Behavioral Addictions

Over the past several years, there has been growing awareness and acknowledgement that various behaviors with obsessive-compulsive tendencies have some of the characteristics of substance addictions, which are known to be complex and chronic medical disorders (such as drug, prescription drug, nicotine and alcohol addictions). These are behaviors that, by definition, can induce addiction even in the absence of a chemical input, by triggering a biological response in the brain, such as stimulating the reward pathway.

In 2013, the first behavioral addiction was officially recognized: gambling. It was classified as gambling disorder (GD) in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Then, in 2018, the World Health Organization (WHO) defined addiction to playing video games as a disorder (gaming disorder).

What addictions to substances and compulsive behaviors have in common are the recurring urges to engage in the activity, cravings, withdrawal symptoms, emotional distress, and more. Nonetheless, there is still debate among researchers and clinicians about the exact definition of behavioral addiction, the criteria for diagnosis, the appropriate screening and monitoring tools, the possible adverse effects, the effects on the brain, and whether or when the behavior should be considered a mental disorder that warrants psychiatric treatment.

For example, shopping is a normal everyday activity that occurs either in person or online. Similarly, exercise is often beneficial and considered a cornerstone of a healthy lifestyle. However, when done to excess, these activities may form addictive patterns. That is, there is scientific evidence that behavioral addictions exhibit similar patterns to substance addictions. While some have yet to be officially recognized in the DSM, certain excessive behavior patterns—including sex, exercise, and shopping—are considered behavioral addictions by many health professionals in the US.

What is shopping addiction?

  There are several signs of shopping addiction:

  • Shopping as a response to emotional distress.
  • Shopping for items that are desired, but not needed.
  • Shopping as a display of financial means and extravagance.
  • Purchasing items that are on sale, just because they are less expensive.
  • Impulsive binge shopping, which leads to a vicious circle of buying and then returning items to the store.
  • Tendency to hoard and the need to complete sets.
  • Attempts to deny, conceal and lie about spending.
  • Feelings of anxiety or guilt over spending, which can trigger further shopping in order to suppress these difficult feelings.
  • Excessive spending that far exceeds one’s financial means, and that comes at the expense of more urgent needs.

 

What is exercise addiction?

  While exercise is generally considered a good habit and part of a healthy lifestyle, with a recommendation for about 30 minutes of physical activity per day, excessive physical activity can be considered an addictive disorder—such as, for example, when a person doubles or triples the recommended amount of activity, and is not willing to skip training even when conditions such as weather or illness make it unfeasible, or when the activity comes at the expense of other significant events. While an exact definition of exercise addiction has yet to be formulated, there are some signs that indicate that a person’s physical activity is either out of control or on its way there:

  • Exercise is extremely important and prominent in a person’s life.
  • Effects mood—that is, exercise is used as a means of reducing stress or depression.
  • Development of tolerance—that is, the need for more activity and additional physical achievements continues to increase over time.
  • Withdrawal symptoms when physical activity decreases.
  • Conflict between exercise and family and other events.
  • Relapse.
  • Subjective feelings of distress about exercise and its impact.

  Exercise addiction can be classified as a primary addiction, in which case the gratification comes from the physical activity itself. It can also, however, be a secondary symptom of another disorder, such as an eating disorder, for example, in which compulsive exercising is sometimes used as a means of losing weight.  

What are the adverse health effects of shopping or exercise addiction?

  Shopping addiction can cause financial deterioration and ruin. It is often associated with other disorders, such as depression and anxiety, and is sometimes associated with other addictions. Excessive exercise can cause severe physical and psychological effects. Overtraining is associated with the risk of injury, exhaustion, depression, and more. Some consider excessive physical activity a health hazard due to excessive production of the hormone cortisol, and overworking the heart.

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