When we mention the word “addiction”, most people would think of a substance use disorder such as alcoholism or drug addiction. However, some of the most damaging addictions involve behaviours rather than substance abuse.
These may include gambling, gaming or exercising, as well as practically any behaviour.
Theoretically, any behaviour could become an addiction, though in practice behavioural addiction involves those behaviours which naturally stimulate the brain’s reward centres. Typically, this is the result of a spike in levels of chemicals including dopamine (associated with motivation and reward) when the individual is anticipating and engaging in the behaviour in question.
What Is a Behavioural Addiction?
Behavioural addiction – also known as process addiction – is a type of addiction characterised by the compulsion to engage in a specific rewarding behaviour (other than substance abuse) regardless of awareness on the part of the affected individual of any negative consequences of that behaviour to themselves or others. Over time, repeated engagement in the addictive behaviour creates a vicious circle whereby the addict becomes more and more dependent upon that behaviour in order to experience positive thoughts and feelings and to stave off negative ones, until they may be unable to stop engaging in it without professional assistance.
The Difference between Process” and “Behavioural” Addiction
In practice, there is no difference between “behavioural addiction” and “process addiction”; the terms are synonymous and are used interchangeably to refer to the condition of being compelled to engage in a specific behaviour which can prove harmful to the addict and/or those around them.
The term “behavioural addiction” is used because the condition describes addiction to a given behaviour rather than to a substance of abuse (although substance abuse is, of course, also a behaviour). The engagement in that behaviour can also be considered a “process”, hence the use of the term “process addiction”.
What Are the Different Types of Behavioural Addictions?
Everyone’s psychology is unique. Some suffer from certain mental health disorders which are characterised in part by behaviour which may be considered addictive even though their overall diagnoses may not include that term. With regards to behavioural addictions, in practice it is about behaviours which create a “natural reward” – a neurochemical response not prompted by an external substance.
A great many different events and emotions can create natural reward some of which are considered to be socially acceptable and even necessary aspects of life. At “normal” (i.e. non-problematic) levels, they may therefore not prompt the same concern as more obviously damaging addictive behaviours such as drug abuse. This can make behavioural addictions hard to identify even in loved ones, which in turn can mean many sufferers can develop extremely profound and damaging additions before their troubles are recognised.
Social media addiction
Mobile phone addiction
What Causes Behavioural Addictions?
As with any addiction, including substance use disorders, the precise causes of behavioural addiction are not yet fully understood. In any given individual there are usually a variety of factors contributing to the development of behavioural addiction, including genetic, environmental and psychosocial elements. They often have an intricate relationship with each other, compounding the complexity of the condition.
Risk factors for behavioural addiction:
childhood exposure to addictive behaviour
associating with a peer group within which addictive behaviour is commonplace
injury or disease affecting brain function
experience of trauma
What Are the Brain’s Reward Mechanisms?
Behavioural addiction is a disorder of the parts of the brain, known as the reward system, which affects and drive feelings of motivation and reward. When a person engages in specific behaviours, certain areas of the brain (including the amygdala and ventral tegmental area) release and receive chemicals (including dopamine) which create positive, “rewarding” sensations, thus driving the person to wish to repeat that behaviour. The action in the brain’s reward system of the gene transcription factor DeltaFosB is a crucial factor in the emergence of almost all forms of addiction.
Over time, persistent engagement in the behaviour causes the reward system to adjust, requiring the person to repeat the behaviour in order to experience the same positive sensations. Abstaining from the behaviour creates a deficiency in dopamine, prompting unpleasant sensations until the behaviour is again engaged in, or until the addiction is overcome and the reward system is able to renormalise.
What Are the Signs and Symptoms of Behavioural Addictions?
Because there are so many different types of behavioural addiction, there is obviously a huge range of different symptoms which may be associated with the condition. Only some will be relevant to particular forms of it. For example, someone suffering from sex addiction may not engage in the binges typical of someone with a shopping addiction; instead, they can be less often, but more intense.
However, along with symptoms specific to each particular form of behavioural addiction, some symptoms may be identified which are common across most instances of the condition regardless of the specific form it takes:
A preoccupation with the addictive behaviour
A growing inability to resist engaging in the behaviour
Becoming tolerant to the behaviour (needing to engage in it more frequently, or more intensely, in order to experience the desired effects)
Experiencing symptoms of withdrawal (including adverse psychological effects) if and when the behaviour is avoided
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What Is the Relationship between Behavioural Addictions and Mental Health Disorders?
The connection between behavioural addiction and other mental health issues can be extremely complex and much research is ongoing into cause and correlation. Strong associations have been made between behavioural addiction and substance use disorders, and current scientific and medical thinking is that both types of condition are linked to an overexpression of DeltaFosB in the brain’s reward system.
Similarly, strong associations have been made between behavioural addiction and depressive and anxiety disorders, with many sufferers of the latter turning to addictive behaviour as a coping mechanism. Many other mental health issues are also correlated to some extent with process addictions, perhaps at least in part as a result of general neurochemical imbalance, though specific causes here are less well understood.
When Is a Behavioural Addiction Out of Control?
Some people can engage in a potentially addictive behaviour for long periods, even indefinitely, without addiction manifesting or any other problems arising. For others, however, addiction can develop extremely quickly.
While some people suffering from behavioural addictions are “functional” addicts (i.e., they can maintain more or less normal lives whilst still suffering from addiction), others lose control of their behaviour at a great cost to their life circumstances and prospects. Some key signs that someone’s behavioural addiction may be going out of control include:
The behaviour becomes obsessive
They engage in the behaviour every day, even multiple times each day
Key relationships are damaged by their engagement in the behaviour
The addict opts to engage in their behaviour at the expense of other, previously enjoyed activities
Serious harm to life circumstances and prospects (for example job loss, financial ruin etc) result from their engagement in the addictive behaviour)
Treatment for Behavioural Addictions
The proliferation of behavioural addiction in recent years has seen the establishment of a range of high-quality treatment facilities and organisations, both public and private, across the UK, many of which are based on residential rehabilitation. Treatment of behavioural addiction typically rests on psychotherapy and abstinence (the latter equating to “detox” in the case of substance addiction treatment).
Medication can sometimes play a role, especially addressing symptoms such as depression and anxiety which can both cause and result from behavioural addiction.
Residential vs outpatient behavioural addiction treatment
Inpatient, or residential, behavioural addiction treatment sees addicts staying for treatment onsite in a dedicated, safe, tranquil and confidential environment, usually for between one and three months, where they can focus wholly on treatment and recovery whilst being kept away from their addictive behaviour. Outpatient treatment, with some appointments attended onsite but other elements of treatment engaged in independently, is typically more affordable but longer-lasting, and does not remove the addict from the environment in which their addiction has developed.
There is currently no pharmaceutical ‘cure’ for addiction, including behavioural addiction, though much research in this field is ongoing. Some medication may be prescribed to deal with symptoms and causes such as depression and anxiety, mostly in combination with therapy (psychopharmacotherapy). This is also valid for any other underlying psychiatric disorders including some forms of substance use disorder).
Treating behavioural addiction has psychotherapy at its heart. Therapy aims to reveal and address the underlying psychological causes of addiction and enable those suffering from addiction to engage in normal life without giving in to the impulse to engage in potentially destructive behaviour.
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A wide range of different therapeutic models and methodologies have been developed for use in the treatment of behavioural addiction, provided in a variety of settings and formats, including in residential rehab as part of a holistic addiction treatment plan. Some of the most common forms of therapy found in addiction treatment include:
cognitive behavioural therapy (CBT)
individual or one-on-one counselling
Numerous support group organisations now operate across the UK helping individuals suffering from behavioural addictions of various kinds. The format of such groups and organisations can differ significantly, but typically meetings are held weekly and are free to attend for anyone committed to abstinence from the addictive behaviour in question. For more information on relevant support groups active in your area, speak with an addiction specialist.
Food Addicts Anonymous
Food Addicts in Recovery
Sex Addicts Anonymous
SMART Recovery’s Gambling Addiction
Treatment for Behavioural Addictions
If someone close to you is suffering from a behavioural addiction, or if you believe they are, it is understandable that you may feel the need to confront them about their condition and/or to intervene for their benefit.
However, doing so in an inappropriate manner or at the wrong time could cause much more harm than good. It could permanently damage your relationship. Contact an addiction specialist about your concerns and to get advice on how best to proceed – and always prioritise your safety and that of those around you.