Bad Habits: Processing Addictions Beyond Alcohol and Drugs

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When people think of addiction, they think of substances like alcohol and drugs. They rarely think of addictive behaviors, but addiction goes well past substance use disorders.

In 2011, the American Society of Addiction Medicine included behavioral addiction in the broader definition of addiction. Behavioral, or process, addiction is the repeated compulsion to engage in a behavior, even when the behavior becomes harmful, because the individual cannot resist engaging in the behavior without intervention. Some of the most common behavioral addictions are eating, shopping, gambling, sex, and use of social media.

While process addictions have always been prevalent in the addiction community, they gained traction fairly recently in the larger medical community due to two big findings. First, people with substance use disorders tend to have more than one addiction. Second, the brain reacts to behaviors the same way it does to substances – this is why certain behaviors, like gambling, can be addictive.

Similar to substance addictions, there is no single cause of behavioral addictions. Addiction is complex, and so are the reasons why certain people develop them while others do not. However, research has indicated genetics play a major role in a person’s susceptibility to developing the disease. In addition, people who develop addictions often report high levels of impulsivity and sensation-seeking personality traits paired with low levels of harm avoidance traits.

Further, diminished control is common in individuals with substance use disorders and process addictions. Due to tolerance, people struggling with addiction experience less pleasure each time they engage in the behavior or consume the substance, so they become motivated by negative reinforcement (relief from withdrawals) as opposed to positive reinforcement.

Co-occurrence with substance use disorders is relatively common among individuals with behavioral addictions. People with a gambling addiction are 3.8 times more likely to struggle with an alcohol use disorder. (Correlation does not mean causation, however, and the relationship between the two is unclear.)

Oftentimes, process addictions are not regarded as dangerous or detrimental compared to substance use disorders. But job or financial loss and relationship issues with family and loved ones still accompany these disorders.

Process addictions can also be more difficult to diagnose, as the signs are usually not as clear as, say, a heroin addiction. Physical health does not immediately start deteriorating and individuals oftentimes hide and disguise their behaviors from people close to them.

One of the biggest challenges in identifying these disorders is the social acceptance and, in some cases, necessity – to a degree – of behaviors such as eating, shopping, and spending money. Others may not consider related addictions issues until it takes a tremendous toll on someone’s life, until it’s too late. Before addictions spiral, though, pay attention to the red flags.

Warning signs of a behavioral addiction:

Making lifestyle changes to accommodate the behavior
– Extreme mood fluctuations related to the activity
– Justifications or rationalizations for continuing to partake in the behavior
– Extreme excitement when discussing the behavior
– Debt and frequent money borrowing

Regardless of the type of addiction, societal stigma often casts addiction as a moral failing, a lack of willpower or motivation. Research shows sustained recovery is more successful when the addiction is treated professionally, so we must continue addressing the roadblocks preventing people with behavioral addictions from seeking and receiving professional treatment.

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