Behavioural Addictions

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What is a behavioural addiction?

In normal speech, the word ‘addiction’ is usually associated with the taking of substances such as alcohol and drugs. However, nowadays the term is being used to include a number of activities. These are known as behavioural addictions (or process addictions).

Behavioural addictions come in many forms, but typically involve highly rewarding, natural behaviours such as eating, shopping, love and sex. These, in moderation, of course, are healthy and normal. However, these behaviours become harmful when a person indulges in them excessively and becomes addicted to the feelings associated with them.

They are most frequently used as a way to get ‘high’, to avoid underlying issues, to numb unpleasant emotions or thoughts, to alter mood, or to replace relationships or commitments.

However, when a person loses control over the rate, frequency and duration of a specific behaviour – and the desire to engage in the behaviour is greater than the consequences to their wellbeing – it is necessary to seek professional help.

The most common behavioural addictions are:

  • eating
  • exercise
  • gambling
  • love and sex
  • new technology (internet, social media, mobile phones)
  • plastic surgery
  • shopping
  • video gaming
  • work

While such process addictions don’t involve taking substances, they do share some common characteristics with alcohol and drug addiction:

  • They initially produce pleasure
  • They provide relief or escape from emotional or physical discomfort
  • They result in an inability to stop the behaviour
  • Tolerance develops, so the frequency or severity of the behaviour needs to be increased to achieve the desired effects
  • Cravings and urges build, so the behaviour becomes the primary focus (large amounts of time are spent planning, engaging in and recovering from the behaviour)
  • Withdrawal symptoms such as anxiety or depression increase if the behaviour is not carried out

Process addictions can frequently co-occur alongside other addictions and mental health disorders (dual diagnosis), and a comprehensive treatment plan is needed to address both conditions simultaneously.

Are there different types of process addiction?

Anything that gives an individual pleasure, and provides a reward to the brain, has the potential to become addictive given the right circumstances. As such, process addictions come in a wide variety of forms, including:

Eating

An eating addiction is a behavioural issue, categorized by the psychological compulsion to eat. This is driven by the positive feelings that the brain associates with the very act of eating.

It can lead to a range of physical, emotional and social consequences, such as digestive problems, heart disease, obesity and depression.

An eating addiction is commonly associated with other mental or behavioural disorders, such as obsessive-compulsive disorders and personality disorders. In some cases, a person with an eating disorder may also have a co-occurring substance use disorder.

The treatment for eating addiction is complex and requires a multi-specialty treatment plan.

Gambling

In many societies, gambling is an easily accessible leisure pursuit. Nowadays there is an abundance of options (casinos, high street betting shops, online, at sports events, etc).

For most people, it is merely a form of entertainment and presents no complications or difficulties. However, the intense emotional high and thrill of winning can have a significant (but short-lived) effect on the brain’s reward centre. This can compel some people to keep returning to it, to feel the intense thrill again and again.

Gambling disorder is frequently associated with co-occurring anxiety and depression disorders and/or drug and alcohol abuse.

Love and sex

Sex and love addictions are usually intimacy disorders, primarily driven by a desire to control or escape emotional pain. Both tend to be dominated by common features, which include fear of abandonment, a history of childhood abuse, emotional distress and/or trauma and an inability to cope with aspects of life in healthy, functional ways.

Treatment typically requires individuals to work through any emotional issues underlying their addiction and learn how to develop healthy intimacy. This is most often through psychotherapy and support groups.

Technology (internet, mobile phones, social media)

The use of technology is a growing social issue and public health threat. Problematic usage is characterized by many hours spent in non-work technology-related internet activities.

This can include an obsession with the internet and digital media, an inability to control the amount of time spent on digital technology, withdrawal symptoms when not engaged and continuing the behaviour despite adverse consequences.

The most common type of technology addiction is to the internet, especially social networks and internet pornography.

Internet addiction can overlap with other process addictions, such as work or shopping. It can also co-occur with some mental health conditions, such as social anxiety disorder or depression.

Treatments, such as psychotherapy and support groups, are proving successful in helping people control and manage their use of technology.

Video gaming

Video games use state-of-the-art, behavioural psychology to keep us hooked. They are specifically designed to be addictive.

There are two major types of video games:

  • Standard video games (played offline by a single player, involving a clear goal or mission). The addiction in these games is typically related to beating a high score or completing a mission.
  • Multiplayer online role-playing games (played online with other people, using various positive reinforcement techniques that appeal to our brains). MMORPGs are highly addictive and tend to have more significant negative impacts on physical health, sleep habits and daily functioning. People addicted to them often have increased emotional difficulties, including depression and anxiety, feel more socially isolated and are more likely to have substance use problems.

It, therefore, comes as no surprise that video gaming addiction is on the rise.

The difference between a fun gaming hobby and an addiction is the negative impact the activity has on a person’s life.

Treatment comes in many forms, including different types of therapy and/or medications. It is essential that treatment addresses any underlying issues, such as depression, to prevent relapse.

Work

In many societies, working obsessive hours is viewed as a positive thing and is actively encouraged. The stress and pressure of endless work demands can feel like a high to some people, making them feel alert, awake and alive. Working hard and the feeling of achievement can activate the brain’s pleasure centres, producing a short-term high. For some people, this is highly addictive.

While work addicts are often driven by a need to succeed or achieve a higher status, they can also use work to escape difficult life circumstances or emotional problems. A common result of work addiction, if left untreated, is burnout.

There are many treatment options for those addicted to work, including Cognitive Behaviour Therapy (CBT), eye movement desensitization and reprocessing (EMDR) and group therapy.

What are the signs and symptoms of a behavioural addiction?

As many of the activities or behaviours involved in process addiction are socially acceptable or even necessary – such as eating, shopping and exercise – it is challenging to recognize when a specific behaviour has become more than a healthy habit or pastime and has developed into an addiction.

However, one key difference between a healthy enthusiasm for an activity and a behavioural addiction is that a healthy enthusiasm adds to a person’s life, while a process addiction takes away from it.

Physical symptoms of substance addictions are typically absent in process addictions, but common mental, emotional and behavioural signs can be present in both, including:

  • Compulsiveness. An inability to stop engaging, despite knowing the harm it causes.
  • Obsession. Spending the majority of time thinking about or engaging in the behaviour, or recovering from its effects.
  • Narrowing of interests. Neglecting family, work, friends, hobbies and responsibilities, in favour of the behaviour.
  • Lying. Hiding the behaviour from others or downplaying behaviour issues.
  • Relying on the behaviour as a strategy to feel in control and/or numb difficult emotions.
  • Tolerance. Needing to increase the frequency or intensity of the behaviour to reach the same satisfaction/relief level.
  • Withdrawal symptoms. Experiencing psychological symptoms of withdrawal, for example, depression or irritability.
  • Relapse after a period of abstaining.

While process addictions do not present the same physical risks to a person’s health that substance addictions do, without professional help and support, the effects of any behavioural addiction will gradually worsen, resulting in a negative impact across all areas of a person’s life.

The signs and symptoms of any addiction will vary from person to person, depending on individual circumstances and addiction type.

What causes a behavioural addiction?

Studies show that process addictions are typically the result of a combination of factors, including:

  • genetics
  • childhood trauma/abuse/neglect
  • co-occurring mental health conditions, such as depression, PTSD or anxiety
  • personality traits
  • low-stress tolerance – lack of healthy coping strategies for easing stress
  • environmental
  • societal
  • an existing substance use disorder

The causes of a behavioural addiction will be unique to each individual, making it very difficult to predict. However, it is commonly accepted that several factors need to interact to trigger any addiction and therefore, it is unlikely that there will ever be one single cause.

Can behavioural addictions be treated?

As many of the behaviours or activities involved in process addictions are ordinary and necessary parts of everyday life, abstinence is not a realistic solution. As such, process addictions present some unique challenges in terms of treatment options.

That said, treatment plans for process addictions typically focus on behaviour therapy approaches. Effective treatment needs to address any underlying issues and offer additional recovery tools to help individuals engage in the behaviours in ‘normal’, healthy ways.

Treatments that are known to be effective include:

  • Individual therapy, such as Cognitive Behaviour Therapy (CBT)
  • Group therapy
  • Psychiatric care (where appropriate, as co-occurring mental health conditions can feed process addictions and need to be diagnosed and treated at the same time)
  • Medication (sometimes used to relieve severe symptoms of co-occurring mental health conditions while undergoing treatment)
  • Complementary therapies (such as equine therapy, mindfulness, music and art therapy, and acupuncture)
  • Aftercare (ongoing support is essential for relapse prevention in process addictions, including access to local support groups).

Treatment plans for process addictions will be based on each individual’s specific needs. An experienced therapist will assess the situation and the addiction – along with any co-occurring conditions – and determine the most effective course of action. If you, or a loved one, need help with a process addiction, effective treatments are available. Please contact us at Centres for Health and Healing to find out more and begin your recovery journey today.

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