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Needy personality disorder symptoms


Dependent Personality Disorder

Written by WebMD Editorial Contributors

In this Article

  • What Are the Symptoms of DPD?
  • What Causes DPD?
  • How Is DPD Diagnosed?
  • How Is DPD Treated?
  • What Are the Complications of DPD?
  • What Is the Outlook for People With DPD?
  • Can DPD Be Prevented?

 

 

Dependent personality disorder (DPD) is one of the most frequently diagnosed personality disorders. It causes feelings of helplessness, submissiveness, a need to be taken care of and for constant reassurance, and an inability to make everyday decisions without an excessive amount of advice and reassurance from others.

 This personality disorder occurs equally in men and women and usually becomes apparent in young adulthood or later as important adult relationships form.

What Are the Symptoms of DPD?

People with DPD become emotionally overdependent on other people and spend great effort trying to please others. People with DPD tend to display needy, passive, and clinging behavior, and have a fear of separation. Other common characteristics of this personality disorder include:

  • Inability to make decisions, even everyday decisions like what to wear, without the advice and reassurance of others
  • Avoidance of adult responsibilities by acting passive and helpless; dependence on a spouse or friend to make decisions like where to work and live
  • Intense fear of abandonment and a sense of devastation or helplessness when relationships end; a person with DPD often moves right into another relationship when one ends.
  • Oversensitivity to criticism
  • Pessimism and lack of self-confidence, including a belief that they are unable to care for themselves
  • Avoidance of disagreeing with others for fear of losing support or approval
  • Inability to start projects or tasks because of a lack of self-confidence
  • Difficulty being alone
  • Willingness to tolerate mistreatment and abuse from others
  • Placing the needs of their caregivers above their own
  • Tendency to be naive and to fantasize

What Causes DPD?

Although the exact cause of DPD is not known, it most likely involves a combination of biological, developmental, temperamental, and psychological factors. Some researchers believe an authoritarian or overprotective parenting style can lead to the development of dependent personality traits in people who are susceptible to the disorder.

How Is DPD Diagnosed?

A diagnosis of DPD must be distinguished from borderline personality disorder, as the two share common symptoms. In borderline personality disorder, the person responds to fears of abandonment with feelings of rage and emptiness. With DPD, the person responds to the fear with submissiveness and seeks another relationship to maintain their dependency.

If most or all the (above) symptoms of DPD are present, the doctor will begin an evaluation by taking a thorough medical and psychiatric history and possibly a basic physical exam. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, they might refer the person to a psychiatrist, psychologist, or other health care professional trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

How Is DPD Treated?

As is the case with many personality disorders, people with DPD generally do not seek treatment for the disorder itself. Rather, they might seek treatment when a problem in their lives -- often resulting from thinking or behavior related to the disorder -- becomes overwhelming, and they are no longer able to cope. People with DPD are prone to developing depression or anxiety, symptoms that might prompt the individual to seek help.

Psychotherapy (a type of counseling) is the main method of treatment for DPD. The goal of therapy is to help the person with DPD become more active and independent, and to learn to form healthy relationships. Short-term therapy with specific goals is preferred when the focus is on managing behaviors that interfere with functioning. It is often useful for the therapist and patient together to pay attention to the role of therapist in order to recognize and address ways in which the patient may form the same kind of passive reliance in the treatment relationship that happens outside of treatment. Specific strategies might include assertiveness training to help the person with DPD develop self-confidence and cognitive-behavioral therapy (CBT) to help someone develop new attitudes and perspectives about themselves relative to other people and experiences. More meaningful change in someone's personality structure usually is pursued through long-term psychoanalytic or psychodynamic psychotherapy, where early developmental experiences are examined as they may shape the formation of defense mechanisms, coping styles, and patterns of attachment and intimacy in close relationships.

Medication might be used to treat people with DPD who also suffer from related problems such as depression or anxiety. However, medication therapy in itself does not usually treat the core problems caused by personality disorders. In addition, medications should be carefully monitored, because people with DPD become dependent on them or misuse certain prescription drugs.

What Are the Complications of DPD?

People with DPD are at risk for depression, anxiety disorders, and phobias, as well as substance abuse. They are also at risk for being abused because they may find themselves willing to do virtually anything to maintain the relationship with a dominant partner or person of authority.

What Is the Outlook for People With DPD?

With psychotherapy (counseling), many people with DPD can learn how to make more independent choices in their lives.

Can DPD Be Prevented?

Although prevention of the disorder might not be possible, treatment of DPD can sometimes allow a person who is prone to this disorder to learn more productive ways of dealing with situations.

The development of personality structure is a complex process that begins from an early age. Psychotherapy aimed at modifying personality may be more successful when begun early, when the patient is highly motivated for change, and when there is a strong working relationship between the therapist and patient.

Anxiety & Panic Disorders Guide

  1. Overview
  2. Symptoms & Types
  3. Treatment & Care
  4. Living & Managing

Symptoms of Dependent Personality Disorder

Fear of “going it alone,” always second-guessing yourself, and depending on reassurance. Understand how to overcome the symptoms of this condition.

Dependent personality disorder is defined as a very intense and overwhelming need to be cared for — often accompanied by fears of being alone, abandoned, or disappointing others.

Folks with this condition might’ve been described as “clingy” or “needy.” But others may just not understand the persistent self-doubt experienced, or that you’re just trying to feel comfort or get direction on what to do.

Signs of this personality disorder usually start to appear in early adulthood.

Symptoms of dependent personality disorder may include:

  • difficulty making everyday decisions without outside advice
  • needing others to take charge of major areas of your life
  • instinctively agreeing with others
  • lacking confidence to start things on your own
  • need for continual reassurance and support from others
  • feeling uncomfortable, anxious, bored, or helpless when alone
  • an urgent need to find someone new when a relationship ends
  • separation anxiety

Dependent personality disorder may look a little different, person to person.

Many people believe the negative thoughts they have about themselves are true — “I’m unlovable. I’m too much. I just can’t. ”

But these are thoughts— not truth. Yet, these feelings can lead someone with dependent personality disorder to subconsciously seek out more care from others.

If the person you depend on for guidance gets frustrated or overwhelmed by your needs, you might think “Ah, I was right,” and negative thoughts might now be validated for you. The cycle then continues as you may insctinctively try to shop for the same kind of comfort from others.

Some other examples of what dependent personality disorder might look like in daily life include:

  • Self-criticizing and self-doubt. You might, for example, refer to yourself as “stupid” over a mistake that you’d easily forgive in someone else.
  • Dodging responsibility at work. Staying away from big projects — or even just your basic duties — to avoid disappointing others could be a sign that your self-esteem might be affected by dependent personality disorder.
  • Steering away from social situations. You might sometimes decline invitations to hang out with those who aren’t in your “inner council.”
  • Complete lack of autonomy. You could be the life of the party when you’re out with people you love, but you feel empty as soon as you’re by yourself.
  • Masking insecurity. Even if people see you as outwardly confident, you might feel a disconnect between the person you show the world and how you feel inside. You might even feel like people who like and care about you don’t actually feel that way.

Is dependent personality disorder the same as codependency?

While they might look similar, the key difference is in the nature of their interpersonal relationships.

Dependent personality disorder is a condition defined by a constant need to be taken care of; some say it’s largely one-sided. Codependency, on the other hand, involves the compulsion to be needed by another, among other maladaptive coping behaviors.

With that said, it’s possible for them to overlap.

Is dependent personality disorder genetic?

The answer isn’t clear. Personality disorders, in general, aren’t fully understood yet. But it’s usually thought that personality disorders like dependent personality disorder are caused by one or a combination of factors:

  • Genetics. Some experts believe that having a family history of personality disorders predisposes someone to have one, as well.
  • Environment. Our experiences shape us. This is why some people believe that traumatic experiences in our lives are a cause of personality disorders.
  • All the above. Another school of thought is that trauma and stress can influence the development of a personality disorder in people who are genetically predisposed.

A note on genetic predisposition

Genetics can play a role in developing some mental or physical health conditions, but that’s not the end of the story.

Epigenetics is the study of how the DNA you inherit does or does not manifest in you.

This means predispositions that run in your family can stay inactive within you, or can even be reversible when signs show up early.

You can learn more about childhood abuse, complex trauma, and epigenetics here.

Personality disorders are diagnosed by a mental health professional. They’ll compare the criteria for a diagnosis with your:

  • symptoms
  • life experiences
  • age

Since personality disorders are usually defined by long-standing patterns of behavior, they’re usually diagnosed in adulthood.

Dependent personality disorder is a long-term condition that can be lived with, by making diligent use of therapy and medication. You can stand on your own and enjoy a fulfilling life while managing the condition.

If you’re diagnosed with dependent personality disorder, your treatment might include:

  • medications, like antidepressants and antianxiety meds
  • therapy with a trained mental health professional, possibly using cognitive behavioral therapy (CBT)
  • a combination of both

There are no medications that have been approved for the specific treatment of dependent personality disorder. But common psychiatric medications are sometimes used to address some of dependent personality disorder’s effects on mood in combination with talk therapy.

Therapy, with or without medication, may be the best route to explore for the time being. According to one 2020 study, personality disorders among people with health-related anxiety — especially those with dependent traits — were found to benefit from CBT.

What you can try on your own

Beyond what your treatment plan includes therapeutically, there are a number of other things you can do on your own to help you manage dependent personality disorder.

These might include:

  • Introspective activities like meditation or journaling
  • Support groups where people understand your perspective
  • Practicing autonomy, bit by bit, a step in a healthful direction each day

Steps to build up your emotional intelligence and autonomous self include practical strategies like sleeping on decisions, so you can get a fresh take the next morning. This helps overcome second-guessing yourself or nagging indecisiveness.

To encourage autonomy in students, developmental psychologists cultivate these specific skills:

  • Expanding comprehensive thinking by becoming cognizant of the fact that you control what and how you think. Personal agency is bred from reflective self awareness and learning to express emotions healthily
  • Stretching your perceptions of your own competence
  • Asking your “inner circle” to hold you accountable for your own life choices and endeavors. The next time you come to them for guidance and reassurance, give them license to warmly put the onus back on you to make a choice for yourself

Like other personality disorders, dependent personality disorder can affect every aspect of your life.

Research from 2020 indicates that folks living with personality disorders have a higher rate of disabilities, healthcare use, and medical co-occuring medical conditions.

It’s possible to lead a fulfilling life with dependent personality disorder if it’s treated and managed. But those with untreated personality disorders are likelier to experience:

  • continued or worsened symptoms
  • sleep disorders
  • substance use disorders
  • chronic health conditions or chronic pain
  • obesity
  • suicide

If you or someone you know is thinking about suicide, contact the National Suicide Prevention Lifeline at 800-273-8255.

If you believe you’re living with dependent personality disorder, you could benefit from reaching out to a mental health professional.

If you think someone you know may have it, you can gently encourage them to seek treatment — but make sure to come from a loving, nonjudgmental place.

Need a little more guidance? You can bookmark our guide for how to talk about mental illness.

If you need help finding someone who can provide a diagnosis and get you started on treatment, you can check out the American Psychiatric Association’s Find a Psychiatrist tool. Talk therapy, also known as psychotherapy, is one of the key ways to start learning how to cope.

Dependent personality disorder can be anxiety inducing, fear filling, and fill you with indecision and insecurity. For your loved ones and those among your “inner circle,” it can be taxing. But it is treatable.

With talk therapies, mindfulness, and educating yourself and your support group on the condition,you can live well.

If you’re diagnosed, while your treatment team arranges a therapeutic program, you can make some emotional intelligence changes to manage dependent personality disorder while also staying true to yourself.

It’s possible to still value closeness without letting dependent personality disorder take over your life. Recognizing how it affects you is an important step forward.

  • Common comorbidities with substance use disorders research report part 1: The connection between substance use disorders and mental illness. (2021). https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
  • Doyle M, et al. (2016). Suicide risk in primary care patients diagnosed with a personality disorder: a nested case control study. https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-016-0479-y
  • Holder S. (2020). Mental disorders: personality disorders. https://pubmed.ncbi.nlm.nih.gov/32757561/
  • McCombs, BL. (2010). Developing responsible and autonomous learners: A key to motivating students. http://www.apa.org/education/k12/learners
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  • Personality disorders. (2017). https://www.nimh.nih.gov/health/statistics/personality-disorders.shtml
  • Ramsay G, et al. (2020). Personality disorders revisited: a newly proposed mental illness. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478931/
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  • Tyrer P, et al. (2020). Influence of apparently negative personality characteristics on the long‐term outcome of health anxiety: Secondary analysis of a randomized controlled trial. https://onlinelibrary.wiley.com/doi/full/10.1002/pmh.1496
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Personality disorder - causes, types, types, symptoms, signs, diagnosis (test), treatment

Features

Causes

Symptoms

Diagnosis

Treatment

Personality disorder, the causes of which are not always obvious, used to be called constitutional psychopathy. This is a mental disorder that accompanies a person throughout life. The main changes affect the character, thinking and behavior, which causes difficulties in social adaptation. The psychopath breaks the norms and rules accepted in the social environment. The severity of the changes is different - from everyday inconsistency to criminal acts with subsequent restriction of freedom. nine0003

Features of personality disorder

World statistics of diseases states that about 10% of the world's population suffers from psychopathy. Each type of personality disorder accounts for an average of about 2% of cases. A distinctive feature is that the first manifestations are noticeable already in early childhood, practically unchanged throughout life.

Psychopathy is not quite a disease in the usual sense of the word. The disease has a beginning, progression and consequences in the form of organic (irreversible) disorders of the function and structure of organs. Psychopathy is a special, painful personality structure that does not undergo any changes in the changing conditions of life. This prevents the psychopath from adapting to the environment. Relatively speaking, a person with a personality disorder will behave in the same way with a first grader and a scientist, in a tram and a living room, not realizing that different people and situations require different behavior. nine0003

The problem of psychopathic personalities, anomalies of character was thoroughly studied by the Soviet and Russian psychiatrist Pyotr Borisovich Gannushkin, whose definitions of personality disorders have not lost their relevance to this day.

Causes of personality disorders

Experts consider several main reasons:

  • genetic factor - practice shows that pathological character traits are found in representatives of different generations of the same family; nine0029
  • an established vicious system of interpersonal relationships - the child does not have before his eyes an example of a normal, sympathetic and empathetic family;
  • a psychopathic pattern (template, model) of behavior that the child unconsciously copies due to the lack of other examples;
  • pathological pregnancy, difficult childbirth and diseases of early childhood;
  • childhood abuse, physical or psychological; nine0029
  • difficult childhood, unfavorable developmental conditions.

Researchers believe that genetic factors are of paramount, determining importance. This theory is confirmed by the twin method: identical brothers and sisters, separated in early childhood and raised in different families, behave exactly the same in adulthood. Twins who have never interacted with each other show the same types of personality disorder. nine0003

Personality disorder symptoms

Gannushkin identified 7 types of psychopathy. Since the 90s, when the 10th revision of the International Classification of Diseases, Injuries and Causes of Death came out, the condition has been called a personality disorder, but the essence has not changed. Each type of psychopathy has its own distinctive features.

Schizotypal personality disorder is distinguished by the minimization of social contacts, lack of need for communication, coldness, lack of empathy (the ability to empathize). Schizoids are attracted to fantasies, various distant theories, they are unable to perceive life directly, sensually. Teamwork is not for them, they can be more or less successful in individual activities. Their main feature is indifference, both to themselves and to others. Such people sincerely do not understand what pleasure and joy are, because they have never experienced them. nine0003

Bipolar personality disorder according to Gannushkin includes 3 types: depressive, agitated and cyclothymic. Depressives are lifelong pessimists who are able to see only sad, gloomy sides in all the diversity of life. Excited - easy-going, carried away, often unable to foresee the consequences of their actions. The vast majority of gamblers and swindlers are of this type. Cyclothymics combine both of the above features, they are characterized by undulating mood swings, lack of stable attachments, blurring and diversity of interests. nine0003

Dissociative identity disorder in Western culture is called a split identity. It is believed that several personalities coexist in one person, which are periodically activated. We have been using this diagnosis since 2000, but it does not take root well. Domestic psychiatrists consider this disorder a kind of psychological defense of a person who has experienced extreme, unbearably painful emotions. At the same time, a person perceives the events of his life as something that happened to others. nine0003

Narcissistic personality disorder refers to the Greek myth of Narcissus, a young man who preferred the love of a real girl to looking at his reflection in the water of a stream. Like the hero of a myth, a narcissist is convinced of his exclusivity and originality, and this applies to everything from appearance to achievements. The narcissist believes that real achievements are hindered by the envy of others who put up all sorts of obstacles. Own uniqueness requires constant confirmation, so the narcissist maintains relationships only with those who admire him. nine0003

Organic personality disorder - a consequence of damage to the brain tissue by various hazards: trauma, intoxication, infection. Such a disorder occurs in the clinic in patients who have had a stroke, encephalitis, in alcoholics and drug addicts. In the latter, the condition is aggravated by the consequences of closed craniocerebral injuries, which they receive when falling from a height of their own height in a state of intoxication.

In a mild form of the disorder, the patient is disturbed by frequent headaches, weakness, fatigue, tearfulness, intolerance to stuffiness, meteorological dependence. Over time, thinking is disturbed, thoroughness, viscosity, concentration on minor details joins. Such a patient cannot separate the main from the secondary, speech becomes impoverished, emotions coarsen, periods of an evil-dreary mood (dysphoria) occur. An intellectual decline occurs, the patient cannot cope with the previous work, criminal episodes with fights and bodily injuries to the “offender” are not uncommon. nine0003

Borderline personality disorder is manifested by unstable mood, fluctuating from overestimation of oneself to humiliation. Patients are impulsive, commit rash acts, anxious, suicidal. Any little thing causes a feeling of emptiness, fears of being unnecessary, "thrown out of life." This disorder is the basis for the formation of drug addiction and eating disorders.

Personality disorder diagnostics

It is desirable to carry out such a diagnosis as early as possible, because the disorder accompanies a person all his life. Problem children should be under the supervision of a child psychiatrist in order to overcome teenage difficulties with minimal losses. Even a single consultation with a specialist will allow parents to correct the behavior of the baby, as they will understand the motives of his actions. nine0003

A variety of tests for personality disorder are used in adolescents and adults. Popular tests based on the work of Eysenck, Beck, Freeman. The test is a questionnaire with several standardized answers, a lie scale is provided so that the subject cannot be misled. The tests are fairly objective and are widely used in the clinic.

Personality disorder treatment

The basis of treatment is the choice of a life path, profession and occupation suitable for the type of personality. This is where a clinical psychologist can help. An occupation corresponding to a personality type can make a person so successful that no one will notice the disorder. nine0003

In severe cases, when the time for professional orientation is missed, medications (antidepressants, tranquilizers, nootropics), psychotherapeutic methods, including psychoanalysis, are used. Treatment options for advanced personality disorders are limited, especially in patients with addiction or irreversible brain damage.

The best solution for suspected psychopathy is timely consultation with an experienced psychiatrist.

Article author:

Novikov Vladimir Sergeevich

psychotherapist, clinical psychologist, kmn, member of the Professional Psychotherapeutic League

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Clinic m. Frunzenskaya

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