You’re probably familiar with the concept of gambling too much or excessive shopping. Known as process addictions, they’re two examples of maladaptive behavior. Others in this category of conditions include sex and love, gaming, exercise, food, pornography, and even work. Why is it so common for people to struggle with more than one process addiction?

It’s All Because of Compulsivity

People develop process addictions, also referred to as behavioral addictions, in the same way as substance or alcohol use disorders: the brain responds to a certain rush of stimuli. According to the National Institute on Drug Abuse (NIDA) neurotransmitters activate the brain’s reward circuit that links:

• The basal ganglia, responsible for creating a pleasurable response to all sorts of things.
• The extended amygdala, the area that produces anxiety, irritability, fear, and other protective reactions.
• The prefrontal cortex, our executive functioning center, which directs how we think, create solutions, and maintain control over impulses.

With repeated behavior or substance use that produces a pleasurable effect, however temporary, this entire circuit becomes more sensitive to transmissions and their constant signals. The brain then adapts to a surge produced by two specific neurotransmitters: endorphins, which provide the reward; and dopamine, which reinforces the action—be it drinking too much or hitting the poker table just one more time—that allows access to the reward.

With normal reward circuit functioning, a person can enjoy a small ice cream cone, savor its taste, and be completely satisfied. But if someone has underlying risk factors, such as mental health issues, trauma, grief, substance or alcohol use, or excessive stress, their brain determines the ice cream is so rewarding that they eat a pint of it next time. Then a half-gallon. Then a half-gallon each night after dinner. The reward circuit responds to all the signals related to this behavior, creating a pattern of compulsive use.

Because of compulsivity, process addictions are usually hard to control, and someone can’t simply stop—even if these behaviors cause serious financial, health, or relationship consequences. Just like substance abuse disorder, an individual’s brain chemistry has been altered to respond to the urge-driven rewards provided by their actions.

Definition of Process Disorders

It’s not uncommon to splurge on the oversize popcorn at the movies, make a wish on a lotto ticket with a big payout, or spend a little too much online during sales events. But scientists indicate the difference between casual activities or hobbies and process addictions includes two major factors:

• A compulsive, almost obsessive, urge to participate in the activity, driven by chemical changes in the brain.
• The presence of some form of dysregulation, such as the conditions we mentioned above.

Other symptoms include hiding the behavior, losing control over participation, and experiencing negative effects when unable to participate in the behavior.

There are many types of process addictions, but the most common are:

• Gambling addiction. This behavior includes betting more than intended or beyond financial security, being preoccupied with gambling, or feeling irritable or aggressive when unable to participate.
• Sex addiction. A person with this condition might engage in dangerous or destructive sexual activity because they feel powerless to control behaviors, thoughts, or urges.
• Shopping addiction. Also known as compulsive buying disorder or compulsive shopping, this usually involves making unnecessary and/or unwanted purchases beyond one’s financial means.
• Food addiction. An individual who struggles with compulsive eating behaviors often eats to excess and craves foods high in fat, salt, and/or sugar.
• Gaming addiction. Compulsive gaming is when a person plays to the extent that it negatively affects relationships and responsibilities.

Currently, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) lists only gambling as an official non-substance behavior addiction, with ongoing research into gaming. Eating disorders are in a different category.

Why Do People Often Have More Than One?

Quite simply, once the brain’s reward circuit has been altered by compulsive behavior, it doesn’t matter what substance or action contributes to it. This makes a person all the more vulnerable to having two or more process addictions. For example, someone who is depressed, and gambles compulsively might also drink or use drugs to excess. This is an example of co-occurring disorders.

NIDA explains that once the brain is artificially stimulated by excessive behaviors or substance and alcohol use, it produces “fewer neurotransmitters in the reward circuit…or by reducing the number of receptors that can receive signals. As a result, the person’s ability to experience pleasure from naturally-rewarding (i.e., reinforcing) activities is also reduced.”

Additionally, the brain builds up a tolerance to the artificial stimuli, requiring a person to take a greater amount of the substance or engage in the behavior more frequently to have the same rewarding effect as before. Unfortunately, the “lows” an individual experiences will become more intense, forcing even more compulsive behavior to achieve the same type of “high” previously experienced.

Treating Process Addictions at Cottonwood de Tucson

The board-certified professionals at our Arizona rehabilitation center approach healing compulsive behavior from the inside, recognizing that each individual’s unique experiences and background contribute greatly to their actions. By addressing the inherent reasons for the behavior and providing more progressive methods for living healthfully, a person can better manage— and perhaps even move beyond—process addictions and any co-occurring disorders. Call today if you’d like more information about our approach to whole-person healing.