CoDependents: Treating Their Underlying
By Christina Veselak, LMFT, CN
Family members of addicts are often referred to as co-dependents, or co-addicts. They have gotten a bad rap in the addiction treatment field. Clinicians often experience them as rigid, angry, blaming, unwilling to change, and very resistant to self-care. This can be very frustrating to clinicians, who see clearly how the co-dependent client’s changing would help the whole family system, but find themselves unable to help effect such change. They often then begin to blame the co-addicted client.
Clinicians typically see this stuckness as a purely emotional issue. Because codependents often come from addicted families themselves, we assume that intergenerational trauma is at the root of their behavior and that it should be, but often clearly isn’t, amenable to psychotherapeutic approaches. However, the position of the Alliance is that the behavior of addicted family members is at least as biochemically driven as that of the addict him/herself. We consider co-addiction to be a multi-faceted biochemical stress-related disorder.
People from families with on-going serious addiction, chronic illness, and violence are often the first to seek treatment because of the serious toll stress has taken on them. This often manifests as rage, depression and anxiety. GI distress, back pain, migraines, insomnia and fatigue often co-occur. One way to understand this is to recognize that chronic stress leads to over-utilization of key nutrients such as zinc and vitamin B6, hormones such as cortisol and adrenaline, and neurotransmitters such as dopamine, GABA, endorphin, and serotonin, leading to their deficiency.
Neurotransmitters allow us to cope with stress gracefully, and mediate all of our feelings, reactions, perceptions and skill utilization. When they are under-functioning, or depleted, we find ourselves unable to effectively cope with stress.
Low levels of dopamine and norepinephrine create states of apathetic depression, inhibition of creative problem-solving skills, and fatigue.
Low serotonin levels lead to an anxious, agitated depression, often characterized by low self-esteem, rigidity, anger, obsessive worry, insomnia, and the inability to be flexible.
Low endorphin levels result in heightened pain sensitivity, both emotional and physical.
Low GABA levels lead to an increase of adrenalin, and is often experienced as stress, overwhelm, muscle stiffness or pain, and insomnia caused by physical tension.
Sound familiar? On-going stress also depletes adrenal functioning (Hans Selye’s Exhaustion Phase). When adrenals begin to falter partly because they have over-utilized and depleted vitamin B5 and vitamin C, which are key to optimal adrenal functioning, we can have deeper issues with insomnia, fatigue, concentration and memory, and starting and finishing tasks. Taking on something new, such as self-care behaviors or going to Alanon meetings, feel out of reach. Infectious illnesses often increase, as do digestive disturbances, which lead to malabsorption of the nutrients we do get from food. Self-care, play and relaxing activities decrease even further, and harmful coping mechanisms such as over-consuming sugar and caffeine, increase.
The answer to this vicious downward spiral is to give family members quick-acting nutritional first aid starting with amino acids which can make a difference to mood, energy, pain- and stress- tolerance within 20 minutes. Additional vitamins, minerals, and fatty acids are also required right away. This can jumpstart an upward spiral whereby codependents start feeling better. They then, with our assistance, start eating more nutrient dense food every 3-4 hours to help stabilize blood sugar levels. This leads to better sleep and mood stability. As sleep and energy improve, and as serotonin and GABA levels rise, family members are more likely to reach out for support and experiment with new coping skills. These then will continue the improvements in their quality of life, increasing their ability to cope more effectively with the behaviors of their addicted family members. This leads them out of the destructive dance we call codependency.
Healthy family members are often the key to change in an addicted or painful family system. Family members who are given user-friendly nutritional tools are able to rebuild their innate, internal coping mechanisms, which will in turn help them create healthier, happier families.
Christina Veselak, LMFT, CN,
Julia Ross: The Mood Cure
Hans Selye: The Stress of Life
James A Wilson: Adrenal Fatigue
By Christina Veselak, LMFT, CN
A 50 year-old woman walked into my office mid-afternoon for the first session crying and shaking. She had not eaten anything all day. She was so upset that she asked if she should go to the emergency room. She had no suicidal or homicidal ideation. She reported that she has had a hard time getting to sleep lately and wakes up at 3 and can’t go back to sleep again. She was having a hard time making time to fix food for herself, and had been too upset to eat a lot. She had been dealing with a possible cancer diagnosis, but the doctors were in disagreement about whether or not she really had cancer. She had found her 26 year-old son in a coma from a heroin overdose a month before and was still highly traumatized from that. He had been in Florida since then with his father in an IOP (Intensive Outpatient Program) and was arriving home the next day to handle some legal affairs, with which he needed her help. She really wanted him to go to Sober Living but was not sure what would happen. She is married and has solid support from her husband. She just found out prior to the initial session that her son's pregnant girlfriend of 19 was coming with him and she didn't know what to do. On top of all of this, she was in a very stressful job, where she didn't know how to set boundaries, and was being taken advantage of. She was profoundly exhausted, and was having trouble remembering things, concentrating, and getting anything done. She was not on any psychotropic medication.
The first thing I did was to give her 1000 mg L-glutamine, as she didn't think she could eat, along with 200 mg Theanine, and 100 mg 5HTP. Within 20 minutes she had calmed down enough to be willing to eat something. I sent her home on an amino acid and multi-nutrient protocol to support her adrenal glands and all of her neurotransmitters, but especially Serotonin and GABA, and asked her to sip on pre-packaged liquid protein shakes through-out the next few days and a prorecovery diet as soon as she could eat solid food. I also told her that I would put her on short term disability leave from her job.
Two days later she walked into my office a different person! The family stressors were the same, but she had settled down so quickly that she was already eating four real meals a day and was beginning to sleep. She was clear, calm and could think again. She stayed on the same nutrient protocol for several months to support her adrenals and rebuild her neurotransmitter systems. She joined an on-line Alanon group and continues to work with me on self-care and boundary setting. She is much happier, rested and more stable, and is getting ready to go back to work. She has stopped worrying and obsessing about her son, but she is urging him to get nutritional help ASAP.
Christina Veselak, LMFT, CN, former President of the Alliance