Learn Spanish (Latin America): Mi amigo vive automedicándose por miedo. - My friend is constantly self-medicating out of fear.

The structure vivir + gerund is used to express that someone does something constantly, habitually, or excessively. While siempre se automedica just states a fact, using vivir adds emotional weight, often implying annoyance, exaggeration, or in this case, deep concern for the friend.

Why is there an accent mark on automedicándose?

The base gerund is automedicando, with the spoken stress naturally falling on the second-to-last syllable (can). When we attach the reflexive pronoun se to the end, we add a new syllable. To keep the spoken stress on that exact same vowel, Spanish requires us to add a written accent mark.

Could I place the reflexive pronoun se somewhere else in the sentence?

Yes! When you have a conjugated verb followed by a gerund, you can place the pronoun before the conjugated verb instead of attaching it to the end. It is completely correct and natural to say Mi amigo se vive automedicando por miedo.

Why is it por miedo and not para miedo?

We use por here because it explains the cause, motive, or reason behind the action (he is doing it because of fear). Para is used for goals, purposes, or destinations, so para miedo would incorrectly imply that he is self-medicating in order to achieve fear.