Dependent Personality Disorder and Borderline Personality Disorder: Comorbidity and Treatment

Comorbid dependent personality disorder and borderline personality disorder is a difficult diagnosis. Both personality disorders cause troubled relationships, overly-emotional reactions, and unhealthy behaviors. The symptoms can lead to significant dysfunction in all areas of life but especially in relating to other people. It is essential to address both conditions in treatment.

Having one personality disorder is challenging.

The characteristics of this family of mental illnesses include a distorted or shifting self-image and impaired relationships. With two personality disorders, like dependent and borderline personality disorders, these issues are magnified.

Comorbid personality disorders must be treated, and it is possible to learn to manage them.

With an accurate diagnosis, a team of expert mental health professionals, and an individualized treatment plan that addresses both conditions, there is hope.

What Is Dependent Personality Disorder?


Dependent personality disorder, or DPD, belongs to the group of personality disorders known as cluster C. These disorders cause anxiety and fear, which trigger reactionary behaviors. One study of over 100,000 people found that DPD was the least common type of personality disorder with a prevalence of just 0.78 percent. Symptoms of DPD include:

  • An excessive need to be cared for by others
  • Submissive and clingy behaviors
  • Difficulty making decisions alone
  • Avoidance of conflict
  • A strong desire to have other people take responsibility
  • Fear of being alone
  • Difficulty accomplishing tasks or starting projects

What Is Borderline Personality Disorder?


Borderline personality disorder, or BPD, is more prevalent than DPD. Statistics indicate that 1.4 percent of the population will be diagnosed with it at some point in their lives. BPD belongs to cluster B, the personality disorders characterized by dramatic, overly emotional reactions, unpredictable behaviors, impulsivity, and a distorted self-image. Some signs and symptoms specific to BPD include:

  • Difficult, unstable, and often intense relationships
  • A shifting, unstable self-image
  • Desperation to avoid being abandoned
  • A feeling of emptiness
  • Intense anger and outbursts
  • Impulsive, often self-destructive behaviors
  • Rapid mood changes
  • Suicidal behaviors

Comorbidity of DPD and BPD


Comorbidity refers to the presence of two or more conditions in an individual. Having another mental illness along with a personality disorder is common. Some studies have found that as many as 91 percent of people diagnosed with a personality disorder can also be diagnosed with a second condition. Up to 42 percent will have multiple additional mental illnesses.

It is also possible to be diagnosed with one or more personality disorders. While DPD is one of the less common personality disorders, it does sometimes co-occur with BPD. In fact, DPD and all the cluster B personality disorders are those most likely to occur along with borderline personality disorder.

Comorbidity complicates all aspects of mental illnesses. It is difficult, for instance, even for experienced mental health professionals to make accurate diagnoses. The symptoms overlap and affect each other, making it difficult to untangle them and determine the root causes.

Treating Comorbid DPD and BPD


Having both types of personality disorders also complicates treatment. For any comorbid mental illnesses, the most effective treatment considers all of them. If you have two personality disorders, your treatment needs to address them both in order to provide lasting relief and management of symptoms.

The reason for this is that if one condition goes untreated, it can trigger the other. For example, if you have and are treated for borderline personality disorder, you may learn to manage your relationships by controlling your emotional responses.

But, if your fear of being abandoned caused by DPD is not addressed in therapy, your ability to manage your emotions and respond less dramatically can be seriously compromised. That irrational fear that is common with dependent personality can become overwhelming, undoing all the positive work you did in learning to manage BPD symptoms.

The general pattern of treatment for BPD and DBD is similar: both are best managed with therapy, and in some cases medications may help. Individual, one-on-one therapy is the cornerstone of treatment. Work with a therapist can help you learn more about your conditions, practice strategies for managing emotions and reactions, and make positive changes to your behaviors.

In addition to individual therapy, you may also benefit from group therapy and the support of other people who struggle with personality disorders. Social skills and relationship training can also be used to develop healthier relationships. Therapy with loved ones is also important for managing personality disorders and learning to relate better to other people.

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Residential Treatment for Personality Disorders


Because personality disorders are complex, and having two is especially challenging, it is important to get treatment that is highly individualized. While outpatient therapy may be helpful for managing these conditions, a better option is long-term, residential care. It can provide you with the time you need to focus on your mental health in a safe, structured environment.

Treatment in a residential facility begins with an expert differential diagnosis. This is the important first step and is necessary before any treatment plan can be created. With that diagnosis of comorbid borderline and dependent personality disorders, a multi-disciplinary team of experts will develop a care plan with the input of the patient and their family.

This individualized treatment plan implemented by a team of experts is what makes inpatient care so beneficial for patients with complicated comorbidities. If you have both personality disorders, you will benefit from working with therapists, medical doctors, psychologists, and holistic practitioners. The treatments you participate in will have been planned just for you and your specific needs. These important factors are difficult to get in outpatient care.

Another great reason to choose inpatient treatment is the variety of types of care you can receive. Far from being just therapy, residential treatment often includes medical care, group support, practical skills training, family therapy, holistic care, alternative therapies, and recreation.

If you or a loved one is struggling with a personality disorder, comorbid DPD and BPD, or with the symptoms that seem like they may be caused by these conditions, the next most important thing you can do is get a diagnosis. With an accurate diagnosis of comorbid disorders you can get the focused, individualized treatment you need to learn to live better and enjoy healthier, happier.

Bridges to Recovery offers comprehensive treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned Los Angeles and San Diego-based programs and how we can help you or your loved one start on the path to lasting wellness.