Most anything that causes the brain to release dopamine can become addictive, whether it's heroin, cocaine, video games, or shopping. While chemical addiction and behavior addiction are not normally lumped together, their similarities far outweigh their differences.
Chemical addiction refers to an addiction to drugs of abuse, including drugs (both prescription and illegal), alcohol, and tobacco products, like cigarettes and snuff. Three easy ways to recognize criteria for when addiction occurs are:
- Tolerance - Needing more and more of the drug to get the same effect.
- Cravings - The body "needs" more of the drug to function normally.
- Withdrawal - Psychological and physical malaise occurs when you take the drug away.
People become addicted to drugs because they give them a feeling of euphoria, or bliss. This euphoria is caused by a release of dopamine in the brain. The user wants to regain that pleasant feeling, so he or she takes more.
The problem is that the person will never experience that same high again, since the brain starts shutting down dopamine receptors to adapt to receiving more of the drug. This turns into a vicious cycle, leading to more cravings, higher tolerance, and endless disappointment.
Behavioral addiction is just like it sounds: an addiction to a certain behavior. Currently, the American Psychiatric Association's DSM-5 classifies two behavioral addictions under "addictions and related disorders." These are pathological gambling and Internet addiction.
Other behaviors not yet classified as "addiction disorders" but which are similar in nature, include addictions to:
These addictions are classified as "obsessive-compulsive and related disorders."
Addiction as Reward
To the brain, addiction is addiction. Both addictive chemicals and addictive behaviors activate the reward pathway in the brain. It's designed to promote eating, exercising and procreation -- activities needed for survival. In fact, the reward system exists so it can reinforce behaviors. The problem is that it doesn't distinguish between healthy and unhealthy ones.
Both chemical and behavioral addictions can run in families. The FosB gene transcription is described as a risk factor in both types. According to researcher Timothy W. Fong, "Family members of pathological gamblers have an incidence of pathological gambling of close to 20 percent, a rate much higher than the rate in the general population."
The American Journal of Drug and Alcohol Abuse asserts, "Growing evidence suggests that behavioral addictions resemble substance addictions in phenomenology, comorbidity, neurobiological mechanisms, and response to treatment." This means that both types of addicts have roughly identical responses to their drugs of choice, when you look at brain chemistry alone. They are also similar in their symptoms.
Similarities in Symptoms and Treatment
Whether addicted to substances or behaviors, the addict:
- Is preoccupied with the source of his addiction, getting it and recovering from it
- Sacrifices personal relationships and responsibilities to pursue a high
- Feels ill at ease when unable to get high
- Continues to get high despite negative consequences
While a person who is solely addicted to a behavior will not necessarily have to go through detox, after that step is done treatment is basically the same. The person needs to get to the root of his addictive behavior through exploration, either through individual or group therapy, develop healthy alternatives to the addiction and come up with a plan to avoid triggers and prevent relapse. For example, a shopping addict may need to cut up his credit cards and stay away from the mall, just like an alcohol may need to avoid the bar scene.
Behavioral addictions cannot always be dealt with using the abstinence-based approach favored by disease-model drug and alcohol counselors. For example, a compulsive eater cannot entirely avoid food, a shopping addict can't stop buying necessities, and a sex/love addict cannot avoid all personal relationships. In these cases, the person must learn to practice healthy moderation.
Also, behavior addicts do not become physically dependent on their drug of choice. This makes it easier for them to hide their addictions because they do not have physical withdrawal symptoms. However, the emotional toll can be just as high, and in the case of eating disorders, the damage to the body as well.
Comorbidity of Addictions
A lot of addicts have both chemical and behavioral addictions, known as comorbidity. Addicts often replace one addiction with another as well -- switching from a drug to a behavior. For example, a person may develop an eating disorder as an unhealthy way to fill the void from giving up drinking. This helps the person avoid the emotional pain at the root of the addiction, which is why people in recovery must focus on healthy and pro-social behaviors.