Behavioral Addictions: Types, Symptoms, Causes, & Treatments

What Is a Behavioral Addiction?

Behavioral addictions (sometimes called process addictions) describe behaviors that become compulsive and problematic. The telltale sign of addiction is continuing a behavior after it negatively impacts a person. These impacts might affect their work,  relationships, or physical and mental health.

The brain chemical dopamine may be a reason people continue behaviors even after they become problematic. Dopamine and addiction are strongly related, as dopamine creates a reward pathway in the brain as a response to a specific drug or behavior, making it more difficult (although not impossible) to stop. Furthermore, dopamine is partially responsible for the “high” people experience using drugs or engaging in specific behaviors. Almost every behavior suspected to have addictive qualities is believed to cause the release of this chemical.^6,4

Are Behavioral Addictions Real?

Behavioral addictions exist in a gray area in the field of addiction. Technically, the only medically recognized behavioral addiction is gambling disorder. Formerly classified as an impulse control disorder, gambling disorder was reclassified in 2013 as an addictive disorder in the DSM-5 (the official reference guide for diagnosing mental illnesses). This reclassification was significant as the first formal recognition that behavioral addictions exist.

Some experts argue that while a physical addiction to behavior may not develop, a psychological addiction can, resulting in the same experience of cravings, tolerance, and even withdrawals common in drug addiction.⁴ Those who deny the existence of other behavioral addictions often cite the lack of conclusive research. Studies on behavior addiction are ongoing, and more possible addictions may be recognized as diagnosable conditions in the future.

Types of Behavioral Addictions

While there is only one formally recognized behavioral addiction, some suspect various others exist. Some behavioral addictions have been researched more than others, resulting in increased“evidence” to suggest that they exist.

Below are examples of behavioral addictions:

Gambling Disorder

Gambling disorder is a formally recognized behavioral addiction characterized by a pattern of compulsive gambling that becomes increasingly problematic over time.¹ Many people with this disorder accrue large gambling debts, frequently borrowing money under pretenses to sustain their habit, “win back” losses, and pay or give collateral for other debts.

They continue chasing the “high” of placing bets, convinced they will come out on top. In many instances, people with gambling addictions lose more than money, including their assets, jobs, or even relationships.

Food Addiction

Some researchers believe people can become addicted to certain kinds of food, especially processed foods high in fat, sugar, and calories. Food addiction is thought to be a behavioral addiction to certain foods that activate the reward pathways in the brain involved in addiction.⁵ This results in a preoccupation and loss of control any time these foods are present, as opposed to the specific “episodes” common in those struggling with binge eating disorder.

Sex & Pornography Addiction

Additional examples of addictive behaviors include sex and watching pornography. Sex addiction has been controversial for several decades, with intense debate among experts who believe that sexual addiction is either possible or not. Those who believe in sex addiction tend to define it as a pattern of compulsive and problematic sexual behaviors.

Porn addiction is believed to be a subtype of sex addiction and is defined as the compulsive use of porn despite causing problems in relationships or other areas of life. Aside from the obvious “symptom” of excessive porn use, other key features that may indicate porn addiction include an inability to perform with real-life partners (mainly in men) and sexual dissatisfaction with real-life partners.²

Addiction to Phones & Devices

Americans spend nearly 10 hours each day in front of screens, with cell phones and mobile devices accounting for at least half of this time.⁸ The sheer amount of time spent on these devices is cause for concern, suggesting that if device addiction is possible, most Americans are at high risk.

Anecdotal reports suggest that some people experience a loss of control over their devices, unable to abide by limits they set for themselves. Some have reported psychological cravings and withdrawals related to their phones, tablets, or other connected devices.³

Research suggests excessive device use is associated with many physical and mental health problems. These findings are relevant because experiencing consequences related to use is a fundamental component of addiction. Children and teens seem to be especially vulnerable to these effects. Young people who spend seven hours or more on devices are twice as likely to be depressed or anxious, and they struggle more with regulating emotions, making friends, and having trouble focusing and completing tasks.⁷

Generally speaking, emailing, texting, or using other basic features are unlikely to lead to addiction. The activities more likely to precede addiction include porn (discussed above), social media, and video games. These activities are also believed to interact with dopamine reward centers in similar ways as drugs and alcohol^3,4

Less Common Behavioral Addictions

The list of behaviors that could become addictive continues to grow, but some are less common. These include behavioral addictions less often reported and those that have not been researched as intently. Some of these behaviors are also more commonly attributed to other known conditions (like impulse control disorders).

Less commonly researched behavioral addictions include:

• Shopping addiction
• Kleptomania
• Exercise addiction
• Love addiction
• Work addiction
• Plastic surgery addiction

Signs & Symptoms of a Behavioral Addiction

No formal list of symptoms is used for diagnosing behavioral addictions. Gambling disorder has a few symptoms more specific to gambling patterns, like chasing losses or placing higher/riskier bets, but the symptoms otherwise mirror those of substance use disorders. Likely, behavioral addictions recognized in the future will also include many symptoms currently used to diagnose other addictions.

A person may not display every symptom to be diagnosed with a substance use disorder. Anyone describing two or more manifestations could be struggling with an addiction.

Symptoms currently used to diagnose substance or alcohol use disorders include:¹

• Using more of a substance than intended or for longer than intended
• A desire to cut back or stop and previous unsuccessful attempts to do so
• Spending a great deal of time thinking about, obtaining, using, or recovering from the effects of a substance
• Cravings or strong urges to use the substance
• Recurrent use that may interfere with fulfilling major role obligations
• Persistent use despite experiencing problems in important relationships caused or exacerbated by substance use
• Reduction or withdrawal from important social, occupational, or recreational activities because of time devoted to substance use
• Use of the substance in potentially dangerous situations
• Continued use despite knowing negative effects on health or mental health
• The development of tolerance to a substance (needing more to get the same effects)
• Experiencing symptoms of withdrawal (physical or psychological discomfort when stopping a substance)

Signs of behavioral addictions could include:

• Efforts to hide the behavior or how often it is engaged in from friends and family
• Feeling an inability to resist urges to engage in the behavior
• Relying on the behavior to relieve stress or cope with difficult emotions
• Becoming defensive when questioned about the behavior
• Experiencing excessive guilt after engaging in the behavior
• Making promises to cut back or stop but not keeping them
• Becoming moody, irritable, or upset when unable to engage in the behavior

What Causes a Behavioral Addiction?

No one cause explains why some people develop compulsive or addictive behaviors, although different social, biological, and psychological factors make some people more vulnerable. Of course, behavioral patterns and personal choices also influence risk. To develop a behavioral addiction, a person needs to have engaged in the behavior, and those who do so often and for long periods are more likely to develop a problem.

Below are possible causes and triggers of a behavioral addiction:

• Experiencing childhood trauma, abuse, or neglect
• Having a family history of addiction or mental illness
• Being impulsive and prone to risk-taking⁶
• Having a pre-existing mental health disorder⁶
• Using a behavior to cope with stress or difficult emotions

Treatment of Behavioral Addictions

Even though many behavioral addictions are not formally recognized as diagnosable conditions, a surprising amount of treatment options for these issues exist. Individual or group therapies, outpatient treatment, and inpatient treatment facilities may treat behavioral addictions. Research suggests many substance use disorder treatments can effectively treat behavioral addictions.⁴

Some of the more common treatment options for behavioral addictions include:

Outpatient therapy

Outpatient therapy is typically provided by a licensed counselor, social worker, or psychologist. Sessions are usually office-based and could include individual, group, family sessions, or a combination. Find a counselor specializing in addiction to ensure they can treat behavioral addictions. Typically, outpatient therapy sessions last about an hour and are offered once or twice a week, although some intensive outpatient programs could offer treatment 3-5 days per week.

Medication

Psychiatric medication is not typically considered a frontline treatment for behavioral addictions, but some people are interested in exploring their options. Medication can only be prescribed by a licensed medical provider with the appropriate license and qualifications.

Medication evaluations and follow-up appointments typically occur in office settings. Medication may be a beneficial part of treatment when combined with therapy, especially for people with other underlying mental health conditions.

Residential & Inpatient Treatment

Residential and inpatient treatment occurs in 24-hour facilities staffed by addiction counselors and health and medication prescribers. People needing more intensive treatment or who feel they need a structured environment to be accountable for changing their behavior might benefit from a stay in one of these facilities.

The length of treatment for behavioral addiction varies depending on the person and the program but could range between a week, a month, or longer. Inpatient and residential treatments typically offer a combination of group therapy, individual therapy, and structured therapeutic activities.

Support Groups

Many communities offer support groups, often at no charge. Informal gatherings of people struggling with a shared issue can be a great way to get support from others with similar experiences. These groups are usually voluntary and peer-led, meaning they might not include trained professionals.

Many people in recovery from addiction find that support groups are a helpful resource when combined with other treatments or as a step-down when completing formal treatment.

How to Get Help for Behavioral Addictions

Going to a trained and experienced provider is crucial in getting help. Call around and find a few options, and don’t be scared to ask questions or for more information that helps you identify the right choice for you.

Those interested in using their insurance should find an in-network treatment provider and inquire whether behavioral addiction treatment would be covered. The best starting place to find an in-network provider is often to go through your insurance company, calling the number on the back of your card, or using their online search tools. You can also use an online therapist directory and filter your search by insurance, specialty, and other preferences.

Those without insurance may need to explore options for sliding-scale therapy. Even if a provider or treatment facility does not advertise a sliding scale or discounted rate for “self-pay” clients, you should ask anyway. There might be some options available to help reduce the financial burden.

Living With a Behavioral Addiction

Having a behavioral addiction is hard. The stigma of addiction makes it difficult to come clean to friends and family, but recovery alone can be even harder. Consider talking to at least a few people in your inner circle about what you are going through and how they can help support you. This will ensure you have a built-in support system to keep you accountable when staying on track is challenging.

Also, remember that recovering from an addiction usually isn’t as simple as stopping the behavior. Be prepared to encounter underlying emotions and stress that might partially drive the addictive behavior.

Activities like exercise, meditation, hobbies, and seeing friends more often can help relieve stress and boost your mood and energy. These activities promote the release of mood-enhancing neurotransmitters that can help you rebalance your brain chemistry, providing a less intense but more lasting (and safe) reward than the one your addiction provided.

Finally, remember that any change begins in the mind as you realize that change is necessary, possible, and worth the effort. Strengthen your mindset by acknowledging these facts and preparing yourself for some difficult days as you work to rebuild a healthier lifestyle. On days when change is particularly challenging, remind yourself why you are making this change. Remembering what matters most to you and how this depends on your recovery can help you get through the hardest days.

Final Thoughts

Struggling with a behavioral addiction is never easy, but help is available for those interested in recovery. Consider locating a therapist to learn more about the underlying causes of your behavior and how to develop healthy coping skills to move forward.