Updated: Jun 28
Process addiction according to the American Psychiatric Association (2013) is a behavioural addiction. Comparable to substance-related addiction, behavioural addiction is a disorder that affects the neural functioning of the brain's reward system. It is typically characterized by the compulsive, repetitive involvement in a rewarding non-substance-related behaviour, despite consistent adverse consequences (American Addiction Centers 2020). Thus, the individual becomes systemically focused on pursuing reward from engaging in the behaviour and/or achieving relief from distress through the behaviour. The individual will struggle with abstaining from the behaviour, experience an intense desire to engage in the behaviour and have difficulty resisting the urge to engage in the addictive behaviour (American Addiction Centers 2020). Subsequently, the individual will have limited awareness of the problems that have emerged as a result of their behavioural addiction (American Addiction Centers 2020).
However, The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) only classifies gambling, but not other behavioural addictions, as an addictive disorder. This is because there is insufficient evidence at this time to group other behavioural disorders into the same category as substance abuse disorders (American Psychiatric Association, 2018).
Types of process addictions according to the American Addiction Centers (2020)
Sex and Love addiction
Video Game addiction
General Classification of Addiction
For reference, these are some of the general criteria for classifying a Substance Use Disorder:
The individual spends larger amounts of time engaging in the behaviour or over a longer period of time than was originally intended.
The individual expresses a persistent desire to stop or regulate use with unsuccessful attempts.
The individual spends excessive time indulging in the behaviour or recovering from its effects.
Craving: an intense desire or urge, especially in certain contexts (e.g., being in the same environment one typically uses the substance).
The individuals continue to engage in the behaviour despite persistent or recurrent social or interpersonal problems.
Impaired social, occupational, or recreational ability (American Psychiatric Association, 2018).
Video Gaming Addiction
Although it is not yet recognized by the American Medical Association as a diagnosable disorder, video game addiction is a very real problem for many people (American Addiction Centers 2020). Video game addiction is also known as gaming disorder or internet gaming disorder is generally defined as problematic, compulsive use of video games, that results in significant impairment to an individual's ability to function in various life domains over a prolonged period of time (American Addiction Centers 2020).
As with gambling addiction, video game addiction is a clinical impulse control disorder. The criteria for video game addiction are the same as that for addiction to a substance (American Addiction Centers 2020). In both cases, the person requires more of the source as time goes on and becomes irritable and despondent when they cannot access it. In fact, video game addicts can even experience withdrawal symptoms, they may play video games to alter their mood (American Addiction Centers 2020).
While the harm in addictions to substances is apparent in physical symptoms, it is often less clear with video game addiction (American Addiction Centers 2020). However, video game addiction can negatively affect life in the same way a substance addiction can. Those who play for hours each day become withdrawn and isolated, foregoing work, school and other responsibilities to play. Younger addicts often miss out on critical education and important social development, while adults tend to experience deteriorating relationships and problems with their employers (American Addiction Centers 2020).
The physical effects of video game addiction include poor personal hygiene, hormonal disturbances from sleep deprivation, and what the American Physical Therapy Association refers to as video gamer’s thumb, a repetitive use injury characterized by tendonitis and swelling. Many addicted gamers gain weight as a result of their sedentary lifestyles and tendency to reach for high-calorie processed foods and beverages (American Addiction Centers 2020).
Some experts warn that excessive gaming can even be fatal. A tech-addiction expert in Seattle said she has known of people who have died from heart attacks and blood clots, both results of the unhealthy lifestyle many extreme gamers live (American Addiction Centers 2020).
Signs to Watch For
The DSM-5 does include a section to help people and doctors know the warning signs of problem video gaming (American Addiction Centers 2020). These problems can happen whether you play online or offline. Here’s what to look for in yourself or someone close to, according to criteria that were proposed in the DSM-5 individual who is addicted to certain behaviour there have to be five or more of these signs in 1 year to have to be diagnosed with compulsive behaviours like video gaming (American Addiction Centers 2020):
Thinking about gaming all or a lot of the time
Feeling bad when you can’t play
Needing to spend more and more time playing to feel good
Not being able to quit or even play less
Not wanting to do other things that you used to like
Having problems at work, school, or home because of your gaming
Playing despite these problems
Lying to people close to you about how much time you spend playing
Using gaming to ease bad moods and feelings
Gaming to escape difficult life situations
Skipping showers and meals to play
Lying to others to hide gaming activities
Exhibiting signs of irritation when forced to stop gaming
Video gaming addiction is more prevalent in men and boys than girls and women, it should also be noted that not everyone who plays a lot has a problem with gaming (American Addiction Centers 2020). On the contrary, stats show an estimation somewhere between 1% and 9% of all gamers, adults and kids alike (American Addiction Centers 2020).
Emotional Symptoms of Video Game Addiction
Some of the emotional signs or symptoms of video game addiction include (American Addiction Centers 2020):
Feelings of restlessness and/or irritability when unable to play
Preoccupation with thoughts of previous online activity or anticipation of the next online session
Lying to friends or family members regarding the amount of time spent playing
Isolation from others in order to spend more time gaming
Physical Symptoms of Video Game Addiction
Some of the physical signs or symptoms of video game addiction include (American Addiction Centers 2020):
Migraines due to intense concentration or eye strain
Carpal tunnel syndrome caused by the overuse of a controller or computer mouse
Poor personal hygiene
Short-Term and Long-Term Effects of Video Game Addiction
Like any other compulsive disorder, video game addiction can have severe negative consequences (American Addiction Centers 2020). Though most of the symptoms listed above have short-term effects, they can lead to more severe long-term repercussions if not addressed properly. For example, someone addicted to video games will often avoid sleeping or eating proper meals in order to continue gaming (American Addiction Centers 2020). While the short-term effects of this may include hunger and fatigue, it could eventually lead to a sleep disorder or diet-related health issues. Similarly, those who isolate themselves from others in order to play video games may miss out on family events, outings with friends, or other events in the short term. If this continues to be a pattern for a long period of time, however, addicts might find themselves without any friends at all(American Addiction Centers 2020).
Other long-term effects of video game addiction to consider are the financial, academic and occupational consequences involved (American Addiction Centers 2020). Video games and video game equipment can be very expensive, especially when factoring in recurring costs such as the high-speed Internet connection required for online multiplayer games. These games can also be very time-consuming, leaving addicted gamers with less time to focus on their education or career (American Addiction Centers 2020).
Treatment and prevention of video gaming addiction
Treatment for video game addiction is similar to that for other addictions. Counselling and behaviour modification is the primary means of treating addicted gamers (American Addiction Centers 2020). Together, individual and family counselling are powerful treatment tools. Some treatment facilities incorporate medication in their programs (American Addiction Centers 2020).
However, unlike drugs or alcohol, video games are tied to computers, which are a key part of life for most people. In that way, the addiction is similar to food addiction, as result, some treatment centres explore controlled use rather than abstinence (American Addiction Centers 2020). No overall cure for video game addiction exists. As with alcoholism and drug addiction, the key is to enter treatment and to stay aware of triggers while continuing to participate in recovery groups, such as Online Gamers Anonymous (American Addiction Centers 2020).
Shopping addiction also known as shopaholic according to Black DW (2007) relates to individuals who shop compulsively and who may feel like they have no control over their behaviour. Some individuals develop shopping addictions because they essentially get addicted to how their brain feels while shopping. Shopping addiction is a behavioural addiction that involves compulsive buying as a way to feel good and avoid negative feelings, such as anxiety and depression (Black DW 2007). Like other behavioural addictions, shopping addiction can take over as a preoccupation that leads to problems in other areas of your life. As they shop, their brain releases endorphins and dopamine, and over time, these feelings become addictive it is further estimated that 10 to 15 per cent of the population may be predisposed to these feelings. It is important to note that going on a shopping spree once in a while does not mean you are a shopping addict. However, there are several signs and symptoms listed below that shopping addicts display that you may want to look for (Black, D.2007).
According to Shopaholics Anonymous as stated by Black D.W. (2007) in his book "A review of compulsive buying disorder". World Psychiatry. , there are several different types of shopaholics, and they are as follows:
Compulsive shopaholics who shop when they are feeling emotional distress
Trophy shopaholics who are always shopping for the perfect item
Shopaholics who want the image of being a big spender and love flashy items
Bargain seekers who purchase items they don’t need because they are on sale
Bulimic shoppers who get caught in a vicious cycle of buying and returning
Collectors who don’t feel complete unless they have one item in each colour or every piece of a set
How Is Shopping Addiction Like Other Addictions?
There are several characteristics that shopping addiction shares with other addictions (American Addiction Centers 2020). As with other addictions, people who overshop become preoccupied with spending and devote significant time and money to the activity. Actual spending is important to the process of shopping addiction; window shopping does not constitute an addiction, and the addictive pattern is actually driven by the process of spending money (American Addiction Centers 2020).
As with other addictions, shopping addiction is highly ritualized and follows a typically addictive pattern of thoughts about shopping, planning shopping trips, and the shopping act itself, often described as pleasurable, ecstatic even, and as providing relief from negative feelings, Koran, LM, Faber, RJ, Aboujaoude, E, Large, MD, Serpe, RT (2006). Finally, the shopper crashes, with feelings of disappointment, particularly with him/herself (American Addiction Centers 2020).
Compulsive shoppers use shopping as a way of escaping negative feelings, such as depression, anxiety, boredom, and anger, as well as self-critical thoughts Koran et.al (2006). Unfortunately, the escape is short-lived.
Items purchased during a compulsive shopping spree are often simply hoarded unused and compulsive shoppers then begin to plan the next spending spree. Most shop alone, although some shop with others who enjoy their thoughts (Koran et.al 2006). Generally, it will lead to embarrassment to shop with people who don’t share this type of enthusiasm for shopping.
Signs of Shopping Addiction
People who shop compulsively experience shopping differently from people who do not have this problem.
Here are some signs to watch out for (American Addiction Centers 2020):
The act of shopping causes feelings of euphoria or a “high.”
The urge to buy is overwhelming and must be gratified instantly.
Items bought during shopping sprees are often unnecessary.
Shopaholics often go shopping with the intention to buy only a few items and end up buying much more than they intended.
Purchased items may be hidden from family and friends out of guilt.
Shopaholics are often in debt, have maxed out credit cards, and are in generally bad financial straits due to spending beyond their means.
Emotional Symptoms of a Shopping Addiction
Like all addicts, shopping addicts may try to hide their addiction, and if a loved one is addicted to shopping, they may try to hide it from you. If you hide credit card bills, shopping bags or receipts, you may be a shopaholic (American Addiction Centers 2020). In some cases, shopaholics may try to hide their addiction by lying about just one element of it. For instance, a person may admit they went shopping, but they may lie about how much they spent (American Addiction Centers 2020).
Some of the other emotional symptoms you may notice from a shopaholic include the following:
Spending more than they can afford
Shopping as a reaction to feeling angry or depressed
Shopping as a way to feel less guilty about a previous shopping spree
Harming relationships due to spending or shopping too much
Losing control of the shopping behaviour
Physical Symptoms of a Shopping Addiction
Although most addictions have physical symptoms related to them, shopping addictions may not. In most cases, the symptoms you experience due to your shopping addiction will be emotional in nature. The physical evidence of a shopping addiction may include a declining financial situation (American Addiction Centers 2020).
Short-Term and Long-Term Effects of a Shopping Addiction
As stated by Zhang, C, Brook, JS, Leukefeld, CG, Brook, DW (2016) the short-term effects of a shopping addiction may feel positive. In many cases, you may feel happy after completing a shopping trip. However, these feelings are often mixed with anxiety or guilt, and in most cases, the guilt or anxiety may propel you back to the store for even more shopping (Zhang et. al 2016).
The long-term effects of shopping addiction can vary in intensity and scope. Many shopping addicts face financial problems, and they may become overwhelmed with debt (Zhang et. al 2016). In some cases, they may simply max out their credit cards, but in other cases, they may take out a second mortgage on their home or charge purchases to their business credit card (Zhang et. al 2016). If you are addicted to shopping, your personal relationships may also suffer. You may end up getting a divorce or distancing yourself from your parents, children, or other loved ones (Zhang et. al 2016).
Treatment and prevention of shopping addiction
Overcoming any addiction requires learning alternative ways of handling the stress and distress of everyday existence (Lawrence LM, Ciorciari J, Kyrios M 2014). This can be done on your own, but often people benefit from counseling or therapy. In the meantime, there is a lot you can do to reduce the harm of compulsive spending and get the problematic behaviour under control (Lawrence et. al 2014). Getting help in understanding the emotional roots of your shopping addiction, as well as finding ways of overcoming your tendency to use shopping to cope, are important aspects of recovery from this confusing condition (American Addiction Centers 2020). Spenders Anonymous is one form of treatment that individuals can partake in, Spenders Anonymous is a community of women and men sharing their experience, strength and hope as they work toward clarity in their relationship with money (American Addiction Centers 2020).
Your relationships may have suffered as a result of your over-shopping. Psychological support can also help you make amends and restore trust with those who may have been hurt by your behaviour. You may also find that therapy helps you to deepen your relationships by leading you to better understand how to connect with other people in ways that don't revolve around money (Zhang et.al.2016).
While food addiction is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it typically involves binge eating behaviours, cravings, and a lack of control around food (American Psychiatric Association, 2018). Like addictive drugs, highly palatable foods trigger feel-good brain chemicals such as dopamine. Once people experience pleasure associated with increased dopamine transmission in the brain's reward pathway from eating certain foods, they quickly feel the need to eat again (American Addiction Centers 2020). Food addiction is closely associated with eating disorders, including obesity, bulimia, and binge eating disorder.
The reward signals from highly palatable foods may override other signals of fullness and satisfaction. As a result, people keep eating, even when they're not hungry. Compulsive overeating is a type of behavioural addiction meaning that someone can become preoccupied with a behaviour (such as eating, or gambling, or shopping) that triggers intense pleasure (American Addiction Centers 2020). People with food addictions lose control over their eating behaviour and find themselves spending excessive amounts of time involved with food and overeating, or anticipating the emotional effects of compulsive overeating (American Addiction Centers 2020). Consuming food triggers chemicals in the brain, such as dopamine, that act as a reward and give pleasurable sensations to the individual. These chemicals can also act as a release from emotional distress. People who show signs of food addiction may also develop a kind of tolerance to food. They eat more and more, only to find that food satisfies them less and less (American Addiction Centers 2020).
Scientists believe that food addiction may play an important role in obesity. But normal-weight people may also struggle with food addiction. Their bodies may simply be genetically programmed to better handle the extra calories they take in. Or they may increase their physical activity to compensate for overeating (American Addiction Centers 2020).
People who are addicted to food will continue to eat despite negative consequences, such as weight gain or damaged relationships. And like people who are addicted to drugs or gambling, people who are addicted to food will have trouble stopping their behaviour, even if they want to or have tried many times to cut back (American Addiction Centers 2020).
Signs of Food Addiction
Here's a sample of questions that can help determine if you have a food addiction (American Addiction Centers 2020). Do these actions apply to you? Do you:
End up eating more than planned when you start eating certain foods
Keep eating certain foods even if you're no longer hungry
Eat to the point of feeling ill
Worry about not eating certain types of foods or worry about cutting down on certain types of foods
When certain foods aren't available, go out of your way to obtain them
Symptoms of food addiction
Symptoms of food addiction can be physical, emotional, and social (American Addiction Centers 2020). These symptoms include:
● having obsessive food cravings
● being preoccupied with obtaining and consuming food
● continued binge or compulsive eating
● continued attempts to stop overeating, followed by relapses
● loss of control over how much, how often, and where eating occurs
● negative impact on family life, socializing, and finances
● the need to eat food for emotional release
● eating alone to avoid attention
● eating to the point of physical discomfort or pain
After consuming large quantities of food, a person with food addiction may also experience negative feelings, such as (American Addiction Centers 2020) :
Food addiction can also trigger physical responses, including (American Addiction Centers 2020) :
intensive food restriction
Treatment and prevention of food addiction
There are also a growing number of programs that help people who are addicted to food. Some, like Food Addicts in Recovery Anonymous, are based on the 12-step program that has helped many people addicted to alcohol, drugs, or gambling (American addiction centers, n.d). Others, like Food Addicts Anonymous, use the principles of the 12-step program along with strict diets that advise people to abstain from problem ingredients, like sugar, refined flour, and wheat (American addiction centers, n.d).
Treatment for food addiction according to Gearhardt, A. N., Corbin, W. R., & Brownell, K. D (2009) needs to address the emotional, physical, and psychological needs of the individual. Treatment will focus on breaking the destructive habit of chronic overeating. The goal is to replace dysfunctional eating habits with healthy ones and to address problems, such as depression or anxiety (Gearhardt et.al, 2009).
Treatments that have been found to be effective include (Gearhardt et.al, 2009):
Cognitive behavioral therapy (CBT) aims to identify and change thought patterns and create new coping mechanisms for food addiction triggers. CBT can be done individually or in a group with others (Gearhardt et.al, 2009).
Medication may be used to relieve symptoms of depression or anxiety (Gearhardt et.al, 2009).
Solution-focused therapy focuses on finding solutions for specific issues in a person's life that cause stress and overeating (Gearhardt et.al, 2009).
Trauma therapy aims to deal with the trauma that may be associated with or may trigger a food addiction (Gearhardt et.al, 2009).
Nutritional counseling and dietary planning can help a person develop a healthy approach to food choices and meal planning (Gearhardt et.al, 2009).
There are also several lifestyle changes that may help a person manage a food addiction, including (Gearhardt et.al, 2009) :
replacing processed foods and sweeteners with nourishing alternatives
allowing time for a food craving to subside, which can be 2-5 days or longer
eating three balanced meals a day
drinking plenty of water
sitting at a table while eating, focusing on the food, and chewing slowly
preparing and sticking to a grocery list of healthful foods when shopping
cooking meals at home
getting enough sleep
reducing workplace and social stress
American Addiction Centers. (2020 January 23). Behavioural Addictions. Retrieved from. https://americanaddictioncenters.org/behavioral-addictions
American Psychiatry Association. (2013). Diagnostic and Statistical Manual of Mental disorders: DSM-5. 5TH ed., American Psychiatry Association
American Psychiatry Association. (2018). Diagnostic and Statistical Manual of Mental disorders: DSM-5. 5TH ed., American Psychiatry Association
Black, D. (2007). A Review of Compulsive Buying Disorder. World Psychiatry 6.1
Black DW. (2007) Compulsive buying disorder: a review of the evidence. CNS Spectra.12 (2):124-32
Food addiction treatment signs and causes. (n.d)
Gearhardt, A. N., Corbin, W. R., & Brownell, K. D. (2009). Yale Food Addiction Scale
Hebebrand, J., Albayrak, Ö., Adan, R., Antel, J., Dieguez, C., de Jong, J., … Dickson, S. L. (2014, November). "Eating addiction", rather than "food addiction", better captures addictive-like eating behaviour. Neuroscience & Biobehavioral Reviews, 47, 295-306
Koran, LM, Faber, RJ, Aboujaoude, E, Large, MD, Serpe, RT.(2006). Estimated prevalence of compulsive buying behaviour in the United States. Am J Psychiatry. 163(10)
Lawrence LM, Ciorciari J, Kyrios M.(2014). Relationships that compulsive buying has with addiction, obsessive-compulsiveness, hoarding, and depression. Compr Psychiatry; 55(5):1137-45.
Zhang, C, Brook, JS, Leukefeld, CG, Brook, DW. (2016).Associations between compulsive buying and substance dependence/abuse, major depressive episode, and generalized anxiety disorder among men and women. J Addict Dis; 35(4):298-304.