependency cause her personal distress, or adversely impact her social environment?
   • Are her symptoms stable and of long duration, having an onset of late childhood or adolescence?
   • Can other adult mental disorders be excluded as possible causes for her symptoms of dependency?
   • Can organic brain disease, injury, or dysfunction be excluded as possible causes for her symptoms of dependency? A frail grandmother who cannot take care of herself does not have dependent personality disorder.
4. Consider how the sufferer appears to feel when left alone. Does he feel helpless, uncomfortable, and anxious? Does he feel indecisive and angry with himself for not knowing what to think or do? Think about how he reacts when the person he's attached to returns. Does he leap on this person straight away expecting immediate attention and even scold this person for leaving him by himself? Feeling helpless, abandoned, and uncomfortable when on his own frequently occurs as a result of exaggerated fears of not being able to take care of himself.
   • Pay heed to people who are unrealistically preoccupied with thoughts and fears of being left alone to take care of themselves. It is a warning signal that they don't feel able to cope alone, no matter how easy the task or the life they're leading.

Assisting Someone With Dependent Personality Disorder

1. Help the sufferer learn to take responsibility. This isn't a habit that she can simply "snap out" of. It will take her time to learn to stand on her own two feet and to feel safe expressing her own thoughts and opinions.
   • Set small, achievable tasks that you know she could manage without trouble. When she's completed them all alone, praise her and increase the difficulty of the tasks gradually.
   • Talk to her about things she enjoys doing. Whenever she is about to be left alone, suggest that she become involved in that activity for the duration of the other person's absence.
   • Help her learn to trust herself more. Offer her books on improving self-confidence, book her into a course on improving self-confidence, and spend time telling her what you have noticed she's really good at doing.
   • Get her exercising, eating balanced meals, and reducing her stress. If she's addicted to any substance, this will need to be treated. Be careful that she doesn’t disengage from others too much, as social support itself does act to reduce stress.
   • Be alert to the possibility of abuse being perpetrated on the sufferer. Her neediness makes her extremely vulnerable to a manipulative or unstable personality. Make sure you ask yourself honestly whether you are playing a role in encouraging her dependency.
2. Encourage the sufferer to read as much as possible about the disorder. Having an understanding of his disorder and seeing that he's not alone can be an immense relief for him, as well as showing him that there is a way forward.
3. Encourage the sufferer to get professional help. Dependent personality disorder can be treated through psychotherapy or psychoanalysis. It is not a life sentence for the sufferer. However, many sufferers are likely to resist getting therapy because they refuse to see that there is anything wrong with how they live their lives or they're so depressed or addicted that they're avoiding facing the issues at all. It is important to motivate the person to seek help.
   • Part of how you can help her to be convinced that getting help is worth it is to explain how this will also help the people she keeps relying on too much. Insist that she deserves to discover herself fully and to live a full life to the best of her own capacity without relying on others to dictate it.
   • Since the person suffering from dependent personality disorder may be so terrified that the person(s) on whom she's dependent will reject/leave her, it is important for the mental health professional to also assess any signs of depression, anxiety, panic disorders, and somatic distress.
4. Avoid negative language. Don't use negative phrases or wording when encouraging him to seek therapy. Telling him that he's "too passive," "too dependent," or a "pain to deal with" will only make things worse.
   • Instead, try to focus on positive language. For example, you might say, "Becoming more independent will ultimately make you happier and more fulfilled."
5. Do your own part to let go. If you the one she is highly dependent on, you're going to need to change your behavior in order to change hers. This is more likely in a family situation but can also occur with friends and situations of mentorship, advising, employment, or relationships of similar closeness. If you have long acted as a protector, guardian, adviser, or as someone who is willing to deflect life's hardships for this person, then you have enabled her and you'll have to start withdrawing this kind of support while she learns to stand on her own two feet.
   • Try to be cautious not to second-guess decisions she makes, to allow her to make and learn from mistakes, and to help her learn that advice doesn't always need to be taken.
   • Try your best to only step in infrequently, as you would do for someone not suffering from this disorder.

Tips

• This condition develops in early adulthood and refers specifically to adult or mature behavior. As children grow older, you should be helping them to think and act independently more and more by letting them make decisions. Also be sure to create a home environment where making mistakes is considered normal and show by example how you pick up and move on after making mistakes yourself.
• The core characteristics of dependent personality disorder set out above serve as a guide for diagnosis of the condition. These characteristics need to be consistent or frequent in a person's disposition or actions before you can be certain that they have the disorder, and professional diagnosis should always be sought.
• Overly protective parenting can contribute to this disorder. Find ways to become a balanced parent.
• Dependent personality disorder is typically grouped under the "Cluster C" type of personality disorders; these tend to display anxious and fearful behavior traits.

Warnings

• Extremely submissive and helpless people are very vulnerable to abuse and need immediate help to improve their sense of self worth.

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Sources and Citations

• Adapted from: Abnormal Behavior and Mental Health, Study Guide for PYC 302A, University Of South Africa, University Press, Pretoria, 2007-2009.

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