Dependent Personality Disorder DSM 5: Signs and Symptoms

Updated August 27, 2020

Medically Reviewed By: Laura Angers

Dependent Personality Disorder is a condition that is typified by a widespread and uncontrolled need to be taken care of, leading to a submissive and dependent behavior and fears of being separated. It often begins in early adult years and is present in several contexts; social and personal.

The dependent and submissive behaviors often arise from a self-perception of being unable to function adequately without the help of others. And may sometimes seem like they are designed to elicit caregiving.

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The prevalence of the disorder in the general population is thought to be between 0.49% and 0.6%. It is believed that the disorder occurs equally among males and females.

The disorder is marked by a poorly developed identity; poor self-esteem and self-appraisal increased levels of intimacy; with caregivers, anxiousness, and separation insecurity; that he or she will be left alone.

Diagnostic Criteria

The Diagnostic and Statistical Manual of Mental Disorders designed by the American Psychiatric Association gets a set of criteria out of which if five or more are present, a person might be thought to have the Personality Disorder, as indicated by five (or more) of the following:

  • Troubled making daily decisions unless he gets a lot of advice and encouragement from others.
  • The intense need for others to take responsibility for major aspects of one’s life.
  • Trouble expressing discord with people due to fear of losing appreciation or approval.

(Note: Does not include true fears of retribution.)

  • Trouble creating projects or initiating something by himself

(due to a lack of self-esteem in making judgments and capabilities instead of a lack of determination or energy).

  • Exerting too much effort in obtaining nurturance and appreciation from other people to the extent of volunteering to do displeasing things
  • Feeling helpless or uncomfortable when he is by himself because of too much fear of being unable to take care of himself
  • The urgent need for new relationships to feel cared for and supported when a relationship ends. Unrealistic preoccupation with a fear of being alone and obliged to care for himself

Signs and Symptoms of Dependent Personality Disorder

Difficulty making everyday decisions without an excessive amount of advice and reassurance from others

People with Dependent Personality Disorder sometimes find it difficult to make daily decisions on their own. They often require the help of a caregiver or loved one to make these decisions for them. These decisions can be anything from what to eat, what to wear to when to sleep. Whenever they make a decision, it is often with the help and reassurance of their loved ones or caregivers. This happens not because they are physically or mentally disabled but because they often believe that they can’t care for themselves appropriately.

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The extreme need of others to assume responsibility for major areas one’s life

People with Dependent Personality Disorder are often more comfortable when someone else takes the lead and helps them to make important life decisions.  This can occur in different ways; an adult who depends on parents, partner or friends to pick out where they should live, the circle of friends to have, and the number of children to have or a high school graduate who allows his or her parents to decide if he or she is going to college or not, what he or she should apply for in college, how he or she should act in school and so on. This has to happen continuously in several areas of life for it to be taken as a symptom.

Also, this need for others to make decisions is not the kind seen with people who might actually need it, for example, the aged, disabled persons, or special needs children.

Difficulty expressing disagreement with others because of fear of loss of support or approval

People with Dependent Personality Disorder often try as much as they can to please those they depend on. They typically worry that their caregivers might leave them, so they hardly ever express a different view from their caregivers even when they have a truly different opinion.

This can’t be taken as a symptom if the individual in question is scared of payback if he or she expresses a different opinion e.g., someone in a gang or an abusive relationship.

Difficulty initiating projects or doing things on one’s own

People with Dependent Personality Disorder find it difficult to start or maintain a project on their own. They often have the erroneous belief that they are not good or smart enough. This comes from a lack of confidence and a belief that they can’t function properly alone. They, therefore, wait for others to initiate projects. And they willingly join on in the project when asked.

They are sometimes able to do well with what they consider “adequate supervision.”

Going to excessive lengths to obtain nurturance and support from others

People with Dependent Personality Disorder sometimes go to great lengths to seek care from the people around them. They often will submit to what the person they get care from wants even if they don’t like what the person requires of them. They often carry this on to the extent that they might volunteer for the most unpleasant tasks possible to keep the person with them. They sometimes tolerate abuse despite adequate opportunities to leave the abuser.

Feeling uncomfortable or helpless when alone due to exaggerated fears of being unable to care for self.

People with Dependent Personality Disorder often feel very helpless when they are left alone. They have heightened fears that they may not be able to take care of themselves. Many people get scared when they are placed in a new environment and worry about how they are going to cope. These people eventually learn how to cope and mix in their new environment. People with Dependent Personality Disorder will find that extremely difficult to do. They will often require a known face or person that can care for them in this new environment.

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The urgent seeking of new relationships as a source of care and support when a close relationship ends

When a relationship with a caregiver ends, a person with Dependent Personality Disorder begins to immediately seek another caregiver or someone they can “depend” on. They quickly seek to fill the space left by the previous caregiver. For example, a woman with Dependent Personality Disorder who lost her husband shifts her attention for care to her child or brother. Also, a young man with the disorder immediately looks for a girlfriend to fill the role of this mother, who always tells him what to do.

Unrealistic preoccupation with fears of being left to take care of self

Individuals with Dependent Personality Disorder often continuously worry and fear that they will be left alone to care for themselves. They often believe that they need someone to care for them at all times. When they are being cared for, they are often preoccupied with unrealistic worry that their present caregiver will leave them alone.

Features Associated with Dependent Personality Disorder

People with Dependent Personality Disorder often show other signs that are characteristic but not diagnostic of the disorder.

Pessimism and self-doubt: People with Dependent Personality Disorder tend to belittle their abilities and assets, and may constantly refer to themselves as “stupid.”

Take criticism poorly: People with Dependent Personality Disorder tend to take criticism and disapproval poorly. They take this as proof that they are worthy and consequently may lose faith in themselves.

Work: People with this disorder often find it difficult to work where they are not dependent on a superior to tell them what to do. They are often unable to work where independence is the norm.

They may avoid positions of responsibility and may pass off promotions to such positions.

Social relations: the social relation of people with the disorder is often limited to the few people on whom they are dependent and these people’s group of friends.

Differentials

Dependent Personality Disorder has symptoms similar to some other disorders. These include:

Other mental disorders and medical conditions such as depressive disorders, panic disorder, and agoraphobia might have similar signs and symptoms to Dependent Personality Disorder.

Other personality disorders: Other personality disorders may be confused with Dependent Personality Disorder because they have certain features in common.

Dependent Personality Disorder and Borderline Personality Disorder are both characterized by the fear of abandonment. People with Borderline Personality Disorder, however, react to abandonment with feelings of emotional emptiness, rage, and demands. Individuals with dependent personality disorder react with increasing appeasement and submissiveness and urgently seek replacement relationships to provide caregiving and support.

Dependent Personality Disorder and Histrionic Personality Disorder are both characterized by a strong need for reassurance and approval. People with Histrionic Personality Disorder flirt and dress very loudly to get the attention they need. At the same time, those with Dependent Personality Disorder focus on 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 have a pattern of seeking and maintaining connections to important others.

Substance use disorders may also have features similar to those seen in Dependent personality disorder.

Many people show traits that are similar to dependent personality traits. These people, however, do not have Dependent Personality Disorder except these traits are inflexible, maladaptive, and persistent. These traits must also cause significant functional impairment or subjective distress to the individual in question.

Also, there are places where dependence is a socially and culturally acceptable norm. In places like this, one can’t make a diagnosis of Dependent Personality Disorder, except the symptoms are out of the norm compared to the general population.

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Conclusion

If you are concerned that you or someone you care about might have a Dependent Personality Disorder, know that there are resources for help out there. You can get further information about the disorder from competent mental professionals at BetterHelp.

Reference

Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington [etc.]: American Psychiatric Publishing. 2013


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