Key takeaways:

  • As they are not outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), behavioral addictions are not classified and cannot be medically diagnosed, except for gambling disorder, which has diagnostic criteria for addiction
  • Those with behavior addictions may also suffer losses that seem too great to bear, such as financial, employment, or relationship problems, leading to mental health issues and suicidal thoughts if left untreated
  • Many therapeutic approaches used to treat substance abuse have been successfully replicated to treat behavioral addictions

People have displayed addictive tendencies from behaviors towards pornography, sex, gambling, and even the internet. While many forms of behavioral addiction aren't recognized as clinical conditions, they are still often treated by psychiatrists and addiction professionals.

Understanding Behavioral Addictions

When most people think of addictions, they think of substance abuse, such as alcohol, drugs, nicotine, or painkillers. However, people often overlook or have difficulty with the concept of addictive behaviors.

Yet, they do exist. People have displayed addictive tendencies from behaviors towards pornography, sex, gambling, and even the internet. Those who do not seek additional gratification from these activities may find it difficult to understand how others can develop compulsions towards them. For those who do experience the enhanced pleasure following such activities, addictions can form for those behaviors, and the same struggles and negative impacts from substance abuse can occur. The desire for the ‘high’ those certain activities can produce may become so intense that symptoms resembling withdrawal can appear, even if they do not engage in that activity regularly.

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Get help during Covid-19

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Are Behavioral Addictions Recognized?

Behavioral addictions such as sex, porn, shopping, work, eating, and many others are not recognized as traditional addictions like substance abuse. This disregard has caused controversy in the field of addiction, with many of the experts campaigning for their recognition.

As they are not outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), behavioral addictions are not classified and cannot be medically diagnosed, except for gambling disorder, which has diagnostic criteria for addiction. This is likely to change when the DSM is updated, given the strong push from medical professionals and public opinion. [2]

What Is a Behavioral Addiction?

While gambling disorder is the only recognized behavioral addiction in the DSM-5, public opinion and professional psychologists and psychiatrists recognize that addictive tendencies and symptoms are present in some behaviors.

The consensus and discussion on behavioral addictions often focus on the more common areas such as porn addiction, sex addiction, and shopping addiction. However, those discussions have opened up to the less talked about topics, like self-harm and plastic surgery addiction.

Sometimes referred to as process addictions, behavior addictions follow the same patterns as substance abuse disorders, including negative impacts outlined in the DSM-5 and its 11 substance abuse criteria. Some of these criteria include cravings, harmful use, unsuccessfully attempting to stop, and withdrawal symptoms. [2]

Behavioral addictions can have the same negative impacts on family and relationships as substance abuse disorders. In addition, they can make the addict neglect meaningful relationships in favor of the addictive activity and put added strain on loved ones by concealing their behavior.

Those with behavior addictions may also suffer losses that seem too great to bear, such as financial, employment, or relationship problems, leading to mental health issues and suicidal thoughts if left untreated.

As behavior addiction is still not officially recognized, finding treatment can be difficult. However, psychiatric and psychological options, such as therapy, counseling, and support groups, help overcome and cope with these behavioral addictions.

What is an addictive personality?

The existence of factors and traits in an individual's ego that makes one person more perceptible to addictive substances or behaviors than another is a hotly debated topic, one that does not have a straightforward explanation. You can find out more about addictive personalities here.

Signs of a Behavioral Addiction

Like substance abuse, such as alcohol, understanding the process of addiction can help you discern whether you or some you know is either displaying problematic behavior, worrying behavior that isn’t an addiction, or a healthy attitude towards a behavior.

Warning signs of behavioral addiction include: 

  1. Relying on the behavior to feel normal

  2. Continuing despite physical and/or mental harm

  3. Having trouble cutting down

  4. Spending the majority of your time engaging in the behavior

  5. Neglecting commitments such as work or school in favor of the behavior

  6. Experiencing symptoms of withdrawal (depression, irritability) when not engaging with the behavior

  7. Hiding the extent of the problem. [1]

Common Behavioral Addictions

Despite not being included in the DSM-5, many behaviors are widely considered to be areas of addiction and can require treatment to overcome. 

Some of the most commonly recognized behavioral addictions include:

  • Work addiction [3]

Behavioral Addiction Withdrawal Symptoms

The way the brain develops a tolerance to addictive substances, such as tobacco or cocaine, is generally highlighted by the user having to increase the usage to achieve the same effect. This is also true of withdrawal symptoms. Therefore, a person addicted to a specific substance and when they discontinue its use may find the physical and psychological effects incredibly uncomfortable and, in some cases, this can be medically dangerous.

Tolerance and withdrawal symptoms have long been used as measurable criteria when judging a person’s level of substance abuse, though it is possible for addicts not to display either. This isn’t the same in behavioral addictions, as both are difficult to identify and can vary depending on the specific problematic behavior. There are no physical withdrawal symptoms from behavioral addictions. 

The only way to label them is through a change in an emotional state when the behavior isn’t engaged. These are most commonly perceived as irritability, restlessness, anger, moodiness, sadness, guilt, anxiety, and feeling tense. But studies have not found a definite correlation between these emotional states and the level of behavioral addiction.

For example, someone with a gambling problem may find themselves experiencing these same emotions after a sustained period of loss despite being constantly engaged in the behavior. [1]

Behavioral Addiction Treatment

For those suffering from behavioral addictions, the prospect of getting treatment may feel daunting. Fortunately, many therapeutic approaches used to treat substance abuse have been successfully replicated to treat behavioral addictions. However, professionals are still developing new therapies and competencies to help with behavioral addictions, and there are many treatment centers already specializing in helping those with specific behavioral issues.

Psychiatric and psychological specialists, including therapists, counselors, and community support groups, are also available to help manage addictive behaviors. Providing techniques and coping skills to help with those emotional imbalances, changing destructive and cyclical patterns of abuse, identifying those underlying causes of behavioral addiction, such as trauma.  All are contributing to lasting recovery. Behavior addiction treatments may include:

  • Cognitive-behavioral therapy

  • Group therapy 

  • Medications (including pharmaceutical, over-the-counter and holistic)

  • One-on-one, family, relationship, or couples counseling

  • Self-help groups