Codependency is a trait rather than a personality disorder. It describes an unhealthy relationship in which one partner relies heavily on another to bolster their self-worth. It can affect people with mental health conditions but is not a mental disorder.
Codependency often involves one partner taking on the role of a “rescuer” to someone who needs support, as this makes them feel needed.
People with personality disorders can have codependent traits, but “codependent personality disorder” is not a distinct medical condition. People may confuse this term with dependent personality disorder (DPD), which is a recognized condition.
This article discusses what codependency is, the signs that it may be affecting someone, and how it relates to personality disorders.
Codependency is a pattern of behavior that affects relationships. It causes a person to become excessively reliant on their partner to fulfill their emotional needs, particularly for self-esteem.
This reliance often causes a person with codependency to stay in damaging, abusive, or one-sided relationships, even when it harms their own well-being. This is because being needed by someone else — for example, someone who may be struggling in some way — makes them feel valued.
Codependency is neither a personality disorder nor a distinct mental health condition. It is a trait that hinders a person from having healthy, mutually satisfying relationships.
It is also distinct from dependent personality disorder (DPD). Although DPD has a similar name, people with DPD feel dependent on others to care for them rather than the other way around.
People who have codependency may:
- feel excessively responsible for others
- feel a need to control others
- consistently do more than is expected of them but then feel hurt if people do not notice
- mistake pity for love, leading them into relationships with people they can “save”
- have a strong fear of abandonment, causing them to stay in unhealthy or unhappy relationships
- feel guilty about asserting their own wants or needs
- lack trust in themselves or others
- have difficulty making decisions
- have difficulty identifying their feelings
These feelings and behaviors can mean that people with codependency are drawn to relationships where they can care for someone else. However, this caregiving role becomes self-defeating and can be compulsive. This means a person finds it difficult to stop.
The more the person cares for someone in need, the more dependent that person may become on their care. This boosts self-esteem, but it also means that in order to keep deriving satisfaction from the relationship, the person in need must continue requiring help.
This traps both people in the roles of victim and rescuer, disempowering the person who needs support.
In an attempt to feel better, people with codependency may also engage in potentially harmful behaviors, such as taking drugs, drinking alcohol, or gambling.
Codependency can occur on its own, but it can also co-occur with several personality disorders. Medical News Today reached out to psychiatrist Ketan Parmar, MBBS, DPM, to explain the relationship among them.
Codependency and borderline personality disorder
Borderline personality disorder (BPD) is a mental health disorder where a person has an unstable self-image, which affects their mood, behavior, and relationships.
“People with BPD often have difficulty regulating their emotions, which can result in intense bouts of anger and depression,” Parmar said. “They may also engage in impulsive behaviors, such as self-harm or substance abuse.”
Individuals with BPD are particularly vulnerable to codependency, as they need consistent validation from others. “They may struggle to form and maintain healthy relationships due to their fear of abandonment,” he added. “This creates an intense need for validation and approval from those closest to them, which can lead to codependency.”
Codependency and narcissistic personality disorder
Narcissistic personality disorder (NPD) is a mental health disorder in which people have an inflated sense of self-importance, a high sense of entitlement, and a lack of empathy.
“People with NPD are highly sensitive to criticism and feel threatened when faced with any kind of rejection or failure,” said Palmar.
“They need constant validation and rely heavily on external sources of praise to feel good about themselves. This puts them at risk of codependency, as they seek out relationships where someone can fulfill their emotional needs.”
Codependency and avoidant personality disorder
Avoidant personality disorder (APD) is a mental health disorder that causes intense feelings of inadequacy, a fear of rejection, and avoidance of social interaction.
“People with APD struggle to form meaningful relationships and often become isolated from friends and family members,” said Palmar. “As a result, they are highly reliant on others for emotional support and may develop codependency in order to gain validation or approval from those closest to them.”
Codependency and dependent personality disorder
DPD causes a person to feel helpless and unable to take care of themselves. As a result, they can be dependent on others to look after them and can allow the needs of others to eclipse their own so they can stay in a relationship.
The similarities between codependency and DPD may cause confusion. For instance, both involve a lack of self-confidence, as well as allowing the needs of others to take precedence.
However, where people with DPD feel that they need others, people with codependency feel the need to be needed by others.
As a personality disorder, DPD also consistently affects a person’s behavior in all situations, rather than just their relationships.
Codependency is a behavior that people learn from others while they are growing up. Often, it comes from witnessing unhealthy family dynamics, in which relatives put their own emotional or physical needs aside to cater to someone else.
This teaches children that their needs are not important, which can lower their self-worth. They may also learn that the only way to gain attention, safety, approval, or love is by sacrificing themselves for the sake of others.
This may happen in households affected by abuse, neglect, and addiction. It can also happen when a family member has a chronic or serious illness that requires a lot of attention, resulting in a child having to take on responsibilities that they are not ready for.
A therapist or other mental health professional may notice signs of codependency in an appointment.
If they suspect that codependency may be part of a personality disorder, they may ask a person to complete a questionnaire or go for a specialized assessment or diagnostic evaluation.
Since childhood experiences are the root cause of codependency, treatment involves examining how events from that time are affecting current behavior.
This may involve individual therapy or group therapy. If appropriate, a therapist may also recommend couples or family therapy to help people communicate, set healthy boundaries, and learn how to create healthier relationships.
It is important to note, though, that couple or family therapy is not appropriate if abuse is still taking place in a household. If that is the case, a therapist’s priority will be client safety. This may involve supporting a person in leaving the abusive situation.
If codependency is part of a personality disorder, treatment may involve the following:
- BPD: Treatment for BPD involves psychotherapy, such as dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT).
- NPD: There is
no standard drug or treatment for NPD. Some practitioners use psychodynamic psychotherapy, which focuses on the defenses that an individual manifests during therapy sessions. - APD:
Various studies have explored the treatment of APD. Options may involve CBT and interpersonal therapy, which may help with social anxiety. - DPD: Treatment may involve CBT to help someone engage in more independent behaviors. Treatment may also include psychodynamic therapy to determine the root of the dependency.
Codependent personality disorder is not a mental health condition. Instead, codependency is a trait that affects relationships. It often stems from childhood. Treatment options include individual or group therapy.
Signs of codependency may include low self-esteem and an unhealthy dependence on a relationship. Codependency bears some similarities to DPD, but the former is a trait, while the latter is a condition that consistently affects behavior across all situations.