We all want to be accepted and cared for by those around us,
but a healthy life requires a balance between self-efficacy and dependence on
others. Similarly, society, in order to function properly, needs both
individuals making independent contributions and the underlying structure of
family, business, and
social relationships holding those individuals together. However,
some people depend on others too much, causing both personal and social
problems. For a very few, this dependence reaches the point of causing a
personality disorder.
اضافة اعلان
As the name implies, dependent personality disorder
(DPD) is a condition in which an individual is overly dependent on others. The
Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
defines DPD as “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”. Research into this personality
disorder is scarce, and little information exists on its prevalence, although
it is estimated to affect 0.5-0.6 percent of the population.
DPD is further characterized by high levels of
pessimism and self-doubt. Individuals who struggle with this condition believe
they are not capable of doing even simple tasks without help, and this lack of
self-efficacy devolves into a sense of worthlessness. Furthermore, any
criticism or disapproval is used to justify such negative feelings,
exacerbating the issue. In order to compensate, individuals with DPD will often
seek out others who are overprotective and dominant.
How much dependence
is too much?
To establish a DPD
diagnosis, healthcare professionals rely on the DSM-5’s list of eight markers,
of which five are sufficient for a diagnosis. These markers include having
difficulty making independent decisions, feeling helpless when alone,
displaying a pattern of needy, clingy, and submissive behavior, and possessing
an overwhelming desire for someone else to care for them.
That said, DPD is very difficult to diagnose due to
the very nature of the condition. It is completely normal and, in fact, healthy
and socially beneficial to be dependent on others to some degree. However,
given the nuanced nature of various social relationships, it difficult to
discern what a healthy level is. For example, according to the DSM-5, DPD
should not be diagnosed in children, or even teens, because dependence on
others, especially parents, is normal developmental behavior.
Culture also plays
a role in the difficulties surrounding DPD diagnosis. For example, a diagnosis
of DPD in the US may be very different from a diagnosis in Jordan. In the
US,
it is normal for a young adult to graduate high school and set out into the
world alone, whether by traveling, studying at university, or finding work.
However, the culture in Jordan is different. Traditionally, Jordanians do not
become fully independent until they get married, meaning that independence
often occurs much later for them than their American counterparts. This could
further complicate a DPD diagnosis since the DSM-5 is a US manual based on
American culture. In order to make it applicable to Jordan, research and
evidence-based practice would need to be implemented to consider cultural
factors.
The three clusters
Personality disorders are
divided into three different classes, known as clusters. Cluster A is
characterized by odd or eccentric behavior, while cluster B is characterized by
emotional or erratic behavior. DPD falls under cluster C, which is
characterized by anxious and nervous behavior. In the case of DPD, the anxious
and nervous behavior manifests in various ways. For example, it is common for
individuals with DPD to behave submissively and rely heavily on friends or
family for decision-making and repeated reassurance. Additionally, they
commonly feel isolated and are afraid of rejection and abandonment. When alone,
symptoms may range from nervousness, fear, and hopelessness to anxiety, and
even panic attacks.
Nature and nurture
There is no clear cause for
DPD, but experts in the field suggest that both biological and developmental
factors play a role. The biological aspect is complex and not fully understood,
but it is currently believed that if there is a family history of DPD or other
anxiety disorders, you may be at higher risk. Additionally, personality traits
are believed to have potential hereditability. Therefore, if your family has
personality traits such as agreeability and low risk tolerance, you may be at
higher risk of DPD.
Several environmental and developmental factors have
also been identified to potentially increase the risk of DPD. Research seems to
suggest that those who have been in an abusive relationship are at a higher
risk of developing DPD. Furthermore, a 2017 study found that individuals with
DPD are more likely to end up in unhealthy or even abusive relationships, which
can further perpetuate the condition. Additionally, traumatic experiences in
childhood could increase the risk of developing DPD later in life. This can
come in the form of a chronic or life-threatening illness during childhood or
child abuse of a physical, sexual, or emotional nature.
Embarking on healing
Managing and treating any
mental disorder, especially a personality disorder, is no easy task. Treatment
typically relies heavily on therapy in order to help the individual confront
their feelings and overcome their way of thinking. Therapy for DPD can come in
a variety of forms. Common forms of individual therapy include
cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). CBT is
focuses, on identifying and changing negative thought patterns, whereas DBT is
a modified form of CBT that focuses on ways to cope. Both have been found to be
effective, but DBT may be a better option, since it was originally intended to
treat another type of personality disorder known as borderline personality
disorder. Additionally, group therapy may be beneficial, as an individual may
be able to recognize negative patterns more easily in a group setting.
Medication such as anti-depressants or anti-anxiety medications may also be
prescribed in conjunction with therapy.
There are also things that you can do on a personal
level to help manage the condition. These tips not only apply to those with DPD
but can be used by people who feel they may lack individualism and
self-efficacy.
First, start by challenging yourself by doing things
on your own. You can start with simple tasks such as grocery shopping, and then
gradually increase to more difficult tasks.
Physical activity can also be an excellent way to
help overcome DPD and dependency issues. Joining a gym or beginning a regular fitness
routine could help you overcome negative thoughts and patterns of thinking.
Once you begin to work out regularly, you can start to push yourself within
your routine, testing the bounds of your own limits. Since the mind and the
body are connected, challenging your physical limits can also help you push
past mental blocks.
The ultimate key to self-treating DPD or dependency
issues is to practice independence, learning to trust yourself. This can be
accomplished via introspective reflection. It may not be easy to overcome DPD,
but with time and practice, it is certainly possible.
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