Behavioral process addictions are addictive patterns of behavior that compel a person to keep returning to certain actions. They are similar to drug addictions in that they hijack the brain’s reward processes, changing how rewarding different activities are, per an article in the American Journal of Drug and Alcohol Abuse. The International Journal of Environmental Research and Public Health reports that as many as 46 percent of Americans may meet criteria for at least one behavioral addiction.
According to an article in the International Journal of Preventive Medicine, a behavior can be considered addictive if it meets the following criteria:
- Salience: The person’s life has become dominated by the behavior to an excessive extent.
- Euphoria: Does the person get a high, a buzz, or other feelings of intense pleasure from engaging in the behavior?
- Tolerance: In order to get the same positive feelings, the person engages in the behavior more and more
- Withdrawal: Ceasing the behavior abruptly can cause anxiety, irritation, frustration, depression, or distress.
- Conflict: Regularly engaging in the behavior causes conflict with others or internal conflict.
- Relapse: The person returns to the behavior over and over again, even though it is causing negative life consequences, such as poor performance at work or school, neglecting children at home, or failing to meet social obligations
Other symptoms of behavioral addiction might include:
- Engaging in the behavior to escape feelings of depression or helplessness
- Lying about the behavior or trying to conceal it from others
- Feeling guilt or remorse associated with the behavior
- Taking increasing risks in order to pursue the behavior
- Feeling preoccupied with or reliving past experiences of the behavior
People with behavioral process addictions are more likely to have substance abuse problems as well as other psychiatric disorders like depression, generalized anxiety disorder, post-traumatic stress disorder, bipolar disorder, obsessive-compulsive disorder, and attention deficit hyperactivity disorder.
The American Journal of Drug and Alcohol Abuse reports that gambling addiction was linked to a 3.8-fold increase in substance abuse, and that Internet addiction had a 1.8-fold increase.
Types of Behavioral Process Addictions
There are many types of behavioral process addictions, which include but are not limited to:
- Gambling addiction, or compulsive gambling, affects about one to three percent of adults, according to a review published in the European Archives of Psychiatry and Clinical Neuroscience. It is characterized by repeated gambling behavior that disrupts the person’s finances, family, or work life. A study in Psychological Medicine found that young age and being male were associated with problem gambling. It also found that 49 percent of people with problem gambling had been treated for a mental illness at some point in the past. Seniors are also at risk for gambling addiction – the Baltimore Sun reported on a survey performed by the University of Pennsylvania that found that almost 11 percent of people over 65 were at risk for problem gambling.
- Shopping addiction, or compulsive buying disorder, affects about 5.8 percent of people within their lifetimes, according to a review in World Psychiatry. Over 80 percent of people with shopping addiction are women, it noted. People with shopping addiction may experience a preoccupation with shopping, feelings of tension or anxiety before purchases, and feelings of relief following purchases. This can result in spending excessive time shopping or preparing for shopping, overspending, and feeling that the shopping has gotten out of control.
- Internet addiction, or compulsive internet use, is a pattern of using the Internet for longer periods of time than intended, skipping important obligations to use the Internet, using the Internet to escape stressful emotions, concealing Internet usage from others, and repeatedly being unsuccessful in attempts to cut back on usage. People with Internet addiction may feel urges or cravings to check the Internet, or feel irritable or moody when unable to use the Internet. According to an article in Iowa Research Online, four to 10 percent of online users were affected by Internet addiction in 2005. The number was higher among players of massively multiplayer online role-playing games (MMORPGs), at around 15 to 29 percent. Among young users, internet addicts were mostly male; among older users, most addicts were female. Internet addiction can also serve as a platform for other addictions, such as video game addiction and pornography addiction.
- Video game addiction is similar to Internet addiction, except the addiction focuses around playing games instead of staying connected to new content. The International Journal of Environmental Research and Public Health noted that the motivations for video game addiction and substance use are the same: boredom, the desire to dampen negative emotions, and the desire to boost positive emotions. Escapism is also a powerful theme – a study in the International Journal of Mental Health and Addiction found that 41 percent of people who played MMORPGs did so to escape, and that about seven percent of the gamers were at elevated risk for video game addiction. Meanwhile, an analysis by Flurry found that about 176 million people worldwide were addicted to using mobile apps, as defined by launching apps over 60 times per day (normal is about 10).
- Pornography addiction appears to resemble a compulsive behavior more than an addiction, according to an article in the American Psychological Association’s Monitor on Psychology. The article noted that as many as 99 percent of men and 86 percent of women consume pornography, while only nine percent say they have tried unsuccessfully to stop consuming pornography. Consumption of pornography becomes problematic for people when it interferes with work, family, responsibilities, or personal sex lives.
- Sex addiction, hypersexual disorder, or compulsive sexual behavior occurs when someone repeatedly finds that they have difficulty controlling their sexual thoughts and behaviors to the point that it interferes with their functioning. Behaviors might include excessive masturbation, viewing of pornography, cybersex or phone sex, unsafe sexual activity, multiple affairs or anonymous partners, oversexualizing or objectifying partners, spending excessive time and money at strip clubs or adult stores, or engaging with prostitutes. Problems from sex addiction can include distance from or conflict with loved ones, feelings of shame or guilt, feelings of boredom or fatigue with sex, contraction of sexually transmitted illnesses, legal consequences from violating laws, loss of social or professional status, and indebtedness from spending. According to a paper in Psychiatric Clinics of North America, about three to six percent of the US adult population experiences compulsive sexual behavior, with mainly men affected.
- Exercise addiction is an obsession with fitness that goes to an extreme, with the person choosing more exercise over work, family, friends, and other healthy activities. The person loses perspective and exercise feels like it takes over their entire life. They may experience symptoms of withdrawal when not exercising, such as depression, anxiety, irritability, or frustration. This occurs in part because exercise releases endorphins into the body, which are opiate-like, feel-good chemicals that can be addictive for some people.More is not unconditionally better, in the case of exercise. People who are addicted to exercise may be at higher risk for fatigue, exercise-related injuries, and stressed relationships. High-achievement individuals are at risk for exercise addiction, says the American Running Association. Exercise addiction can also develop as a replacement addiction, such as if a person is using exercise’s endorphin boost to help quit addiction to a drug. According to an article in the International Journal of Environmental Research and Public Health, about three percent of people are addicted to exercise. It noted that 15 to 20 percent of such people were also addicted to nicotine, alcohol, or illegal drugs like amphetamines and cocaine. Exercise addiction also had a high rate of co-occurrence with eating disorders – about 39 to 48 percent of people with eating disorders also have exercise addiction.
- Eating addiction, binge eating, or compulsive overeating occurs when someone repeatedly eats substantially more than most people would for a given time period, far exceeding their body’s nutritional requirements for the day. They usually have the feeling that their eating is outside of their control. They may spend a great deal of time craving food, planning to eat, concealing the fact that they have eaten, and feeling ashamed, guilty, or depressed about their eating habits.According to research in NeuroImage, eating addiction’s mechanisms in the brain bear a strong resemblance to drug addiction – the reward signals produced by eating fat and sugar activate the brain in similar ways as do drugs, and alter its chemistry to lead to addiction. Psychology Today reports that up to four million American adults live with eating addiction, including over 15 percent of people with obesity. In some people, binge eating can lead to weight cycling or obesity, and for others, it can exist in a self-perpetuating cycle with anorexia (chronic undereating).
- Self-injury addiction, or self-harm, is a pattern of behaviors characterized by willfully hurting oneself, such as intentionally cutting or slicing the skin, scratching off the top layer of skin, burning oneself, or punching objects to hurt or cause injury to oneself. Injury might be to the hands, feet, wrists, thighs, or stomach – some people may deliberately choose areas that will be hidden under clothing or won’t show. Self-injury is different from the intent to commit suicide, and may occur for a number of reasons. These can include using self-injury as an outlet for stress or anxiety, to feel a sense of control over emotional pain, or to cut through emotional numbness and feel anything at all.Self-injury is addictive in similar ways as opiate drugs – injuring the body causes it to release endorphins, the body’s natural painkillers, which produce a high that is addictive for some. According to the Cornell Research Program on Self-Injury and Recovery, anywhere between four and 38 percent of adolescents and young adults may practice self-injury. The article added that about 17 percent of people will practice self-injury within their lifetimes, 11 percent of whom will do so repeatedly.
Treatments for Behavioral Process Addictions
Behavioral addictions respond to many of the same therapies as drug and alcohol addiction, according to an article in the American Journal of Drug and Alcohol Abuse.
- Cognitive Behavioral Therapy helps clients get to the root of the thought patterns that keep them returning to their addiction and replace these thoughts with new ways of dealing with the world and its stresses. It also teaches how to replace addictive behaviors with healthy alternatives.
- Motivational Enhancement Therapy helps clients understand the extent to which their addiction has become a problem. In a few short sessions, it can help clients find their motivation to recover from addiction, giving them the drive they need to seek further treatment or cease the addictive behavior on their own.
- Contingency management involves offering rewards for desired behaviors – in this case, for reducing or abstaining from the addictive behavior.
- 12-Step self-help programs offer a structured peer group to provide a social support network of others going through the same ordeal with addiction. In 12-Step programs, clients admit that their addiction has gotten out of control, that abstinence is the only option, and that continuing to return to meetings is the best way to maintain abstinence.
- Group therapy offers therapy in a group setting, offering peer support in additional to guidance from a therapist.
- Family and couples therapy can help rebuild damaged relationships and give family members better tools to support recovery from addiction.
- Pharmacotherapy may be useful for people whose addictions are driven by depression or anxiety. In addition to treating those conditions, antidepressant and anti-anxiety medications can also be effective for treating disorders with aspects of compulsive behavior. Finally, according to the American Journal of Drug and Alcohol Abuse, naltrexone, a drug that treats alcohol and opiate addiction, may be helpful for treating gambling addiction, Internet addiction, and shopping addiction.
Dual Diagnosis: Behavioral Process Addictions and Substance Abuse
It can be easy to find yourself turning to alcohol or drugs to help quiet the compulsions, anxieties or cravings that drive you to engage in your behavioral addiction. Although they might make you feel better for a short time, in the long run, this opens you up to potentially developing a substance abuse disorder as well. When you have both a substance use disorder and a behavioral addiction, they are called co-occurring disorders or a Dual Diagnosis situation. A study in Substance Use & Misuse found that 55 percent of people in a substance abuse treatment program also had some form of behavioral addiction.
There’s nothing to be ashamed of – millions of other Americans live with behavioral addictions, and the good news is that it’s never too late to start a healthy new life. At Black Bear Lodge, we specialize in Dual Diagnosis treatment, developing a customized therapy regimen that meets your individual needs. We’re ready to take your call – get in touch today to learn more.