Behavioral Addictions: Signs, Symptoms, and Treatment Options

What is a Behavioral Addiction?

Central to the idea of any addiction is its dependence on an activity or substance. Behavioral addictions such as gambling, overeating, television compulsion, and internet addiction are similar to an alcohol or drug addiction except that the individual is not addicted to a substance. Instead, the individual is addicted to the behavior or feeling experienced by acting out the behavior.¹ 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

Some common behavioral addictions may include:

Gambling. 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. Problem gambling may be characterized by behaviors that include placing bets more frequently, betting larger amounts than intended, “chasing” losses by continually betting beyond the ability to pay, feeling irritable or aggressive when unable to gamble or when losing, or being preoccupied with gambling.²

Food. People who struggle with food addiction cannot control their compulsive eating behaviors. They experience cravings—usually for chocolate, carbohydrates, or salty foods; reduced control over intake; increased impulsivity; and altered reward sensitivity. Additionally, there is some evidence suggesting that individuals with a food addiction may have developed a tolerance to food. One study found that 77% of overweight respondents reported eating more now than when they originally became overweight; 15% indicated that they were less satisfied by food.³

Gaming. Video game addiction is the steady and repetitive use of the internet to play games frequently with different gamers, potentially leading to negative consequences in many areas of a person’s life. Research indicates that more than 5 million children could be considered addicted to video games.⁴

Smartphone. A smartphone addiction is fueled by internet overuse or an internet addiction disorder. One national survey found that 46% of smartphone users believed they could not live without their phone. Overuse patterns involve constantly checking notifications, which can lead to “reassurance seeking” and “fear of missing out.” Research suggests that smartphone addiction is associated with physical and mental health problems, including depression, anxiety, musculoskeletal problems, and poor sleep. ⁵

Sex or porn. Also known as hypersexual disorder, compulsive sexual behavior, or sex addiction, involves continued engagement in sexual activities despite the negative consequences. These activities fall under a wide umbrella that encompasses various problematic behaviors, including compulsive masturbation, cybersex, excessive viewing of pornography, phone sex, engaging in exorbitant amounts of consensual sex, and visiting strip clubs. Its prevalence rates range from 3% to 6%, though it is difficult to determine since there is no formal definition of the disorder.^6,7

Exercise. What distinguishes an exercise addiction from a gym enthusiast is increasing the amount of exercise to feel the desired effect; feeling anxious, irritable, restless, or experiencing sleep problems when not exercising; making unsuccessful attempts to cut back on exercise; unable to stick to a predetermined routine; spending a great deal of time preparing to exercise, exercising, and recovering from exercise; giving up other activities to exercise; continuing to exercise despite the physical, psychological, and interpersonal consequences it has created.⁸

Buying/shopping. Compulsive shopping or buying, also known as buying or shopping dependence or addiction, pathological buying, or oniomania, is defined by excessive financial investments that cause the individual distress or significant dysfunctions. Research indicates that it affects about 5% of the U.S. population. Experts sometimes lump this disorder in with impulse-control disorders or within the obsessive compulsive disorders (OCD) spectrum, but those with a buying/shopping disorder engage in irresistible impulses and have a frequent preoccupation with buying but also feel discomfort as well as time-consuming or negative financial and social consequences as a result.⁹

Work. Work addiction shares some similarities with other behavioral addictions, but it fundamentally differs since it is the only behavior that individuals are typically required to perform. There is, however, a difference between work addiction and passionate work engagement. Research indicates that a very small number of individuals work in a repeated compulsive manner over a long period of time that results in harm, distress, and long-term impairment.¹⁰

Internet. While some of the above disorders or behavioral addictions may fall under an internet addition—such as gambling, buying/shopping, and gaming—internet addiction disorder is characterized by time spent in non-work technology-related  activities; changes in mood; preoccupation with digital media; withdrawal symptoms when not engaged; and a continuation of the behavior despite problems at work, home, school, or in social settings. Surveys suggest that in the United States and Europe, 1.5% to 8.2% of individuals struggle with internet addiction disorder.¹¹

Signs and Symptoms of Behavioral Addiction

Each behavioral addiction comes with its own signs and symptoms, but some experts say that there are a set of criteria that, when met, indicate the presence of a behavioral addiction. These include:¹

• Salience, meaning the activity dominates the individual’s life.
• Euphoria, meaning that engaging in the activity provides the individual with a high.
• Tolerance, meaning that time spent doing the activity has had to be progressively increased to reach the high.
• Withdrawal symptoms, meaning that stopping the activity all together results in unpleasant emotions or physical effects.
• Conflict, meaning the individual’s involvement in the activity has caused interpersonal, social, work, or school problems.
• Relapse and reinstatement, meaning that despite efforts to stop, individuals resume the activity with vigor; suffer negative consequences; and neglect home, work, or school responsibilities.

Why Are Certain Behaviors Considered Addictions?

Most people engage in hundreds of different behaviors throughout the day. Some come with consequences; most are done without much thought. For example, when you’re hungry, you may choose a healthy snack to satisfy your hunger but also give you energy to continue your day. Another individual may eat whether they are hungry or not and engage in binge eating or overeating. However, this doesn’t necessarily mean they have 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. Some experts do not feel that characterizing a behavior as an “addiction” is correct; they believe that these compulsive behaviors are actually symptoms associated with another mental health disorder such as social anxiety, depression, or substance dependence.¹

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

If a substance use disorder, the clinical term for a drug or alcohol addiction, is a part of the experience of a client seeking treatment for a behavioral addiction, it is essential that treatment for that substance use 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 behavioral 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 individual seek co-occurring treatment, which treats all disorders simultaneously. Utilizing the Substance Abuse and Mental Health Services Administration’s treatment locator tool, individuals can filter results to find help for substance use and behavioral addiction near them.

What Type of Programs Are Offered to Treat Behavioral Addictions?

Many of the same programs that are effective in the treatment of dependence on drugs or alcohol are effective in the treatment of behavioral addictions.¹ An effective behavioral addiction treatment program should offer all clients access to the resources they need. This may include any combination of the following:^1,12

• Diagnosis and evaluation. Just as with substance use disorders, there are often co-occurring disorders at play that may impact an individual’s compulsivity and ability to remain abstinent in recovery. A thorough evaluation can 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 individual’s experience with behavioral addictions.
• Treatment plan. Depending on the behavioral addiction and other physical an/or mental health disorders, mental healthcare professionals and other clinicians will create a tailored treatment plan for each individual that utilizes a unique combination of therapies and addresses an individual’s personal circumstances and comfort level and goals for recovery now and in the future.
• Cognitive-behavioral therapy (CBT). CBT is a behavioral therapy that is used to treat a number of disorders, including substance use and behavioral addictions. It focuses on the identification and changing of dysfunctional thoughts to modify negative emotions and behaviors. Treatment includes coping skills training and problem-solving therapy.
• Family support. 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.

Frequently Asked Questions