Learning to become independent, in thought and action, is one of the hallmarks of growing up. But independence for some is elusive. About one million American adults may suffer from Dependent Personality Disorder (DPD), a condition that compels them to continually seek out and defer to the authority of others. The need for direction and approval is pervasive in DPD, affecting even trivial decisions such as what clothes to wear and what foods to eat. The authority figure for someone with DPD can be anyone in a position to provide consistent direction, typically a spouse or close friend.

DPD usually begins in adolescence or early adulthood and is equally common in men and women. Two key factors define the condition: lack of self-confidence and fear of abandonment. Lack of self-confidence makes people with DPD distrustful of their own decisions, leading them to continually turn to others for guidance. They see themselves as incapable of managing their own lives, and can suffer from high anxiety if put in a position requiring independent action. Fear of abandonment makes it difficult for them to be alone, which further limits development of the skills they would need to act independently.

Not surprisingly, people with DPD become extremely upset when a relationship ends and often rush into a new one. The requirement to be taken care of makes them vulnerable to abuse by authority figures. Their overwhelming need for someone else to be in charge can override concerns about being treated poorly.

The cause of DPD remains unclear, but it appears to be a combination of both environmental and biological factors. A person with DPD may be innately disposed toward anxiety and a generally pessimistic outlook. These tendencies, combined with an upbringing that stunts development of independence, increase the likelihood of adult dependency.

Parenting Style Can Set Stage for Dependent Personality Disorder

Soliciting attention and help from caregivers is a natural instinct when we’re young. A child’s crying and clinging are not weaknesses; they’re inborn behaviors to keep parents attentive. Children typically evolve out of these behaviors and eventually want to—and can—act more independently. Overprotective or authoritarian parents can thwart this natural development.

Consistently harsh punishment when orders are disobeyed can make children fearful of doing things without prior parental approval, thus compromising the development of decision-making skills. Micromanaging children’s lives also may increase the likelihood of DPD. As pointed out by Joseph Allen and Claudia Worrell Allen in Escaping the Endless Adolescence, today’s teens are much less independent than those in previous generations. The authors claim that parents often maintain too much control nowadays, which makes it harder for their children to grow up into independent decision makers.

Treatment for Dependent Personality Disorder

Many people with DPD don’t seek therapy for it because they don’t know they have it. They’re more likely to want help for the depression or anxiety that may be associated with their dependent coping behaviors.

DPD is usually treated with short-term psychotherapy. This can involve revisiting childhood experiences to determine which ones may have contributed to dependence. Being aware of these experiences can help patients recognize situations in adult life that trigger dependence, fostering healthier, more give-and-take relationships.

Therapeutic strategies may include assertiveness training to help build confidence, as well as cognitive-behavioral therapy to reshape attitudes. Group therapy can make it easier for some people with DPD to open up about their condition. In any case, short-term therapy is preferable; extended treatment risks creating a dependence on the therapist or another participant in a group therapy setting.

Reach Out to Anyone You Think May Have DPD

People with DPD often lead circumscribed lives and never reach their full potential. They are also at higher risk for substance abuse, as well as abuse from authority figures. You may help someone just by informing them about the disorder.

Do you have a friend or loved one you suspect of having DPD? Reach out to that person. It could be the first step to a new declaration of independence

Read about Ed Decker.