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What Is Codependency?

Posted in Dual Diagnosis Help on September 8, 2016
Last modified on May 9th, 2019

Codependency refers to psychological behavioral problems that cause people with addictions and those in their lives to engage in mutually destructive habits and maladaptive coping strategies.1 The term has been around for nearly 40 years and was originally used in context with alcoholism. Codependent people who are not addicted are often referred to as enablers. Codependent behaviors typically manifest as a way to maintain a sense of balance or status quo, but have deeper psychological implications. This relationship can occur between two people, such as a husband/wife, or can affect the family unit as a whole. Although codependency most often affects a member of the immediate family, it can also involve friends or coworkers of the person afflicted with alcohol or drug dependence.2

Typically, a person struggling with addiction will become exceedingly focused on obtaining and using drugs to the exclusion of important responsibilities and relationships. Enablers often compulsively maintain associations with children or partners who abuse drugs despite the suffering and lack of compensation that characterize these relationships.2 They compensate for the drug abusers’ behavior, believing they are doing this out of love, when in fact, they are merely reinforcing and strengthening the abuser’s destructive habits. The codependent person is often unhappy with him/herself, however, he or she gets satisfaction from taking care of someone else’s needs.3 Micromanaging many aspects of the drug abuser’s life is a way for the enabler to control a situation that is out of his or her control.

Common Traits in Codependent People

  • Low self-esteem and feelings of inadequacy
  • Guilt and perfectionism
  • Obsessive thoughts about other people or relationships
  • Poor or ineffective communications skills
  • The inability to be truthful about one’s feelings
  • Engaging in risky, dangerous or illegal behaviors
  • Buying drugs for a significant other
  • Getting involved with addicts, chronic underachievers or emotionally abusive people
  • Sacrificing one’s own needs to take care of the addict, which can mean managing all aspects of his or her life other than drug use
  • Problems being emotionally intimate with a significant other3

Enabling Behavior and Consequences

  • Taking on added responsibilities such as extra work in the home
  • Making excuses at the loved one’s place of employment, e.g., for absences
  • Lying to others when the addictive person does not attend important events
  • Changing or cancelling personal plans
  • Expressing a desire to change behavior without being able to do so2,3

Codependency Research

A Brazilian study was conducted on 505 family members of drug users who had requested help through a drug-prevention information call line. Of these, 64% showed high codependency according to the Holyoake Codependency Index (HCI), a self-reporting assessment tool. The study yielded insightful data and patterns on codependent behaviors and repercussions.1

  • Self-neglect was almost three times more likely to occur in family members with high codependency than in those with low codependency.
  • Among the highly codependent participants, 69% reported that they were receiving medical treatment compared to 31% in the low-codependency group.
  • Medication was used by 70% of the high-codependency participants versus 29% of the low-codependency participants.
  • Psychological/psychiatric treatments were reported by 65% of the high-codependency participants versus 35% of the low-codependency participants.

Other research has shown a correlation between depression and codependency. A small study published in the late 1990s showed that 36% of 105 depressed women were moderately to severely codependent.4

Changing the Dynamic

Codependency and addiction frequently go hand in hand, however, it is possible to change the relationship dynamic. It typically takes a crisis in order for the enabler to realize that he or she also has a problem. Sometimes the hospitalization of the drug user will spark this realization, while in other cases, drug rehab is where unhealthy relational habits are uncovered. Family therapy is an integral part of rehab, offering all impacted members the opportunity to uncover why they are contributing to the problem and learn how to develop healthier coping and communications skills.

  1. Bortolon CB, Signor L, Moreira T, et al. Family functioning and health issues associated with codependency in families of drug users. Cien Saude Colet. 2016 Jan;21(1):101-7. doi: 10.1590/1413-81232015211.20662014.
  2. Co-Dependency. Mental Health America website. http://www.mentalhealthamerica.net/co-dependency Accessed August 19, 2016.
  3. 6 Symptoms of Codependency: The Disease of the Lost Self. The Earth Tribe website. http://www.theearthtribe.com/2016/05/31/11-signs-you-might-be-in-a-codependent-relationship/ Published May 31, 2016. Accessed August 19, 2016.
  4. Hughes-Hammer C, Martsolf DS, Zeller RA. Depression and codependency in women. Arch Psychiatr Nurs. 1998 Dec;12(6):326-34.
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