15 Behavioral Addictions: Definition, Types Causes, Effects, and Treatment

The 15 common behavioral addictions include porn addiction, sex addiction, shopping addiction, binge eating/food addiction, gambling addiction, internet addiction, tattoo addiction, video game addiction, love addiction, work addiction, exercise addiction, plastic surgery addiction, fantasy addiction, risky behavior addiction, and self-harm addiction.

Behavioral addiction involves compulsive, non-logical engagement in normal actions. Individuals with behavioral addictions cannot cease these actions, hiding and lying about them, resulting in long-term consequences such as social withdrawal, depression, and medical conditions. Behavioral addictions share common origins, including childhood trauma, life stressors, family history, substance abuse, and psychological disorders. Psychotherapeutic measures effectively treat these behavioral addictions.

According to Alimoradi, Z.’s 2022 study, ‘Estimation of Behavioral Addiction Prevalence During COVID-19 Pandemic: A Systematic Review and Meta-analysis.’, the overall prevalence of behavioral addiction was 11.1%. Breaking down specific addiction types, smartphone addiction showed the highest prevalence at 30.7%, followed by food addiction at 21%, and social media addiction at 15.1%. Internet addiction affected 10.6% of participants, while sex addiction was observed in 9.4% of cases. Exercise addiction, gambling addiction, and shopping addiction showed similar rates at 7%, 7.2%, and 7.2% respectively, with gaming addiction showing the lowest prevalence at 5.3%.

Signs and symptoms of behavioral addiction include a persistent urge to repeat actions despite negative consequences, characterized by intense desire and preoccupation with the behavior. Individuals neglect responsibilities and continue the behavior despite adverse outcomes, leading to financial, legal, or relational issues. Withdrawal symptoms like irritability and anxiety can occur when unable to engage in the behavior, indicating a loss of control. Excessive time and resources are spent on the activity, which is used as an unhealthy coping mechanism for stress or negative emotions, sometimes involving risky behaviors.

The causes of behavioral addiction are complex and multifaceted, with various factors contributing to its development. These include addictiveness, stress and self-esteem, and social anxiety. Overusing addictive behaviors results in many health and personal relationship problems similar to those seen in substance addictions.

The effects of behavioral addiction include short-term impacts like heightened anxiety and disrupted sleep, leading to emotional instability. Long-term effects involve poor mental health, increased depression, and social isolation as individuals withdraw from relationships. Prolonged engagement can also alter brain structure, impairing decision-making and impulse control, ultimately resulting in a significant decline in overall well-being. 

The treatment options for behavioral addiction include cognitive-behavioral therapy, contingency management, and medication-assisted treatment. These approaches aim to help individuals understand the underlying causes of their addiction, develop coping skills, and learn healthier ways to manage stress and negative emotions. It is crucial to seek help as soon as possible, as addiction is treatable.

What is a Behavioral Addiction?

Behavioral addictions are repetitive impulsive behaviors that occur despite negative effects on the individual and their relatives. Behavioral addictions are accompanied by feelings of tension or arousal before committing the act, and pleasure, gratification, or relief at the time of committing the act.

Behavioral addictions share many similarities with substance use disorders, such as onset in adolescence and young adulthood, higher rates in these age groups than among older adults, and the ego-syntonic nature of the behaviors. Both behavioral and substance addictions have phenomenological similarities, such as an urge or craving state prior to initiating the behavior, and decreasing anxiety and resulting in a positive mood state or “high” similar to substance intoxication.

According to Villella, C.’s 2011 study, ‘Behavioural addictions in adolescents and young adults: results from a prevalence study’, many teens and young adults have behavioral addictions, which means they can’t control certain behaviors. These include:

• Pathological Gambling (PG): 7.0% of teens gamble too much.
• Compulsive Buying (CB): 11.3% can’t stop shopping.
• Internet Addiction (IA): 1.2% use the internet excessively.
• Work Addiction (WA): 7.6% work too much.
• Exercise Addiction (EA): 8.5% exercise too much.

The study showed that these behaviors are connected, meaning if someone has one addiction, they are likely to have others too.

What are the 15 Common types of behavioral addictions?

The 15 common types of behavioral addictions are porn addiction, sex addiction, shopping addiction, binge eating/food addiction, gambling addiction, internet addiction, tattoo addiction, video game addiction, love addiction, work addiction, exercise addiction, plastic surgery addiction, fantasy addiction, risky behavior addiction, self-harm addiction.

Here are the 15 common types of behavioral addictions in detail:

1. Porn Addiction

Porn addiction is a compulsive behavior characterized by excessive consumption of pornography that leads to negative impacts on mental, physical, and social health, often resulting in emotional distress and interference with daily life. Hormone imbalance, substance addiction, relationship difficulties, stress escape, and medical conditions like epilepsy and dementia cause porn addiction. 

According to a study published in the Journal of Clinical Medicine, porn addicts exhibit cravings, constant masturbation, risky behaviors, unsatisfactory sex life, and anxiety. Long-term consequences include social withdrawal, body weakness, and depression.

The development of internet pornography addiction is influenced by various psychological factors, including anxiety, depression, and low self-esteem. Exposure to pornography at an early age or using it as a coping mechanism for stress also contributes to developing this addiction. Additionally, elevated dopamine levels, changes in brain chemistry, underlying mental health conditions, lack of sexual satisfaction, and the desire to escape from stress and other issues further exacerbate the problem.

Porn addiction leads to impaired control, impairment, and risky use, affecting relationships, work, and financial well-being. According to de Alarcón, Rubén et al.’s 2019 systematic review, “Online Porn Addiction: What We Know and What We Don’t”, the triple-A factors of accessibility, affordability, and anonymity contribute to the risk of developing an addiction to online pornography use. The review notes that hypersexual disorder, which involves problematic use of online pornography (POPU), is a complex entity with adverse effects on sexual development and sexual functioning, especially among the young population.

Treatment options for pornography addiction include seeking help from a qualified therapist or counselor. Evidence-based therapies, such as cognitive-behavioral therapy (CBT) and schema therapy, effectively address underlying issues and help change maladaptive behaviors. Other options include support groups, self-help resources, and mindfulness practices, which provide additional tools for managing urges and developing healthier habits. It’s important to find a personalized approach that works best for the individual.According to Todd Love, Christian Laier, Matthias Brand, Linda Hatch, and Raju Hajela’s 2015 review on “Neuroscience of Internet Pornography Addiction: A Review and Update,” internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction, highlighting the need for comprehensive treatment approaches.

2. Sex addiction

Sex addiction refers to excessive sexual thoughts, desires, urges, or behaviors that cannot be controlled and cause distress and harm to one’s relationships, finances, and other aspects of life. Sexual addiction is also known as hypersexuality, compulsive sexual behavior, and other names.

According to Dickenson, J. A. et al.’s 2018 study “Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United States”, 8.6% (7.0% of Women and 10.3% of men) of the nationally representative sample endorsed clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behaviors.

Sex addiction manifests in various ways, including obsessive thinking about sex, spending excessive time planning and engaging in sexual activities, frequent use of pornography or engaging in other forms of sexual activity, and difficulty controlling sexual urges and behaviors.

The causes of sex addiction include genetic predisposition, brain chemistry imbalances, trauma or abuse, environmental factors, such as exposure to explicit content or peer pressure, and sociocultural factors, such as societal expectations around sexuality and relationships.

Symptoms of Sex Addiction include obsessive sexual thoughts and urges, frequent sexually transmitted diseases (STDs), feeling intense shame or guilt after sex, inability to stop sexual behavior, and engaging in paraphilia (Abnormal Sexual Behavior).Treatment for sex addiction typically involves a combination of therapies, including cognitive-behavioral therapy (CBT), psychodynamic therapy, support groups, such as Sex Addicts Anonymous (SAA,) and medications, such as antidepressants or anti-anxiety drugs.

3. Shopping addiction

Shopping addiction, also known as compulsive buying disorder, is a behavioral addiction characterized by an excessive and uncontrollable urge to buy things, leading to financial problems, debt, and emotional distress. According to Koran, L. M.’s 2006 study, ‘Estimated prevalence of compulsive buying behavior in the United States.’, the estimated point prevalence of compulsive buying among respondents was 5.8% (by gender: 6.0% for women, 5.5% for men). The gender-adjusted prevalence rate was 5.8%.

Signs of Shopping Addiction include frequent and excessive shopping, accompanied by feelings of guilt or shame; difficulty controlling spending habits, leading to financial problems and debt; hoarding or accumulating large quantities of items, without a practical use; feeling anxious or irritable when unable to shop or buy something, neglecting responsibilities, relationships, or work due to excessive shopping.

Loneliness and stress lead individuals to use shopping as a coping mechanism, contributing to the development of shopping addiction. Furthermore, marketing and advertising trigger impulsive buying, while certain personality traits, such as impulsivity and sensation-seeking increase the risk of developing this addiction.

Financial literacy is negatively associated with Problematic Internet Shopping, suggesting that individuals with lower financial literacy are more likely to engage in Problematic Internet Shopping according to Lam, Lawrence T. et al.’s 2017 study “The association between financial literacy and Problematic Internet Shopping in a multinational sample”.

Online shopping addiction treatment involves addressing the underlying causes of excessive online shopping and developing strategies to manage triggers and emotions.

4. Food Addiction

Food addiction is the inability to resist eating due to the brain’s chemical reactions that create pleasure and satisfaction, despite negative consequences. Individuals with food addiction experience physiological changes, emotional responses, and compulsive eating behaviors similar to those experienced by individuals with substance use disorders.

According to Yi Zhang et al.’s 2011 study “Food Addiction and Neuroimaging”, obesity has become a serious epidemic and one of the leading global health problems. The food addiction model suggests that food is not eaten as much for survival as pleasure and that hedonic overeating is relevant to both substance-related disorders and eating disorders. Accumulating evidence has shown that there are a number of shared neural and hormonal pathways as well as distinct differences in these pathways. This helps researchers discover why certain individuals continue to overeat despite health and other consequences and become more and more obese.

Symptoms of food addiction include craving for specific foods, loss of control over food intake, weight gain or health problems, increased tolerance to addictive foods over time, feeling anxious or depressed when unable to access the addictive foods, and spending a significant amount of time thinking about food or planning meals.

The symptoms, cravings, and causes of “eating addiction” are remarkably similar to those experienced by drug addicts, and both drug-seeking behavior and eating addiction share the same neural pathways. However, while the drug addiction process has been highly characterized, eating addiction is a nascent field.

According to a study by Fauconnier, M., et al. (2020). Food Addiction among Female Patients Seeking Treatment for an Eating Disorder: Prevalence and Associated Factors published in the Journal of the Academy of Nutrition and Dietetics, adult women with eating disorders seeking treatment at an eating disorder center, it was discovered that 83.6% of the participants met the criteria for food addiction. This finding was based on the Yale Food Addiction Scale, which measures the level of addiction to food.

Individuals with Major Depressive Disorder (MDD) are more likely to meet the criteria for food addiction and are at an increased risk of weight gain and chronic disease as per the study done by Mills, Jessica G., et al.’s 2020 study “Overeating and food addiction in Major Depressive Disorder: Links to peripheral dopamine”.

Treatment for food addiction includes nutritional guidance and education to help individuals develop healthy eating habits and identify trigger foods and cognitive-behavioral therapy to help individuals recognize and change negative thought patterns and behaviors associated with food addiction. Other treatments are:

• Support groups, such as food addiction support groups or online forums, provide a sense of community and support for individuals struggling with food addiction.
• Medications, such as antidepressants or anti-anxiety medications, help manage symptoms of depression or anxiety that are related to food addiction.

5. Gambling Addiction

Gambling addiction is an uncontrollable urge to engage in gambling activities despite the negative consequences it brings to one’s life. The DSM-5 includes gambling disorder as a behavioral addiction within the category of Substance-Related and Addictive Disorders. The DSM-5 describes behavioral addiction as characterized by cravings, strong urges, and disruptions in one’s functioning related to a particular behavior.

Gambling addiction in the USA is a growing public health concern, with rates of problem gambling having almost doubled in the last decade, affecting around 7-11% of the emerging adult population. About 61% of New Jersey residents gambled in the past year, down from 70% in the prior survey, likely due to COVID-19 and the proportion of individuals gambling exclusively online nearly tripled to 15%, while land-based-only gambling dropped significantly to 49% which highlights the accessibility and ease for individuals to gamble online according to the Rutgers center for gambling studies 2023 report titled “The Prevalence of Online and Land-Based Gambling in New Jersey.”

According to Gloria Wong et al.’s 2013 study, men tend to have higher levels of gambling involvement and problems compared to women, with men taking more risks and having lower levels of impulsive coping than women. In New Jersey, Men (66.3%) were more likely to gamble than women (56.4%), with a significant increase in online-only and mixed-venue gambling for both genders according to The Rutgers Center for Gambling Studies 2023.

The signs and symptoms of compulsive gambling include feeling the need to keep gambling to recoup losses or chase big wins, anxiety, lying to friends about winnings, guilt, shame, etc. Other symptoms are:

• Hiding one’s gambling behavior from others and potentially committing fraud or theft to finance their habit.
• Feeling the need to escape reality or cope with stress through gambling.

According to the National Research Council (1999), gambling addiction in the United States is a complex and multifaceted phenomenon. The etiology of pathological and problem gambling is uncertain, but likely, risk factors such as genetics, personality traits, environmental factors, and life experiences contribute to an individual’s propensity for gambling addiction.

The effects of gambling addiction are debt, financial difficulties, legal problems, depression, and physical problems like sleep disturbances and mood disorders.Gambling addiction treatment includes counseling, support groups, medication, Cognitive Behavioral Therapy (CBT), and lifestyle changes such as stress management, sleep hygiene, and fostering healthy relationships. Gamblers Anonymous, an international fellowship, has been effective for many who struggle with compulsive gambling.

6. Internet Addiction

Excessive internet use is referred to as internet addiction. This behavior is driven by the brain’s ‘dopamine reward system, which leads to addiction. Factors such as high-stress levels, psychological disorders, genetics, loneliness, and environmental factors contribute to the development of internet addiction.

According to Cash, H. et al.’s 2012 article “Internet Addiction: A Brief Summary of Research and Practice,” surveys conducted in the United States and Europe reveal prevalence rates ranging from 1.5% to 8.2% for IAD.

Symptoms of internet addiction include headaches, insomnia, poor nutrition, decreased interest in leisure activities, using the internet during social gatherings, anxiety, isolation, and feelings of guilt.Treatment for excessive internet use starts with Cognitive behavioral therapy (CBT) which focuses on identifying and modifying negative thought patterns and behaviors associated with excessive internet use. According to Winkler, Alexander et al.’s (2013) meta-analysis, a review of 16 studies found that both psychological and pharmacological interventions demonstrated significant improvements in internet addiction symptoms, time spent online, depression, and anxiety from pre-treatment to post-treatment. The American Society of Addiction Medicine (ASAM) recommends a multi-faceted approach to address internet addiction, including individual therapy, family therapy, and support groups.

7. Tattoo Addiction

Tattoo addiction involves a strong psychological attachment to obtaining tattoos, creating a cycle of dependency and compulsive behavior. Tattoo addiction lacks formal recognition as a disorder but poses a growing concern. Excessive spending, a significant time commitment, and a body adorned with ink are all consequences of a compulsive need for tattoos. According to Möazen et al.’s 2018 study, “Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates,” tattooing is a common risk behavior among prisoners, with a prevalence rate of 11.3% in Latin America and the Caribbean, 17.3% in Eastern Europe and Central Asia, and 20.2% in Asia Pacific.

Tattoo addiction is also associated with substance use disorders. Alcohol, marijuana, antidepressants, and sedatives are significant correlates of having tattoos among adolescent detainees. According to Ronald Braithwaite et al.’s 2001 study “Tattooing and body piercing among adolescent detainees: Relationship to alcohol and other drug use”, 29% of the sample had at least one tattoo, and more than half (69%) had at least one body piercing.According to Statista’s 2019 report from 2018, roughly 46% of Americans have at least one tattoo. 30% of those with tattoos have 2-3, and 19% have 4-5. Tattoo addiction poses dangers, including increased risk of infection, skin allergies, scarring, blood-borne diseases, and cancer. Severe issues arise from ink, such as blindness from eye tattoos. Specific treatment approaches like Cognitive behavioral therapy and counseling are effective in addressing tattoo addiction due to its behavioral nature.

8. Video Game Addiction

According to Mohammad, S.’s 2023 study, ‘Symptoms, Mechanisms, and Treatments of Video Game Addiction’, video game addiction is defined as the steady and repetitive use of the Internet to play games frequently with different gamers, potentially leading to negative consequences in many aspects of life. This addiction has become a serious public health issue with increased prevalence, with many studies showing that it leads to changes in the brain that are similar to those that occur in substance addiction and gambling.

According to Mohammadi, B.’s 2020 study, ‘Structural brain changes in young males addicted to video-gaming.’, males addicted to violent video games (playing on average 4.7 hours daily) found widespread regions of decreased gray matter.

Symptoms of video game addiction include the inability to stop or limit gaming despite negative consequences and the prioritization of gaming over daily activities and interests.

The causes of video game addiction include constant pursuit of the enjoyable aspects of gaming, difficulty controlling urges to play, using gaming as an escape from emotional distress, and preference for immediate rewards offered by games.

The consequences of video game addiction include difficulty sleeping due to excessive gaming, increased absenteeism and declining academic performance, fatigue, restlessness, and hunger. Other physical symptoms associated with excessive gaming include anger and irritability, neglect of hobbies and hygiene, and isolation from friends and family.

Treatment options for video game addiction include cognitive behavioral therapy (CBT), self-help groups, addressing underlying thoughts and behaviors, and PIPATIC: A structured program focusing on self-control and motivation.

9. Love Addiction

Love addiction, also known as pathological love, is a term used to describe a pattern of unhealthy behaviors characterized by an excessive focus on romantic partners. It leads to a lack of control, neglecting other aspects of life, and experiencing negative consequences.

According to a 2019 paper published in the European Journal of Psychiatry by Sanches and John, love addiction is estimated to affect 3-10% of the general population, but that number is higher in certain groups.

The concept of “love addiction” is debated, with some arguing it shares similarities to substance addictions due to its brain chemistry and behaviors, but unlike substance addictions, most people desire to experience love. A study by Helen E. Fisher et al. published in the Journal of Neurophysiology in 2010 used fMRI (functional MRI) to examine brain activity in people who had recently been rejected by a romantic partner. The study found that rejection-activated areas of the brain are associated with reward, motivation, addiction, and emotion regulation. This suggests that the brain responds to romantic rejection similarly that it responds to withdrawal from drugs.According to a study by Earp et al. in Philosophy, Psychiatry & Psychology, symptoms of love addiction include intense emotions, preoccupation with the loved one, and negative emotions when separated. Psychotherapy is the primary treatment for love addiction.

10. Work addiction

Work addiction, also known as workaholism, is an uncontrollable compulsion to work excessively, neglecting personal needs and responsibilities. Workaholism stems from a deep-seated need for validation, control, or a desire to avoid other aspects of life.

According to Andersen, F. B.’s 2023 study, ‘The prevalence of workaholism: a systematic review and meta-analysis.’, approximately 1 in 7 workers (14.1%) experience workaholism after adjusting for publication bias, with initial pooled estimates showing 15.2%. The comprehensive analysis included 53 studies spanning 23 countries, with data from 71,625 participants, of which 10 studies were nationally representative.

Work addiction is caused by various factors, including underlying mental health conditions like obsessive-compulsive disorder (OCD) and bipolar disorder. It also stems from an individual’s personality traits, such as a high need for achievement or a strong work ethic. Furthermore, workplace culture contributes to work addiction by promoting excessive work hours and a competitive environment. Additionally, environmental factors, such as a lack of personal support or stressful life events, increase the risk of developing work addiction.

Work addiction symptoms include excessive and compulsive work, neglecting personal and social life, and experiencing feelings of guilt or anxiety when not working.

Work addiction treatment options include addressing the individual’s interaction with their environment and building self-efficacy.Effective treatments for work addiction focus on the individual’s interaction with their environment and building self-efficacy.According to Peele, S. (1990), in the article “What works in addiction treatment and what doesn’t: is the best therapy no therapy?”, Therapies emphasizing coping skills, community support, and prosocial values demonstrate higher success rates than therapies focusing solely on the disease model. This complex issue requires a multifaceted treatment approach, considering individual mental health, personality traits, workplace culture, and environmental factors. Effective treatment addresses compulsive work behavior, builds a supportive environment, and develops coping strategies.

11. Exercise addiction

Exercise addiction, also known as compulsive exercise, is a controversial term that describes an unhealthy obsession with exercise, bodily movement, and/or physical fitness. This excessive focus on exercise results in negative consequences and disrupts one’s daily life. Despite the lack of official diagnostic criteria, exercise addiction shares similarities with substance use disorder and other behavioral addictions.

Exercise addiction is not a formally recognized symptom of Obsessive-Compulsive Disorder (OCD), but it shares similar characteristics. OCD involves recurring, intrusive thoughts and compulsive behaviors, whereas an excessive focus on exercise characterizes exercise addiction. However, individuals with OCD experience compulsive behaviors, such as exercising excessively, as a way to cope with their mental health.

Exercise addiction symptoms are characterized by exaggerated exercise volumes, lack of control, withdrawal symptoms, and conflicts with family and friends, which lead to health problems and social isolation. In a study by Lichtenstein, M. B., Melin, A. K., Szabo, A., & Holm, L. (2021). The Prevalence of Exercise Addiction Symptoms in a Sample of National Level Elite Athletes, 7.6% were at risk of exercise addiction, with this group being younger, more likely to exercise despite pain and injury, and reporting substantial eating disorder symptoms. The prevalence of exercise addiction symptoms varies widely depending on the type of sport and assessment tool used, with rates ranging from 3 to 42%.

Exercise addiction symptoms are also accompanied by depressive symptoms, with a higher prevalence of MDD in individuals with exercise addiction compared to the general population. According to Tschopp et al.’s 2023 study, 16 out of 31 participants who were at risk of exercise addiction suffered from major depressive disorder (MDD). The onset of MDD occurred in 10 participants after excessive exercising and in 5 before excessive exercising.

Treatments for exercise addiction include cognitive-behavioral therapy (CBT) to reframe negative thought patterns and behaviors, mindfulness-based stress reduction techniques to manage stress and anxiety, physical therapy to address any physical issues or injuries, and support groups or online resources to connect with others struggling with exercise addiction.

12. Plastic Surgery Addiction

Plastic surgery addiction is a compulsive behavior where individuals repeatedly seek cosmetic procedures to “fix” perceived flaws, resulting in negative consequences for their mental, physical, and social health. This addiction is linked to Body Dysmorphic Disorder (BDD), where individuals obsess over minor or imagined defects in their appearance, leading them to undergo multiple surgeries in pursuit of an unattainable ideal. Unlike other forms of addiction, plastic surgery addiction is driven by a distorted self-image and a relentless desire for perfection.

The psychological factors contributing to plastic surgery addiction include low self-esteem, anxiety, depression, and a strong desire for social acceptance or validation. Triggers for plastic surgery addiction include exposure to unrealistic beauty standards in the media, past trauma or bullying related to appearance, and underlying mental health conditions. The compulsive nature of this addiction leads to frequent surgical procedures, each of which temporarily relieves the individual’s distress but ultimately fails to address the underlying psychological issues.

Long-term consequences of plastic surgery addiction include physical complications from multiple surgeries, increased risk of surgical errors, financial strain, and worsening mental health conditions such as anxiety and depression. According to a study published in the Journal of Aesthetic Surgery, individuals with plastic surgery addiction experience worsening body image over time, as each procedure fails to deliver the expected emotional relief, leading to a cycle of dissatisfaction and further surgeries. Treatment for plastic surgery addiction typically involves cognitive-behavioral therapy (CBT) and other forms of psychotherapy to address the underlying BDD and help individuals develop a healthier self-image.

13. Fantasy Addiction

Fantasy addiction is a compulsive behavior where individuals excessively escape into imaginary worlds, leading to significant disruptions in their daily lives, relationships, and mental health. This addiction typically manifests in the form of obsessive daydreaming or immersion in fictional stories, games, or scenarios, which provide temporary relief from real-life stressors or emotional pain. Unlike other addictions, fantasy addiction is driven by a desire to avoid reality and the challenges it presents.

The psychological factors contributing to fantasy addiction include feelings of inadequacy, low self-esteem, anxiety, and a need for control in an otherwise uncontrollable environment. Triggers for fantasy addiction include trauma, loneliness, or dissatisfaction with one’s real-life circumstances, leading individuals to retreat into their imagined worlds where they feel safe and empowered. This addiction leads to neglect of personal responsibilities, social isolation, and a gradual detachment from reality.

Long-term consequences of fantasy addiction include impaired social functioning, strained relationships, and a worsening ability to cope with real-world challenges. Over time, the individual finds it increasingly difficult to distinguish between fantasy and reality, leading to further emotional and psychological distress. According to research published in the Journal of Behavioral Addictions, individuals with fantasy addiction experience heightened feelings of depression and anxiety as their reliance on escapism deepens. Treatment typically involves cognitive-behavioral therapy (CBT) and other therapeutic approaches aimed at helping individuals reconnect with reality, develop healthier coping mechanisms, and address the underlying psychological issues fueling their addiction.

14. Risky Behavior Addiction

Risky behavior addiction is a compulsive need to engage in activities that involve a significant degree of danger or uncertainty, leading to severe physical, emotional, and social consequences. This addiction manifests in behaviors such as reckless driving, extreme sports, gambling, or unprotected sexual activity, driven by the thrill and adrenaline rush these activities provide. Unlike other addictions, risky behavior addiction is fueled by a need for excitement and an escape from boredom or emotional discomfort.

Psychological factors contributing to risky behavior addiction include high impulsivity, sensation-seeking, and a tendency to disregard potential negative outcomes. Triggers for risky behavior addiction include underlying mental health conditions such as anxiety, depression, and a history of trauma, which drive individuals to seek high-risk situations for a sense of aliveness or control. The compulsive pursuit of risk escalates over time, as individuals become desensitized to dangers and seek increasingly hazardous activities for the same level of excitement.

Long-term consequences of risky behavior addiction are severe, including physical injury, legal issues, financial ruin, and damaged relationships. Repeated exposure to danger not only jeopardizes the individual’s safety but also leads to chronic stress and mental health deterioration. According to a study published in the Journal of Risk Research, individuals with risky behavior addiction are more likely to suffer from long-term psychological effects, such as anxiety disorders and PTSD, due to the cumulative impact of their actions.

Treatment for risky behavior addiction typically involves cognitive-behavioral therapy (CBT) and other therapeutic approaches focused on impulse control, risk assessment, and developing healthier outlets for managing emotions and stress.

15. Self-Harm Addiction

Self-harm addiction is a compulsive behavior where individuals intentionally inflict harm on themselves as a way to cope with emotional pain, stress, or feelings of numbness. Self-harm addiction involves behaviors such as cutting, burning, or hitting oneself, driven by the temporary relief or sense of control these actions provide. Self-harm addiction is rooted in deep emotional distress and serves as a cry for help rather than a desire for physical sensation or escapism. Psychological factors contributing to self-harm addiction include depression, anxiety, trauma, and a lack of healthy coping mechanisms for intense emotions. Triggers for self-harm include overwhelming feelings of sadness, anger, guilt, or hopelessness, leading individuals to self-injure to release emotions or feel something when numb. The addiction escalates as individuals become dependent on self-harm for emotional management, making cessation increasingly difficult.

Long-term consequences of self-harm addiction include physical scars, infections, chronic pain, and an increased risk of serious injury or accidental death. Psychologically, self-harm deepens feelings of shame, guilt, and worthlessness, trapping individuals in a harmful cycle of behavior. According to research published in the Journal of Clinical Psychology, self-harm is associated with other mental health disorders, such as borderline personality disorder (BPD), and requires comprehensive treatment.

Treatment typically involves dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and other therapeutic approaches focused on building emotional resilience, developing healthier coping strategies, and addressing the underlying causes of the addiction.

What are the Signs and Symptoms of Behavioral Addiction?

The signs and symptoms of behavioral addiction include a persistent urge to repeat actions despite consequences, frequent preoccupation with the behavior, and an increasing need to engage in the activity to achieve satisfaction. Common indicators involve neglecting key responsibilities, experiencing withdrawal when unable to engage in the behavior, and using it as an unhealthy coping mechanism for stress or negative emotions.

Here are the signs and symptoms of behavioral addiction:

• Intense Desire: A strong urge to repeat the behavior despite knowing the negative consequences.
• Preoccupation: Constantly thinking about the behavior or planning to engage in it.
• Increased Frequency or Amount: Needing to engage in the behavior more or in larger amounts to achieve the same effect.
• Neglecting Responsibilities: Failing to fulfill work, school, or family commitments due to the behavior.
• Continued Engagement Despite Consequences: Persisting in the behavior even when it leads to negative outcomes.
• Negative Consequences: Experiencing financial problems, legal issues, or damaged relationships as a result of the behavior.
• Withdrawal Symptoms: Experiencing irritability, anxiety, or depression when unable to engage in the behavior.
• Loss of Control: Inability to stop or reduce the behavior despite wanting to.
• Excessive Time and Money: Spending an inordinate amount of time and resources on the behavior.
• Coping Mechanism: Using the behavior to manage stress or negative emotions.
• Risky Behaviors: Engaging in dangerous activities related to the addiction.

Examples of risky behaviors related to addiction are:

• Gambling: Borrowing money to gamble, lying about gambling, feeling restless or irritable when unable to gamble, neglecting responsibilities to gamble, and feeling a need to gamble more to achieve the same level of excitement.
• Obsession with Sex: Engaging in compulsive sexual behavior, such as having multiple partners, engaging in risky sexual behavior, feeling a need to have sex multiple times a day, and feeling a loss of control over sexual behavior.

Dr. Kenneth Blum, a renowned Pharmacologist, highlights that behavioral addictions share a common problem model consisting of reduced control, impairment, and risky use despite the awareness of negative consequences. These commonalities are observed across various types of behavioral addictions, such as compulsive shopping, internet addiction, and compulsive gambling, among others.

What Are The Factors That Contribute To The Development Of Behavioral Addiction?

Factors that contribute to the development of behavioral addiction include psychological disorders, personality issues, co-occurring addictions, cognitive impairments, genetic factors, or everyday stressors, as per a study by Dr. John E Grant in The American Journal of Drug and Alcohol Abuse.

• Psychological Factors: Individuals with behavioral addictions report feeling a sense of pleasure, relief, or gratification when engaging in the behavior, which leads to a desire to repeat the behavior despite its negative consequences. Additionally, individuals with behavioral addictions experience feelings of anxiety, depression, or stress, which drive them to engage in the behavior as a coping mechanism.
  According to Fuchshuber, J.’s 2018 study, ‘Depressive symptoms and addictive behaviors in young adults after childhood trauma: The mediating role of personality organization and despair.’, 37.4% reported psychiatric disorders, with 69% diagnosed with depression and 5% with substance use disorders. The model demonstrated that childhood trauma influenced addictive behaviors through structural deficit (p < 0.01), explaining 39% of addiction variance.
• Social Factors: Social pressure, peer influence, and cultural norms also contribute to the development of behavioral addictions. For example, an individual is exposed to a particular behavior, such as gaming or internet use, through social media or peer groups, and feels pressure to engage in the behavior to fit in or avoid social isolation. According to Xu, X.’s 2023 study, ‘Peer pressure and adolescent mobile social media addiction: Moderation analysis of self-esteem and self-concept clarity.’, peer pressure significantly predicts adolescent mobile social media addiction, with self-esteem and self-concept clarity as important moderators. Higher self-esteem weakens the effect of peer pressure on addiction, and this effect is further enhanced when combined with higher self-concept clarity.
• Environmental Factors: Environmental factors, such as access to technology, availability of addictive substances, and lack of parental supervision, also contribute to the development of behavioral addictions. For example, an individual is exposed to addictive substances or behaviors through family members or friends who have access to technology that facilitates addictive behaviors.
• Common Pathophysiology: Behavioral addictions share a common pathophysiology with substance use disorders, including alterations in brain reward processing, impulse control, and executive function. These alterations lead to changes in behavior and cognition, including cravings, impulsivity, and lack of self-control.

What Are The Effects Of Behavioral Addiction?

The effects of behavioral addiction manifest through immediate and long-lasting impacts on mental, physical, and social well-being, including heightened anxiety, disrupted sleep patterns, emotional instability, and deteriorating personal relationships. These addictive patterns trigger intense euphoric sensations, lead to social withdrawal, and cause significant changes in brain function, particularly affecting decision-making abilities and impulse control.

Here are the effects of behavioral addiction in detail below:

Short-term Effects:

• Anxiety: Behavioral addiction leads to anxiety as individuals constantly worry about their ability to control their compulsive behaviors.
• Sleep disturbances: The preoccupation with the addictive behavior disrupts sleep patterns, resulting in insomnia or poor-quality sleep.
• Exhaustion: Engaging in addictive behaviors for extended periods drains energy, leading to physical and mental exhaustion. According to Gu, S.’s 2024 study, ‘Correlation of negative emotion, fatigue level, and internet addiction in college students: implication for coping strategies.’, an internet addiction prevalence of 20.38%. This addiction was positively correlated with fatigue levels, indicating that higher scores on the internet addiction scale corresponded with increased feelings of fatigue3. The average fatigue score among addicted students was significantly higher than their non-addicted peers.
• Mood swings: The fluctuations in engagement with the addictive behavior create emotional instability, causing unpredictable mood swings.
• Compulsive need to engage in addictive behavior: The brain’s reward system reinforces the behavior, creating a strong compulsion to repeat it despite negative consequences.
• Feelings of euphoria: The release of dopamine during the addictive behavior produces intense feelings of pleasure, reinforcing the cycle of addiction.

Long-term Effects:

• Poor mental health: The ongoing stress and guilt associated with behavioral addiction contribute to deteriorating mental health.
• Depression: The isolation and shame stemming from addiction lead to feelings of hopelessness and depression. According to Zhang, C.’s 2016 study, ‘Associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder among men and women.’, individuals with behavioral addictions, such as compulsive buying or gambling, report higher rates of mood disorders. For instance, compulsive buying has been associated with a 70% increased risk of major depressive episodes (MDE) and generalized anxiety disorder (GAD) compared to those without such behaviors.
• Social isolation: Individuals withdraw from social interactions to engage in their addictive behavior, resulting in loneliness and isolation.
• Weight loss: Behavioral addiction leads to neglect of self-care, including proper nutrition, resulting in unintended weight loss.
• Alterations in brain structure: Prolonged engagement in addictive behaviors changes brain pathways, affecting decision-making and impulse control. According to Lewis M.’s 2017 study, ‘Addiction and the Brain: Development, Not Disease.’, prolonged addictive behaviors cause significant brain structure changes, primarily affecting dopamine pathways in the striatum and reducing grey matter volume in the prefrontal cortex. These alterations lead to decreased cognitive control, increased compulsive behavior, and emotional blunting, though these changes reflect the brain’s natural plasticity rather than permanent damage.
• Physical health issues: The neglect of physical health due to the focus on addictive behaviors leads to various health problems. According to Ford, M.’s 2020 study, ‘Problem gambling, associations with comorbid health conditions, substance use, and behavioral addictions: Opportunities for pathways to treatment.’, there are significant associations between problem gambling and various health conditions, including daily tobacco use, moderate psychological distress, and other behavioral addictions such as problematic shopping and gaming. The research indicates that 5.7 percent of participants screened positive for lifetime problem gambling. These findings highlight the need for healthcare settings to incorporate screenings for problem gambling, given its comorbidity with other health issues.
• Negative impact on relationships: The compulsive nature of the addiction strains personal relationships, leading to conflicts and disconnection.
• Detrimental effects on work performance: The distraction and preoccupation with the addiction reduce productivity and focus at work.
• Overall decline in well-being: The cumulative effects of behavioral addiction result in a significant decline in an individual’s overall quality of life.

Can Behavioral Addiction Affect Your Mental Health?

Yes, behavioral addiction significantly affects your mental health. It impacts you in the short term by inducing disorders like anxiety, depression, impatience, and obsessive thoughts. Over time, these addictions harm your mental well-being through social withdrawal, isolationism, disrupted relationships, educational or financial failure, and neglect of family and personal responsibilities.

Can Behavioral Addiction Impact The Brain?

Behavioral addiction impacts the brain through functional and structural modifications. Key brain regions implicated in behavioral addictions include the ventral tegmental area (VTA), nucleus accumbens, dorsolateral prefrontal cortex, amygdala, anterior cingulate cortex (ACC), and parahippocampus. Activation of the VTA and nucleus accumbens releases dopamine, leading to a rewarding sensation.

Behavioral addictions, such as pathological gambling and internet addiction, have been found to share dysfunction in reward mechanisms and cognitive control with substance addiction disorders according to Finocchiaro, R., & Balconi, M. (2016). Left/Right Hemispheric “Unbalance” Model in Addiction. Addictive Substances and Neurological Disease.

The study also mentions – that there is a reduction in activity in the mesolimbic reward system in pathological gambling and structural abnormalities in gray and white matter volume in specific brain regions associated with cognitive control in internet addiction disorder. 

These alterations in prefrontal activity, coupled with enhanced striatal responses to addictive stimuli, contribute to the habitual seeking of addictive behaviors despite negative consequences. Additionally, studies have established a strong correlation between behavioral inhibition system/behavioral activation system (BIS/BAS) components and cortical brain activity, highlighting the role of these systems in addictive behaviors.

How Does Behavioral Addiction Affect Your Physical Health?

Behavioral addiction affects your physical health by promoting sedentary behavior and triggering negative mental effects. These impacts manifest through decreased physical activity, chronic fatigue, eating disorders or malnutrition, fluctuating weight, sexual dysfunction, and disrupted sleep patterns.

According to Kohn, M.R.’s 2022 study, ‘Management of the malnourished patient: it’s now time to revise the guidelines.’, malnutrition from eating disorders severely impacts multiple body systems, with 56% of severely malnourished patients experiencing bradycardia and 64% developing leukopenia. Cardiac complications include 27% developing pericardial effusions and 15% showing left ventricular systolic dysfunction.

Do Behavioral Addictions Cause Depression?

Yes behavioral addictions cause depression. Behavioral addictions are a coping mechanism for pre-existing depression and anxiety. People with behavioral addictions use their addictive behavior to temporarily reduce negative feelings like depression and anxiety. However, the long-term consequences of these behaviors worsen depression, creating a vicious cycle.

According to Fuchshuber, J.’s 2018 study, ‘Depressive symptoms and addictive behaviors in young adults after childhood trauma: The mediating role of personality organization and despair.’, behavioral addictions and depression share significant interconnections through common emotional and neurobiological pathways. The study revealed that childhood trauma influences both conditions, with addictive behaviors mediated by personality structural deficits (p < 0.01) and depressive symptoms mediated by emotional despair characterized by decreased SEEKING and increased SADNESS (p < 0.01). The research model successfully explained 39% of addictive behaviors and 85% of depressive symptoms, demonstrating that while these conditions manifest differently, they stem from similar underlying emotional dysregulations and early life experiences.

Is Behavioral Addiction A Disease?

Yes, behavioral addictions are diseases, as recognized by leading medical institutions. The American Society of Addiction Medicine (ASAM) officially classifies them as mental disorders. This classification is further supported by the Diagnostic and Statistical Manual of Mental Disorders (DSM), which specifically includes gambling disorder as a non-substance-related condition under “Substance-Related and Addictive Disorders.” Like diseases that involve substance addiction, behavioral addictions affect the brain’s reward system and result in compulsive behaviors that continue despite harmful consequences.

Is Behavioral Addiction Genetic?

Yes, behavioral addiction has a genetic component that is inherited from parents to children, but the genetic evidence is still limited.

According to Leeman, R. F.’s 2013 study, ‘A targeted review of the neurobiology and genetics of behavioral addictions: an emerging area of research.’, genetic research in behavioral addictions is still developing, with significant hereditary patterns identified, particularly in pathological gambling (PG), which shows high heritability linked to dopamine receptor gene polymorphisms. Other behavioral addictions exhibit varying genetic influences: problematic internet use is associated with SS-5HTTLPR expression, while compulsive gaming relates to the Taq 1A polymorphism of the DRD2 gene.

Are Behavioral Addictions Considered A Disability?

Yes, behavioral addictions are considered a disability. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes gambling disorder as a behavioral addiction.  Many individuals with behavioral addictions also experience other mental disorders.

What Are The Methods For Treating Behavioral Addiction?

The methods for treating behavioral addiction include cognitive behavioral therapy, group therapy, medications, individual counseling, and support groups.

Here are the treatment methods for treating behavioral addiction:

Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) for behavioral addiction treatment involves identifying and challenging negative thought patterns and behaviors that contribute to addictive behaviors.

According to Sudhir, P. M. (2018). Cognitive behavioral interventions in addictive disorders. Indian Journal of Psychiatry CBT aims to enhance self-awareness, self-efficacy, and distress tolerance through techniques such as problem-oriented therapy, relapse prevention, cognitive reframing, and mindfulness meditation.

Cognitive Behavioral Therapy (CBT) is a widely used talking therapy that focuses on changing the way one thinks about negative life consequences. It is particularly effective in treating behavioral addictions. According to a study published by Jeremy Adams, a Psychology Professor, in the Lancet, therapists utilizing CBT help individuals by identifying and correcting irrational thoughts and maladaptive behaviors.

A separate study published in BioMed Research International examined the effects of CBT on internet addiction. The results indicated that 70% of the patients experienced a reduction in psychopathological symptoms and psychosocial problems after undergoing CBT.

Group Therapy

Group therapy, led by one or more psychologists, effectively reduces behavioral addiction symptoms. Cognitive behavioral group therapy, a common approach for behavioral addicts, demonstrates reductions in compulsive behavior, interpersonal and health issues, and improvements in tolerance and time management.

According to a study by Choobdari, M., Bahrainian, S. A., & Shahabizadeh, F. (2022). Effectiveness of Cognitive-behavioral Group Therapy and Acceptance and Commitment Group Therapy in Mental, Spiritual, and Social Health of Addicts. The effectiveness of Group Therapy, specifically Cognitive-Behavioral Group Therapy (CBT) and Acceptance and Commitment Group Therapy (ACT), in the mental, spiritual, and social health of addicts. 

The results showed that both CBT and ACT improved mental health, spiritual health, and social health, but ACT had a more significant impact on these aspects. The study suggests that ACT and CBT are effective in treating addiction, and ACT has an additional advantage in promoting mental, spiritual, and social health.

Medications

Behavioral addictions are addressed through medications that target causative agents such as psychological and personality disorders, and neurotransmitter imbalances. Despite limited evidence, studies in the Journal ‘Of Pharmacology Biochemistry and Behavior’ and Neuropsychology Review suggest that drugs impacting glutamatergic and opioidergic transmission aid in managing behavioral addictions.

One-on-one Or Couples Counseling

One-on-one or couples counseling is effective in managing behavioral addictions by assisting individuals in recognizing triggers and developing strategies to avoid them. By addressing these triggers, it becomes possible to curb impulsive and compulsive behaviors, leading to a reduction in continuous engagement in detrimental activities.

Self-Help Groups

Self-help groups, informal gatherings of people recovering from behavioral addictions, provide support and encouragement. These groups, such as Sex Anonymous, Love Anonymous, and Gamblers Anonymous, enhance understanding and foster a sense of purpose among addicts as per Dr. Timothy W. Fong, a Psychiatry Professor. Additionally, self-help groups aid in relapse prevention.

What Are Behavioral Addiction Treatment Programs Like?

Behavioral Addiction treatment programs provide comprehensive care designed to help individuals regain control over compulsive behaviors. The main attributes of behavioral addiction treatment centers and mental health treatment centers are listed below:

• Accommodation and Amenities: Most programs offer residential options, providing a focused and supportive environment for recovery. Accommodations include private or shared rooms, with all basic amenities. Personal items such as clothes and toiletries are required, and facilities have specific guidelines, so checking the list of approved items is advisable.
• Communication Policies: Policies on phone use vary by program. Some programs allow limited phone use, while others restrict it to maintain focus on recovery. Understanding these policies sets expectations for communication with the outside world during treatment.
• Cost and Financial Options: The cost of treatment varies based on length of stay, level of care, and specific services provided. Discussing financial options with the facility is important, as many offer payment plans, accept insurance, or provide financial assistance to enhance accessibility.
• Comprehensive Mental Health Care: These programs address mental health comprehensively, offering therapies such as Cognitive Behavioral Therapy (CBT), support groups, and stress management techniques. This holistic approach helps individuals build healthier, addiction-free lives.

Understanding these aspects of addiction treatment programs for behavioral addictions helps individuals make informed decisions and find the right support for their recovery journey.

What Is The Difference Between Behavioral Addiction And Physical Addiction?

The difference between behavioral addiction and physical addiction lies in their fundamental mechanisms: behavioral addiction involves compulsive involvement in activities rather than substances, while physical addiction stems from substance abuse and chemical dependence. Behavioral addictions manifest through psychological compulsions toward activities like gambling, shopping, or internet use, without introducing external chemicals into the body, while physical addictions develop when the body becomes dependent on substances like drugs or alcohol.

While both types share high psychological dependence and cravings, they differ in their treatment needs and withdrawal patterns. Physical addiction uniquely presents withdrawal symptoms like tremors and nausea when the substance is removed, requiring medication-assisted treatment alongside therapy, whereas behavioral addictions primarily need cognitive-behavioral therapy and don’t cause physical withdrawal symptoms, though they lead to emotional distress when the behavior is restricted.

The National Cancer Institute defines physical addiction as the presence of unpleasant physical symptoms upon discontinuation or reduced intake of the substance. Conversely, behavioral addiction is characterized by persistent participation in an activity despite its detrimental effects on an individual’s well-being.

This table explores the differences and similarities between behavioral and physical addiction, including their characteristics, symptoms, treatments, and outcomes.

Aspect	Behavioral Addiction	Physical Addiction
Definition	Compulsive behavior despite negative consequences	Physical dependence on a substance or substance-like experience
Characteristics	Escalating behavior, loss of control, and preoccupation	Withdrawal symptoms, tolerance, and physical dependence
Brain Response	Activation of the reward system, release of dopamine	Activation of reward system, release of dopamine and other neurotransmitters
Symptoms	Social isolation, financial problems, and emotional distress	Physical symptoms such as tremors, sweating, and nausea
Treatment	Cognitive-behavioral therapy, support groups, and medication	Medication-assisted treatment, behavioral therapy, and support groups
Withdrawal	None	Withdrawal symptoms such as headaches, nausea, and anxiety
Physical Dependence	None	Physical dependence on the substance or substance-like experience
Psychological Dependence	High	High
Craving	High	High
Relapse Rate	High	High
Comorbidity	Often comorbid with other mental health disorders	Often comorbid with other mental health disorders
Social Impact	Negative impact on relationships and daily life	Negative impact on relationships and daily life
Treatment Outcomes	Varies, but successful with long-term recovery	Varies, but successful with long-term recovery

What Is The Difference Between Behavioral Addiction And Substance Addiction?

The key difference between behavioral addiction and substance or drug addiction is that behavioral addiction involves compulsive actions and behaviors, while substance addiction depends on ingesting drugs or other substances. Repetitive engagement in compulsive behavior triggers brief happiness from neurotransmitter release, such as dopamine. Common behavioral addictions include exercise, food, and internet addiction. In contrast, substance addiction creates both physical and psychological dependence through substance use, leading to temporary dopamine highs and pleasure sensations.

The table below presents the key differences between behavioral addictions and substance addictions:

Aspects	Behavioral Addiction	Substance Addiction
Definition	Compulsive engagement in a non-substance-related behavior despite negative consequences.	Compulsive use of a psychoactive substance despite negative consequences.
Examples	Gambling, video gaming, shopping, exercise, internet use, sex.	Alcohol, drugs (cocaine, heroin, cannabis), nicotine, prescription medications.
Physical Dependence	No.	Yes, the body becomes reliant on the substance to function normally.
Withdrawal Symptoms	Primarily psychological.	Can be both physical and psychological.
Brain Changes	Affects the brain’s reward system, similar to substance addiction.	Alters brain chemistry, potentially leading to permanent damage.
Treatment	Therapy, support groups, lifestyle changes.	Detoxification, therapy, support groups, medication.