Dependent personality disorder (DPD) is a condition where a person feels terrified about being alone or abandoned. People with dependent personality disorder are entirely dependent on others. This disorder can eventually lead to substance abuse and other negative consequences that require several treatments for dependent personality disorder.
A person struggling with this type of personality disorder is usually completely reliant on a relationship to meet all their needs (emotionally and physically). The reason people develop DPD is currently unknown. However, several factors may contribute to someone having DPD.
Dependent personality disorder can be an intense and crippling disorder for some. At Free by the Sea in Washington, we understand how tough disorders like DPD can be. Our staff provides continuous comfort and support for every individual throughout their treatment journey. Going through this experience alone is not necessary; let us be your guide toward a better life.
Factors that Contribute to DPD
While the exact cause is unknown, several factors may contribute to the development of DPD, including:
- Trauma: Distressing past experiences that shape dependency patterns.
- Genetics: A family history of personality disorders or anxiety conditions.
- Separation anxiety: Early childhood fears of being left alone or abandoned.
- Environmental factors: Unstable or unpredictable home environments during development.
- Overprotective parenting: Caregiving styles that limit a child’s independence.
- Chronic physical illness: Long-term health conditions that increase reliance on others.
Regardless of why someone may develop DPD, getting help is important. DPD can be an intense and painful experience. This disorder causes a person to forfeit their personal identity, with another person’s decisions dictating their life. Fortunately, several dependent personality disorder treatments are available.
Symptoms of Dependent Personality Disorder
There are a variety of symptoms associated with DPD. Together, these symptoms can make everyday tasks difficult and can be a source of stress. Being aware of these signs helps ensure a loved one or friend receives proper care. Common DPD symptoms include:
- Difficulty with solitude: A persistent inability or discomfort when being alone.
- Trouble with self-initiation: Hesitancy or inability to start projects or tasks independently.
- Fear of abandonment: An intense and pervasive fear of being left to care for oneself.
- Extreme sensitivity to criticism: Reacting strongly to any form of negative feedback.
- Tolerance of mistreatment: Accepting abuse or mistreatment from others to avoid conflict.
- Placing others’ needs first: Consistently prioritizing caregivers’ or others’ needs above their own.
- Avoiding personal responsibilities: Especially those that require independent decision-making.
- Avoiding disagreement: Suppressing differing opinions out of fear of losing approval.
- Difficulty making decisions: Requiring constant reassurance from others for everyday choices.
- Devastation after relationship loss: Feeling helpless when a relationship ends and quickly seeking a new one.
In some cases, people confuse dependent personality disorder with borderline personality disorder (BPD). With borderline personality disorder, a person’s fear of being alone occurs alongside feelings of anger and rage. A person with DPD, on the other hand, will likely be passive and submissive rather than angry.
How Dependent Personality Disorder Compares to Other Personality Disorders
Understanding how DPD differs from related personality disorders can help clarify a diagnosis and guide treatment planning. The table below outlines key distinctions between dependent personality disorder and three other commonly discussed personality disorders.
| Personality Disorder | Core Fear | Interpersonal Style | Common Behaviors | Dual Diagnosis Considerations
|
| Dependent Personality Disorder (DPD) | Abandonment and being alone | Submissive, passive, clinging | Seeks constant reassurance, avoids disagreement, defers decisions to others | May use alcohol or drugs to manage separation anxiety or relationship distress |
| Borderline Personality Disorder (BPD) | Abandonment and instability | Intense, reactive, unstable | Emotional outbursts, impulsivity, shifting relationships, self-harm | Higher rates of substance use and emotional dysregulation can complicate treatment |
| Histrionic Personality Disorder (HPD) | Loss of attention or approval | Dramatic, attention-seeking, expressive | Exaggerated emotions, discomfort when not the center of attention | May use substances to lower inhibitions or maintain social engagement |
| Antisocial Personality Disorder (ASPD) | Loss of control or autonomy | Manipulative, disregarding others | Disregard for rules and others’ rights, impulsivity, deceitfulness | Strongly associated with substance use disorders; requires specialized dual diagnosis care |
While all four disorders can appear in a dual diagnosis treatment setting, the patterns of behavior and emotional response differ significantly. A thorough clinical assessment is essential to distinguish between them and develop an appropriate treatment plan.
Dependent Personality Disorder and Substance Abuse
When someone is dealing with a mental disorder as intense as DPD, turning toward substances is not uncommon. A person may use drugs or drink alcohol to cope with their symptoms. Prescription drug misuse is also frequently observed in individuals who live with dependent personality disorder.
Prescription medication can be a slow-acting process, and effects sometimes do not appear until weeks later. A person struggling with DPD may become impatient when they are not getting the desired results. This impatience may lead to misusing the medication over time.
How Substance Abuse Deepens Dependency
People struggling with DPD may fall deep into addiction after continuous substance abuse. Symptoms can become too difficult to manage, leading the person to turn to drugs and alcohol for relief. This situation consistently worsens when substance abuse occurs alongside DPD.
The Effects of Substance Abuse on Dependent Personality Disorder Symptoms
While many people who struggle with DPD may turn to substance abuse to cope with their symptoms, the long-term effects are negative. Substance abuse affects not only the body but the mind as well. There are several negative psychological effects that drugs can have on the mind.
Abusing drugs while suffering from a mental illness is referred to as a co-occurring disorder. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), co-occurring disorders require integrated treatment that addresses both conditions simultaneously. What tends to happen is that both the mental disorder and the addiction start to reinforce each other over time.
Over time, the symptoms of DPD will only worsen with drug abuse. Many people may get short-term relief when using alcohol and drugs, but this only intensifies symptoms over time. During treatment, substance abuse can also complicate dependent personality disorder treatments because of underlying mental health issues.
Here are a few commonly misused substances and their effects on DPD:
- Alcohol misuse: While it provides short-term relief, it does not take long for someone to become dependent on alcohol. Alcohol misuse is frequently observed in cases of co-occurring DPD.
- Stimulant misuse: Stimulants may address some DPD symptoms temporarily. However, excessive or prolonged use creates additional health and psychological problems.
- Marijuana misuse: Individuals may use marijuana to relax and relieve some DPD symptoms. However, when the effect wears off, symptoms typically return.
- Opioid misuse: Opioids are among the most commonly misused substances. They are highly addictive and may be used to escape the emotional weight of DPD symptoms.
Mental Health Conditions that Commonly Co-Occur with Dependent Personality Disorder
Dependent personality disorder rarely exists in isolation. Many people who receive a DPD diagnosis also experience one or more co-occurring mental health conditions that can intensify symptoms and complicate recovery. Understanding these overlapping conditions is an important part of building an effective dual diagnosis treatment plan.
Anxiety and depression are among the most frequently co-occurring conditions with DPD. The persistent fear of abandonment and reliance on others for emotional stability can fuel chronic anxiety. The loss of a relationship or perceived rejection may trigger episodes of depression. Anxiety or depression often co-occurs with DPD and substance use. In these cases, integrated treatment that addresses all three conditions simultaneously produces the best outcomes.
CPTSD (Complex Post-Traumatic Stress Disorder) can overlap significantly with DPD, particularly when early trauma, attachment disruption, or chronic childhood stress shaped a person’s dependency patterns. Individuals with CPTSD may develop deep-seated fears of abandonment and an inability to self-regulate emotionally — patterns that closely mirror DPD. Recognizing a trauma history is essential in treatment planning, as it may change both the therapeutic approach and the level of care needed.
Agoraphobia is another condition that can co-occur with DPD. Both involve avoidance behaviors and difficulty functioning independently. A person with DPD who also experiences agoraphobia may become increasingly reliant on a caregiver or partner to navigate daily life, which can reinforce dependency patterns and increase vulnerability to substance use. It is important to note that agoraphobia and DPD are distinct conditions — their overlap requires careful clinical assessment rather than a combined diagnosis.
Schizoaffective disorder and psychosis represent more complex presentations that can sometimes appear alongside DPD in a dual diagnosis context. When more severe psychiatric symptoms are present, treatment requires a higher level of psychiatric oversight and integrated care. These cases underscore why a thorough clinical evaluation is so important before beginning any treatment program.
Treating Dependent Personality Disorder and Co-Occurring Disorders
In cases of co-occurring disorders, both drug addiction and mental disorders are treated concurrently. This requires specialized treatment and a comprehensive approach, such as inpatient or residential rehab. At Free by the Sea, the focus is on achieving the right level of treatment and supporting long-term recovery through personalized dependent personality disorder treatments.
Treating dependent personality disorder requires long-term behavioral therapy. There is no set cure for DPD. However, several therapy options can help a person manage DPD and build a more independent, fulfilling life.
Behavioral therapy is one of the most effective approaches for addressing both drug addiction and DPD. Cognitive-behavioral therapy (CBT) is one of the most commonly used therapy options in cases of co-occurring disorders. CBT helps a person change their thought processes and behaviors.
In cases of DPD, a person may be in a toxic relationship or may exhibit an intense fear of abandonment. Cognitive-behavioral therapy helps a person change the way they think about themselves and their circumstances. This can support greater independence and build confidence over time.
Several behavioral therapy techniques may be used in treatment for dependent personality disorder and addiction, depending on a person’s specific needs and clinical presentation:
- Dialectical Behavior Therapy (DBT): DBT builds on CBT by adding skills training in emotional regulation, distress tolerance, and interpersonal effectiveness. For people with DPD, DBT can be especially helpful in developing the ability to tolerate discomfort without seeking immediate reassurance or turning to substances. It teaches practical tools for managing intense emotions and navigating relationships in healthier ways.
- Schema Therapy: Schema therapy addresses long-standing patterns of thinking and behavior that often develop in childhood. For individuals with DPD, this approach helps identify and challenge deeply held beliefs about helplessness, dependency, and the need for others’ approval. It is particularly useful when early attachment experiences or trauma have shaped the dependency pattern.
- EMDR (Eye Movement Desensitization and Reprocessing): When trauma or CPTSD is part of the clinical picture alongside DPD, EMDR may be incorporated into the treatment plan. EMDR helps process distressing memories that can drive fear-based behaviors, including the intense abandonment fears common in DPD. It is typically used as one component of a broader trauma-informed treatment approach rather than as a standalone therapy.
- Group Therapy: Group therapy provides a structured environment where individuals with DPD can practice interpersonal skills, receive feedback, and build confidence in expressing their own needs and opinions. The group setting challenges avoidance and dependency behaviors naturally in a supportive context.
- Family Therapy: Because DPD often plays out most intensely within close relationships, family therapy can be a valuable part of treatment. It helps family members understand the disorder, recognize patterns that may unintentionally reinforce dependency, and develop healthier communication and boundary-setting skills.
Medication is not typically prescribed as a primary treatment for dependent personality disorder. However, medication can address certain co-occurring symptoms such as depression or anxiety. It can also support recovery from drug addiction by managing severe withdrawal symptoms.
No medication cures dependent personality disorder itself. However, medication may play a supportive role in managing co-occurring symptoms and substance use disorders when clinically appropriate. According to the National Institute of Mental Health, medication is most effective when used alongside therapy in co-occurring disorder treatment:
- SSRIs (Selective Serotonin Reuptake Inhibitors): SSRIs such as sertraline (Zoloft) or other antidepressants may be prescribed to address co-occurring anxiety or depression symptoms in individuals with DPD. They do not treat the dependency pattern directly, but reducing the severity of anxiety or depressive episodes can make it easier for a person to engage in and benefit from therapy.
- Benzodiazepines: Benzodiazepines are used with significant caution in individuals with DPD. Because dependent personality disorder already involves a strong tendency toward reliance and dependency, these medications carry a heightened risk of misuse and physical dependence in this population. When anxiety management is needed, clinicians typically explore other options first and monitor closely if benzodiazepines are considered.
- Naltrexone and other addiction medications: When alcohol use disorder or opioid use disorder co-occurs with DPD, medications such as naltrexone may be part of the treatment plan. Naltrexone works by reducing cravings and the rewarding effects of alcohol or opioids, supporting recovery while therapy addresses the underlying personality patterns. Medication-assisted treatment decisions are always made on an individual basis through careful clinical assessment.
Inpatient Treatment, also called residential treatment, offers comprehensive care for both DPD and drug addiction. This type of rehab allows a person to reside in a structured treatment center with 24/7 clinical support available at any time.
With co-occurring disorders, residential treatment is often the most effective option. Treating both drug addiction and mental illness simultaneously requires a structured, intensive environment. Free by the Sea in Washington offers a compassionate team ready to support individuals and families through every step of recovery.
Get Help Today
Dependent personality disorder can be a crippling disorder for a person and those around them. Rehab centers in Washington, like Free by the Sea, offer a variety of dependent personality disorder treatments personalized for each individual. Contact us today to learn more about treatment options and available drug addiction resources.
Frequently Asked Questions
Dependent personality disorder is a long-term pattern of relying heavily on other people for reassurance, decisions, and emotional support, often accompanied by an intense fear of separation or abandonment. It is a recognized personality disorder that can significantly affect daily functioning and relationships.
When a person with DPD uses alcohol or drugs to manage fear, helplessness, or relationship distress, substance use can quickly become a coping mechanism. Over time, this typically worsens both the emotional dependence and the addiction, making integrated dual diagnosis treatment the most effective approach.
No. Both conditions can involve fear of abandonment, but dependent personality disorder is more closely associated with submissiveness and reassurance-seeking, while borderline personality disorder more often involves emotional instability, impulsivity, and intense anger or rapidly shifting relationships.
Treatment commonly includes cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), schema therapy, group therapy, and family therapy. When trauma is also present, EMDR may be incorporated. These approaches focus on building self-efficacy, emotional regulation, healthy boundaries, and independent decision-making.
Anxiety, depression, CPTSD, and agoraphobia are among the most frequently co-occurring conditions. In more complex cases, schizoaffective disorder or psychosis may also be present, which requires a higher level of integrated psychiatric and addiction care.
No medication cures dependent personality disorder itself. SSRIs may be prescribed to help manage co-occurring anxiety or depression, while benzodiazepines are used with caution due to the elevated dependency risk in this population.
Inpatient or residential treatment is often recommended when substance use is active, withdrawal risk is present, symptoms are severe, or home support is limited. A structured residential setting allows mental health and addiction treatment to occur simultaneously, which is particularly important in dual diagnosis cases.
Dr. Richard Crabbe joined our team in 2019 as our psychiatrist and medical director. He attended the University of Ghana Medical School where he became a Medical Doctor in 1977. From 1978 through 1984, he was a medical officer in the Ghana Navy and provided a variety of services from general medicine to surgeries. He received his Certificate in General Psychology from the American Board of Psychology and Neurology in 2002.
