Experts once used the term “codependency” to describe the behaviors of people in relationships with individuals who had some form of alcohol use disorder. In recent decades, the definition of codependency has become more complex and extends to behaviors in many other situations, not just those that involve substance abuse.


Codependency is not a mental health condition. There are no symptoms or diagnostic guidelines in any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for these unique patterns of behavior. Most professionals agree that codependency occurs when one person in a relationship loses their sense of independence. They feel the need to focus entirely on the needs of the other person to the point where it becomes unhealthy, dysfunctional, or imbalanced.


Patterns of Codependency

The symptoms of codependency can overlap with mental health conditions, such as dependent personality disorder (DPD) and borderline personality disorder (BPD). According to a 2018 study, four distinct patterns can develop in people with codependent behavior:

  • A need for control, which can incite conflict
  • Tendency to focus on others
  • Self-sacrifice
  • Difficulty expressing and recognizing emotions


Signs and Symptoms

Although there are no official diagnostic criteria for codependency, several signs and symptoms can emerge, including:

  • Lacks a clear sense of self, has low self-esteem
  • Compulsive attention to someone
  • Self-worth relies on what others think about them
  • Avoids conflict, or apologizes or takes the blame to maintain a relationship
  • Feels guilty when doing something for themselves
  • Overwhelming feelings of abandonment or rejection
  • Does things to make others happy even though they do not want to do them
  • Minimizes or ignores personal desires


Codependent Characteristics

Both women and men can be codependent. A 1990s study showed that the female subjects exhibited five characteristics: control, exaggerated responsibility, worth dependency, rescue orientation, and change orientation. Male subjects showed two of those characteristics: control, and exaggerated responsibility. Codependents often stay in the relationship even if it is not emotionally rewarding because they develop a compulsive need to stay connected to the other person.



Many codependent adults report incidents of childhood trauma, such as physical, emotional, or sexual abuse, or difficult relationships with their caregivers as a child. Family dynamics, living with a mentally or physically ill family member, or a history of parental substance abuse can all contribute to the development of codependency. The parent ignored the child’s needs in favor of their own. On the other end of the spectrum, overprotective or controlling caregivers may prevent the child from learning how to establish safe limits and healthy boundaries in their adult relationships, leading to a codependent dynamic.


Codependency is a Learned Behavior

People with codependency may develop or maintain relationships that are one-sided, abusive, or emotionally destructive. Research shows that codependency is a learned behavior that takes root in childhood and is passed down from one generation to the next. Because a person with codependency has low self-esteem, they seek gratification outside of themselves to feel better. They establish relationships with those who have addictions or who struggle with physical or emotional challenges, in order to rescue that person and feel better about themselves.


Types of Codependency

Symptoms of codependency vary from mild to severe, but the common characteristics are a poor concept of self and a deep-seated need for approval by others. It can develop in any type of relationship where there is an unequal distribution of power, including friendships, parent-child relationships, romantic partnerships, and employee-employer relationships.


Codependency and Addiction

Researchers have found a high level of codependency among family members, friends, and romantic partners of those who abuse drugs or alcohol. In these relationships, the person who takes on the caretaker role makes it their job to ensure the safety of the addicted individual who they believe cannot survive without them.  This becomes a problem for both people in the relationship: caretaking feeds the codependent person’s self-sacrificing needs and prevents them from healing, and it enables the behavior of the person with the addiction.


Stages of Codependency

Codependency consists of three distinct stages. In the early stage, the codependent ignores healthy boundaries, becomes obsessed with the person, and rationalizes problem behaviors. In the middle stage, they may withdraw from family and friends to hide problems in the relationship or try to change their partner through manipulative behaviors. Stress-related disorders are common in the late stages, along with addictions, lack of self-care, and feelings of hopelessness, anger, and depression.


Diagnosis and Treatment

Most professionals agree that there is a lack of psychometric instruments available to effectively study and understand codependency. However, cognitive therapy, group therapy, and family therapy can help a person unlearn their codependent traits. Learning to express needs, pursue personal interests, and establish greater self-awareness can help them overcome codependency and develop healthy relationships.


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