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Personality disorders are a specific type of behavioral health disorder that affect an individual’s ability to function and maintain a high quality of life. People who struggle with a personality disorder may have difficulty maintaining healthy relationships and often have a skewed perception of themselves and others. Codependent personality disorder can affect a person’s quality of life and relationships, and it may occur with other mental health disorders.
“Codependency” initially referred to someone in a relationship with a person struggling with a substance use disorder. However, modern definitions of the term encompass a wide range of dependent behaviors – emotional, social, or physical. The concept of codependency still applies to families with substance dependencies, but it also refers to other situations where drug or alcohol use is not present. Codependency has many signs and symptoms, but a common consequence is that persons affected neglect to care for themselves, to the point where the codependency can disturb perception, self-identity, and even self-worth. Codependent individuals are more than just dependent on others – their happiness is determined by meeting others’ needs and wants, even if those are unreasonable.
Is Codependency a Mental Illness?
Is Codependency a mental illness? The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), provides a comprehensive framework for symptoms and classification of behavioral health conditions. As early as 1986, mental health experts argued that codependency should be an officially recognized mental health condition with qualifying diagnostic criteria borrowed from other disorders, including dependent personality disorder, borderline personality disorder, histrionic personality disorder, and even post-traumatic stress disorder (PTSD). However, efforts to make codependency a recognized disorder have been unsuccessful. The latest iteration of diagnostic criteria, the DSM-5, only includes dependent personality disorder as an official diagnosis, not codependency.
The argument against having a distinct diagnosis for codependency stems from the idea that the condition shares too much overlap with other mental health conditions to merit its own diagnosis. For example, codependency symptoms overlap significantly with dependent personality disorder (DPD), as well as borderline personality disorder (BPD). However, more recent research shows that while people with codependent personalities can exhibit traits from both DPD and BPD, there are also those with codependency who do not have symptoms from either, suggesting that codependency is a unique mental health condition.
What Are The Differences Between Dependent Personality Disorder and Codependency?
Dependent Personality Disorder (DPD) shares the most overlap with codependency. The primary distinction between DPD and codependent people is the nature of the relationship. Codependent individuals tend to display dependent traits focused on a specific person, while dependent personality disorder refers to dependent traits toward others in general. Similarly, a person with borderline personality disorder struggles with stability in interpersonal relationships, while codependency involves a specific dependence on an individual.
At the most basic level, codependency is a psychological condition in which persons feel an extreme dependence for certain loved ones in their lives. This dependence often progresses to the point where affected individuals feel responsible for the dependents’ actions and feelings. As the condition progresses, it may affect self-perception and esteem.
Codependency is neither an officially recognized personality disorder nor an official mental illness. Rather, it is a unique psychological construct that shares significant overlap with other personality disorders.
The Symptoms of Codependency
Being familiar with the signs of the condition is the first step in understanding codependency as an issue. A person who struggles with codependency may show signs of:
- Low self esteem
- Dysfunctional family dynamics
- Inability or difficulty expressing emotions
- Having a hard time saying no or setting boundaries
- Reacting with strong emotions, even to small incidents
In addition, a codependent often feels compelled to take care of others and feels a need to be liked by everyone. Intimacy issues, fear of abandonment, and confusing love with pity are common traits. As a whole, these symptoms pertain to a single person or family as opposed to dependent personality disorder where the symptoms apply to people within the social network as a whole. Taking a codependency quiz can help to better understand the symptoms and traits inherent in people who struggle with the condition.
The Codependent Versus the Dependent
When examining the symptoms of codependency, it’s important to understand that a codependent relationship generally involves two parties: the codependent and the enabler. This differs significantly from a relationship in which a person is dependent on another. In the latter, the feelings of dependence may or may not have reciprocation; in a codependent relationship, the enabler is more than happy to accept the codependent’s behavior and sacrifice.
Whereas dependent relationships can be healthy, codependent relationships are not. Oftentimes, a codependent has no interests or feelings of worth outside the relationship. Extreme dedication to the enabler may cause the codependent to neglect other responsibilities, relationships, and even career. While most relationships involve some sort of dependency on another person, the codependent constructs an identity and life around that person. The enabler’s willingness to accept the behavior creates a cycle of codependence that can be difficult to alter without appropriate intervention.
What Causes Codependency?
Codependent adults often have incidence of childhood trauma or had difficult relationships with their parents or caregivers. Their learned behaviors often stem from learning from their caregivers that their own needs are not as important as those of others in their lives. The following have established connections to codependency:
Dysfunctional family roles often tie into codependence. For example, adults with codependency may have been told as children that they were not important, and their feelings lacked validation from important adults. Codependent adults may have heard they were greedy or selfish if they tried to put their own needs first.
Living with a Physically or Mentally Ill Family Member
Playing the role of caregiver from a young age can lead to codependent behavior as an adult. Caring for a loved one with a drug dependence, for example, can lead to a cycle of codependence as an adult. In fact, research shows that children who grow up with parental substance use have difficulty maintaining meaningful, healthy attachments later in life.
The Link between Codependency and Addiction
Codependency and addiction often occur simultaneously in a relationship. When a person struggles with a dependence on drugs or alcohol, loved ones can play a vital role in assisting that individual to seek out help and find the motivation to go through the recovery process. However, codependent relationships can have the opposite effect. A person with a substance use disorder in a relationship with a codependent can make overcoming the dependence on alcohol or drugs even more challenging.
Similarly, a codependent may have difficulty making it through the codependent recovery process because of a need to help and enable the person with the dependence on drugs or alcohol. Relationships between a person with an addiction and the codependent are often self-destructive and will continue to be so without appropriate intervention.
Treatment for Codependence
Treatment for codependence may require evidence-based interventions such as cognitive behavioral therapy (CBT), motivational interviewing, and one-on-one and group therapy sessions. A holistic view of the individual and the family unit, including co-occurring issues such as addiction and mental illness, can help guide the treatment plan. Tips for dealing with codependency during drug addiction can vary, so talk with a professional to determine the best course of action.
Codependency may not be an official diagnosis, but it is a unique psychological construct that has a marked effect on the individual and the family dynamic. It is essential to recognize the signs and symptoms of the condition, as well as the role it plays in fueling substance use disorders and dysfunctional family roles. A codependent can help facilitate drug dependence in a partner or friend, and a person with a substance use disorder may serve as an enabler to a codependent. This cycle of codependency can be very difficult to stop without appropriate intervention and treatment. The codependency recovery process requires a specific approach based on relationship dynamics.
Family First offers comprehensive evidence-based interventions for drug and alcohol dependence as well as behavioral health conditions. Our family case management services help individuals and their families understand the importance of the family system in the recovery process. Contact us to learn more about our services and family-focused care.