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Behavioral Addictions

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Editorial Staff
Editorial Staff
The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.
Addiction can occur in many forms. Often, it is assumed that physical dependence characterized by withdrawal symptoms
is required in order for someone to be diagnosed with an addiction disorder, but the fact is that behavioral 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 abuse.

It is the compulsive nature of the behavior that is often indicative of a behavioral addiction, or process addiction, in
an individual. The compulsion to continually engage in an activity or behavior despite the negative impact on the person’s
ability to remain mentally and/or physically healthy and functional in the home and community defines behavioral addiction. The person may find the behavior rewarding psychologically or get a “high” while
engaged in the activity but may later feel guilt, remorse, or even overwhelmed by the consequences of that continued choice.
Unfortunately, as is common for all who struggle with addiction, people living with behavioral addictions are unable to stop
engaging in the behavior for any length of time without treatment and intervention.

Common Behavioral Addictions

Sex and Love Addcitions

Shopping Addiction

Gambling Addiction

Gaming Addictions

Food addiction

Exercise addiction

Though almost everyone engages in all of the activities listed above – shopping, gambling, and certainly
eating and exercise – to a certain degree and may even enjoy the behavior very much, it is not termed an addiction until
the following is true:

  • The person struggles with mental health or physical health issues as a consequence of the behavior and/or the inability
    to stop.
  • The person has difficulties in significant relationships at home and, in some cases, at work because the behavior is
    so disruptive.
  • The person experiences other negative consequences that are directly caused by continued, extreme, or chronic engagement
    in the behavior. For example, a person with a gambling addiction may gamble away the house, lose a job, and be forced into
    bankruptcy due to the extreme nature of the gambling.
  • The person is unable to stop engaging in the behavior despite these consequences.

If you believe that you, or someone you love, are struggling with a behavioral 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.

Further Reading

Why Are Certain Behaviors Considered Addictions?

Most people engage in hundreds of different behaviors throughout the day, each one with its own set of consequences. In general,
people make choices about which behavior 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 addiction may choose to eat even when not hungry
and may binge eat unhealthy foods in large amounts. 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 behavior 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 termed an addiction. Does this mean that you can be addicted to any behavior? It is a question that fuels an ongoing
debate. Many do not feel that characterizing a behavior 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 behavioral addictions would certainly stop engaging in their behavior of choice long before it harmed their physical
health, ended primary relationships, and caused a host of financial, legal, and mental health 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 behaviors
that are commonly reported as occurring at an addiction level, wreaking havoc and destroying lives for as long as they
remain untreated.

gambling die

Gambling Addiction

Gambling addiction
Gambling addiction, also called problem gambling or gambling disorder, is an addiction that refers to any and all types of gambling or choices related to gambling that endanger or compromise a person’s life, job, or family. 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 characterized 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

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.


Food Addiction

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 behaviors. 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. People who struggle with food addiction may be obese, but people who have a normal BMI may also struggle with the disorder. Damaged relationships, issues of self-esteem, and other health problems may also result.

video game controller

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 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. Similarly, taking on the role of someone else and living a virtual life can also be alluring. As compared to a substance abuse 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 relationships, maintain responsibilities at work, and make choices that support their physical and mental health (e.g., eating regularly or healthfully, going to the doctor, 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 outside of the video game world.

When Addiction Is Out of Control and Help Is Needed

Identifying when a behavior has turned into a problem issue and that problem has developed into an addiction can
be tricky.

brain and addiction
It can be easy to be too close to the person and unable to recognize when things have gone
from occasionally upsetting to a diagnosable disorder that requires treatment. The fact is that addiction is defined as a
disease of the
, a chronic illness that requires intensive therapeutic and medical treatment. 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 behavior even with a genuine desire to stop or great fear or remorse about what has and will happen, it is
time to seek treatment.

What Type of Programs Are Offered to Treat Behavioral Addictions?

Many of the same programs that are effective in the treatment of dependence upon drugs or alcohol are effective in the treatment of behavioral addictions. An effective behavioral 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 behavior. 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 abuse and addiction, there are often co-occurring disorders
    at play that may be impacting the person’s compulsivity and ability to remain abstinent in recovery. A thorough evaluation
    process can help to identify any co-occurring substance abuse issues and/or mental health disorders that may be contributing
    to, causing, or in any way impacting the person’s experience with behavioral 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.
  • 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 behavioral 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.

Choosing a range of therapies that assist the client in reaching treatment
goals, and staying in treatment for as long as necessary to ensure that the client is strong and stable in recovery are
key to an effective behavioral addiction treatment program.

What if Substance Abuse Is a Part of a Co-Occurring Disorder?

If a substance abuse or addiction disorder is a part of the experience of a client
seeking treatment for a behavioral addiction, it is essential that treatment for that substance abuse disorder 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 behaviors triggered by or related to sex addiction. No matter what the
combination of disorders is, it is often recommended that the person enroll in a residential treatment center that is equipped
with the staff, resources, and experience to empower healing on all fronts.

Statistics, Facts, and Data

women and gambling addiction

  • Gambling addiction may impact up to 2-3 percent of the American public. Its signs, symptoms, and impacts may vary across genders,
    age groups, and other populations. Men are more likely to develop a gambling problem and at an earlier age as compared
    to women, but women make up about 25 percent of those living with a gambling addiction. Risk factors for the disorder
    include mental health disorders like bipolar disorder, mood disorders, and substance abuse 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 characterized
    with different eating behaviors among patients living with BED as compared to food addiction.
  • It is estimated that about one
    in 10 young people
    who plays video games has an addiction to the behavior. 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 percent of women struggle with the problem – and so do 5.5 percent of
    men. Unfortunately, because shopping is a common and normal behavior, 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.

video game addiction

struggle with compulsive shopping

  • People who struggle with 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 behavior 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 ‘Behavioral’ in Regards to Addiction?

There is no difference between the terms “process addiction” and “behavioral addiction.” Both refer to compulsive indulgence in a specific behavior or type of behaviors that have the net result of harm to
the person
, plus the inability of the person to moderate or manage those behaviors without treatment.

What Types of Behavioral
Addictions Are There?

Individuals may report a number of behaviors 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 behavior that is at the base of the addiction. For
others, it is a ritual that comes before or after indulging in a destructive behavior. For example, some clients in recovery
from heroin addiction report feeling nostalgic about the process of “cooking up,” loading the needle, and tying off 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 behavior itself. Still others define the obsessive and compulsive behaviors engaged in due to OCD as
being addictive. However, in general, though the cravings for different aspects of a behavioral addiction may play a large
role in recovery, the top behavioral 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. Often, this is a risky behavior connected to other mental health disorders as many do not use protection and thus open themselves up to the
    possibility of contracting STDs, including deadly viruses like HIV.
  • Love addiction: Some clients prefer to feel emotionally attached to the partners they connect with. Often
    serially monogamist with little time spent in 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
  • Porn addiction: Porn
    may start small and be a relatively normal behavior among Americans, but when people find it impossible to engage
    one on one 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 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 vacation/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.
  • 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 functional
    relationships with others, remain employed, and to prioritize physical and mental health.
  • Internet addiction: Just being connected
    and online can be compulsive and addictive
    for many people. Some check email compulsively, stock updates, breaking
    news, blog updates, and more, feeling as if they are missing out if they are not connected 24/7.
  • 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.
  • Food addiction: As indicated above, 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
and How?  

Because almost everyone engages in the behaviors listed above – social media use, shopping, etc. – it is not always easy
to recognize when someone’s engagement with these behaviors reaches an addiction level and thus requires treatment. Though
the signs of an addictive issue may vary depending upon the behavior at the focus of the addiction, it is time to get
help for a behavioral addiction when:

  • Practice of the behavior becomes an obsession.
  • Practice of the behavior becomes frequent – daily and/or multiple times per day.
  • The person chooses to engage in the behavior rather than work, spend time with family, or engage in other activities
    that were once enjoyed.
  • Relationships are harmed by the person’s chronic engagement in the behavior.
  • Other serious consequences result from an inability to stop the behavior (e.g., problems at work or maintaining
    a job, financial issues, health problems, legal issues, etc.).

What Are the Underlying Causes
for Behavioral 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
  • Biology
  • Living in or growing up in an environment that is permissive of the behavior
  • Trauma that alters brain function
  • Acute issues of stress that trigger the person to attempt to utilize the behavior as a coping mechanism

Are Addictive Behaviors Hereditary?
In some cases, genetics and growing
up in a home where other family members regularly engage in a certain behavior 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 Behavioral 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 behavior
    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 behaviors and institute new, healthier coping mechanisms.
  • Family therapy: Often, relationships at home are negatively impacted by the person’s chronic engagement
    in the behavioral 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 behavioral addictions, especially those who
    are in recovery for the same behavioral addiction, can help the person to feel less alone and increase the support
    network that is necessary for long-term healing.
  • 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

How Can a Family Help a Member
with a Behavioral 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 client’s 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. 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 Behavioral Addiction? 

In some cases, depending upon the specific nature of the behavioral 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. Therapy, not medication, is almost always the primary focus
in the treatment of behavioral addictions.<

What Kinds of Relapse Preventions
Skills Exist for Behavioral 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 behavioral addiction include:

  • Identifying the people, places, situations, feelings, and other events that can trigger the urge to engage in the
  • 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
  • Building a support system in recovery that includes people who genuinely support the client’s desire to avoid relapse
    and engage in more positive behaviors
  • Learning how to return to recovery if a relapse should occur

What Support Groups Exist
for Behavioral Addictions?

For almost every type and style of behavioral addiction, there are both online and in-person support groups that range from
informal 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 behavioral 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 SMART Recovery’s
Gambling Addiction
group or Gamblers Anonymous.
Similarly, those living with a shopping addiction can attend Shopaholics
meetings, and those living with a sex addiction can find support at Sex
Addicts Anonymous

Last Updated on October 26, 2021
Editorial Staff
Editorial Staff
The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.
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