What Are Process Addictions?

Process addictions, also known as behavioral addictions, are one of the most-common forms of addiction, affecting millions of people worldwide. While behavioral addictions have often been seen as less-than or a lower class of addiction than substance addictions, evidence increasingly points to the fact that these addictions are heavily linked and often harmful on many levels. If you or a loved one is suffering from a process addiction, it’s important to understand what behavioral addiction is, how it works, and how it overlaps with the more classically understood substance use disorder (addiction).

How Behavioral Addictions Work

Behavioral addictions are quite simply patterns of behavior in which a person behaves irrationally and compulsively. For this reason, they’re sometimes known as compulsive use disorder or compulsive behavior disorder. Here, individuals become addicted to the process of performing an activity, typically because the brain produces chemicals in the reward circuit (such as dopamine and serotonin). These processes work similarly to substance abuse in that an individual performs an activity, receives a reward through stimulation, and then attempts to recreate that “high” again and again. Eventually, the individual develops problematic and compulsive use, defined by the DSM-5 as:

• Persistent and recurrent problematic behavior resulting in significant impairment or distress over a 12-month period
• The individual needs to perform the activity, typically with increasing intensity, or is restless and irritable
• The individual has made repeated and unsuccessful attempts to stop the activity or cut back
• The individual is frequently preoccupied with the activity
• The individual participates in the activity to deal with negative emotions (self-medication)
• The individual hides the activity or lies about it
• The individual has continued the activity despite it interfering with personal, career, or educational life or responsibilities
• The individual goes to extreme lengths to make time/money/etc. to enable the behavior
• The behavior cannot be explained by manic episodes

In addition, to meet DSM-5 criteria, behavior must be episodic in that it meets criteria over several months, even if symptoms subside between those points. It must also be persistent, meeting diagnostic criteria for at least 12 months. In most cases, behavioral disorders are classified as mild if 4-5 criteria are met, moderate if 6-7 criteria are met, and severe if 8-9 criteria are met.

Most individuals with behavioral addictions share similar personalities and behavioral patterns to individuals with substance use disorders. These include impulse control, sensation seeking, low-harm avoidance, and typically negative factors such as interpersonal conflict, stress, and self-directedness.

Symptoms of Process Addictions

Individuals with process addictions typically show a series of well-defined symptoms:

• The behavior becomes an obsession
• The individual spends most of their time, resources,
  or energy on the behavior, prioritizing friends and family
• If disproval is shown, the individual will typically hide the behavior
• The individual continues the behavior even as
  it causes personal, interpersonal, or relationship harm
• The individual expresses a desire to quit but cannot

In most cases, if someone is frequently repeating a behavior, cannot seem to stop, and is pursuing it to the point of causing problems to themselves and others, they have a problem. While it might not be a full addiction, it may be time to discuss the issue with a therapist to get advice.

Common Process Addictions

Process addictions are thought to be caused by interaction with the reward circuit, meaning that any activity stimulating a reward action in the brain can become an addiction. In most cases, this means that activities stimulating higher levels of reward activity are more-likely to be addictive. Some examples include gambling (thrill/risk-taking), sex, high-fat or high-sugar foods, exercise, etc. Of these, gambling is the most officially recognized by the DSM-5 and was the first officially recognized behavioral addiction.

• Gambling – Gambling addiction is thought to stem from risk/reward and is very common in pleasure-seeking and thrill-seeking individuals. With as many as 1-3% of the American population potentially struggling with gambling behavior, gambling is a persistent and problematic addiction in the United States.
• Porn – Porn addiction is a significant behavioral addiction, affecting the daily life and romantic life of thousands of individuals. Here, individuals typically experience compulsive behavior resulting in an inability to function in social situations or in other activities, resulting in negative health consequences.
• Sex – Sex is a very common addiction and millions of Americans struggle with it. Sex addiction is risky in that individuals are more likely to take risks, expose themselves to STDs, and possibly risk pregnancy.
• Shopping – Most people think of shopping addiction as a joke or gimmick, but many people actually struggle with a behavioral disorder. The result is often hoarding, purchases that are never opened, and compulsive buying at the detriment of social activities, finances, and even necessary life expenses.
• Media Addiction – Media including video games, television, internet, and social media are very much addicting. Individuals suffer compulsory behavioral problems relating to spending too much time on an activity, prioritizing it over other aspects of their life, and often feeling as though they aren’t alive when not participating.
• Smartphone Addiction – This is one of the newer addictions, and society is just beginnings to realize how serious it may become. Compulsive and harmful smartphone use can interfere with social, personal, and other goals. Smartphone Addiction is remarkably similar to any other type of addiction, and so the same types of changes in behavior and thought patterns are necessary to bring about recovery.
• Food – Food addictions can result in eating too much or too little and can result in major health consequences. Individuals are especially prone to food disorders surrounding high-fat and high-sugar or high-salt foods because these foods impact the reward circuit in the brain a great deal. For example, high sugar and high fat foods both trigger a stronger dopamine reaction than something with a lower percentage of either. However, food-related addictions can stem from otherwise healthy activities like clean eating, where individuals become addicted to the behavior of eating “healthy”. Bulimia and anorexia nervosa are also food process addictions.

Process addictions can include nearly any possible behavior. If a person is struggling with a behavior to the detriment of other aspects of their life, they may have a problem.

Overlap Between Behavioral Addiction and Substance Abuse

Process addictions typically heavily overlap with substance abuse and other disorders. In fact, new research shows that both require the same gene expressions, similar behavior patterns, and similar personality. As a result, individuals who are prone to behavioral addictions are also more vulnerable to substance abuse.

Getting Treatment for Process Addictions

Process addictions ranging from gambling disorder to skin-picking disorder are a diagnosable and treatable problem. If you or a loved one is struggling, there is help. Modern treatment including cognitive behavioral therapy approaches addiction from a holistic perspective, treating the most dangerous symptoms first and then working to find and treat root problems. This means treatment works to help individuals solve the problems contributing to addiction, so they can move on and live happily, without relying on a process addiction.

Behavioral addictions aren’t always as serious as substance addictions, but they often cause serious ramifications to health, finances, and happiness. Getting help will help you get your life back.