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Behavioral Addiction: Definition, Causes, Effects, and Treatment

Behavioral addiction refers to compulsive conduct towards certain actions which are otherwise considered normal. Compulsive conduct urges individuals to crave or engage in actions without logical purpose.

Individuals with behavioral addictions are unable to stop their actions even if they try to. They try to hide and lie about their behavioral addictions, which leads to long-term consequences. Some long-term issues include social withdrawal, depression, and medical conditions like heart and liver diseases. 

Behavioral addictions have common origins stemming from childhood trauma, life stressors, family history, substance abuse, and psychological disorders. Due to common origins, all types of behavioral addictions can be treated with psychotherapeutic measures like cognitive behavioral therapy and pharmacotherapy.

What is behavioral addiction?

Addiction is an inability to stop engaging in a behavior or using a substance even after knowing its negative consequences. Behavior addiction, or compulsive behavior, is to repeatedly engage in an activity harmful to a person’s mental and physical well-being that affects their societal role, as defined by American Addiction Centers. 

According to a study in the International Journal of Preventive Medicine, behavioral addiction is when an individual is addicted to a behavior or feeling brought about by a relevant action. 

What is the difference between behavioral addiction and physical addiction?

The difference between behavioral addiction and physical addiction is that behavioral addiction is a compulsive engagement in behavior other than substance use, and physical addiction occurs in response to substance abuse.

According to the National Cancer Institute, physical addiction is characterized by unpleasant physical symptoms that occur if the substance is stopped or taken in small doses. On the other hand, behavioral addiction is compulsively taking part in an activity even after knowing its negative impact on an individual’s well-being. 

What is the difference between behavioral addiction and substance addiction?

The difference between behavioral addiction and substance addiction is that behavioral addiction is a compulsive action or behavior, while substance addiction is simply the dependence on substances or drugs. 

Repetitive engagement in a compulsive behavior or action results in brief feelings of happiness due to the release of neurotransmitters like dopamine. Some common behavioral addictions are exercise, food, and internet addiction. Contrarily, substance addiction is a physical and psychological dependence on the ingestion of a substance or drug that leads to a temporary dopamine high, causing a sense of pleasure. 

What are the types of behavioral addictions?

The types of behavioral addictions are the following.

  1. Exercise addiction
  2. Food addiction
  3. Gambling addiction
  4. Internet addiction
  5. Porn addiction
  6. Sex addiction
  7. Shopping addiction
  8. Tattoo addiction
  9. Video game addiction
  10. Love addiction
  11. Work addiction
types of behavioral addiction

1. Exercise addiction

Exercise addiction is an obsessive behavior characterized by exaggerated training, physical fitness, and bodily movement despite negative consequences. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also refers to unhealthy exercise obsession as an addiction. 

Exercise addiction occurs as a result of psychological disorders like OCD and megarexia, personality disorders, other addictions, or as a coping mechanism to life stresses. Obsessive exercise behavior aggravates due to the overstimulation of dopamine and endorphins released by regular exercise. 

what is exercise addiction

Common symptoms of exercise addiction are exercising even with injury, anxiety, and irritability after missing a workout session, and relationship withdrawal symptoms, as mentioned by Dr. Krisztina Berczik co in ‘Substance Use & Misuse.’ 

Exercise addiction can be treated with cognitive behavioral therapy (CBT) and psychiatric medication, according to Jeremy Adams, a Psychology professor at London Metropolitan University. 

2. Food addiction

Food addiction is the inability to stop eating food due to the triggering of chemical reactions in the brain that induce pleasure and satisfaction despite its negative consequences. 

According to a study published in Psychiatria Polska in 2017, food addiction is caused by the release of high levels of dopamine and serotonin after eating palatable foods. Eventually, cravings start to have the same feeling of pleasure. Food addiction may also be caused by psychological reasons like sexual abuse, experiencing grief or loss, and social reasons like lack of social support and stressful life events. 

Common symptoms of food addiction are eating when not hungry or to the point of illness, feelings of worry, hiding food intake, and experiencing withdrawal symptoms like craving, headache, and restlessness. 

You can treat or prevent food addiction by detoxifying from triggering foods and changing eating habits. 

3. Gambling addiction

what is gambling addiction

The American Psychiatric Association defines gambling addiction or disorder as a repeated and ongoing pattern of betting and wagering that continues despite multiple problems in different areas of an individual’s life. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies gambling as a behavioral addiction. 

The major causes of gambling addiction include diagnosed psychiatric disorders, increased release of dopaminergic and opioidergic signals, and genetic and environmental factors, as described by Prof. Dr. David C Hodgins in a study published in The Lancet. 

The symptoms of gambling addiction are gambling despite knowing the negative consequences, hiding gambling, chasing losses, stealing money to gamble, and lying. These symptoms of gambling addiction can be treated by psychological and pharmacological intervention. 

4. Internet addiction

what is internet addiction

Internet addiction is characterized by preoccupations, urges, or behaviors leading to excessive Internet use, as defined by Martha Shaw in her study “Internet addiction: definition, assessment, epidemiology, and clinical management.” 

Internet use triggers the ‘dopamine’ reward system in the brain that leads to its addiction. High stress levels, psychological disorders, genetics, loneliness, and environmental factors also pose a risk to internet addiction.

The signs and symptoms of internet addiction are headache, insomnia, poor nutrition, loss of interest in leisure activities, internet usage in social gatherings, anxiety, isolation, and feelings of guilt. 

A meta-analysis, ‘Treatment of Internet addiction‘ in Clinical Psychology Review, concludes that both psychological and pharmacological interventions are effective in treating Internet addiction and associated symptoms of anxiety and depression. 

5. Porn addiction

Porn addiction is a compulsive behavior where an individual cannot stop watching porn even if they want to, which results in negative consequences to mental, physical, and social health.

Porn addiction may occur due to hormone imbalance, substance addiction, relationship difficulties, escape from stress, and medical conditions like epilepsy and dementia.  

According to a study published in the Journal of Clinical Medicine, porn addicts depict cravings for watching porn, engage in constant masturbation, show risky behaviors like viewing porn in the office, are unsatisfied in their sex life with their partner and often have anxiety due to the inability to stop porn. The long-term consequences of porn addiction include social withdrawal, body weakness, and depression. 

Like other behavioral addictions, porn addiction can be treated using cognitive behavioral therapy, individual counseling, and medications. 

6. Sex addiction

Sex addiction or hypersexuality is a loss of control over sexual desires or impulsive engagement in sexual activities despite negative life consequences, as described by a study in Psychiatry (Edgmont) by Dr. Timothy Fong, a Psychiatry Professor.  

The causes of sex addiction include neurotransmitter imbalance, epilepsy, dementia, bipolar disease, substance abuse, stress, or childhood trauma. 

The signs and symptoms of sex addiction include fantasizing about sex, masturbating, viewing pornography, constantly planning sexual activity, and engaging in dangerous and immoral sexual activities. The negative long-term consequences include lack of a healthy relationship, sexually transmitted diseases, and depression and anxiety. 

The effective treatment for sex addiction is cognitive behavioral therapy, individual counseling, and pharmacotherapy, as found in a meta-analysis in the Journal of Behavioral Addictions.

7. Shopping addiction

signs of shopping addiction

Shopping addiction or compulsive shopping is a behavioral addiction defined as excessive buying as a way to feel pleasure and avoid negative emotions, according to Lorrin Koran, a Psychiatrist at Stanford University. 

The causes of shopping addiction are boredom or high excitement levels, instant gratification, low self-esteem, or stress. It is also comorbid with anxiety disorders, impulsive behaviors, and substance abuse.

The signs and symptoms of shopping addiction are always thinking or talking about buying stuff, regularly surfing online stores, feeling euphoria or regret after buying, buying things one doesn’t need, and lying about purchases. A study published in The American Journal of Drug and Alcohol Abuse on compulsive buying states that the long-term consequences of compulsive shopping are debt, depression, frustration, shame, and relationship breakdown. 

The treatment approaches for shopping addicts include pharmacological intervention, counseling, and cognitive behavioral therapy. 

8. Tattoo addiction

Tattoo addiction is yet to be recognized as a separate disorder. It is more of a compulsive need to get tattoos where you spend considerable time and money, as stated by Dr. Daniel Selling, a psychologist at Williamsburg Therapy Group. 

Nearly 46% of Americans have a tattoo, 30% of 46% have 2-3 tattoos, and 19% have 4-5 tattoos, as per a report by Statista in 2019. These stats show that a considerable amount of people are hooked on tattooing. 

The dangers of tattoo addiction are increased risk of infection, skin allergies, scarring, bloodborne diseases, and cancer. 

Since tattoo addiction is not an official disorder, there is no established treatment protocol for it. However, cognitive behavioral therapy and counseling may be helpful in this behavioral addiction. 

9. Video game addiction

what is video game addiction

Video game addiction is a behavioral addiction defined by the 11th Revision of the International Classification of Diseases (ICD-11) as a lack of control over gaming, giving priority to gaming over daily activities and other interests despite consequences.

The etiological factors of video game addiction are constant pleasure-seeking, impulsiveness, depression, escape from real-life problems, and instant gratification. These causative factors make video game addicts suffer from sleep disturbances, higher school absenteeism, and lower grades, as concluded by a study in Psychology Research and Behavior Management. Other symptoms include fatigue, restlessness, hunger, anger, giving up old hobbies, lying to play games, decline in personal hygiene, and social withdrawal. 

Video game addiction is treated by cognitive behavioral therapy, PIPATIC, self-help groups, and medications, as indicated by a study published in the Journal Cureus.

10. Love addiction

what is love addiction

Love addiction, as defined by Marsal Sanches and John Vineeth P. in The European Journal of Psychiatry, is a maladaptive, pervasive, and excessive affection towards one or more romantic partners, which results in negative consequences like lack of control and reduced interest in other behaviors.

Love addiction or pathological love occurs due to cultural influences, childhood trauma, low self-esteem, past break-ups, fear of abandonment, and sex or porn addiction. 

The symptoms of love addiction are feeling lost without a partner, constantly seeking relationships, prioritizing partner over family, and obsessively thinking about a partner. Extreme emotional dependence and idealization are also present in love addicts, as found in a study in the Electronic Journal of Sociology.  

Sanches and Vineeth P. further state that psychotherapy is the cornerstone of love addiction treatment instead of medications. 

11. Work addiction

what is work addiction

Work addiction is defined as a compulsive behavior to work and preoccupation with work activities in personal time, leading to significant functional harm and distress to the individual and/or friends and family. 

The causes of work addiction include competitive work culture, high expectations, genetic predisposition, and psychological disorders like OCD, bipolar disorder, and perfectionism.  

According to a Polish researcher, Paweł A. Atroszko, the signs and symptoms of work addiction are working more than planned, irritability, worrying about work-related success, and sleep disturbances. Other symptoms include fear of failure at work, working to avoid negative feelings like guilt or financial problems, and defending an obsessive work attitude in front of others. 

The treatment options include counseling, cognitive behavioral therapy, and medications for comorbid psychological disorders. 

What are the Signs and Symptoms of Behavioral Addiction?

The signs and symptoms of behavioral addictions are spending excessive time in a behavior or action, behavior dependence, neglecting personal, educational, and job-related needs, hiding specific behavior patterns, experiencing withdrawal symptoms, having difficulty changing behavior, and engaging in addictive behavior to avoid life problems.  

Each type of behavioral addiction has variable symptoms. However, Dr. Kenneth Blum, a famous Pharmacologist, states that behavioral addictions have a common problem model, including reduced control (like craving or inability to stop a behavior), impairment (like losing interest and neglecting other phases of life), and risky use even when knowing the damaging effects. 

What are the causes of Behavioral Addiction?

The causes of behavioral addiction are psychological disorders like major depressive disorder, bipolar disorder, or OCD, personality disorders, comorbid addictions, diminished neurocognition, genetic history, or common-life stressors, according to a study by Dr. John E Grant in The American Journal of Drug and Alcohol Abuse.

Marco Di Nicola states in a study published in the Journal of Affective Disorders that bipolar disorder and major depressive disorder are the etiological factors in behavioral addiction.  

A study in the Journal of Clinical Psychiatry states that people with impulsive personalities and low harm avoidance measures have a higher risk of developing behavioral addictions. 

What are the effects of Behavioral Addiction?

The effects of behavioral addiction are poor mental health, changes in the brain’s structure and neural pathways, and physical health problems. The short-term effects of behavioral addictions include anxiety, sleep disturbances, and excessive fatigue. The long-term effects include depression, social withdrawal, and weight loss. 

How can Behavioral Addiction affect your mental health?

Behavioral addiction can affect your mental health in the short term by causing collective disorders like anxiety, depression, impatience, and obsessive thoughts. In the long run, behavioral addictions affect mental health due to social withdrawal, isolationism, disturbance in relationships, educational or financial failure, and negligence of close ones and personal responsibilities, as described by a study published in the Journal of Research in Medical Sciences.

How does Behavioral Addiction affect the brain?

Behavioral addiction affects the brain due to functional and structural changes in the brain. The brain structures involved in behavioral addictions are the ventral tegmental area (VTA), nucleus accumbens, dorsolateral prefrontal cortex, amygdala, anterior cingulate cortex (ACC), and parahippocampus. The activation of VTA and nucleus accumbens releases dopamine, which is a consequent reward. 

Kai Yuan and his colleagues from Xidian University published a paper in Plos One where they found that the dorsolateral prefrontal cortex, ACC, and parahippocampus in behavioral addiction. 

How does Behavioral Addiction affect your physical health?

Behavioral addiction affects your physical health due to a sedentary lifestyle and the negative impact on mental health. The effect of non-substance addiction on physical health manifests as reduced physical activity, excessive fatigue, malnutrition or eating disorders, weight gain or loss, sexual deviations, and sleep problems.

According to the UK Addiction Treatment Center, the long-term physical symptoms can appear as cardiovascular diseases or liver problems. 

What are the risk factors for Behavioral addiction?

risk factors for behavioral addiction

The risk factors for behavioral addiction are family history, comorbid psychological disorders, peer pressure, stress, and consuming addictive drugs. 

  • Family History. According to Psychology Today, family history can increase the risk of developing behavioral addictions by 40-60%. 
  • Comorbid Psychological Disorders. Trevor W. Robbins, a Psychology Professor at the University of Cambridge, states that impulsiveness in behavioral addictions is closely related to other psychological disorders like OCD, ADHD, depression, and anxiety.
  • Peer Pressure. A study in the Journal of Adventist Education mentions that the starting point of behavioral addictions is peer pressure. 
  • Stress. Dr. Marie Pierre Tavolacci from Rouen University Hospital and her colleagues found that individuals with perceived stress had a higher risk of developing behavioral addictions like food and internet addiction. 
  • Consuming addictive drugs. The use of addictive substances like cocaine, nicotine, or heroin can trigger behavioral addictions. Dr. John E Grant estimates up to 21-64% chances of developing behavioral addictions in people with substance use disorder. 

How Is Behavioral Addiction Treated?

behavioral addiction treatment

Behavioral addiction can be treated by cognitive behavioral therapy, group therapy, medications, one-on-one or couples counseling, and self-help groups. 

1. Cognitive behavioral therapy

Cognitive behavioral therapy, a talking therapy aimed at changing the way one thinks about negative life consequences, plays a fundamental role in treating behavioral addictions. Jeremy Adams, a Psychology Professor, states in his study published in the Lancet that therapists help individuals undergoing CBT by identifying and correcting irrational thoughts and maladaptive behavior. 

A study in the BioMed Research International monitored the effects of CBT on internet addiction. The results showed that 70% of the patients had decreased psychopathological symptoms and psychosocial problems.   

2. Group therapy

Group therapy, a therapy of one or more psychologists leading a group of 10-15 people, is effective in reducing behavioral addiction symptoms. Cognitive behavioral group therapy is a type of group therapy commonly implemented in behavioral addicts. Evidence shows that group therapy reduces compulsive behavior and interpersonal and health issues while improving tolerance and time management. 

According to studies published in the Journal ‘Trends in Psychiatry and Psychotherapy’ and the International Journal of Environmental Research and Public Health, CBT group therapy increases the mental well-being of individuals with internet behavioral addiction. 

3. Medications

Medications treat behavioral addictions by treating causative agents like psychological disorders, personality disorders, and neurotransmitter imbalances. There is little evidence of pharmacological use in behavioral addictions. However, studies published in the Journal ‘Of Pharmacology Biochemistry and Behavior’ and Neuropsychology Review conclude that drugs affecting glutamatergic and opioidergic transmission help in behavioral addictions. 

4. One-on-one or couples counseling

One-on-one or couples counseling can control behavioral addictions by helping you identify triggers and ways to prevent them. Controlling triggers impair impulsive and compulsive behavior, reducing non-stop engagement in harmful behaviors. 

5. Self-help groups

Self-help groups are informal groups where individuals support and help each other to recover from different behavioral addictions. Dr. Timothy W. Fong, a  Psychiatry Professor, explains that self-help groups foster a sense of understanding and purpose among addicts and serve as an adjunct treatment. Famous behavioral addiction self-help groups include Sex Anonymous, Love Anonymous,  and Gamblers Anonymous. Another benefit of self-help groups is relapse prevention. 

Can behavioral addiction include gambling?

Yes, behavioral addiction includes gambling, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 

Are behavioral addictions recognized by the DSM-5?

Yes, behavioral addictions are recognized by the DSM-5. Some common behavioral addictions recognized are exercise addiction, gambling addiction, internet addiction, and food addiction. 

Do behavioral addictions cause depression?

Yes, behavioral addiction causes depression because addiction triggers feelings of loneliness and hopelessness. A study published in the Journal of Frontiers in Psychiatry found a strong association between behavioral addiction and depression and anxiety disorder. 

Is behavioral addictions a disease?

Yes, behavioral addiction is a disease, according to the American Society of Addiction Medicine (ASAM). It is a chronic medical disease that affects your brain circuits and behavior to the point where you can’t control it despite its negative consequences. 

Is behavioral addiction genetic?

Yes, behavioral addiction can be genetic. Individuals with a family history of substance use, psychological disorders, and pathological gambling are more prone to develop behavioral addictions, as explained by Judson A. Brewer, an American psychiatrist and neuroscientist. 

Is behavioral addiction a disability?

Yes, behavioral addiction is a disability that impairs brain and neurological function and limits certain aspects of life. 

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