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Dependent Personality Disorder vs. People Pleasing: A Deep Dive

dependent personality disorder

Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD

Dependent Personality Disorder (DPD)

In the nuanced landscape of mental illnesses and mental health, understanding the dynamics of personality disorders and behavioral patterns is crucial. Dependent Personality Disorder (DPD) and chronic people-pleasing are often discussed in relation to emotional well-being and interpersonal relationships. While they share some overlapping features, such as a fear of rejection and a tendency toward self-sacrifice, they are fundamentally distinct. DPD, a condition often misunderstood similarly to Borderline Personality Disorder, involves an excessive reliance on others to meet emotional and adult responsibilities. This dependency is not merely a personality trait but aligns with specific diagnostic criteria. On the other hand, people pleasers often set aside their own needs to avoid feeling uncomfortable, driven by an intense desire to avoid anger and not feel guilty. This blog will delve into the core problems caused by these behaviors, examine their impacts on a person’s family and close relationships, and discuss the importance of setting healthy boundaries for self-care.

What is Dependent Personality Disorder?

Dependent Personality Disorder (DPD) is a psychological condition characterized by a pervasive and excessive need to be taken care of, leading to submissive and clinging behavior and fears of separation. This disorder is one of several personality disorders identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

While a people pleaser may exhibit some similar behaviors, such as seeking approval and avoiding conflict, they do not necessarily meet the criteria for DPD.

People with DPD often struggle with self-confidence and tend to depend on others to make decisions for them. They may have difficulty initiating projects or doing things on their own because of a lack of self-trust. Other features include:

  • Difficulty disagreeing with others for fear of losing support or approval
  • Tolerance of poor or abusive treatment, even when other options are available
  • Urgent need to start a new relationship when one ends
  • Unrealistically preoccupied with fears of being left to care for themselves


These behaviors and fears typically arise from and are perpetuated by underlying issues of self-esteem and anxiety about being alone or unsupported. Treatment often involves psychotherapy, which can help individuals become more independent and learn to maintain healthy relationships.


What are the Symptoms of DPD?

Dependent Personality Disorder (DPD) is characterized by a wide range of symptoms that revolve around an excessive emotional reliance on others. The symptoms can interfere significantly with an individual’s personal, social, and professional life. Key symptoms of DPD include:

  1. Difficulty Making Decisions Without Reassurance: Individuals with DPD often struggle to make everyday decisions without an excessive amount of advice and reassurance from others.
  2. Need for Others to Assume Responsibility: They may need others to take responsibility for most major areas of their life. This can include trivial decisions as well as significant life choices.
  3. Fear of Abandonment: People with DPD typically have a pervasive fear of abandonment and being alone. They might go to great lengths to avoid being alone or to avoid perceived or real abandonment.
  4. Submissive Behavior: To obtain support and care, individuals with DPD may exhibit overly submissive behavior and may not express disagreement, especially with those they depend on.
  5. Difficulty Initiating Projects: They often feel unable to initiate projects or do things on their own due to a lack of self-confidence or fear of not doing it right.
  6. Feelings of Helplessness When Alone: Because of their dependence on others, they may feel helpless when left alone, unsure of their ability to care for themselves.
  7. Urgently Seeking Another Relationship: When one close relationship ends, they might urgently seek another relationship to provide the care and support they feel unable to provide for themselves.
  8. Tolerance of Poor Treatment: Due to their fear of losing support or being left alone, individuals with DPD might tolerate poor or abusive treatment, even when better options are available.


People pleasers tend to exhibit behaviors such as empathy, thoughtfulness, and a need for control, which can sometimes overlap with the symptoms of DPD.

These symptoms can vary in intensity and may not all be present in every individual with DPD. The disorder can only be diagnosed by a qualified professional through a comprehensive clinical evaluation, often involving an in-depth interview and standardized assessment tools. Treatment typically involves psychotherapy, particularly cognitive-behavioral therapy (CBT) or psychodynamic therapy, which can help individuals develop healthier relationships and build self-esteem and autonomy.


What Causes Dependent Personality Disorder?

The causes of Dependent Personality Disorder (DPD) are not fully understood, but it is believed to result from a complex interplay of genetic, developmental, psychological, and social factors. Here are some of the contributing factors believed to play a role in the development of DPD:

  1. Genetic Factors: There may be a genetic predisposition to developing DPD, as personality disorders and other mental health conditions often run in families.
  2. Early Parenting Styles: How a person is raised can significantly influence their personality development. Overprotective or authoritarian parenting can contribute to dependency traits by not allowing children to develop a sense of autonomy and self-sufficiency. Conversely, neglectful or inconsistent parenting can lead to feelings of insecurity and a subsequent excessive need for support and approval.
  3. Attachment Issues: Problems with early attachment, such as inconsistent or insecure attachment to caregivers, can lead to fears of abandonment and a long-term pattern of dependent behavior in relationships.
  4. Childhood Trauma: Experiences of trauma or chronic stress in childhood, such as the loss of a parent, abuse, or severe illness, can increase the likelihood of developing dependency issues as these events might lead the child to develop an overly dependent relationship style to gain security.
  5. Cognitive and Behavioral Factors: Certain cognitive and behavioral patterns, such as an exaggerated fear of abandonment or a belief that one is incapable of caring for oneself, can reinforce dependent behavior and make a person more susceptible to DPD.
  6. Cultural Influences: Cultural backgrounds that emphasize interdependence and familial reliance may also influence or exacerbate dependent traits, although this alone is unlikely to cause DPD.


Understanding the specific causes of DPD in an individual typically requires a detailed personal history and professional evaluation. This understanding can also guide effective treatment planning, including psychotherapy techniques aimed at helping the individual develop more autonomous and adaptive coping strategies.


How is DPD Diagnosed?

Diagnosing Dependent Personality Disorder (DPD) involves a comprehensive clinical evaluation conducted by a mental health professional, such as a psychologist or psychiatrist. The diagnosis is based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. Here are the general steps and criteria involved in diagnosing DPD:

Steps in Diagnosis

  1. Clinical Interview: The diagnosis typically begins with a detailed clinical interview where the mental health professional gathers extensive information about the individual’s symptoms, life history, relationships, and behavior patterns.
  2. Psychological Assessment: In some cases, standardized psychological tests and questionnaires may be used to assess personality traits and to help clarify the presence of DPD traits compared to other personality disorders.
  3. Medical Evaluation: Although DPD is a psychological issue, a medical evaluation might be conducted to rule out physical health problems that could influence the person’s behavior.
  4. Review of DSM Criteria: The clinician will compare the individual’s symptoms with the DSM criteria for DPD. According to the DSM-5, the presence of several specific symptoms related to excessive dependence and fear of abandonment is required for a diagnosis.


DSM-5 Criteria for DPD

To be diagnosed with DPD, a person must exhibit at least five of the following criteria:

  • Difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
  • Needs others to assume responsibility for most major areas of their life.
  • Has difficulty expressing disagreement with others because of fear of loss of support or approval.
  • Has difficulty initiating projects or doing things on their own (due to lack of self-confidence in judgment or abilities, rather than a lack of motivation or energy).
  • Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
  • Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themselves.
  • Urgently seeks another relationship as a source of care and support when a close relationship ends.
  • Is unrealistically preoccupied with fears of being left to take care of themselves.



The process of diagnosing DPD can be challenging because the symptoms often overlap with other personality disorders, mental health conditions, or behavioral patterns. Furthermore, cultural, familial, and individual differences in behavior and attitudes must be carefully considered to avoid misdiagnosis. The clinician must determine that these behaviors are inflexible, maladaptive, and persisting across a wide range of personal and social situations, causing significant distress or impairment in social, occupational, or other important areas of functioning.

Effective diagnosis is crucial as it guides treatment planning, which typically involves psychotherapy aimed at helping the individual develop greater self-confidence and independence, and learning healthier ways to form and maintain relationships.


What is People Pleasing Behavior?

People pleasing is a behavioral pattern where an individual consistently prioritizes the happiness and approval of others over their own needs and desires. This often involves altering one’s behavior, suppressing true feelings, and going out of their way to accommodate others, sometimes at a significant personal cost. People who exhibit this behavior might do so for various reasons, such as fear of rejection, low self-esteem, or a strong desire for harmony and acceptance.

This tendency can lead to problems such as chronic stress, burnout, and difficulty in maintaining healthy relationships. While it’s natural to want to make others happy, people pleasing becomes an issue when it consistently outweighs one’s own well-being and leads to neglect of personal needs and boundaries.


How does DPD Relate to People Pleasing?

Dependent Personality Disorder (DPD) and people-pleasing behaviors share some similarities but are fundamentally different in terms of their scope and impact on an individual’s life. Understanding their relationship involves examining how dependency needs manifest in each and the consequences they have on personal and interpersonal dynamics.


Common Ground

Both DPD and people-pleasing behaviors involve a high degree of concern about the opinions and needs of others, often at the expense of one’s own needs and desires. Here are some ways they intersect:

  • Fear of Rejection: Both individuals with DPD and people pleasers might exhibit behaviors driven by a fear of rejection or abandonment. They seek to make others happy as a way to secure their place in relationships.
  • Submissive Behaviors: Submission and reluctance to express dissent are common. Both groups might suppress their own opinions and desires to keep others comfortable and supportive.
  • Dependency on Approval: There’s a significant reliance on the approval and validation of others to feel secure and valued, which can lead to dependency in relationships.



Despite these overlaps, there are critical differences between DPD and general people-pleasing tendencies:

  • Degree of Impairment: DPD is a diagnosable personality disorder that significantly impairs various areas of life, including social, occupational, and personal functioning. People-pleasing, while potentially problematic, does not usually impair functioning to the same degree and is not recognized as a formal disorder.
  • Dependency Level: The level of dependency in DPD goes beyond seeking approval. It involves a pervasive psychological need to be cared for and a difficulty in functioning independently, which is more severe than typical people-pleasing.
  • Fear of Abandonment: While people pleasers might fear disapproval, the fear in DPD includes a profound fear of being left to fend for themselves, which can lead to desperate behaviors to keep someone present and supportive.
  • Self-Perception and Behavior Rigidity: People with DPD often have a deeply ingrained view of themselves as incapable and helpless without support, which is more rigid and stable than the often situation-specific behavior seen in people pleasers.


Therapeutic Considerations

In therapeutic settings, addressing DPD involves strategies to build autonomy, improve self-esteem, and develop healthier, less dependent relationships. For people pleasers, the focus might be more on setting boundaries, assertiveness training, and improving self-worth without as much emphasis on overcoming deep-seated fears of abandonment or helplessness.

Understanding the nuances between these two can help in providing the appropriate support and interventions for individuals exhibiting these behaviors, tailored to the severity and impact of their issues on daily living.


What are Some Complications of DPD, Including Fear of Abandonment?

Dependent Personality Disorder (DPD) can lead to various complications that affect multiple areas of an individual’s life. The intense dependency and submissive behaviors characteristic of DPD can result in several negative outcomes, including:

  1. Relationship Problems: Individuals with DPD often form relationships that are unbalanced and characterized by excessive clinginess and submissiveness, which can lead to dysfunction. They may also stay in unhealthy or abusive relationships due to their fear of abandonment and belief that they cannot manage life on their own.
  2. Difficulty with Independence: People with DPD struggle to make independent decisions and may fail to develop the necessary skills for self-reliance. This dependency can limit their ability to perform tasks alone, manage life challenges, or pursue personal goals without support.
  3. Vulnerability to Abuse: Due to their submissive nature and desperation to maintain relationships, individuals with DPD are particularly vulnerable to manipulation and abuse, whether emotional, physical, or financial. Their tolerance for poor treatment can prevent them from recognizing or escaping abusive situations.
  4. Mental Health Issues: The chronic anxiety, stress, and low self-esteem associated with DPD can contribute to the development of other mental health disorders, such as depression, anxiety disorders, and substance abuse, as individuals might use drugs or alcohol as a coping mechanism. DPD can also increase the risk of developing other mental illnesses, such as depression and anxiety disorders.
  5. Occupational Challenges: Dependency on others and lack of self-confidence can impair an individual’s ability to function independently in the workplace. This might lead to underachievement and difficulties in maintaining employment or advancing in careers.
  6. Social Isolation: Despite their need for constant support, individuals with DPD might experience social isolation due to their clingy behavior, which can push others away. Alternatively, they might isolate themselves by interacting only with a few close caregivers.
  7. Difficulty Handling Stress or Change: Those with DPD often have heightened difficulty adapting to change or coping with stress without support. This can lead to significant distress and dysfunction when they are faced with new situations or when relationships change or end.


These complications underscore the importance of seeking professional treatment for DPD, which typically involves psychotherapy. Therapy can help individuals learn to function more independently, develop healthier relationships, and build resilience against the challenges posed by this disorder.


Can DPD be Prevented?

Preventing Dependent Personality Disorder (DPD) entirely may not be entirely feasible, especially since genetic predispositions and early childhood experiences play significant roles in its development. However, there are strategies that can potentially reduce the risk or mitigate the severity of the disorder. These approaches focus on promoting healthy emotional development and resilience from an early age:

  1. Fostering Independence: Encouraging children to take on age-appropriate responsibilities and make decisions can help build their confidence and self-reliance. This can be balanced with appropriate support, ensuring they feel secure while also promoting autonomy.
  2. Healthy Parenting Styles: Parents and caregivers can adopt parenting styles that are neither overly protective nor neglectful. Providing a secure and supportive environment while also encouraging exploration and self-sufficiency can contribute to a healthier emotional development.
  3. Early Intervention: Addressing any early signs of excessive dependency or anxiety in children can be crucial. Early intervention through counseling or therapy can help children develop more adaptive coping skills and healthier interpersonal patterns.
  4. Education and Awareness: Educating parents, teachers, and those in child development roles about the signs of dependency issues can lead to earlier identification and support for at-risk children.
  5. Building Social Skills: Teaching and reinforcing social skills and problem-solving abilities can help individuals feel more capable of handling life’s challenges independently, reducing the likelihood of developing dysfunctional dependency.
  6. Support Systems: Establishing a robust support system that provides emotional support without fostering dependency can be beneficial. This includes encouraging relationships with multiple individuals rather than reliance on a single caregiver or partner.
  7. Therapeutic Support: For individuals who show tendencies towards dependency or have experienced factors known to contribute to DPD, engaging in therapy can be a preventative measure. Therapy can address underlying issues such as low self-esteem, fear of abandonment, and inability to cope with stress effectively.

While these strategies may not prevent DPD in every case, they can significantly contribute to healthier psychological development and lower the risk of developing severe dependency behaviors.


Is Dependent Personality Disorder Hereditary? 

The heritability of Dependent Personality Disorder (DPD) isn’t fully understood, but like many personality disorders, it likely involves a combination of genetic and environmental factors. Research suggests that genetic factors can contribute to the development of personality disorders in general, though specific genes associated with DPD have not been clearly identified.


Genetic Factors

  1. Family Studies: Studies of families, including twins, indicate that personality disorders might have a genetic component. For example, if one twin has a personality disorder, the other is more likely to have a personality disorder as well, though not necessarily the same type.
  2. Inheritance Patterns: While no specific genes have been directly linked to DPD, the broader patterns of inheritance in personality traits suggest that genetic predispositions, such as those influencing anxiety and other aspects of personality, could contribute to the risk of developing DPD.


Environmental Factors

Environmental influences often play a crucial role in the development of DPD. These can include:

  • Parenting Styles: Overprotective or authoritarian parenting can inhibit the development of autonomy in a child, potentially leading to dependent traits.
  • Early Attachments: Early experiences with caregivers and the quality of attachment (secure vs. insecure) can significantly impact personality development.
  • Childhood Trauma: Experiences such as loss, neglect, or abuse can increase the risk of developing DPD, as individuals may become excessively dependent on others for support and reassurance.


Interaction of Genetic and Environmental Factors

The development of DPD is likely the result of complex interactions between genetic predispositions and environmental experiences. Genetic factors may predispose an individual to certain traits, such as anxiety sensitivity or behavioral inhibition, which can be shaped further by their environment into the full clinical presentation of DPD.

In summary, while there may be a hereditary component to DPD, it is not solely determined by genetics. The disorder reflects a complex interplay of genetic, developmental, and psychological factors, each contributing to the overall risk and manifestation of the disorder. Early identification and intervention can help mitigate some of the potential impacts of these predispositions.


What is the Best Treatment for Dependent Personality Disorder?

The treatment for Dependent Personality Disorder (DPD) typically involves psychotherapy, which is considered the most effective approach. Medication may be used to manage specific symptoms, particularly if they co-occur with other disorders like anxiety or depression. Here’s a detailed look at the primary treatment modalities for DPD:


  1. Cognitive-Behavioral Therapy (CBT): CBT is often used to challenge and change the unhelpful thinking patterns and behaviors associated with DPD. This approach can help individuals develop healthier, more autonomous ways of thinking and behaving, reduce anxiety around independence, and enhance self-esteem.
  2. Psychodynamic Therapy: This form of therapy focuses on increasing awareness of unconscious thoughts and behaviors, improving insight into dependency patterns, and understanding past experiences that contribute to current behaviors. It can help patients understand the roots of their emotional dependency and develop more mature ways of relating to others.
  3. Schema Therapy: Schema therapy combines elements of cognitive, behavioral, and psychodynamic therapies to address deep-seated patterns or schemas. It is particularly useful in treating personality disorders and can help individuals with DPD identify and change complex and enduring patterns of thinking and behavior that underlie their condition.
  4. Interpersonal Therapy (IPT): IPT focuses on the interpersonal relationships of the patient. It helps individuals understand and improve their relationship patterns that may contribute to or exacerbate their dependent behaviors.


Group Therapy

Participation in group therapy can be beneficial as it offers a supportive environment where individuals can practice interpersonal skills, receive feedback from others in similar situations, and learn to relate to others in less dependent and more balanced ways.



While there are no medications specifically approved for the treatment of DPD, medications may be prescribed to address specific symptoms such as anxiety or depression, which often co-occur with personality disorders. Antidepressants, anti-anxiety medications, or mood stabilizers may be used as part of a comprehensive treatment plan.


Other Supports

  • Education and Awareness: Educating patients about the disorder can empower them to understand their symptoms better and engage more fully in treatment.
  • Building a Support Network: Encouraging patients to broaden their support networks can help reduce the over-reliance on single caregivers or partners.


Long-Term Management

Long-term management strategies are crucial as personality disorders can be enduring. Regular follow-up with mental health professionals can help manage symptoms effectively and adjust treatment strategies as needed. The overall goal is to help individuals with DPD develop greater self-confidence, autonomy, and healthier relationships, which can significantly improve their quality of life.

Each individual’s treatment should be tailored to their specific needs, taking into account their overall psychological profile, the severity of the disorder, and any co-existing mental health issues.



Understanding the complexities of Dependent Personality Disorder and chronic people-pleasing behavior offers valuable insights into the preservation of mental health and the development of healthy interpersonal dynamics. While the exact cause of DPD is not fully understood, it is evident that those who develop DPD tend to seek constant reassurance and struggle significantly when relationships end. Similarly, chronic people pleasers frequently undermine their own needs and self-care, leading to long-term repercussions on their emotional well-being. Most people can benefit from learning to set boundaries and prioritize self-care to foster healthier, more balanced relationships. By addressing these core problems, individuals can improve their quality of life and navigate the challenges of these complex emotional landscapes more effectively. Whether dealing with a mental illness like DPD or managing people-pleasing tendencies, the journey towards healing and balance begins with awareness and the right support.


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If you or a loved one are struggling with mental health challenges or substance abuse, reach out to New Hope Healthcare today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-799-0806

dependent personality disorder

Frequently Asked Questions

Dependent Personality Disorder is a mental health condition characterized by excessive dependency on others for emotional and physical support, a pervasive fear of abandonment, and difficulty making independent decisions or functioning alone.
DPD is diagnosed based on a clinical evaluation by a mental health professional, who uses the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This involves assessing the individual’s history, symptoms, and the overall impact of these symptoms on their functioning.
While preventing DPD might not be fully possible, early intervention in at-risk individuals, such as those with a family history of personality disorders or those who exhibit early signs of dependency, can help mitigate the severity of the disorder.
While people pleasing and DPD both involve dependency traits, people pleasing does not necessarily include the intense fear of abandonment and the significant impairment in personal and social functioning seen in DPD.
Being considerate and attentive to others’ needs is generally positive, but when these behaviors are driven by an unhealthy need for approval or fear of displeasing others, they can become detrimental. Healthy relationships require a balance between meeting one’s own needs and those of others.

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