Identifying Common Behavioral Addictions

I spend a lot of time and effort in this space describing sexual addiction—what it is, how it can be identified, and how it can best be treated. However, sex is not the only behavioral addiction. In fact, just as it is with pleasure-inducing substances, almost any pleasure-inducing behavior can be used in an addictive way.

Most people rather easily understand the idea of substance addictions. If they’re not addicted themselves—to cigarettes, booze, prescription meds, illicit substances, or even simple things like caffeine and processed sugars—then they almost certainly know someone who is. At the very least, most people have seen relatively accurate portrayals of substance addiction on TV and in the movies.

Behavioral addictions are not so easy to fathom. That does not, however, mean they don’t exist, nor does it mean they’re not every bit as serious and debilitating as substance abuse issues. The simple truth is people can and do become addicted to all sorts of pleasurable (and therefore escapist/dissociative/addictive) behaviors, just as they get hooked on pleasurable (and therefore escapist/dissociative/addictive) substances. And they do so with similarly problematic results.

Part of the confusion around behavioral addictions arises because certain addictive behaviors are (for most people, most of the time) healthy and essential to life. For instance, eating and being sexual contribute to survival of both the individual and the species. (This is why our brains are programmed to register/experience pleasure when we engage in these activities.) Unfortunately, for vulnerable people (people at-risk for addiction thanks to genetics and/or their environment), this inborn pleasure response can become a go-to coping mechanism used to deal with any and all forms of emotional and/or psychological discomfort, turned to time and time again until the individual loses control over it.

In addition to sexual addiction, which I’ve written about extensively both here and elsewhere, the most common behavioral addictions include:

• Gambling Addiction: Also called gambling disorder and compulsive gambling, this is an uncontrollable urge to gamble. Typically, compulsive gamblers will play whatever game is available, though their preference is usually fast-paced games like video poker, slots, blackjack, and roulette, where rounds end quickly and there is an immediate opportunity to play again. Nowadays, digital technology offers these games in abundance, so gambling addicts no longer need to frequent casinos, tracks, and gambling parlors to engage in their addiction.
• Love Addiction: Love/Relationship addiction is the compulsive search for romantic attachment. Love addicts sacrifice time, health, money, self-esteem, and more in their pursuit of the perfect partner. Love addiction is, in many ways, similar to sexual addiction. The main difference is love addicts focus their obsession on a single individual, while sex addicts tend to chase multiple partners/fixes. Digital technology offers hundreds of dating sites and apps, allowing love addicts to engage in their addiction 24/7, regardless of their current physical location.
• Social Media Obsession: Social media obsession is the quest to have the most friends or followers on sites and apps like Facebook, Twitter, and Instagram, to have one’s lovingly constructed posts and tweets responded to in positive ways, and to “look good” through an endless series of (usually) narcissistic posts. Social media addicts sometimes choose to bypass real world relationships, recreation, and social engagement for their online life.
• Spending Addiction: Spending addiction, also called oniomania, compulsive spending, shopping addiction and compulsive buying disorder, occurs when people spend obsessively despite the damage this does to their finances and their relationships. Nowadays, it is just as easy to shop online via websites and apps as it is to visit the local mall. As such, spending addicts need not visit brick and mortar stores to engage in their addiction. Moreover, they can engage in their addiction 24/7.
• Video Game Addiction: Video game addiction is the extreme use of computer and video games. Typically, gaming addicts play for at least two hours daily; sometimes they play four or five times that amount. They often neglect sleep, personal hygiene, diet, relationships, jobs, financial obligations, exercise, and life in general. Again, digital technology greatly facilitates this addiction.

Based on the above, it may seem as if almost anything can be addictive—substances and behaviors alike. This is not in fact the case. For a substance or a behavior to be addictive, it needs to trigger the neurochemical experience of pleasure (the release and reception of dopamine, serotonin, adrenaline, and similar neurotransmitters). Without this, a behavior may be compulsive, but it does not qualify as an addiction. For instance, compulsive hand-washing, though out of control and possibly causing negative consequences, does not cause feelings of pleasure. As such, it is not an addiction. Instead, this behavior is best classified as an Obsessive-Compulsive Disorder (OCD). In short, it is pleasure that drives addiction. Pleasure is the “carrot on a stick” that keeps an addict trudging forward. Other compulsive behaviors lack this element.

Even though behavioral addictions are in most respects similar to substance addictions, they are typically more difficult to identify. Generally, this is because they’re easier to hide and (usually) more socially acceptable. As a result, behavioral addicts often must experience serious directly related consequences before their problem is recognized by self or others. For instance, a woman in treatment for depression and an addiction to Xanax may find herself continually starting relationships with other patients or even staff, leading to an evaluation for love addiction. Meanwhile, a recovering cocaine addict might find himself continually relapsing at the local casino, leading to a realization that he has an intertwined drug and gambling addiction.

Another major obstacle in the identification and treatment of behavioral addictions is the fact that most people view them as being less serious than “real” addictions (i.e., substance addictions). In reality, nothing could be further from the truth. Behavioral addictions wreak the same types and degrees of havoc as substance use disorders—relationship woes, issues at work or in school, depression, anxiety, isolation, loss of interest in previously enjoyable activities, financial problems, physical ailments, legal trouble, and more.

For the most part, behavioral addictions of all types are treated using the same basic methods that have proven effective with substance abuse issues, most often a combination of cognitive behavioral therapy, accountability, social learning, and external support. Often that external support is found in 12-step recovery groups like Gamblers Anonymous, Sex and Love Addicts Anonymous, Debtors Anonymous, Spenders Anonymous, Online Gamers Anonymous, and Computer Gaming Addicts Anonymous, to name but a few. For those who struggle to establish or maintain behavioral sobriety, intensive treatments are available for many issues, including gambling addiction, love addiction, dual substance abuse and love addiction, and more. At worst, behavioral addicts can benefit from generalized addiction treatment as provided by an addiction specialist, especially when this treatment is utilized in conjunction with a more specifically focused external support group.

Robert Weiss LCSW, CSAT-S is Senior Vice President of National Clinical Development for Elements Behavioral Health, creating and overseeing addiction and mental health treatment programs for more than a dozen high-end treatment facilities, including Promises Treatment Centers in Malibu, The Ranch in rural Tennessee, and The Right Step in Texas. An internationally acknowledged clinician, he has served as a subject expert for multiple media outlets including The Oprah Winfrey Network, The New York Times, The Los Angeles Times, The Daily Beast, and CNN, among many others. He is the author of several highly regarded books. For more information please visit his website at robertweissmsw.com or follow him on Twitter, @RobWeissMSW.