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?
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.
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
I drink a glass of water every day. I sleep every day. But I am not addicted to water or sleep. The same can be said for those who claim they are addicted to sex. Sex is a natural activity that activates the same brain stimulants as truly addictive substances, but if it was to be truly and medically classified as an addiction, then it could protect many from certain criminal prosecution, among other things. Verdict: Compulsive behavior
This is one from left field and doesn’t have a name. So let’s call it “funeral addiction” for now. There can be little reward for attending funerals, seeing other people’s misery, or celebrating the life of someone you don’t know. However while the ASAM definition of an addiction does mention “spiritual manifestation”, this is a long bow. Verdict: Compulsive behavior
There are only so many tattoos the human body can host, even if there is evidence of those tattooing their insides (mouth/gums), which is becoming increasingly popular. While many may choose to get “inked” in the name of art or as a commitment to a cause, tattooing can make the body give off high levels of endorphins which can lead to more emotional ties with the memory of the tattoo. Verdict: Addiction
There are various forms of this, all which have different signs and reactions. Some conditions are linked to contamination obsession; others, such as hypochondriasis, are categorized by an obsession with cleaning. Let’s address the latter and determine that in the context of our study, there is a reward and obvious evidence of an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Verdict: Addiction
In many ways the means to the end is similar to tattooing. Though the mass media often makes light of those who regularly “go under the knife”, and the celebrity tendency towards surgical enhancement glamorizes cosmetic surgery, there is clear evidence to suggest the behavior is linked to negative body image, which in extreme cases is known as body dysmorphic disorder. Verdict: Addiction
Hoarding can be done by accumulating a variety of seemingly useless matter, or can be the result of collecting specific items, such as newspapers, magazines or teacups. Whatever is being collected (and not thrown out) is not the result of any reward, as the motivation for hoarding may well stem from an anomaly in the brain or a past experience. Verdict: Compulsive behavior
Ultraviolet (UV) light can speed up endorphins, that could well affect and feed a tanning addiction. However tanning can also be simply about appearance. The value of a tan depends on where you are from. For example, in western cultures, a tan often indicates you have been on vacation and is usually viewed as something positive, whereas in Asia it is seen as a sign of being a member of the working class (working outdoors in the fields) and has negative implications. Verdict: Compulsive behavior
If you cut off a nicotine addict's access to cigarettes, the short-term result would be a significant chemical imbalance inside their body, resulting in any number of symptoms and reactions. If the world wide web suddenly stopped working, there would be a lot of frustration and anger and IT departments the world over would collapse from the weight of demand. But it is simply not an addiction. Verdict: Compulsive behavior
The term “pathological liar” is often used when referring to someone whose reputation or behavior is being questioned. There have been movies made about it and jokes told relating to it. The reality is you cannot, by definition, be “addicted” to lying. You can be good at it, and get away with it often, but the rewards for such actions belie human nature. Verdict: Compulsive behavior
They say heroin addicts are forever chasing the high they get from that very first hit, and the same can be said for regular gamblers, who are forever chasing the high they get from the huge windfall. Gambling could be considered an addiction when it affects your every day life, your bank balance, and your livelihood. The house always wins. Verdict: Addiction
Compulsive exercise, such as repeating the same routine despite illness, injury or outside commitments (such as work) can be seen as an addiction. The release of endorphins into the system can be one of the many reasons for repeated exercise, as can a strong desire to get fit and “look good”. Other motivations can be a desire to win or be better than the rest. It can be treated. Verdict: Addiction
Known as pagophagia (and is also a form of Pica), that affects about two percent of American males ages 18 and older as well as 16 percent of females between ages 16 and 19 (according to The U.S. Centers for Disease Control and Prevention). The reasons are varied, a nervous habit, the love for the noise and crunch of ice, or more likely, an iron deficiency. Equalizing the iron in the system has been known to eradicate the condition. Verdict: Addiction
Known as oniomania it is either a well-worn excuse or a genuine disorder. It affects between two to eight percent of Americans with more women afflicted than men. Studies have shown that low levels of serotonin, which is often linked to depression, are the major factors in its onset. If the demand for shopping is outweighed by the supply (money available), then this could well be determined as an addiction. However with proper counseling and other treatment, there is plenty of evidence that it can be curtailed. Verdict: Compulsive behavior
This is more common today than it was 40 years ago due to the increased coverage of celebrity in the media. There are some instances of borderline-pathological obsessions, which come in the form celebrity worship, and include copying facets of the celebrity’s life and appearance and emotional attachment. The most serious cases include criminal activity such as trespassing or stalking. However there is no evidence to suggest you can genuinely become addicted to a person or their lifestyle. Verdict: Compulsive behavior
Chris Bisogni is an Australian journalist based in San Francisco.