But Is It Addiction?
Is there really such a thing as “sex addiction,” “food addiction,” “shopping addiction,” or “Internet addiction”? Addiction has less to do with what someone is addicted to and more about how their brain and behavior change over time. Recognizing the signature behaviors of addiction can save lives.
Pleasure is a Survival Mechanism
In everyday conversation, we often hear the remark “I’m so addicted to…” usually followed by a cherished band, a romantic interest, a beloved television show, or a favorite food. The speaker almost always means that they have a strong enjoyment of and affinity for the object of their “addiction” and a desire to repeat the experience.
While this common usage of “addiction” does share a few aspects of what addiction specialists study and treat as a disorder, what’s really being described here is a normal and necessary part of our psyche, operating as it should. Food, social connection, sex, and novelty are all things that most people enjoy and contribute to our survival both individually and as a species. If we didn’t feel pleasure from these things, if something deep in our brains didn’t signal us with the message “that was good…do it again,” then we wouldn’t be nearly as effective at feeding ourselves, collaborating, exploring, and reproducing. Mere affinity is not addiction.
But sometimes the healthy process of affinity and pleasure-seeking spirals out of control into true, clinical addiction.
Addiction: Marks of the Beast
A common perception of addicts is that they over-indulge in their drug of choice. This is certainly true, but overindulgence is not addiction. In the case of alcohol, many college students drink to excess, throw up, and pass out. Most of them aren’t addicted to alcohol and many of them never will be. As someone begins drinking on a regular basis, they can not only drink more before getting sick or passing out, but they need to drink more in order to feel intoxicated. This is increased tolerance, which is found in addicts, but also in non-addicts. Many people who drink regularly have an increased tolerance for alcohol, but can be distinguished from addicts in that they do not show an acceleration in their drinking over time.
Actual addiction occurs because of changes deep within the brain which result in distinctive behaviors. Addictive substances and experiences intensely stimulate the pleasure centers of the brain. The brain, in turn, adapts to this over-stimulation by becoming less sensitive. This manifests as tolerance, which we’ve already discussed, but also leads to a steady increase in the dosage needed to achieve the same pleasurable high. Addicts may be using more, but they get less pleasure with every exposure. These physiological changes are why addiction is now classified as a brain disease. Worse still, since drugs of addiction stimulate the pleasure centers of the brain far more intensely than other pleasurable experiences in ordinary life, other experiences become less enjoyable and less motivating, leading the addict to withdraw from other activities in favor of drug-seeking. At the extremes of addiction, the body and brain become severely adapted to very high doses. Failure to maintain usage leads to intense withdrawal and compulsion to use at all costs. At this stage, the addict uses not to get high, but to function at all.
When tolerance has increased, the pleasure centers of the brain have become numbed, and everyday life has become unrewarding, the addict loses a sense of the risks of his usage. Negative consequences to health, family, and employment fail to deter the addict from continuous, heavy use. Ultimately, only external factors such as running out of money, being thrown in jail, or passing out end the binge. This is what recovering addicts describe as “losing control” or being “powerless over our addiction.”
Understanding the process and progression of addiction allows us to separate the peripheral factors like affinity and overindulgence from the true heart of the disease: accelerating usage, changes to the brain’s pleasure centers, ignoring negative consequences of use, needing to use to function, and ultimately the inability to stop using for any reason.
Addiction isn’t about the object of the addiction. It is about physical changes to the brain and the behavior of the addict. So it may be possible to be addicted to food, shopping, the Internet, or almost anything that stimulates the brain’s pleasure center, but only when the signature changes to brain and behavior are present.
Why Definitions Matter
Addiction is dangerous because it is so hard for addicts to see what is obvious to everyone else: that using has eroded and endangered their lives and threatened those closest to them. Defining and describing the brain disease of addiction can help addicts understand the gravity of their situation and motivate recovery.
Finding addiction where it is not can be as dangerous as failing to recognize true addiction. When addictive behavior is confused with mere affinity or overindulgence, then the word “addiction” loses its impact. This enables genuine addicts to reinforce their denial with the beliefs that “everyone is addicted to everything”, that the consequences are not all that serious, that they can stop any time they like, and that being “addicted” is nothing more than liking their drug of choice a little more than their friends or family would prefer.
Defining addiction accurately allows us to recognizing its behavioral signature in ourselves and those we love. When we understand the symptoms, the consequences, and progression of the brain disease called addiction, then we can know when to seek treatment that can make the difference between life and death.
7 Responses (3 Discussion Threads) to “But Is It Addiction?”
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Would it be fair to say that having only one thing to live for qualifies as an addiction if the reliance on this one thing increases over time, or if the pleasure it gives decreases? I am thinking of things like some males reliance on their job.
I think the brain will likely adapt to any kind of experience – I don’t see how this assists the definition of addiction.
Hi Evan. You’re right. The brain does adapt to pretty much any kind of stimulus. The normal adaptation is called habituation. The abnormal adaptation is called addiction.
Let’s imagine Alice and Bob go to Vegas. They both play slot machines and both have a good time — for a while. When Alice finds the experience less rewarding, she heads up to her room, thinking nothing more of it. Bob on the other hand, plays more and more, trying to recreate the same pleasurable experience and failing. When he has to stop because he runs out of money, he feels intense anxiety and compulsion to play anyway. He goes to a loan shark to borrow money to play again.
Bob is addicted and Alice isn’t. It shows up in how they respond to the reduced enjoyment they get from playing the slots. I hope that clarifies things to some degree.
Hi Gordon, thanks for your reply. Yes, to some degree.
It seems to me that your saying that addiction is persisting despite diminishing pleasure. Have I got that right? This seems to mean that addiction has some feeling of compulsion about it or re-capturing past experience(s).(?)
Would this apply to a person whose life is increasingly occupied with their job?
What I’m trying to say is that addiction is a syndrome that includes neurological changes that lead to diminished pleasure, but while that’s central, it’s not the whole story. There’s also withdrawal / craving, accelerating usage, and disregard for consequences. Compulsion, the urge to use, is also a central factor.
So someone could be addicted to work — a “workaholic” — if the person needed to stay at work longer and longer or needed a more and more intense work experience, if they disregarded the negative consequences (failing health, divorce) and they could not be comfortable away from work (withdrawal). When all or most of the signs are there, then there’s what I consider true addiction.
Thanks Gordon, that’s clearer for me.
You’re very welcome! I think that was an outstanding example of how hard it is to explain addiction fully and correctly.
I think that was a really clear and useful explanation, Gordon. I agree about the difficulties with an over-liberal use of the the term addiction. I sometimes see an overlap in use with the buddhist concept of attachment, which better explains to me things like work or shopping addiction or things we do which are central to maintaining our identity. Addiction needs to remain specific, to help people struggling with it.