Addictions can occur in a wide variety of forms. Often, it is assumed that physical dependence characterised by withdrawal symptoms is required in order for someone to be diagnosed with an addiction use disorder, but the fact is that behavioural addiction can occur with all the negative consequences in a person’s life minus the physical issues faced by people who compulsively engage in drug and alcohol use.
It is the compulsive nature of the behaviour that is often indicative of a behavioural addiction or process addiction in an individual.
The compulsion to continually engage in activities or behaviours, despite the negative impact and subsequent consequences that they have on the person’s ability to remain mentally and/or physically healthy and functional in the home and community defines behavioural addiction.
The person may find the behaviour rewarding psychologically or get a “high” while engaged in the activity, but may later feel guilt, remorse, ashamed, embarrassed, angry, depressed, or even overwhelmed by the consequences of that continued choice.
Unfortunately, as is common for all who struggle with an addiction, people living with behavioural addictions are unable to stop engaging in that behaviour for any length of time without treatment and intervention.
If you believe that you, or someone you love, are struggling with a behavioural addiction, the good news is that treatment is a powerful tool. Learning how to manage the behavior and begin to address the issues caused by the long-term behaviors begins with intensive and integrated treatment.
When the behaviour becomes impulsive in nature and begins to contribute to the development of a range of physical and mental health problems and the person is unable to stop, it is then termed an addiction.Drink ‘n’ Drugs
Two of the best definitions of addiction come from the National Institute on Drug Abuse (NIDA) and the American Society of Addiction Medicine (ASAM).
Why Are Certain Behaviours Considered Addictions?
Most people engage in hundreds of different behaviours throughout the day, each one with its own set of consequences, often involving both positive and negative consequences.
In general, people make choices about which behaviour to engage in next relatively thoughtfully, and with the intent to improve their experience. For example, if you are hungry, you may choose to get a healthy snack that will not only satisfy your hunger but also give you energy to continue your day.
However, someone who is living with a food/sugar addiction may choose to eat, even when they’re not hungry and may binge eat unhealthy foods in large amounts throughout the day.
Though this is an unhealthy choice, many people can and will overeat, or eat when they aren’t hungry and do not struggle with a food addiction. When the behaviour becomes impulsive in nature and begins to contribute to the development of a range of physical and mental health problems and the person is unable to stop, it is then termed an addiction.
Does this mean that you can be addicted to any behaviour? It is a question that fuels an ongoing debate for many years, even decades!
Many do not feel that characterising a behaviour as an “addiction” is correct; they believe that a little self-control is all that is needed.
Unfortunately, the fact is that if a little self-control were the only issue, then people struggling with behavioural addictions would certainly stop engaging in their specific behaviours of choice long before it harmed their physical health, mental health, ended primary relationships, and caused a host of financial, legal and social problems.
Whether or not any behavior can become an addiction that is harmful to a person’s ability to function is still open to debate. What we do know is that there are several behaviours that are commonly reported as occurring at an addiction level, wreaking havoc and destroying lives for as long as they remain untreated, ignored or continually indulged in.American Addiction Centres
Gambling addiction, also called problem gambling or gambling disorder, is an addiction that refers to any and all types of gambling, betting or choices related to gambling that endanger or compromise a person’s life, including their physical or mental health.
Whether it’s going to the casino and playing the slot machines, staying up for overnight poker games, gambling online or sports betting, if the choice is characterised by the following then it is termed a gambling addiction:
- Placing bets more and more frequently
- Betting more than originally intended
- “Chasing” losses by continually betting beyond the ability to pay
- Feeling irritable or aggressive when unable to gamble or when losing
- Being preoccupied with gambling
- Wracking up debt or gaining credit for gambling
When gambling turns into an addiction, those who seek treatment often report huge losses, including legal problems, foreclosure, bankruptcy, divorce, lost careers and more. Additionally, many who struggle with gambling addiction may consider or attempt suicide in severe cases.
You can find help and support from a wide range of groups, charities and organisations who can help. You can find their contact information on our help and support page here.
Though we all have to eat, and many people are prone to overeating on occasion or eating out of boredom or for pure enjoyment, people who struggle with food addiction cannot control their compulsive eating behaviours.
They tend to crave foods that are high in fats, sugar and/or salt and often describe feeling “high” while engaging in the activity. Additionally, people who are addicted to food may develop a tolerance for food, as is characteristic of people who are addicted to drugs or alcohol.
That is, they require more and more of their favorite foods in order to experience the “high” they seek. This is known as building a tolerance. People who struggle with food addiction may be obese, but people who have a normal BMI may also struggle with the disorder too. Damaged relationships, issues of self-esteem, body dysmorphia and other health problems may also occur as a result of their addictive behaviours.
Video Game Addiction
Addiction to the fantasy and escape provided by video game play as a growing phenomenon. Graphics are getting better all the time, new games are always coming out and the ability to communicate with others virtually via headsets while playing the game with people who would otherwise be strangers from all around the world is uniquely interesting to people who may have a hard time connecting with others in person. This could be due to their physical appearance, mental health conditions, anxieties and others.
Similarly, taking on the role of someone else and living a virtual life can also be alluring. As compared to a substance use addiction or even to other process addictions, video game addiction may seem relatively harmless, and certainly many people can play video games on occasion without ever developing a problem.
However, compulsive video game play can interrupt a person’s ability to connect positively with others and have healthy, real life relationships, maintain responsibilities at work or home and make choices that support their physical and mental health wellbeing (for example, eating regularly or healthfully, going to the doctor, looking after their personal hygiene, maintaining commitments and responsibilities etc.).
Ultimately, those who don’t get treatment may end up completely isolating themselves from the real world, losing their ability to function, be with family and achieve any goals, dreams or milestones outside of their virtual “life” in their video game world.
Sex & Love Addiction
Sex and love addiction is not measured or diagnosed in quantity but instead by the negative impact and consequences associated with the behaviour, on yourself and others. It is characterised by obsessive feelings and behaviours which the sufferer feels compelled to repeat regardless of the consequences. These behaviours and thoughts get progressively worse, ultimately resulting in the breakdown of personal relationships. This repetitive pattern with negative consequences can happen both as a result of excessive acting out (sexual bulimia) or the opposite, sexual anorexia.
Love Addiction Behaviours
- Clinging to an idealised relationship, despite a different reality
- Returning time and again to an abusive and damaging relationship
- Placing responsibility for emotional wellbeing on others
- Craving attention from many different relationships and seeking new sources of attention
Sex Addiction Behaviours
- Engaging with multiple sexual partners
- Excessive masturbation
- Interactions with prostitutes
- Excessive use of pornography
When Addictions Become Unmanageable & Help Is Needed
Identifying when a behaviour has turned into a problem issue, and that problem has developed into an addiction can be tricky.
It can be easy to be too close to the person and unable to recognise when things have gone from occasionally upsetting to a diagnosable disorder that requires treatment, as these addictive behaviours develop gradually over time, rather than just happening overnight.
The fact is that any addiction is defined as a disease of the brain, a chronic illness (any illness or disease that lasts more than three months) that requires a holistic program that includes intensive therapeutic and medical treatment.
Understanding what an addiction is, what causes them and how to overcome them is a vital part to overcoming any type of addiction. You can learn about the science behind addictions and how medication assisted treatment (MAT) programs work by clicking here.
It can quickly spiral out of control, causing problems in every part of the person’s life. When this happens and the person is still unable to stop engaging in the addictive behaviour, even with a genuine desire to stop or great fear or remorse about what has and will happen, it is time to seek professional help, support, treatments and therapies for not only the addict, but their family, friends and/or loved ones too.
You can learn how to support a friend or loved one without unintentionally enabling them by reading our previous article on this topic by clicking here.
If in doubt, reach out!
If you’re not sure whether you or someone close to you may have an addiction, it’s better to ure on the side of caution and contact your nearest drug and alcohol service or Doctors Surgery.
It’s better to do too much before something occurs, rather than doing too little once it’s too late and the damage has begun, which could have been prevented earlier.Drink ‘n’ Drugs
What Type of Programs Are Offered to Treat Behavioural Addictions?
Many of the same programs that are effective in the treatment of dependence upon drugs or alcohol are effective in the treatment of behavioural addictions.
An effective behavioural addiction treatment program should offer all clients access to the resources they need. This may include any combination of the following:
- Detox support: Some clients describe insomnia, feelings of agitation, panic, angry outbursts, headaches and other withdrawal symptoms when they stop indulging in the addictive behaviour. Therapeutic support through this transitional period can assist the client in reaching stability in treatment and improve the capacity to focus on growth and healing going forward.
- Diagnosis and evaluation: Just as with substance use and addiction, there are often co-occurring disorders at play that may be impacting the person’s compulsivity and ability to remain abstinent or sober in recovery. This is often in the form of mental health conditions such as borderline personality disorder, bipolar, schizophrenia or others. A thorough evaluation process by your Doctor, drug and alcohol Keyworker or healthcare professional will help to identify any co-occurring substance use issues and/or mental health disorders that may be contributing to, causing or in any way impacting the person’s experience with behavioural addictions.
- Treatment plan: A unique combination of therapies will be chosen based on the person’s evaluation and diagnosis results, personal circumstances and comfort level, and goals for recovery now and in the future. You can also take more responsibility for your addiction by creating and implementing a daily recovery plan. These will help you to make the most of your time, provide structure and ensure that you’re taking care of the little things that are often neglected, such as personal hygiene, changing clothes, socialising and doing fun things. Recovery doesn’t have to be and Shouldn’t be boring! You can check out our ultimate guide to create and implement your own, along with downloadable templates by clicking here.
- Family support: It is often just as important for loved ones and family members to engage in their own healing processes as it is for the person living with the behavioural addiction. Family members are encouraged to not only take part in their loved one’s recovery but also to engage in support groups designed for family members, personal therapy sessions and family therapy sessions with the person in treatment. You can find groups and organisations who can help you on our help and support page here. You can also read our previous article on supporting a friend or loved one without enabling them by clicking here.
What If Substance use Is A Part of A Co-Occurring Disorder?
If a substance use or addiction disorder is a part of the experience of a client seeking treatment for a behavioural addiction, it is essential that treatment for that substance use disorder (SUD) is integrated into the overall treatment plan.
For many clients, the urge to drink or do drugs is coupled with the urge to engage in the process addiction. For example, some say that as soon as they get a drink in hand, the next thought is gambling. Others may include the use of stimulant drugs as a part of their ritual when they engage in behaviours triggered by or related to sex addiction. Another example could be an addict who only uses crack cocaine only uses it when they also have heroin.
No matter what the combination of disorders is, it is often recommended that the person enroll in a residential treatment centre, detox program or community based drug and alcohol service that are equipped with the staff, resources and experience to empower healing on all fronts.
Statistics, Facts & Data
- Gambling addiction may impact up to 2-3 percent of the American public and 1% of UK residents. Its signs, symptoms and impacts may vary across genders, age groups and other populations.
- In the UK, it is estimated that around 350,000 people are suffering from a gambling addiction.
- Men are more likely to develop a gambling problem and at an earlier age as compared to women, but women make up about 25% of those living with a gambling addiction.
- Risk factors for the disorder include mental health disorders like bipolar disorder, mood disorders and substance use disorders, especially cocaine and/or alcohol abuse or addiction.
- Though similar in many ways, food addiction is different from binge eating disorder. Though both may result in obesity, people who struggle with food addiction may also be of normal weight. The period between sessions of eating large amounts of food may be characterised with different eating behaviours among patients living with BED as compared to food addiction.
- Between 1.25 and 3.4 million people in the UK are affected by an eating disorder, including addiction to food and/or sugar.
- 0.3% to 1% of the general population fit the criteria for a video game addiction diagnosis in the US, UK, Canada, and Germany.
- South Korea declared video game addiction a public health crisis since more than 600,000 children struggle with it.
- 8.4% of children and teenagers are addicted to gaming, of which, 11-12% are boys, and 6-7% are girls.
- It is estimated that about one in 10 young people who plays video games has an addiction to the behaviour. Some people in treatment for video game addiction report experiencing something like withdrawal symptoms when they are unable to play – angry outbursts, sweating, etc.
- Compulsive shopping is often believed to be a female problem, but CNN reports that about 6% of women struggle with the problem – and so do 5.5% of men. Unfortunately, because shopping is a common and normal behaviour, and compulsive shoppers often go out of their way to hide the evidence of their purchases, it’s not always easy to identify the problem. Even one of the common signs of the disorder – frequent arguments over money with a spouse or significant other – is a normal issue. However, alcohol use disorders and/or an eating disorder like binge eating or bulimia often co-occur with shopping addiction, so these issues may be signs of the disorder as well.
- People who struggle with sex addiction sex addiction are often also living with other significant mental health disorders such as bipolar disorder or borderline personality disorder. Engaging in potentially self-injurious behaviour during manic periods or in general may be a sign of these other disorders and must be considered as a possibility during evaluation and diagnosis at the outset of treatment.
- Social media use can lead to addiction if it is compulsive and disruptive to the person’s ability to function in everyday life. Well before it becomes an addiction, however, chronic social media use can contribute to anxiety in users who describe feelings of discomfort and agitation if they are unable to connect – an issue that could potentially be termed a withdrawal symptom.
- Some studies suggest that medication may be helpful in the treatment of some process addictions even if they do not co-occur with other mental health disorders. For example, some studies suggest that naltrexone may be an effective choice in the treatment of online sex addiction.
Frequently Asked Questions
Is There a Difference Between ‘Process’ and ‘Behavioural’ in Regards to Addiction?
There is no difference between the terms “process addiction” and “behavioural addiction.” Both refer to compulsive indulgence in a specific behaviour or type of behaviours that have the net result of harm to the person, plus the inability of the person to moderate or manage those behaviours without treatment.
What Types of Behavioural Addictions Are There?
Individuals may report a number of behaviours that they compulsively engage in that contribute to their inability to move forward or focus on other parts of their lives. For some, it is a behaviour that is at the base of the addiction. For others, it is a ritual that comes before or after indulging in a destructive behaviour.
For example, some clients in recovery from heroin addiction report feeling nostalgic about the process of “cooking up,” loading the syringe and tying off the vein that comes before the actual high. Others describe their process prior to engaging in sex addiction (e.g., the “hunt”) as a ritual they enjoyed; others talk about the ritual of rolling a cigarette prior to actually smoking as being just as addictive as the behaviour itself.
Still others define the obsessive and compulsive behaviours engaged in due to OCD as being addictive. However, in general, though the cravings for different aspects of a behavioural addiction may play a large role in recovery, the top behavioural addictions are often reported to include:
- Sex addiction: Anonymous sex, sex with multiple partners and other sex acts designed to be as highly stimulating as possible are often the focus of sex addiction. Such as role play, fetishes or bondage. However, this can also be risky behaviours connected to other mental health disorders as some do not use protection and thus open themselves up to the possibility of contracting STIs, including deadly viruses like HIV and AID’s.
- Love addiction: Some clients prefer to feel emotionally attached to the partners they connect with. Often a serial monogamist with little time spent in with that new person ensuring that the person will be a positive partner, the person craves the love and attention of the prospective partner before it is clear that there is any genuine connection. For example, a person may “jump in” head first into a relationship with someone after only knowing them for a couple of weeks and then end up finding that they aren’t the right person to be their partner.
- Porn addiction: Porn addiction may start small and be a relatively normal behaviour among Americans and UK residents, but when people find it impossible to engage sexually with someone on a one on one basis without the use of porn, compulsively engages in the use of porn to the detriment of their ability to engage in other activities and/or begin to experience physical or mental health issues as a result, it is an addiction that requires treatment.
- Gambling addiction: There are different levels of gambling that can indicate problem gambling and ultimately, a gambling addiction. As indicated above, when it reaches the point of destroying the person’s financial status, career and family, it is time to seek treatment.
- Shopping addiction: There is usually a “good” reason for the copious purchases made by someone who struggles with a shopping addiction: “It was a great deal I couldn’t pass up.” “We can use this later/on holiday/in this specific circumstance.” “So-and-so would love this.” “You can never have too many of these.” Unfortunately, the end result is usually totes, bags and boxes of items with the tags left intact that are forgotten because the need is not necessarily the item but the feeling of acquiring something and filling a perceived hole in life, even if there isn’t one.
- Video game addiction: As indicated above, addiction to playing video games is a growing problem and one that can negatively impact the person’s ability to have physical, functional relationships with others, remain employed and to prioritise physical and mental health.
- Internet addiction: Just being connected and online can be compulsive and addictive for many people. Some check their emails compulsively, stock updates, breaking news, blog updates and more, feeling as if they are missing out if they are not connected 24/7, 365 days of the year.
- Social media addiction: Similar to internet addiction, some people are compulsive in their use of social media. They may post even the minutest details of their life, spending hours taking pictures to post on Instagram, editing videos to upload to YouTube, updating their posts to Twitter and Facebook and responding to others on those same social media forums. Unfortunately, it can mean that they do not make positive in-person connections and may ultimately reduce their options in life and can cause real world physical and mental health conditions.
- Food addiction: The compulsive need to eat high-fat, high-sugar or high-salt foods in large amounts when not hungry can be an addiction that leads to copious health problems especially related to obesity and mental health issues.
When Is It Time To Intervene & How?
Because almost everyone engages in the behaviours listed above – social media use, shopping, etc. – it is not always easy to recognise when someone’s engagement with these behaviours reaches an addiction level and thus requires treatment.
Though the signs and symptoms of an addictive issue vary depending upon the behaviour at the focus of the addiction, it is time to get help for a behavioural addiction when:
- Practice of the behaviour becomes an obsession or consumes your thoughts throughout the day.
- Practice of the behaviour becomes frequent – daily and/or multiple times per day.
- The person chooses to engage in the behaviour rather than work, spend time with family, keep commitments or responsibilities or no longer engage in other activities that were once enjoyed.
- Relationships or friendships are harmed by the person’s chronic engagement in the behaviour.
- Other serious consequences result from an inability to stop the behaviour (e.g., problems at work or maintaining a job, financial issues, health problems, legal issues, criminal issues and others.
What Are the Underlying Causes for Behavioural Addictions?
Like a substance abuse and addiction, there is usually no single cause responsible for the development of the addiction disorder. Often, it is a combination of issues, including:
- Genetic predisposition to the development of an addiction disorder
- Living in or growing up in an environment that is permissive of the behaviour
- Trauma that alters brain function
- Acute issues of stress that trigger the person to attempt to utilise the behaviour as a coping mechanism
Are Addictive Behaviours Hereditary?
In some cases, genetics and growing up in a home where other family members regularly engage in a certain behaviour may contribute to a person’s development of a behavioral addiction. However, it is not guaranteed that because a sibling, parent, or other family member struggles with addiction that someone else in the family will have the same problem. Additionally, it is possible to develop an addiction disorder and have no known hereditary contribution to the issue.
What Therapies Are Used in Treating Behavioural Problems?
There is a range of therapies that can be useful in the treatment of behavioral addictions. These include:
- Personal therapy: Discussing the acute issues that may be triggering the urge to engage in the behaviour during treatment while also discussing childhood and other past events that may have contributed to its development can empower the person to take responsibility for behaviours and institute new, healthier coping mechanisms.
- Family therapy: Often, relationships at home are negatively impacted by the person’s chronic engagement in the behavioural addiction. It can contribute to feelings of broken trust and resentment that must be addressed therapeutically if the family unit is to continue and thrive in recovery.
- Support groups: Connecting with others who also struggle with behavioural addictions, especially those who are in recovery for the same behavioural addiction, can help the person to feel less alone and increase the support network that is necessary for long-term healing, abstinence and success.
- Alternative therapies: Sports and adventure therapies, nutritional therapy, animal-assisted therapy, journaling and psychodrama – there is a number of holistic therapy options that may be beneficial to the person in developing new methods of self-exploration and paths for healing.
How Can a Family Help a Member with a Behavioural Issue?
Family members can be instrumental in the person’s ability to accept that there is a need for change and understand that enrollment in an integrated treatment program can be a positive agent of that change. Additionally, the addicts loved ones can play an active role in that person’s recovery by attending family therapy sessions and going to support groups for family members to learn more about the disorder and what to expect during the first years of recovery at home. You can find contact information for them on our help and support page here.
When family members are empowered to help their loved one in recovery, they can heal themselves and also help to heal the family as a whole, whether or not the client remains actively in treatment.
Are There Medications that Can Help Treat a Behavioural Addiction?
In some cases, depending upon the specific nature of the behavioural addiction and the impact it has on the client as well as the nature of any mental health symptoms experienced and/or the diagnosis of a co-occurring mental health disorder including addiction, medication may be appropriate during some or all of the treatment process.
However, this varies significantly from client to client and medication is never the focus of treatment. Rather, it is used to assist in transitional periods of recovery that may be difficult, to address underlying chronic issues, and/or to help increase the client’s comfort level during the therapeutic process and should not be seen as a long term solution to addictions. Therapy, not medication, is almost always the primary focus in the treatment of behavioural addictions.
Kinds of Relapse Preventions Skills Exist for Behavioural Addictions?
Avoiding relapse is a daily task, sometimes an active task that takes place minute by minute. Some of the ways that people can improve their ability to avoid relapse in recovery from a behavioural addiction include:
- Identifying the people, places, situations, feelings and other events that can trigger the urge to engage in the behaviour
- Determining how best to eliminate those triggers
- Creating an actionable plan to mitigate the impact of those triggers and deal with the urge to relapse that may occur, see our daily recovery plan to create your own
- Building a support system in recovery that includes people who genuinely support the client’s desire to avoid relapse and engage in more positive behaviours
- Learning how to return to recovery if a relapse should occur
What Support Groups Exist for Behavioural Addictions?
For almost every type and style of behavioural addiction, there are both online and in-person support groups that range from informal meetings, fellowship meetings to formal therapy sessions that are designed to create a support base for people who would like to learn how to live without engaging in the behavioural addiction.
For example, for people who live with food addiction, some support group options include Food Addicts Anonymous and Food Addicts in Recovery.
Those who are addicted to gambling can find support in Gamblers Anonymous. Similarly, those living with a shopping addiction can attend Shopaholics Anonymous meetings and those living with a sex addiction can find support at Sex Addicts Anonymous groups.
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