What Are Addictions?
According to the dictionary, an addiction is defined as dependence on the consumption of a certain substance or the practice of a certain activity. When we talk about addictions, the first thing we think of is drug dependence.
However, the essential element of all addictive disorders has been found to be a lack of control. We could say that the basis of all addictions is the lack of control that the person has over a certain behavior pattern.
At first, this behavior can be pleasant. But, over time, the person suffering from addiction can see how it’s taking control of their life.
Currently, addictions aren’t limited to behaviors created by uncontrollable substance use. Some examples of these substances are alcohol, tobacco, cannabis, or amphetamines.
Nowadays, there are also apparently harmless behavior habits that, under certain circumstances, can become addictive and seriously interfere with the daily lives of those affected.
Classic addiction: substance abuse
Drug or substance addiction is a prototypical disorder of the neural reward system. Drugs start to ‘hijack’ this system and induce potent forms of reinforcement learning, resulting in aberrant sequences, increased drug-seeking, and drug-associated behavior.
Thus, hypothetical transitions from action-outcome (ie, goal-directed) behaviors to the habitual response in addiction have been related to the basal ganglia.
An alternative, but possibly related, perspective is the opponent-process theory, perhaps more relevant to opiate and alcohol addiction. This hypothesis also invokes physical and subjective phenomena such as craving, tolerance, and withdrawal. The growing analysis of compulsive gambling is taking the same course.
As in chemical addictions, people addicted to certain behaviors experience a withdrawal syndrome when they can’t carry them out. This is characterized by the presence of deep emotional distress.
When behavioral addiction progresses, behaviors become automatic, activated by emotions and impulses, with poor cognitive control and self-criticism over them. Thus, the core aspect of behavioral addiction isn’t the type of behavior involved, but the type of relationship that the subject establishes with it.
However, in the words of the researcher Echeburúa, any normal activity that’s pleasant for an individual can become addictive behavior. The essence of the disorder is that the person loses control over the chosen activity and continues with it despite its adverse consequences.
In short, if a person loses control over a pleasant behavioral experience, they have become a behavioral addict. The main symptoms of a behavioral addiction are:
- An intense desire, craving, or unstoppable need to carry out the pleasant activity.
- Progressive loss of control over it.
- Neglect of usual activities.
- Denial of the problem.
- Progressive targeting of relationships, activities, and interests around the addiction.
- Irritability and discomfort due to the impossibility of carrying our the addictive pattern or sequence (withdrawal ).
Research indicates that the consumption of certain substances or drugs produces an increase in dopamine in the nervous system, which leads to a feeling of euphoria. The increase in dopamine can be generated through other types of behaviors such as gambling, uncontrolled sex, or compulsive shopping.
The most common behavioral addictions are:
- Gambling disorder (gambling or pathological gambling)
- Internet addiction and new virtual technologies
- Compulsive shopping (oniomania)
- Sex addiction
- Work addiction
Similarities between substance addictions and behavioral addictions
Thus, the evidence suggests that there are clear similarities between behavioral addictions and substance addictions. These are:
- Clinic and phenomenology
- Tolerance and withdrawal
- Overlapping genetic aspects
- The involvement of neurological circuits
- Responses to treatment
Characterization of addictions in the DSM-5
In the publication of the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, a new category on addictions is proposed. This is called ‘Addictive and Substance-Related Disorders’. This new chapter includes:
- Substance-related disorders
- Non-substance related disorders
To conclude, it seems that we have to start becoming more aware of behavioral addictions. They’re no less important than substance addictions and can have serious consequences for those who suffer from them. Giving them the importance they deserve will allow techniques and resources to continue to be developed for both their treatments and their diagnoses.