Exploring Addictions Beyond Substance Abuse - Humantold

Exploring Addictions Beyond Substance Abuse

Juli Walchuk, MHC-LP February 14, 2024

Explore the different behavioral addictions that can manifest with compulsive behaviors that are persistent and harmful in some way.

When you hear the word “addiction,” your mind might immediately jump to substance abuse. Addiction to substances like alcohol, tobacco, and drugs may be the most common, but these are not the only types of addiction. Addictions can also be behavioral, which we'll be diving into in this article. But first, what constitutes an addiction? An addiction is marked by an inability to stop using a substance or engaging in a behavior, feeling a lack of control, experiencing cravings, increased tolerance, physical or mental withdrawal symptoms, and impairment affecting work/school, home life, and social relationships. Any activities or substances that impact the brain’s reward and pleasure system and increase the dopamine levels in our brain have the potential to be addictive.

There are two main categories of addiction: chemical and behavioral. As the name suggests, a chemical addiction (aka substance or physical addiction) involves the use of a substance, such as alcohol, tobacco, opioids, prescription drugs, stimulants, hallucinogens, and caffeine. A behavioral addiction (aka process addiction) involves compulsive behaviors that are persistent, repeating, and harmful in some way. Some examples of behavioral addictions include food, exercise, internet, video games, shopping, gambling, and pornography. Note that all of these things can be perfectly healthy in moderation, but when taken to an extreme, it can be considered an addiction. As you’ll see, most of these addictions are not recognized as DSM-5 diagnoses by themselves, but many are closely linked with other conditions. Let’s dig a bit more into some common behavioral addictions. 

Common Behavioral Addictions

  • Food: With a food addiction, a person will engage in compulsive overeating, especially of food rich in sugar, fat and salt. This behavior is in pursuit of that pleasurable dopamine rush we get when we eat certain foods, and this pursuit can drone out our body’s hunger and satiation signals. Food addiction can be linked with binge eating disorder (BED), which is a DSM-5 diagnosis. 
  • Exercise: Lots of people enjoy exercising to support their physical and mental health, but when behaviors like exercising and dieting become obsessive and reach the point of causing harm, it can become an addiction. Compulsive exercising in conjunction with other symptoms may constitute a body image and/or eating disorder, such as anorexia nervosa. An exercise addiction by itself maintains the purpose of exercising to experience that hit of dopamine and endorphins, rather than in pursuit of weight loss or general fitness. 
  • Internet/Cell Phone: Let’s be honest, many of us are glued to our phones for much of the day and spend way too much time on social media. Some signs that you may have crossed into addictive territory are: you feel an inability to control the amount of time you spend on the internet, you forego basic needs in the pursuit of more time scrolling (like diminished social time, missing out on hours of sleep or time outdoors), and symptoms of withdrawal (like anxiety, low mood, or irritability) when not on your phone. 
  • Video games: Many children, teens, and adults alike enjoy playing video games, but it can become all-consuming and impact other areas of life, like social relationships and basic self care when excessive. The DSM-5 outlines criteria for Internet Gaming Disorder.
  • Shopping: When we purchase things either at a store or online, we get that dopamine hit in our brains. When someone feels a lack of control over their spending habits, regularly makes purchases to cope with negative moods, or suffers financial hardship due to their habits, it may constitute a shopping addiction. 
  • Gambling: Gambling disorder does have its own diagnosis in the DSM-5. The main features include feeling the need to gamble more or with higher stakes to achieve the same effect, irritability when unable to gamble, lying about behavior, and experiencing financial and/or social consequences as a result of gambling. 
  • Pornography: Addiction to pornography is characterized by continuing to consume pornographic material despite adverse consequences, oftentimes in inappropriate settings like work and for excessive amounts of time. People with porn addictions have trouble moderating their behavior and it can cause issues in their relationships. 

Treatment for Behavioral Addictions 

If you suspect that you are experiencing one of these behavioral addictions, the good news is that there are treatment methods that can help! We have witnessed a cultural shift where addiction is being recognized as a disease rather than a moral failing, and as something that warrants treatment and compassion over punishment. We are growing to understand addictions as attempts to numb, soothe, distract, and cope with circumstances; in response, treatment aims to address both the addictive behaviors as well as underlying stressors. Behavioral addictions also often occur in conjunction with other conditions, such as anxiety, depression, and substance addictions. Below are some common mental health treatments: 

  • Cognitive Behavioral Therapy (CBT): This branch of psychotherapy focuses on the connections among our thoughts, feelings, and behaviors, known as the cognitive triangle. A therapist helps a client with identifying their triggers and building up tangible coping tools to better address thoughts and emotions that have led to addictive behaviors in the past. 
  • Dialectical Behavioral Therapy (DBT): This type of therapy helps people with addictions of all types and offers a more regimented and structured approach than some other therapies. By focusing on mindfulness, distress tolerance skills, emotional regulation, and interpersonal effectiveness, this method helps clients manage their urges and take steps towards harm reduction. 
  • Group Therapy: You may associate group therapy methods with substance addictions, such as Alcoholics Anonymous, but there are 12-step and other support groups out there for specific behavioral addictions, such as Spenders Anonymous and Internet & Technology Addicts Anonymous. Group therapy offers the unique benefit of peer support from others who are experiencing the same challenges, while offering tangible skills and tools to overcome the addiction. 

To get connected with a therapist that specializes in CBT, DBT, and addiction treatment, reach out to Humantold’s intake team today! 

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