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Are These Fifteen Behaviors Addictions or Compulsions?

The word "addiction" gets thrown around a lot these days—anything from sex to eating dirt—but what's the difference between an actual addiction and a compulsive behavior?

By Chris Bisogni


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To the layman, there is a fine line between identifying the symptoms of an addiction, as opposed to what is known as compulsive behavior. There are many cases of such confusion; we often read or hear about those who are “addicted” to the likes of cleanliness, tanning, hoarding, cosmetic surgery and tattoos, to name a few. Debate continues as to whether these are addictions or compulsive behaviors.

By definition, a compulsion is a behavior which occurs in response to an obsessive thought that will only be relieved by engaging in the behavior. Therefore when the obsessive thought returns, as thoughts do, there is a perceived need to act on it, and the compulsion occurs. This stops the obsessive thought temporarily. An addiction is due to a brain chemical (dopamine), and is acted upon to elicit a desired heightened state of elation. 

According to the American Society of Addiction Medicine (ASAM), the “Short Definition of an Addiction” is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. 

The fact that ASAM, as recently as August 2011, issued a statement announcing its new definition of addiction is evidence to suggest diagnosing actual addictions is not set in stone.

“At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a brain problem whose behaviors manifest in all these other areas,” said Dr. Michael Miller, past president of ASAM. “Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It’s about underlying neurology, not outward actions.”

Armed with this information, we have handpicked 15 addictions/compulsive behaviors (yes some of them are extreme) and put them to the test to see just where they sit when put to the both the layman’s and expert’s opinion.

Eating dirt

As kids, many of us probably did this at least once, or knew someone who did, and there is a significant number of those who carry this onto into adulthood. Pica, as it is known, can be treated but if we address the ASAM definition, there surely can be no reward for eating dirt. Verdict: Compulsive behavior

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