Humans are a social species that crave connection to, and support from, other humans in order to survive. When we’re born, we rely solely on adults to keep us alive; our parents or caregivers dedicate practically all of their time to making sure that we are clothed, fed, and protected. As we get older, we become less and less reliant on others to take care of us, as we become more capable of completing daily tasks independently.
For some, however, reaching this developmental milestone is more difficult than others and it takes longer for them to be able to feel confident and secure in making their own decisions and providing for themselves. While some people can eventually grow into a sense of independence on their own, others can experience increasing anxiety at the thought of becoming less dependent on others.
When an older adolescent or able-bodied adult severely struggles with being independent and is in desperate need of other people’s care to the point where it impacts their own ability to function, they may have dependent personality disorder (DPD).
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), someone with dependent personality disorder experiences “a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation.” This usually presents itself before “early adulthood” and is categorized by a person experiencing five or more of the following symptoms:
- Difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
- Needs others to assume responsibility for most major areas of their life.
- Difficulty expressing disagreement with others because of fear of loss of support or approval.
- Difficulty initiating projects or doing things on their own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
- Goes to excessive lengths to get support from others, to the point of volunteering to do things that are unpleasant.
- Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themselves.
- Urgently seeks another relationship as a source of care and support when a close relationship ends.
- Unrealistically preoccupied with fears of being left to take care of themselves.
DPD is a mental health condition that can impact a person’s ability to develop an independent life. A person may first begin to notice symptoms in young adulthood because that is the time that most adolescents begin to separate from their parents and determine their own wants and needs, which often conflict or contrast with those of their parents.
While this is not the case for every adolescent, this is the norm based on the changes in the brain that adolescents experience at that time. If an adolescent is unable to begin making age-appropriate decisions for themselves, this may suggest that they are experiencing symptoms of dependent personality disorder. Age-appropriate decisions would include choosing your own clothes, taking care of your hygiene, doing chores without excessive parental involvement, choosing electives to take in school.
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According to the DSM, DPD is diagnosed in 0.5-0.6% of the general population. Personality disorders are a type of mental health condition that take time to develop and ultimately increase in severity over time, so the most extreme cases of DPD are in people who are in their 40’s or 50’s, though anyone at any age can struggle with DPD if they have dependency issues.
Most people with personality disorders rarely seek treatment, because they typically do not see their symptoms as anything out of the ordinary. It isn’t until their symptoms become extreme and end up impacting either their social functioning and relationship with others or their ability to function in their school or career choices that they realize they need help.
Personality disorders are difficult to treat, partially because the symptoms are so often ingrained in a person’s personality, and they may not even realize they have a problem. Instead they may try to blame and diagnose others’ behavior as the cause of their own reactions and feelings.
While those who struggle with personality disorders, particularly DPD, may not be eager to join treatment, once they do, they can learn tips and techniques for managing their desperation to be cared for by others, and can find strategies to make confident decisions about their lives.
Therapists will often use cognitive behavioral therapy (CBT) to help patients learn that their thoughts are connected to how they feel, and that their feelings contribute to their behaviors. This relearning about emotional regulation can teach people how to soothe their anxieties around becoming an individual who is separate from others. Therapy can also help those with DPD find ways to have a healthy balance of social connectedness and individuality in the process.