Personality Disorders 101: Dependent PD

Standard

Dependent Personality Disorder was introduced in the first version of the DSM in 1952. Originally, it was seen as a subtype of an now-unused condition named “Passive-Aggressive Personality Disorder”, but it was quickly changed to being a separate condition.

The core symptom of DPD is a person’s belief that they are unable to function independently. A person with DPD is compelled to rely excessively on either one person (often a significant other) or multiple people (such as a close group of friends) to help them navigate most or all parts of their life. This reliance is not out of laziness, nor a wish to delegate responsibility. Instead, it is to escape a primal fear of inability. A person with DPD sees the world as a cold, dangerous place, and usually believes that they are deficient and unable to survive on their own. Therefore, they will seek out others who they view as stronger and more capable to help them navigate through life. They are terrified of losing that support or angering their support network, as they believe they cannot function alone.

The DSM-5 describes DPD as a pervasive and excessive need to be taken care of, which leads to submissive and clinging behaviour and fears of separation. To be diagnosed with DPD, someone needs to have at least 5 of these criteria:

  • They have difficulty making everyday decisions without excessive advice and reassurance from others
  • They need others to assume responsibility for most major areas of his or her life
  • They struggle to disagree with others because they fear a loss of support or approval.
  • They have difficulty initiating projects or doing things on their own. because they lack self-confidence in their own judgment or abilities (Not because of lacking motivation/energy etc)
  • They go to extremes to get nurture and support from others, even to the point of volunteering for uncomfortable or dangerous situations
  • They feel uncomfortable or helpless when alone, as they are convinced they cannot care for themselves
  • They must urgently seek out new relationships to provide care and support when a relationship ends
  • They are unrealistically preoccupied with fears about being left to take care of themself alone

The general personality disorder criteria must also apply. “A person needs to have a collection of unusual behaviours and traits which affect a large portion of their everyday life. Those behaviours and traits must start before early adulthood. They need to cause negative consequences for the person, who should be upset by or annoyed at those behaviours.”

People with DPD are often well-liked, as their tolerance, willingness to help others, and desire to accommodate others make them easy to get along with. They will usually be seen as good employees for the same reasons. However,  difficulties will emerge if friends or work colleagues get annoyed or frustrated at their perceived lack of initiative.

Most people with DPD are unlikely to get into trouble of their own accord, as they dislike conflict and dislike doing anything to hurt anyone else. However, they may easily be drawn into the “wrong crowd”, or taken advantage of, through being unable to challenge situations and people they disagree with. In extremes, a person with DPD may not be able to remove themselves from an abusive relationship or friendship. This is especially concerning because research has found that people with DPD face an increased risk of experiencing abusive relationships.

Fictional characters who realistically represent DPD are hard to find. Although some people have suggested Buster Bluth from Arrested Development, the show displays such exaggerated family dysfunction that Buster’s notable DPD traits can be seen as an adaptive response to his situation rather than as disordered traits.

One large-scale study found that 0.49% of adult Americans could be diagnosed with DPD. which makes it rarer than other PDs. Someone with DPD is likely to seek treatment after a conflict with others; they may see themselves as a burden to others, or they may be distraught after a friendship or relationship ends. The recommended treatment is counselling which gets the person with DPD to examine their beliefs about the world and discover what they can do themselves. However, as someone with DPD may become stuck in the therapeutic relationship and become dependent on the therapist, short-term types of counselling are preferred.

Psychological Criticisms of DPD

The description of DPD can be criticised because of how it relates to female stereotypes. Dependent or “clingy” behaviour is usually assigned to female media characters and it’s often portrayed as a path to validation. In real life,  women are often expected to depend on others while men are expected to be autonomous, decisive and stubborn. This gendered pattern can affect how, or if, people with DPD are diagnosed: men may feel unable to discuss their symptoms with others, while women may be overlooked.

DPD is also more culture-specific than many other mental health conditions, because of how Western societies focus on the value of autonomy and independence. One example of this is how in patriarchal societies women are expected to depend on male family members and to relinquish responsibility for the course of their life to others. In cultures with these expectations, the concept of DPD would be disregarded. Someone with DPD would be showing a desirable behaviour pattern in a patriarchal state, rather than an abnormal one.

A similar cultural gap exists between collectivist and individualistic societies. In a collectivist society which focuses on maintaining a cohesive and conflict-free group rather than on individuals’ desires, DPD would be much harder to notice. In the same way that Schizoid PD is seen as dysfunctional mostly by Western societies which emphasise extraversion, DPD may only be noticeable because of how Western societies emphasise individual autonomy and decision-making.

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