Addiction is one of the more complex mental health conditions that psychiatrists and psychologists deal with. Despite past notions that addiction was a personal failing, it is now classified as a disease that affects the brain. The American Psychological Association defines addiction as “ a chronic disorder with biological, psychological, social, and environmental factors influencing its development and maintenance”. Simply stated, there is a lot more to addiction than meets the eye.
What is Addiction?
When people hear the term “addiction” many people automatically assume an addiction to drugs or alcohol. While drugs and alcohol represent a specific type of addiction known as substance use disorder or chemical addiction, they are not the only kind of addiction. In fact, mental health experts acknowledge two different types of addictions: chemical and behavioral.
Chemical addictions are those that involve the use of substances, for example drugs and alcohol. There are many different types of chemical addictions, including:
- Cocaine, methamphetamine, and other stimulants
- Inhalants (paint thinner/glue)
- Opioid painkillers (codeine, oxycodone, heroin)
- PCP, LSD, and other hallucinogens
- Sedatives, hypnotics, and anxiolytics
Behavioral addictions are those that involve compulsive behaviors that are persistent, repetitive and often have little or no benefit. Unfortunately, almost any behavior has the potential to become addictive if the high from the behavior outweighs any negative consequences. However, here are some common behavioral addictions:
- Gambling addiction
- Sex addiction (hypersexual behavior disorder)
- Internet addiction
- Shopping addiction
- Video game addiction
- Plastic surgery addiction
- Food addiction
- Risky behavior addiction (adrenaline junkies)
It is important to note that currently only gambling addiction and internet gaming disorder are currently recognized by the DSM-5 as behavioral addictions. This is primarily due to the fact that it is hard to define the point at which behaviors become addictions and what behaviors are considered addictive.
How Addiction Works
When it comes to addiction one of the main risk factors is genetics. This is because genetics help to determine the amount of reward the body experiences when using certain substances or participating in certain behaviors. Additionally, genetics also determines how your body processes different addictive substances, like drugs and alcohol. Psychological factors like stress or trauma, environmental factors like accessibility, and social factors like family or friend participation can also lead to chronic use or exposure.
Overtime, addiction can actually lead to changes in the brain, specifically in the prefrontal cortex and limbic system. This ultimately affects the parts of the brain responsible for reward, motivation, memory, impulse control, and judgement. Without getting too technical, here is a basic explanation of how addiction develops:
- Addiction begins when the reward center in the brain releases dopamine while doing something pleasurable. Dopamine reinforces the link between activity and reward in your brain, which will make you seek it out in the future.
- When your body wants to feel pleasure again, a craving for the substance or behavior will develop. This is especially true in cases where there are recognizable triggers for the substance or behavior. For example, a bar during happy hour can be a cue for someone who struggles with drinking too much alcohol.
- When an individual continues to consume a substance or participate in a specific behavior, the brain continues to produce large amounts of dopamine until there is more than enough. At this point, the brain will decrease dopamine production in response to triggers. However, since the reward system in the brain is now accustomed to functioning on excess dopamine, it requires the individual to consume more of the substance or take the behavior further to obtain the same effects. This is known as tolerance.
- Since your brain also produces less dopamine in response to natural triggers not associated with the substance or behavior of the addiction, this often results in a lack of interest in the things that were once pleasurable. This also makes it difficult to stop the substance use or behaviors since it can feel like there is nothing else to feel good about.
- At some point, addiction often causes a loss of control due to the fact that the source of addiction becomes the primary source of motivation. This can cause job loss, health issues, relationship problems, and various other problems.
Overall, addiction is a complicated disease that changes the brain over time and causes fixation on a particular substance and/or activity. Because of this, it can be hard for a person with an addiction to notice they have an addiction and even harder for them to overcome their addiction. However, it is possible to recover from chemical and behavioral addictions with the right type of supportive assistance. If you or someone you care about is dealing with addiction, then seeing a licensed mental health professional can be the first step towards recovery.
Dr. Miller is trained in Adult, Child and Adolescent Psychiatry. She is also trained in Anesthesia and Pain Management. Because of her broad experience, Dr. Miller is uniquely qualified to treat psychological trauma, depression and anxiety that can occur as a result of injury or disability. For more information, schedule a consultation at NJ Family Psychiatry & Therapy.