Codependency & Health Anxiety

By: Bria Wannamaker

You’ve probably heard of codependency in mainstream media used to describe someone who is dependent on someone else to meet their needs, characterizing this person as someone who is “clingy, needy, or desperate”, and the truth of the matter is that it takes two to tango. In order for someone to continue to display this behaviour, there has to be something reinforcing it. If you keep feeding the neighbourhood cat, it will keep coming right back to your door.

It Takes Two

Not only is codependency comprised of someone who requires an excessive amount of emotional support and validation from others, but there is also a person in the relationship who provides this continuous support and validation. What’s more is that this provider also gets something out of the relationship. While the Passive Codependent (described in detailed below) loved to be needed, the Active Codependent loves to need them. In this type of relationship, there’s someone who is constantly giving and lives in fear that they’ve never done enough, and there’s someone who is always receiving, in lives in fear that they might lose what they have.

The Biological Components of Codependency

In codependent relationships (romantic, familial, friendships, work-related), there’s one person who takes on roles and responsibilities as the helper, the fixer, the doer, the caregiver, and the other who tends to blame, seek constant guidance and support, and may have little to no close relationships with others outside of the codependent partnership. This is similar to trauma bonding where there’s a cycle of highs and lows in a relationship which might include toxic behaviour or abuse (lows), and then making up, apologizing, or feeling heard and understood by your partner (highs). The lows elicit feelings of fear, anxiety, and stress, and the brain and body release stress hormones (cortisol, adrenaline, and norepinephrine); the highs elicit feelings of comfort, safety, and security, and the brain releases endorphins and feel-good hormones (serotonin, oxytocin, and dopamine). When they say “love is like a drug” – this is precisely what they mean. This chemical release of hormones within the body becomes physiologically addictive. It’s the same experience that you get when you feel like you need a cup of coffee in the morning for that cortisol dump. When you need to go for a run and experience that hit of dopamine from the ‘runner’s high’. When you’re hungry, need food, and your body and brain are rewarded with serotonin and dopamine upon nourishment. When you hold your newborn child skin to skin and get that oxytocin release. In the same way that all of these experiences feel wonderful – so can a relationship that’s based on trauma bonding or codependency.

Adult-to-Adult Relationships

Outlined below are two types of codependent behaviour – you can look at these as the parent (Passive Codependent) and the child (Active Codependent). Children need adults to co-regulate their emotional state when they are young; their brains are not yet fully developed, and they have a limited experience of the world. Parents carry out their maternal and paternal responsibilities of child rearing by leading, teaching, guiding, and caring for their young.

In terms of adult-to-adult relationships such as friendships, co-workers, and romantic partners – it does not feel good when there is an imbalance in their relationship. In fact, take for example, this workplace relationship: if a co-worker of yours takes on the role of the parent in your co-working relationship, you might feel like you’re inadequate at your job, that you aren’t capable to handle things but that your co-worker is, and it can also lead to you feeling that they are being condescending toward you. How can you build trusting relationships at work if one person has a “I’ll just do it myself” attitude, and the other feel ill-equipped with little room for positive feedback and validation of their work efforts?

Or, take a romantic relationship for example: if one person is regularly feeling insecure and blaming the other for their experience, and the other partner tries to make up for this by being more attentive – even if it’s outside of their means and their capacity – will anything really be resolved? How much of a turn off is it if you feel that you can’t have an open conversation with your partner without walking on eggshells? It is essential that as adults, we work to foster adult-to-adult healthy relationships that are balanced and interdependent.

Character Traits of Codependent Adults

Passive Codependent (tend to avoid conflict, is responsible, empathetic, compassionate, & covertly resentful )Active Codependent (tends to initiate conflict, idealizes others, needs affection and approval, & covertly terrified of being abandoned)
HelperFeels helpless/low self-confidence
FixerBlames others
DoerSeeks validation
CaregiverSeeks support
Enabler Difficulty recognizing boundaries
RescuerFeels out of control

The Cycle Continues

Without intervention, passive codependents abandon their own wellbeing and needs in order to attend to the needs of their active counterparts; while active codependents have a constant fear of being abandoned or unsupported. The passive codependent will feel like they are never doing enough, while the active codependent will never feel fully capable and content on their own.

This relationship meets everyone’s inner wounds and needs. It allows individuals to experience a sense of safety and security, and to feel valuable, and loved. However, this allows little to no room for growth and change within the relationship as this is a pretty exclusive way of being. There’s minimal room for reciprocity and interdependence within the relationship. Codependent relationships are imbalanced and these habitual ways of reacting to one another can continue to build and evolve; unless you take the time to acknowledge your experience of distress and discomfort in relation to these patterns.

Character Traits Within Desirable Relationships

Healthy Relationships (friendships, workplace, romantic, familial)
Each partner has the opportunity to feel supported by one another
Each partner is able to set their boundaries
Each partner is able to communicate their needs to the other
Each partner is able to recognize and respect the boundaries of the other
Each partner is able to take responsibility for their actions
Each partner is able to make mistakes, try, fail, and work through things
Each partner is able to feel and express reciprocal validation, admiration, and acceptance
Now, I’m not saying that everyone has these communication skills right from the get go, but if you’re able to talk openly and actively work toward these traits – that is the marker of healthy relationships. *Not someone just saying that they’re going to do the work and then they don’t.

So, how can a history of codependent behaviour relate to your experience of health anxiety?

Health anxiety fosters an emotional state of feeling out of control in regard to psychological and physiological symptoms. These may be related to a medical health condition, chronic pain, diagnosis, or may be somatic symptoms related to stress and anxiety. You become preoccupied with your symptoms and they drive your behaviour and further perpetuate feelings of stress, anxiety, depression, discomfort, distress, unease, fear, and worry.

Passive Codependent Active Codependent
Tries to reassure others and maintain a positive outlook on the situation while avoiding personal feelings of pain and difficulty
Feels helpless/low self-confidence
Requires reassurance from others and has limited coping skills for processing emotions and managing reactions
Constantly giving advice and suggestions to others in regard to health, but neglects to take this advice into practice
Blames others
Looks to the media, government, workplace, family, friends, and social media to find answers to their discomfort
Doesn’t recognize their own needs for rest and recuperation. Refuses to take breaks, time off from work, does not prioritize sleep
Seeks validation
Regularly researching symptoms online, and frequent visits to the doctor due to preoccupation with physiological symptoms
May project their own health and self-care needs onto others
Seeks support
Struggles to regulate their emotions and turns to others regularly when distressed
Offers to provide assistance even when they are already too busy. Offers to be available, even when they don’t want to be

Difficulty recognizing boundaries
Unsure of when they can trust their own abilities to self-care, which leaves them to default to calling on someone else for assistance
Will drop everything to be present for others – even if what they were doing was important for their own health
Feels out of control
Feels like health symptoms are permanent and that there is nothing that they can do. Feels that symptoms will worsen and lead to severe illness or death.

What to do about it…

In terms of health anxiety, if you’re stuck in the Passive/Parent type codependent, as an adult, it might present IRL as:

  • Overwhelm
  • Chaos
  • Compulsive behaviour
  • Anger
  • Resentment
  • Stress
  • Feeling that you need to rest but you’re not sure how to take time off
  • Difficulty sleeping
  • Illness or injury
  • Irritability
  • Taking on more work
  • Somatic symptoms such as back pain or gastrointestinal issues

In terms of health anxiety, if you’re stuck in the Active/Child type codependent, as an adult, it may present IRL as:

  • Powerlessness
  • Confusion
  • Procrastination
  • Depression
  • Panic
  • Uncertainty
  • Feeling like a burden or that you should be able to handle things
  • Feeling unable to function at work
  • Racing thoughts
  • Somatic symptoms such as sweating and heart pounding

Of course, please get checked out by a doctor or medical healthcare professional if you’re experiencing any of the above as they can be related to a multitude of other causes. These lists are my interpretation of codependent behaviour as it relates to health anxiety for educational purposes only and are not intended as a substitute for medical health care or psychological treatment.


What does the Passive/Parent codependent need to feel safe, secure, and valuable outside of this relationship?

  • Time to rest and rejuvenate
  • Boundaries that they honour and maintain
  • Time for self-care; cooking a nourishing meal, going for a walk
  • Meditation or stillness practice
  • Time for fun and leisure activities
  • Support and trustworthiness from others
  • Beginning to delegate tasks
  • Time boundaries such as disconnecting from technology or just remembering that you don’t always have to be available
  • Time and space to get in touch with your needs and learning to communicate them openly and effectively
  • Work with a therapist who offers Cognitive Behavioural Therapy (CBT), and Mindfulness-Based Relaxation practices, Internal Family Systems (IFS), or Somatic Experiencing

What does the Active/Child codependent need to feel safe, secure, and valuable outside of the relationship?

  • Building up coping skills to self-soothe for emotional regulation
  • Hobbies, passions, leisure activities
  • Engage in social activities and connect with others
  • Build self-esteem by trying new things or engaging in previous activities that you used to enjoy/have success in
  • Build self-confidence by committing to a goal of yours and following through on it
  • Re-connect with who you are, your likes, dislikes, interests – create and hone in on your sense of self
  • Beginning to take ownership of what is in your control focusing on your internal locus of control
  • Work with a therapist who offer behavioural activation through cognitive behavioural therapy (CBT), skills from a Dialectical Behaviour Therapy (DBT) lens, Acceptance and Commitment Therapy (ACT), or Internal Family Systems (IFS), or Somatic Experiencing.

Final Thoughts

Maybe you reflect on some things that you need that aren’t on the list or you find that the above suggestions don’t seem to work for you. Regardless, it’s time to take action and to make a change. If you’re feeling any sort of discomfort and distress in your life as it related to your relationships and your health, you’ve probably been feeling this uneasiness for a long time. It’s time to acknowledge where you’re at and take things one step at a time from there.

Final, final thoughts…

To you Passive Codependents – Why should you be the least happy person in your life? Why should you put your health and wellness aside?

And to you, Active Codependents – Don’t you want to hop into the driver’s seat of your life and be fully engaged with the world around you? Why do you keep giving up your power to make change and to create a life that you love and that makes you happy?

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