Other codependent symptoms, such as shame, intimacy issues, and lack of assertiveness contribute to chronic depression. Internalized shame from abuse or emotional abandonment in childhood causes low self-esteem and can lead to depression. Untreated, codependency worsens over time, and feelings of hopelessness and despair deepen.
Codependency and depression can be caused by growing up in a dysfunctional family that’s marked by abuse, control, conflict, emotional abandonment, divorce, or illness.
The Ace Study demonstrated that adverse childhood experiences lead to chronic depression in adulthood. All subjects with a score of five or more were taking anti-depressants fifty years later. Other causes of dysthymia are isolation, stress, and lack of social support. (Research shows that people in abusive relationships aren’t likely to disclose it.)
Psychotherapy is the treatment of choice. It is more effective when combined with antidepressant medication. Cognitive therapy has been shown to be effective be eliminating negative thinking to prevent recurrence of depressive symptoms. It may mean healing trauma and PTSD from prior abuse.
In addition, patients need to develop better-coping skills, heal the root cause, and change false shame-based beliefs that lead to feelings of inadequacy and unlovability. Goals should be to increase self-esteem and confidence, self-efficacy, assertiveness, and restructuring of dysfunctional thinking and relationship patterns.
Group therapy or support groups, such as Codependents Anonymous or other Twelve-Step Program are effective adjuncts to psychotherapy. Lifestyle changes, such as exercise, maintaining healthy sleep habits, and participating in classes or group activities to overcome isolation are also ameliorative.
©Darlene Lancer 2015
Written by Darlene Lancer JD, MFT Originally appeared on What Is Codependency