Treating Dependent Personality Disorder (DPD)

Someone with DPD has a pervasive reliance on other people to make decisions or complete daily responsibilities for them. This dependency is paired with frequent severe anxiety at the thought of being alone or having to make a decision alone.

Fear of abandonment is at the heart of DPD, and this can lead to being seen as “clingy,” jumping from relationship to relationship, and avoiding criticism or rejection at all costs. Those with DPD may avoid expressing opinions for fear that they’ll be met with disapproval.

Not being cared for by another person can cause anger or distress. People with DPD may also find that they have codependent behaviors, which also stem from a lack of independence.

There are many possible causes of DPD, including:

• childhood trauma, neglect, or severe illness that led to reliance on others
• an abusive relationship
• cultural factors that emphasize deference to authority
• biological predisposition to DPD or anxiety

As with all personality disorders, there’s no cure for DPD. But there’s still a lot of reason for hope. Several treatment options can help manage DPD symptoms and encourage independence.

Finding and sticking with the right treatment can help you lead an independent and rewarding life.

There are various treatment options available for DPD. They include therapy, medication, or a combination of both.

Psychodynamic psychotherapy and cognitive behavioral therapy (CBT) are two of the most popular therapy approaches for treating DPD.

Cognitive behavioral therapy

CBT can help people with DPD work on better coping mechanisms. CBT examines how a person’s thoughts, feelings, and behaviors are connected, and it works through ways to replace harmful and irrational thoughts with more rational ones.

If you have DPD, CBT can help you with your thought patterns surrounding dependence on other people. Thought patterns may be difficult to recognize at first, but a therapist can help guide you through CBT to develop healthier relationship models.

Psychodynamic psychotherapy

Psychodynamic psychotherapy is a longer-term therapy used for the treatment of DPD and other mental health conditions.

Psychodynamic psychotherapy explores childhood events, trauma, abandonment issues, and attachment styles that may be shaping current behaviors and symptoms.

Psychodynamic psychotherapy can help you gain greater insight into your challenges. It can also help you improve your relationships.

Schema therapy, a psychotherapy approach designed to treat personality disorders, is the most effective treatment for DPD, according to one study. Schema therapy aims to help people understand their unhelpful patterns and coping strategies and replace them with helpful ones.

Therapists practicing schema therapy also re-parent clients by meeting their unmet childhood needs — such as giving praise — within a healthy boundary.

Medication

There are no Food and Drug Administration (FDA)-approved medications for DPD, though some experts believe certain antidepressants may help.

Medications can treat symptoms associated with DPD, such as anxiety and depression. The efficacy of medication should be evaluated on a case-by-case basis and paired with therapy.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) outlines several symptoms that must be present for a clinical diagnosis of DPD. Symptoms must be long lasting and lead to submissive or clinging behavior, as exhibited by five or more of the signs below:

• obsessive preoccupation with being abandoned or being unable to care for yourself
• feeling anxious or helpless when you’re alone
• trouble making decisions without others involved
• need for others to take care of even simple responsibilities
• extreme fear of disapproval or rejection from others
• difficulty starting tasks or projects without others supporting you
• quickly seeking another relationship after one ends to avoid being alone

Mental health professionals must use great caution if diagnosing this condition in children or adolescents, as these behaviors may be appropriate for their developmental stage.

The DSM-5 suggests that less than 1% of the population has DPD. Men and women may be equally likely to have DPD, though women are diagnosed more often.

Aside from the symptoms of DPD itself, untreated DPD can also be associated with complications like:

• anxiety disorders, such as panic disorder, avoidant personality disorder, and obsessive-compulsive personality disorder
• depression
• substance use disorder
• phobias

Since people living with DPD often have more than one mental health condition present, DPD can be difficult to diagnose. Diagnosis is further complicated by other mental health conditions that have some similar symptoms as DPD.

DPD is a Cluster C personality disorder, meaning it’s defined by anxious and fearful thoughts. Other similar conditions include:

• avoidant personality disorder and obsessive-compulsive personality disorder (Cluster C)
• borderline personality disorder (BPD) and histrionic personality disorder (HPD) (Cluster B)
• social anxiety disorder

There’s a crossover in symptoms in individuals with these related conditions. People living with BPD, HPD, and avoidant personality disorder all share a hypersensitivity to rejection. In addition, individuals with BPD and DPD may have abandonment issues.

Anxiety in social situations — seen in social anxiety disorder and DPD — can lead to extreme dependence on others.

Patience and resolve in finding the right mental and medical support team will help on the path to a proper diagnosis — and therefore the most helpful treatment — for DPD.

You can overcome the challenges of living with DPD, and you don’t have to do it alone. There are treatments and support available to help you navigate symptoms.

The sooner you receive treatment for DPD, the less likely you are to develop other mental health conditions, so it’s important to look for a therapist you trust.

Meeting with a therapist can help you process past experiences and build the necessary skills you need to complete tasks on your own.

Your treatment journey will be as unique as you are, and that’s completely normal. You have an independent, rewarding life ahead of you.

To learn more about DPD, consider checking out this podcast by Mike Leary, LPC.