A friend of mine recently observed that I have an addictive personality. While my addictions to things such as caffeine, bargain hunting, and social media are not life threatening, the statement prompted me to wonder why some people have addictive behaviors while others appear to be asymptomatic.
By definition, a person with an addiction uses a substance, or engages in a behavior, for which the rewarding effects provide a compelling incentive to repeat the activity, despite detrimental consequences. Addiction may involve the use of substances such as alcohol, inhalants, opioids, cocaine, and nicotine, or behaviors such as gambling.
While the above definition of addiction excludes a plethora of behaviors, such as impulse shopping, overeating, gaming disorder, and even exercising, they all share a common key neurobiological component that severely involves brain pathways of reward and reinforcement involving the neurotransmitter dopamine. The good news is that these brain changes are reversible after the substance use or behavior is discontinued.
Since addiction affects the brain’s executive functions, centered in the prefrontal cortex, individuals who develop an addiction may not be aware that their behavior is causing problems for themselves and others. Over time, desire for the pleasurable effects of the substance or behavior may dominate an individual’s actions.
Characteristics such as a lack of ability to tolerate stress or other strong feelings have been associated with addiction, but there is no one “addictive personality” type that can clearly predict whether a person will face problems with addiction or not.
When most people think of addictive behaviors, alcoholism is often one of the first to come to mind. Alcohol addiction is a disease that affects people of all walks of life and can unfold in a variety of ways. The severity of the disease, how often someone drinks, and the alcohol they consume varies from person to person. Some people drink heavily all day, while others binge drink and then stay sober for relatively-long periods of time. Regardless of how the addiction looks, someone who relies on drinking and can’t maintain their sobriety is most likely an alcoholic.
Substance abuse and gambling affect the reward, reinforcement, motivation, and memorysystems of the brain. They are generally characterized by impaired control, changes in personality, and cravings that can disrupt everyday activities and relationships. These addictions can be particularly harmful to relationships and can impact job or school performance.
According to Psychology Today, the clinical diagnosis of an addiction is based on the existence of at least two of the following features:
- The substance or activity is used in larger amounts or for a longer period of time than was intended.
- There is a desire to cut down on use or unsuccessful efforts to do so.
- Pursuit of the substance or activity, or recovery from its use, consumes a significant amount of time.
- There is a craving or strong desire to use the substance or engage in the activity.
- Use of the substance or activity disrupts obligations at work, school, or home.
- Use of the substance or activity continues despite the social or interpersonal problems it causes.
- Participation in important social, work, or recreational activities drops or stops.
- Use occurs in situations where it is physically risky.
- Use continues despite knowing it is causing or exacerbating physical or psychological problems.
- Tolerance occurs, indicated either by need for markedly increased amounts of the substance to achieve the desired effect or markedly diminished effect of the same amount of substance.
- Withdrawal occurs, manifest either in the presence of physiological withdrawal symptoms or the taking of a related substance to block them.
There are many options for recovery, including self-guided recovery where an individual can improve physical, psychological, and social interactions on their own. Other recovery tools include community support, and of course, clinical-therapy with the help of a certified professional.
The road to recovery from any addiction can feel like a rollercoaster ride. It is extremely common for someone to relapse. Not just once but multiple times. Thus, it is critical to recognize the desire to change. Should you or a loved-one relapse, don’t think of it as failure. Instead, get back on track and resume treatment as soon as possible.
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