What Is Codependency?

Sometimes called "relationship addiction", codependency is an emotional and behavioral condition that influences a person's ability to have a healthy, mutually satisfying relationship. People with codependency are often in relationships that are one-sided, emotionally destructive, and dysfunctional.

The term codependency originally referred to the partners of people with substance use disorder, but it has branched out to include a variety of relationship dynamics.

Updated studies on the statistics of codependent relationships and codependency are lacking—but older studies suggest that codependency is common.

What Is Codependency?

Mental health professionals continue to argue that codependency should be considered an official mental illness, but as of the printing of The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), codependency is not recognized as a unique mental disorder.

This does not mean that codependency isn't real or is inconsequential—far from it. Codependency can be debilitating.

A codependent person puts their own needs aside and becomes hyper-vigilant about meeting the needs of another person, to the point that their life revolves around this person, creating a one-sided relationship that is destructive and dysfunctional for both parties.

Codependent Relationships vs. Dependent Relationships

Codependency refers to an unhealthy attachment to one specific person, but that person does not have to be a romantic partner. Codependency can also occur in friendships, between family members, between a boss and subordinate or coworkers—any relationship in which one partner is dysfunctionally dependent on the other can be considered a codependent relationship.

A codependent relationship is different than a dependent relationship. A relationship between two dependent people is usually considered healthy. All relationships require some amount of dependence on the other person.

In a dependent relationship, the roles are more equal and both the support for and the dependence on the other partner is give-and-take, instead of skewed like in a relationship between a codependent person and an enabler.

Symptoms

The severity of codependence symptoms works on a spectrum instead of an all-or-nothing scale.

The characteristics and behaviors of people who are codependent fall into a series of patterns.

Denial Patterns

• Difficulty identifying what they are feeling
• Minimizing, altering, or denying how they really feel
• Perceive themselves as completely unselfish and dedicated to the well-being of others

Low Self-Esteem Patterns

• Difficulty making decisions
• Harsh judgement of themselves, thinking what they think, say, or do is never good enough
• Embarrassment at receiving recognition, praise, or gifts
• Inability to identify or ask for what they want and need
• Higher value placed on others’ approval of their thinking, feelings, and behavior than on their own
• Do not perceive themselves as lovable or worthwhile

Compliance Patterns

• Compromise of values and integrity to avoid rejection and other people’s anger
• High sensitivity to other’s feelings and take on the same feelings
• Extreme loyalty, remaining in harmful situations too long
• Higher value placed on other’s opinions and feelings
• Fear of expressing differing viewpoints or feelings
• Setting aside their own interests to do what others want
• Acceptance of sex as a substitute for love

Control Patterns

• Belief that people are incapable of taking care of themselves
• Attempts to persuade others what to think, do, or feel
• Resentfulness when others decline their help or reject their advice
• Freely offering unsolicited advice and direction
• Giving gifts and favors to those they want to influence
• Use of sex to gain approval and acceptance
• Must feel needed in order to have a relationship with others

Avoidance Patterns

• Behaviors and actions that solicit rejection, shame, or anger from others toward them
• Harsh judgement of what others think, say, or do
• Avoidance of emotional, physical, or sexual intimacy to avoid feeling vulnerable
• Allowance of addictions to people, places, and things to distract them from intimacy in relationships
• Indirect or evasive communication to avoid conflict or confrontation
• The belief that displays of emotion are a sign of weakness

Diagnosis

The symptoms of codependency overlap with several other conditions, most notably dependent personality disorder.

Though they sound similar, there are key differences between codependency and dependent personality disorder, primarily that codependency involves a dependence on a specific person, but dependent personality disorder describes dependent traits towards others in general.

Unlike codependency, dependent personality disorder is included in the DSM-5 and is considered an official mental illness.

Diagnosing codependency relies largely on self-reflection. Several questionnaires are available online that you can take on your own with the idea that a high number of yes answers raises red flags for codependence. These questionnaires are generally variations of questions based on the symptoms listed above.

While these questionnaires may be a starting point, they are not a substitute for an evaluation by a health care professional.

If you suspect you may be codependent, book an appointment with your health care provider or with a mental health specialist such as a counselor, therapist, or psychiatrist. Because many of the symptoms of codependency are the same or similar to other conditions, your care provider can help you determine an accurate diagnosis.

Causes

Codependence is believed to develop within dysfunctional family environments, particularly during childhood. Underlying problems in a dysfunctional family environment include:

• A family member who has substance use disorder, including drugs, alcohol, relationships, work, food, sex, or gambling
• The presence of physical, emotional, or sexual abuse
• A family member living with a chronic mental or physical illness

In a dysfunctional family environment, fear, anger, and shame go unacknowledged, leading family members to repress their emotions and ignore their own needs.

While it is no longer a requirement for a designation of codependency, substance use disorder and codependence are often linked within a relationship, making recovery from each condition more difficult.

A person who is codependent may have difficulty with the recovery process for codependency because of a need to help the person with substance use disorder. Conversely, a person who is codependent lacks the ability to set the boundaries and give the appropriate support needed by someone with substance use disorder. It becomes a vicious circle, requiring help for both parties in order for either to succeed.

Treatment

Unless there are co-occurring conditions also being treated, medications is not generally a part of treatment for codependency.

Some places to start when seeking treatment for codependency include:

• Speaking with a licensed mental health practitioner
• Enrolling in counseling with a therapist
• Reading self-help books about codependency
• Talking with trusted friends and family members about codependent relationships

Therapy

Therapy for codependency focuses the current relationship, past relationships, and childhood trauma that may have contributed to the codependent tendencies.

Cognitive behavioral therapy (CBT) is a form of talk treatment that involves recognizing and changing unhealthy thought patterns and behaviors. CBT can be helpful for people struggling with codependency.

Co-Dependents Anonymous

Similar to the more well-known Alcoholics Anonymous, Co-Dependents Anonymous (CoDA) is a recovery group in which people who are codependent support each other, work through their treatment together, and gain access to programs.

Like Alcoholics Anonymous, CoDA involves 12 steps. The program also includes 12 traditions, 12 promises, and 12 service concepts.

Coping

There are activities and exercises you can do at home to work through codependency recovery.

• Take an honest inventory of the relationship: After learning about codependency, examine yourself, your partner, and your relationship for red flags.
• Understand the impact of a codependent relationship on your life: Compare a healthy, dependent relationship to a codependent one. Note the positive effects of a healthy relationship versus the harmful effects of a codependent one. This can help you realize what you value and want to change.
• Take responsibility: A person who is codependent and their enabling partners can both have difficulty taking responsibility for their own feelings and shortcomings. Each person taking charge of themselves, and reminding each other that they are in control of their own emotions and behaviors, can help break the cycle.
• Read books: Books on codependency can be a great way to gain an understanding of the condition and help you to be introspective.

Work on the Relationship—or Get Out

Working through treatment for codependency means changing the unhealthy relationship, or even leaving the relationship. This extends to all codependent relationships, not just romantic partnerships.

• Take a break: If possible, take a break from the relationship to focus on yourself for a while. Resist the urge to begin a new romantic relationship right away if you have just ended one.
• Set boundaries: When you pull away from the relationship or break it off, resistance from your partner is likely. It may turn toxic. They may be angry, manipulative, and persistent. They may bombard you with calls and texts. Drawing clear boundaries and consistently upholding them sends a powerful message. They will need to change or find a relationship with someone else.
• Practice self-awareness: Just leaving the relationship will not "cure" the codependency. You will still have work to do on yourself, either on your own or with the help of a professional. You will also need to be vigilant when beginning new relationships. Watch for behaviors from your partner that might trigger your past codependent behaviors. Be introspective, look for red flags that you are repeating past problematic behaviors, or that your relationship is unbalanced, unhealthy, or not enjoyable.

A Word From Verywell

Codependency can be a confusing concept, and recognizing it isn't always easy—especially within yourself. While codependency is toxic within any relationship, the good news is it can be managed and overcome. Whether you decide to stay in the relationship or leave it behind, learning about codependency, being introspective, and, if needed, talking to a professional can help you learn more healthy ways to approach relationships.