here's a venn diagram showing DPD & AvPD symptoms and overlap.
AVPD and DPD are difficult to distinguish
Both are shy, lack confidence and self-esteem, are afraid of criticism and disapproval, and need approval and support
People with DPD try to encourage others to take control of their lives, and this requires trust and openness to relationships
People with AVPD withdraw from relationships because they fear rejection and humiliation
People with DPD struggle with making their own decisions, while people with AVPD don’t if there isn’t a chance of judgement and rejection
AVPD and DPD both result in the person feeling inadequate, but their response to this feeling is different: people with DPD seek people who they can depend on, while people with AVPD avoid for fear of their negative self-view being voiced by others
People with AVPD do well on their own, while people with DPD tend to feel increasingly helpless
When faced with criticism, people with AVPD avoid the situation, while people with DPD stay and try to please
Millon has a DPD subtype with AvPD traits (the "disquieted dependent"):
> Like other people with DPD, rely on others for guidance and support, but their anxiousness makes them avoid autonomy and initiative
> Easily disconcerted, feel a general sense of dread and foreboding
> Separation anxiety, sometimes expressed with anger
> Withdraws from social life, causing loneliness and isolation
> Tend to be pleasant and agreeable, but feel sad and guilty, overwhelmed by fear of abandonment
> Depressed, fatigued, “life is seen as empty but heavy”
Withdrawing from relationships are features of both
People with SZPD are indifferent or passive to relationships
Lacking strong desires and emotions is part of SZPD, where people with AVPD are anxious and hypersensitive
People with SZPD find relationships boring, while people with AVPD find them punishing
People with AVPD often have a strong internal fantasy as an escape method
Thought processes in AVPD and SZPD can seem tangential and disconnected.
Both struggle with focusing, for different reasons: anxiety and feeling overwhelmed in AVPD, and boredom in SZPD
STPD:
Concentration problems, social anxiety, and fantasy as an escape method in AVPD are similar to eccentricism, social detachment, and low self-esteem in STPD
In AVPD, concentration issues aren’t pervasive - when alone or with a trusted person, they are able to concentrate
In STPD, eccentricity is pervasive. They are more “dramatically bizarre” and can experience psychosis, which is not a feature of AVPD
PPD:
Anxiety, fear, mistrust and fear of embarrassment or humiliation are part of both PPD and AVPD
In AVPD, they believe that the root of this fear is themselves - that they are inadequate and deserving of embarrassment
In PPD, it’s the opposite, that other people are attempting to humiliate them
Although people with PPD and AVPD are often lonely, both are reluctant to confide in others; people with AVPD are afraid it will cause embarrassment for them, while people with PPD are afraid the person will use the information against them
DPD & OCPD:
Since DPD, AVPD and OCPD are all Cluster C disorders, there is a lot of overlap, particularly in anxiety
AVPD and DPD both result in the person feeling inadequate, but their response to this feeling is different: people with DPD seek people who they can depend on, while people with AVPD avoid for fear of their negative self-view being voiced by others
People with AVPD do well on their own, while people with DPD tend to feel increasingly helpless
When faced with criticism, people with AVPD avoid the situation, while people with DPD stay and try to please
Both people with AVPD and OCPD are anxious over being criticised. People with AVPD withdraw, while people with OCPD direct their anxiety into increased preoccupation with rules, details, lists, etc
- From Millon et al., Personality Disorders in Modern Life (2004)
This would be an interesting combination... I think that the narcissism might create a sort of paradox where the person in question is both The Best [needed] in general but Dependent [needing] around their specific safe people. Or the two symptom profiles might fluctuate, being more NPD at times and more DPD at others.
Many NPD traits are ones that would be more likely to be associated with DPD, like low self esteem, fear of humiliation and rejection, hypersensitivity to criticism, fantasies of 'ideal love' (i.e., care), seeking new relationships as soon as one ends, & needing words of affirmation.
Traits that conflict are NPD's grandiosity, sense of entitlement, sense of specialness, exploitation, lack of empathy, & arrogance. Conflicting DPD traits are needing excessive advice in decision making, difficulty disagreeing, difficulty doing things by themselves, fears of abandonment, and voluntarily doing unpleasant things in exchange for care.
Someone with both might feel like they're entitled to have someone to care for them, needing excessive advice so they can make The Right decision (which would show that they're Good and The Best at making good decisions), difficulty doing things alone because they need someone to see their skills etc., difficulty disagreeing because it may expose their perceived flaws, & only feeling comfortable expressing their more overtly NPD traits around their safe person(s).
could someone have ppd, npd, avpd, dpd, and ocpd and what would it look like?
dont respond / answer if you dont want to!! its okay, thank you for everything you do and have a good day
[not including ppd as per anon's request]
The common thread between all of these PDs is anxiety. NPD, OCPD and AvPD are anxious that their flaws will be revealed, DPD is anxious that they’ll have to be independent. NPD & OCPD are most similar to each other, and both focus on themselves (internal), while AvPD & DPD are most similar to each other and focus on others (external)
Long post underneath (it's a bit all over the place, sorry!):
Low empathy in NPD & OCPD; both value something else over relationships (perfection in OCPD & validation and attention in NPD). They both need validation as perfect, though in different ways (OCPD needs to have their work seen as perfect, and NPD needs themself to be seen as perfect). AvPD & DPD don't have these things.
All struggle with close relationships: OCPD needs perfection, NPD with seeing people as more than givers validation, AvPD struggle with entering close relationships for fear of rejection, DPD becomes dependent and overattached. OCPD, NPD & AvPD will fixate on flaws in the relationship while DPD is likely to ignore them
Relationships are intensely valued in DPD, but not so much in AvPD, and not in NPD or OCPD.
OCPD values their independence and maturity and “adult self-control”, as part of their self-image. Therefore they're unlikely to value relationships very much
All can be impulsive, irritable, anxious, and struggle with planning for the future or seeing consequences, though less so in DPD (except future planning)
All rely very heavily on others’ opinions
OCPD & NPD set impossibly high goals for themselves. AvPD & DPD don't experience this
NPD & OCPD both use superiority as a defence mechanism, and struggle with anger issues. DPD & AvPD feel inferior and struggle to express anger.
DPD & AvPD conform to expectations of others out of feelings of inadequacy, and fear of rejection/losing support. OCPD & NPD don't really do this unless it aligns with their need for perfection
OCPD can cause indecision and overwhelm, like DPD, but in DPD it’s the fear of having to make their own decisions, while in OCPD it’s anxiety and fear of lack of control
The underlying motivations of OCPD, NPD, DPD & AvPD are the same: they are afraid of criticism and disapproval, and need approval and support. The way this presents externally is very different for OCPD & NPD vs AvPD & DPD
AvPD & OCPD do well on their own, while DPD & NPD tend to feel increasingly helpless/losing self esteem
When faced with criticism, AvPD avoids the situation, DPD stays and tries to please, NPD may avoid or fall into shame redirect, OCPD falls into anxiety and redirects this by becoming increasingly rigid and performance-focused
NPD, AvPD & OCPD fear failure & are perfectionists, and are highly conscious of how others see them. They all have fantasies of success, ideal life, etc. This isn't really part of DPD.
Rigid focus on work, maturity, and achievements is integral to OCPD only, and really sets it apart from the other PDs discussed here
NPD (& DPD to an extent) desires attention, OCPD & AvPD don't (& AvPD fears it)
Summary: Anxiety and fear of criticism is common to OCPD, AvPD, NPD and DPD. Over-reliance on others is part of DPD only. Rigid focus on performance (work/school etc) is part of OCPD only (though may be a way that NPD expresses itself). There's nothing in AvPD or NPD that set them apart from the combination of these PDs. Grandiosity is part of NPD & OCPD, inferiority is part of DPD & AvPD. Someone with all of these will struggle with anxiety, hypersensitivity to rejection and criticism, and a need to be seen as perfect. Their relationships will be very messy as their OCPD & AvPD independence clashes with their NPD & DPD dependence, OCPD & NPD superiority clashes with DPD & AvPD inferiority, and their OCPD & AvPD & NPD fear of criticism and less-than-perfection makes relationships very difficult (yet their DPD needs relationships).
