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Normalising the activities of behavioural addictions makes recovery process complicated

Addictive behaviours bring with them the possibility of developing poor health

Non-substance addictions such as shopping, internet use and phone use are not yet considered an official diagnosis due to apparent insufficient evidence, making it complicated for those battling these addictions

Geraldine Walsh
Mon Dec 18 2023 - 05:31

Anything that is capable of creating a stimulus in a person can be addictive. Behavioural science experts believe that when a habit becomes a necessary obligation for a person, then it can be considered an addiction.

While certain addictive behaviours are still not recognised by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), researchers believe that there are similarities, as well as pertinent differences, between the symptoms of drug, substance and behavioural addictions.

Non-substance addictions such as shopping, internet use and phone use are not yet considered an official diagnosis due to apparent insufficient evidence, making it complicated for those battling these addictions. While a substance may not be involved in behavioural addictions, the behaviour can be the same, as the person is addicted to the feeling brought about by the physical action of the behaviour whether it is compulsively shopping or spending money or another kind of addiction.

Most importantly, these similarities allow for better understanding of treatment options as 12-step programmes and diagnostic criteria not only support recovery in terms of the addiction as well as mental wellbeing, but have been adapted from the ideologies of substance addiction.

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“The initial decision to take drugs is voluntary for most people,” says Maurice Quinlan, EAP Institute director and member of the Irish Association of Alcohol and Addiction Counsellors, “but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a “relapsing” disease, meaning people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug.

Substances affect the brain’s “reward circuit”, causing excitement and euphoria as the brain is flooded with dopamine. However, as Quinlan says, when a person continues to use drugs, “the brain adapts by reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug, an effect known as tolerance. They might take more of the drug to try and achieve the same high.”

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These fluctuations in “reward” come with uncertainty, cognitive distortions such as reduced perception and understanding of the problem, and altered thinking making recovery problematic, all of which is evident in those experiencing behavioural addictions.

“The majority of these particular addictive behaviours start out as coping mechanisms, either in dealing with the aftermath of trauma, or simply as a means of coping with life pressures experienced either in adulthood or in childhood and adolescence around social anxiety, not fitting in, or bullying,” says Austin Prior, addiction counsellor. “In other words, people discover that alcohol or a particular substance or behaviour helps them to cope, to feel better about themselves, or to avoid feeling bad about themselves. That, combined with the ‘feel-good’ factor and availability of their chosen substance creates the perfect context in which addiction flourishes.”

Behavioural addictions can be considered passive, such as watching television, or active, for example the need to shop, game or gamble. For an addiction to be diagnosed, however, a person with adverse addictive behaviours must showcase a functional impairment in their lives. Furthermore, the addiction exists for a reason. Behavioural addictions have been noted to occur coinciding with depression and social anxiety, and are likely to overlap with additional types of addiction.

“When we look at ‘modern’ addictions such as phone, internet or shopping, there is a noticeable shift in the balance,” says Prior. “The ease of accessibility and availability have, in a very subtle way, created an almost unconscious dependence, which hasn’t started out as necessarily a coping mechanism, but which very easily becomes a way of dealing with whatever challenges life throws up.”

Addictive behaviours bring with them the possibility of developing poor health because of fatigue due to lack of sleep or poor quality of sleep

However, normalising the activities of behavioural addictions makes the recovery process for an individual complicated as cultural acceptance plays a significant role in validating destructive behaviours, despite researchers affirming that real addictions can exist in the absence of psychoactive drugs.

“It makes it more difficult for people to acknowledge any dependence or difficulty in resisting the compulsion, and yes, the shame of not having the willpower to ‘just stop’,” says Prior. “The availability and easy accessibility and the apparent ‘non-threatening’ aspect of time spent in these activities, combined with the belief that ‘everybody is doing it’, forms a very strong habit and creates an unconscious dependency and irresistible compulsion for some people.

“For most people these activities have become just another aspect of life and aren’t particularly problematic, but it is quite important to raise the question and open some debate on the issue. Overdependence on phone or internet use has the potential to adversely affect people in many different ways. It’s my opinion that these are the areas that are causing most damage at the moment, with really destructive consequences for both the addicted person and their partners or families.”

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Addictive behaviours bring with them the possibility of developing poor health because of fatigue due to lack of sleep or poor quality of sleep. Working lives can suffer because of the ease of access to addictions during working hours and students may find their behaviours complicate their attention and ability to finalise assignments or become sidetracked in their learning, leading to stress with last-minute pressures of deadlines.

“As with any addictive behaviour the important element in early days is really around self-awareness,” says Prior, who suggests that individuals become aware of their own behaviour and notice how much time they spent using their phone, connected to an online world, as well as the time and money spent on shopping.

It is preferable that people are conscious of whether or not their behaviour is having an impact on any aspect of their life, including family time, conduct at work, professional and personal relationships, as well as their quality of sleep, financial situation, or “maybe you notice yourself being a bit irritable,” says Prior, “or making excuses about being tired, not having time to do whatever and absolutely denying should anyone have the nerve to suggest that you might be spending too much time on the phone.”

Treatment for addiction is not straightforward and is dependent on multiple factors including the availability of appropriate levels of care in settings that are supportive for the individual’s needs. “Matching individuals to the appropriate treatment is an essential step in recovery,” says Prior.

Addiction series

Geraldine Walsh

Geraldine Walsh

Geraldine Walsh, a contributor to The Irish Times, writes about health and family

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