Behavioral Addiction

What is a Behavioral Addiction?

A behavioral addiction (or process addiction) happens when a person becomes obsessed with a specific activity and continues to do it despite the negative consequences it creates in their lives. For example, someone with a shopping addiction will continue to shop even if they don’t have the funds or are significantly in debt due to their buying habits.

Currently, the American Psychiatric Association (APA) only officially recognizes one type of behavioral addiction: gambling disorder. The APA explains that no other behavioral addictions appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) because mental health professionals are still researching to define the specific criteria for these other non-substance addictions.

How Addiction Works

Substance and behavioral addiction affect the same part of the brain that causes individuals to seek the same good feelings they get from performing a specific activity. Certain substances or activities can activate specific neurotransmitters in the brain, releasing dopamine. Dopamine is our brain’s “feel-good” chemical and is tied to our brain’s reward center.

Over time, repeat substance abuse or continued non-substance behaviors make us dependent upon that substance or activity. They may need more of the substance or activity to feel the same effects. Eventually, they can become so obsessed with that addictive substance or activity that they cannot stop—even if it causes problems in their daily lives.

Both alcohol addiction and drug addiction are classified as “substance use disorders.” Alternatively, non-substance behavioral addictions fall under “impulse control disorders.”

Common Types of Behavioral Addictions

As mentioned, gambling addiction is the only clinically-recognized behavioral addiction in the DSM-5, but several other behavioral addictions exist. Thankfully, we have enough information about behavioral addictions to treat their symptoms and help individuals get back to living healthier, happier lives.

Some of the most common behavioral addictions include:

• Gambling
• Video Games (a.k.a. Gaming Addiction)
• Social Media and/or Internet Addiction
• Sex
• Porn
• Food
• Shopping
• Exercise
• Kleptomania

Risk Factors for Developing a Behavioral Addiction

Research shows similarities in the causes of behavioral addiction and substance addiction. General risk factors include a combination of hereditary influences and existing mental health issues. However, each behavioral addiction type can have unique risks.

For example, according to research from the University of Connecticut School of Medicine, gambling disorder occurs more often in lower socioeconomic groups and among racial/ethnic minorities.

Mental Health Issues

The connection between behavioral addictions and co-occurring mental illness shows up in research consistently. Individuals with pre-existing disorders known for impulsive features have an elevated risk of developing a behavioral addiction.

According to research published in the journal Frontiers in Psychiatry, common comorbidities found in behavioral addictions like gambling disorder, internet addiction, compulsive sexual behavior disorder, compulsive buying, and exercise addiction include:

• Other impulse control disorders such as hair-pulling (trichotillomania), pathological skin picking, and kleptomania
• Major depressive disorder (MDD)
• Attention deficit hyperactivity disorder (ADHD)
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Generalized anxiety disorder
• Social anxiety disorder
• Insomnia
• Eating disorders
• Obsessive-compulsive disorder (OCD)
• Borderline personality disorder
• Antisocial personality disorder

Individuals with these disorders may never develop a behavioral addiction, but the compulsive behaviors patients often experience put them at greater risk.

The presence of substance use disorder or alcohol use disorder also increases the risk of behavioral addiction. Because addictive substances and addictive behaviors activate the same part of the brain, an addict may turn to behaviors when substances are unavailable to get the “high” they crave.

Hereditary Influences

Addictive disorders tend to run in families. Certain genes passed from a parent can put certain people more at risk for experiencing addiction in life. In addition, these addictive behaviors may be taught through childhood, normalizing the problematic behavior. For example, a child may grow up to have a gambling addiction because a parent was a gambler and glorified the lifestyle, never openly discussing how destructive it was.

Warning Signs of Behavioral Addiction

Like substance abuse, behavioral addiction causes cravings and withdrawal symptoms for addicts. This is due to the “high” or positive feeling these behaviors cause in the brain—once those feelings are gone, symptoms manifest and cause distress for the addict.

These lists are not exhaustive and serve as a guideline if you suspect your loved one is struggling with a behavioral addiction.

Physical Signs of Addiction

Physical signs of behavioral addiction include:

• Lack of effort in appearance or hygiene
• Withdrawal from social obligations
• Issues with money
• Headaches
• Insomnia
• Upset stomach
• Diarrhea
• Muscle aches or cramps
• Heart racing or palpitations
• Chills or fever

Emotional and Behavioral Signs of Addiction

Emotional and behavioral signs of behavioral addiction include:

• Intense cravings
• Excessive fixation on behavior
• Constantly asking for money and being unable to explain where money is going
• Anxiety
• Disrupted sleep and eating patterns
• Depression
• Restlessness
• Irritability

Negative Consequences of Behavioral Addictions

When left unchecked, behavioral addictions have a destructive effect on the well-being of individuals struggling with them. Whether it’s the financial ruin of gambling and compulsive shopping or the health risks of food addiction or sex addiction, each addictive behavior comes with a cost. Aside from the physical or financial damage, many individuals also suffer from social isolation due to secrecy around their behavior.

For gaming addiction and internet addiction, patients may miss work, school, social commitments, and doctor’s appointments to stay online or play their games. When individuals begin to withdraw from the world around them and only focus on their addictions, they lose access to support systems and resources to help them in dire situations.

Food addictions often lead to weight gain and obesity, resulting in multiple health problems. Kleptomania, the compulsive desire to steal, can create many legal issues for the addict that follow them for the rest of their lives. While the dangers of behavioral addictions on paper may appear less serious than substances, they can still lead to grave outcomes.

Behavioral Addiction Statistics

• The World Health Organization reports that gambling addiction rates vary from 0.1% to 6%, and young adults are among the most susceptible; up to 14% of college students report problem gambling.
• Based on research from the University of Minnesota Medical Center, an estimated 5.8% of Americans experience shopping addiction, the compulsive behavior usually appearing in the late teens or early twenties.
• While percentages can vary widely, the WHO reports that the prevalence of gaming addiction varies in populations from 1.3 to 9.9%.

Treating Behavioral Addictions

Gambling addiction is currently the only behavioral addiction described in the DSM-5, most mental health providers treat behavioral addictions as serious diagnoses with specific treatment methods. Unlike substance abuse treatment, in-patient rehab or hospitalization for behavioral addictions is rare. Instead, mental health care professionals or psychiatrists will use either therapy, medications, or a combination of both to treat behavioral addictions.

Treatment Programs

Some treatment facilities may have formalization treatment plans for behavioral addictions.

These may include intensive therapy programs or inpatient rehab if the behavior is severe enough. While they aren’t common, you can always check with an addiction treatment center in your area to see if they offer any specific programs for behavioral addictions.

Therapy

Psychotherapy or “talk therapy” often serves as a first-line treatment for behavioral addictions. Typically conducted by a trained mental health professional, common types of therapy include Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT).

CBT focuses on helping you identify destructive or unproductive thought patterns and redirect them into positive or neutral ones. On the other hand, DBT helps with balancing intense emotions and combating black-and-white thinking.

Medication

When using medication for behavioral addiction, it can often address symptoms of comorbidities as well. Common medications used for behavioral addictions include:

• Antidepressants
• Antianxieties
• Antipsychotics
• Mood stabilizers
• Naltrexone (commonly used for alcohol use disorder and opioid use disorder)

Support Groups

Feeling like you’re not alone in your addiction helps more than people realize. Support groups are a fantastic resource for individuals ready to recover from their behavioral addictions. The following list is not exhaustive—ask your doctor if they have any recommendations for your unique situation or if any local support groups exist.

• Debtors Anonymous
• Shopping Addiction Support Group
• Shopaholics Anonymous
• Gam-Anon
• Gam Talk
• DailyStrength: Sex/Pornography Addiction Support Group
• Internet and Technology Addicts Anonymous (ITAA)
• Support Groups: Exercise Addiction
• Porn Addicts Anonymous
• Sex Addicts Anonymous

Finding Help for a Behavioral Addiction

Struggling with a behavioral addiction can be incredibly isolating and often leads to immense shame. While each behavioral addiction treatment might be unique, the support of loved ones and a mental health team will be the same. Many treatment options are available, from treatment programs and support groups to therapy and medications.