Is Everyone An Addict?

With the term “addiction” being used so loosely these days, it seems we all could fit into at least one category of addiction.  There’s sex addiction, love addiction, chocolate addiction, carb addiction, gaming addiction, shopping addiction, Facebook addiction, the list goes on…  So are these “real” addictions or just a reflection of our tendency to think the worst of ourselves and others?  The answer to this lies in how you define the term addiction.

There is no formal diagnosis of addiction in the DSM-IV (the so-called bible for psychological diagnoses).  So the definition of addiction is left up to one’s personal opinion.  I use the term addiction under certain circumstances.  If person continues to engage in a behavior despite it causing significant negative consequences in their life, then it might be an addition.  But it’s also more than that.  I consider a person to have an addiction if they feel compelled to act in a way that is detrimental to them in the long run.  By compelled, I mean that they feel out of control and have difficulty limiting or adjusting the behavior (i.e., a person tries to stop or limit their use of a substance, but just can’t seem to do it).

I also believe that a person can be addicted to activities, not just substances.  Research has shown that similar parts of the brain are stimulated in various types of addictive behaviors.  So whether it’s chocolate, cocaine or sex the same part of the brain is activated when a person is addicted.  But I also think that the term addiction is often used improperly.  Some people use the term addiction and compulsion interchangeably.  But there is a difference between these two.

A compulsion, as in Obsessive Compulsive Disorder, is when an individual engages in a specific behavior in an attempt to mitigate their feelings of anxiety.  A compulsion is a ritual that a person performs that is repetitive and excessive.  It can be an action or a mental activity that the person feels driven to perform.  In order to be a true compulsion as part of OCD, it must take up more than an hour per day and interfere with the person’s ability to function effectively in social, work or other personal activities.  These compulsions can also be detrimental to the person in the long run, similar to an addiction, but in a different way.  For example, an individual’s compulsion to wash their hands repeatedly due to fears of contamination and germs may create problems in the long run when their behavior causes them distress and interferes with their relationships.  They may spend so much time engaging in the behavior that it interferes with them getting other things done at work or home.

So even though both types of behaviors may seem out of control and have negative consequences, they are different.  They are also different in terms of brain activity.   The addictive behaviors stimulate the pleasure centers of the brain and OCD behaviors trigger deeper parts of the brain (the basal ganglia and thalamus, in particular).  In addition, a compulsion differs from an addiction because the individual with an addiction is responding to a craving, whereas a person with a compulsion is responding to obsessive worry.

Being more precise about the terms we use helps to ensure we get the right treatment.  With greater precision we are also casting a smaller net in deciding what behavior is problematic.  To call a tendency to spend a lot of time of Facebook an addiction may minimize the severity and seriousness associated with a true addiction.  Like most things, both compulsions and addictions occur along a continuum.  Some addictive behavior is normal.  And some compulsive behavior is normal.  To determine the severity of an addiction or compulsion often requires looking at the consequences on one’s overall quality of life.

So what do you think?  Does this mean everyone is an addict?  Are you convinced that food addiction, for example, is real?  Post your comments  below.

Tags: addiction, anxiety, brain, compulsion, diagnosis, OCD