What are Behavioral Addictions? Different from other addictions?

Key Points:

• Behavioral Addictions are defined by continued compulsive behaviors, despite negative consequences.

• Behavioral addictions do not involve a substance that alters an individual's mind, such as substance use disorders.

• Most behavioral addictions are not included in the DSM-5 with specific diagnostic criteria

• Treatment for behavioral addictions may include group support, individual counseling or at times medication.

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Historically, the term “addiction” was only used to describe an excessive and uncontrolled use of drugs or alcohol. It was not until 2013 with the release of the Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that addictions outside of substance use disorder would be included in any capacity. While inclusion in the DSM is still limited, behavioral addictions have gained recognition as potentially being just as detrimental to individuals’ mental, physical and emotional health as substance use disorders. 

What is a behavioral addiction? How do they differ from other types of addictions?

Behavioral and process addictions are defined by engaging in compulsive behaviors, despite adverse consequences. Behavioral addictions differ from other types of addictions, such as drug or alcohol abuse, as there are no substances and generally no outward physical indicators present. In behavioral addictions, a person becomes addicted to the feeling they experience when acting out the behavior, resulting in a harmful compulsion.

Examples of behavioral addictions can include gambling addiction, sex addiction, social media or video gaming addiction and even shopping addiction. Behavioral addictions are often diagnosed alongside other mental health disorders, such as anxiety, depression or substance use. While behavioral addictions are not considered as physically dangerous as other addictions, there are many mental and emotional dangers that can occur without proper treatment. However, gambling addiction, the most-researched behavioral addiction and the only one formally included in the DSM-5, is connected with high rates (upwards of 20%) of suicidality.

Examples of different behavioral addictions

Gambling Addiction

Gambling addiction (“Gambling Disorder” in the DSM-5) is characterized by an impulsive, uncontrolled desire to place bets, despite the negative impacts on an individual's life. 

Sex Addiction

Sex addiction is also referred to as compulsive sexual behavior (not listed in the DSM-5, but is in the World Health Organization’s ICD-11) or hypersexual disorder. Sex addiction can be diagnosed when an individual repeatedly engages in sexual behaviors despite adverse consequences. 

Internet Addiction

Internet addiction can be thought of as a category that includes a variety of compulsive behaviors including video gaming addiction, shopping addiction, ebay and online auction addiction and multiple forms of social media addiction. Internet addiction can cause issues in relationships, work, school and real-life social situations.

How are behavioral addictions diagnosed?

Currently the majority of behavioral disorders are not included in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). Gambling disorder is the only “Non-substance related disorder” in the DSM-5, with Internet gaming disorder included as a condition that requires further research. 

Without a concrete set of criteria, behavioral addictions are diagnosed by a clinician by observing or identifying behaviors that negatively impact an individuals’ everyday life and their ability to function in a healthy way. Signs that someone may have a behavioral addiction can include:

• Compulsive and uncontrolled engagement in a behavior or activity 

• Behaviors interfere with daily responsibilities

• Continuing to engage in behaviors despite negative consequences

• Behaviors impact relationships, school or work

• Using compulsive behavior to sooth negative feelings or emotions

• Experiencing symptoms of withdrawal, agitation, depression or stress when ceasing a behavior

• Lying about or hiding the extent or seriousness of a behavior

   

What are the treatment options for behavioral addictions?

While there is not a specific treatment designated for behavioral addictions, it may include one or more methods to help manage its symptoms. One treatment option for behavioral addiction is group therapy. There are support groups for many behavioral addictions, including ones for gambling, sex and porn. These groups use mutual support and shared experiences to help guide those struggling with a specific issue to maintain abstinence from harmful behaviors. These groups tend to follow a 12-step program that is also used in Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). 

Medication to help control certain behaviors may also be recommended depending on the severity of an individual's addiction. Some research suggests that selective serotonin reuptake inhibitors (SSRIs) may be helpful in some with reducing urges or cravings to engage in negative behaviors.

Cognitive Behavioral Therapy (CBT) is a popular therapeutic technique that helps an individual understand the connection between their thoughts, feelings and behaviors. In CBT, triggers and false beliefs are identified so that healthier and alternative coping skills can be developed in place of the addictive ones. 

Individual therapy, both in-person or virtual, can provide expertise to help treat behavioral addictions. Birches Health offers 100% virtual treatment with therapists specifically trained in treating a variety of behavioral addictions. Birches allows easy access to specialized treatment types and accepts most major insurance carriers, making treatment affordable. To get started with Birches you can:

• Book an appointment by clicking here

• Call 833-483-3838

• Email help@bircheshealth.com