“Clinical” means “diagnosable,” which codependency is not. If you go to a mental health professional—and if you think you should, you should—the only tool they have to diagnose you with is a giant book called the “Diagnostic and Statistical Manual of Mental Health Disorders” (DSM), currently in its fifth edition (DSM-5), and is over ten years old.

It was approved of by the American Psychiatric Association, the leading mental health diagnostic organization in the world, which not only disbelieves in codependency, but neither does it provide any diagnosis for sex or internet addiction, hypochondria, loneliness, or developmental trauma.

To diagnose, dysfunctional behaviors are extrapolated into symptoms, and symptoms are grouped into thematic clusters. In the case of sex and internet addiction, the main symptoms are compulsion, rumination, and intrusive thoughts, which are thematically appropriate for a diagnosis of obsessive-compulsive disorder.

The symptoms from developmental trauma can receive a variety of diagnoses, including anxiety, depression, post-traumatic stress disorder (PTSD), addiction, personality disorders, eating disorders, dissociative disorders, and obsessive-compulsive disorders. All of these are petals of the same flower, and all of these can manifest with codependent behavior.

Codependency will never make it into the DSM because it represents too many symptoms. For most people, mental healthcare is only affordable with insurance, so diagnosing you is the only way that your therapist can get paid.

A diagnosis is what the insurance companies “need” to fund your mental health treatment. Since codependency is not a diagnosable condition, and in some professional circles is considered a myth, it is not a condition that insurance agencies cover treatment for.

You may get a therapist who knows the game and can write down what is necessary to keep your treatment covered, but you deserve to know that your mental health treatment is dependent on a game.

An accurate but serious diagnosis that has no real bearing on your treatment may negatively affect the way you see yourself. This outcome is inconsistent with ethical codes that give patients the absolute right not to be exposed to anything that might cause them further harm.

Insurance companies not only restrict the conditions they are willing to cover to those acknowledged by the DSM-5, they also restrict therapeutic techniques to those which don’t last very long. They all prefer brief therapy, since brief means “short” and is therefore “cheaper.” Brief therapy is all about managing symptoms rather than pursuing elusive causes.

Most insurance companies will fund ten sessions for a therapist to treat you. After that, they will ask for written justification for longer treatment, which will include your diagnosis and the therapeutic modality being used to treat it. Neither codependency or psychoanalysis is on the list.

Your insurance-covered therapy will therefore involve an adjacent diagnosis to the reason you are there and will be treated with techniques that potentially target something other than your deepest pain. All as fast as possible. But processing the deep, painful conflict inside someone’s soul takes real time, and none of it is possible without a deeply meaningful therapeutic relationship—another thing that takes real time.

When you finally get a counselor or therapist, they will be confused when you bring up codependency. It means too many things. I once heard a licensed psychologist say what most people mean by “codependency” is “love.” Of course, if that were true, it wouldn’t be healthy love, nor love worth pursuing.

After all, codependency is what so often brings people and psychologists together. Another analyst, this time training me in clinical skills, dismissed codependency as an eccentric theory that saw relationships as an addiction but wasn’t worth taking seriously. He made no eye contact and had no interest in discussing it.

Could you imagine being confronted with this after waiting 9 months to see a therapist?

But all is not lost. There are plenty of competent therapists who know the game very well and have plenty of experience treating your specific symptoms. Unfortunately, there is a global mental health crisis caused by a shortage of practitioners, tremendous arbitrary red tape slowing down the production of new therapists, unaffordable premiums, uncovered conditions and therapies, and occasional jaw-dropping incompetence by someone who gets paid to be knowledgeable and trustworthy.

Instead of worrying about it, promise yourself to go to therapy and prepare to make the most of it. Are you going to go to the doctor for a headache? Probably not before you take some aspirin.

By the time you go to the doctor, you are going to tell them that you took aspirin, ibuprofen, drank water, took a nap, ate food, consumed sugar, drank coffee, went for a walk, haven’t consumed alcohol, suffered no recent injuries, aren’t unusually stressed, aren’t on your period, and you aren’t fumigating for roaches. If you bring this information to a doctor, you are going to get the most out of your time with them.

Think of each section of this blog like an aspirin for your codependency headache. If you are on a long wait list for therapy, this is the perfect use of your time. Start asking the hard questions and learning the lingo so you can walk in there loaded with a self-care practice, awareness of boundary enforcement challenges, and specific relationship goals.

Preparation will save your precious, expensive therapy minutes from being wasted on explanations about what anybody with an internet connection can learn on their own…

See the Crack Your Codependency book for more. In the meantime, familiarize yourself with the following clinical conditions that often rub shoulders with codependency.