Diagnostic Criteria
A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
(2) needs others to assume responsibility for most major areas of his or her life
(3) has difficulty expressing disagreement with others because of fear of loss of support or approval. Note: Do not include realistic fears of retribution.
(4) has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
(5) goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
(6) feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
(7) urgently seeks another relationship as a source of care and support when a close relationship ends
(8) is unrealistically preoccupied with fears of being left to take care of himself or herself
Personality disorders cause people to appear different than “normal” cultural behavior. Often they have different beliefs about the world and about how people should act. These beliefs differ far enough that their behavior appears socially inappropriate in a number of ways.
The differing beliefs show themselves in a number of situations including:
The primary feature of a personality disorder is that these different beliefs cause them a great deal of difficulty getting along in relationships. These relationships don’t have to be personal relationships although often they are. Work relationships or school relationships can also be impacted.
It is important to note that these different beliefs and behaviors are not once in a while and are an enduring overall pattern to the relationships in their lives. Having difficulties in only a few relationships in life does not qualify one as having a personality disorder.
Having a personality disorder is a very frustrating experience. Trying to be successful and trying to make the world work for them is a lot of work and it is often confusing to those suffering from a personality disorder as to why they work so hard with other people, only to have everything fall apart.
Dependent personality disorder individuals usually appear needy, anxious, or paranoid, specifically about being dependent or “needing” others. This individuals usually show many signs of worry, stress and anxiety over losing the person or persons who mean the most to them and “take care” of them. They usually also have unrealistic expectations about how much they should be cared for and loved by others.
The exact cause of personality disorders is unknown. However, there are two major factors that increase the chances of developing a personality disorder; genetic sensitivity and abusive or neglectful childhood experiences.
It is not known why some people go through an experience as a child and develop a personality disorder, while other children go through the same experiences and do not develop a disorder. This is where genetic sensitivity comes in. The prevailing theory is that certain people are more sensitive to certain situations.
When we are young we learn to develop appropriate behavior, beliefs and emotional expression. If our needs are not met because our caretakers are neglectful emotionally, or if we experience abuse, the development of our beliefs and emotional expression can be impacted.
With our beliefs and expressions impacted from abuse or neglect, the beliefs that are formed can stay childlike and immature, or they can shift and mold into beliefs that are not in line with mainstream expectations. As we grow up and express these unbalanced beliefs, the world around us does not respond to them in a positive way – the molded beliefs do not mesh well with the unmolded beliefs of society and those around us. This causes conflict and difficulty in relationships and expression of feelings – a personality disorder.
There is no “cure” for a personality disorder. The most successful treatments for personality disorders include a combination of medication and psychotherapy.
Psychotherapy can help to learn coping skills for dealing with beliefs and expressions that are not received well by society while medications can be used to help improve mood symptoms.