The Science Behind Behavioral Addiction

The term “addiction” makes most people think of abuse of substances such as drugs, alcohol, or tobacco. However, addiction is not limited to substances alone. It is possible for people to develop harmful patterns of compulsive behavior known as behavioral addictions. They mimic the same brain processes that are seen in drug or alcohol dependence.^[1]

So what is the difference between substance addiction and behavioral addiction? Behavioral addiction can involve any harmful behavior, from gambling and gaming to social media scrolling and compulsive shopping. Many people have one or another form of behavioral addiction but do not take it as a serious health issue. Although the physical effects of behavioral addiction are not as obvious as those of substance addiction, the toll it has on emotional, mental, and social well-being can be real. 

Only by understanding the underlying science behind behavioral addiction can a proper treatment pathway be initiated.

What Is Behavioral Addiction?

Behavioral addiction is when a person becomes compulsively engaged in a behavior that provides temporary satisfaction in spite of the negative impact it has on the person’s overall well-being. 

Common examples of behavioral addiction include:

• Gambling disorder
• Internet or gaming addiction
• Compulsive shopping or spending
• Pornography or sex addiction
• Excessive exercise or eating behaviors
  

These addictions can have powerful consequences, not because of the behavior in itself but due to the way it affects the brain. A simple activity such as placing a bet, leveling up in a game, or making an online purchase can trigger the release of dopamine. Dopamine is the brain’s reward chemical. With time, the brain begins to adapt, making the affected person crave more of the activity to feel satisfied.

The Neuroscience: How Behavioral Addictions Hijack the Brain

The mesolimbic dopamine system is at the center of behavioral addiction. It is often referred to as the reward pathway of the brain. This system has evolved over time to reinforce pre-existing survival behaviors such as eating, social bonding, and reproduction.

If you repeatedly engage in a stimulating activity, several changes can occur in the mesolimbic system such as:

• Release of dopamine: If the activity is continued, it leads to a spike in dopamine every time the activity is performed, which reinforces the behavior in itself.
• Tolerance: With continued and repeated exposure to the exciting stimulus, the sensitivity of the brain to dopamine is reduced. This makes the person need more frequent or intense activity to get similar sensation of pleasure.
• Craving and preoccupation: The brain begins to anticipate rewards before they even happen. This leads to strong urges to repeat the behavior.
• Impaired self-control: The prefrontal cortex is responsible for decision-making and impulse control. This part of the brain eventually becomes less effective at regulating behavior due to repeated stimulation.
  

Studies that use brain images have found that the same neural circuits that are activated by drugs are also activated during these addictive behaviors. For instance, people addicted to gambling displayed heightened activity in the ventral striatum, which is quite similar to cocaine users when anticipating rewards.

Behavioral vs. Substance Addiction: The Similarities

Many experts believe that behavioral and substance addictions are more similar than most people realize. Here are some major similarities between the two:

• Cravings: Similar strong and persistent urges to engage in the activity.
• Loss of control: Inability to cut back despite wanting to stop.
• Negative consequences: Relationship issues, financial stress, poor mental health, or decline in work/school performance.
• Relapse: After a period of abstinence, returning to the behavior under stress or temptation.
• Neurological overlap: Both involve dysfunction in the reward and control circuits of the brain.

This could be the reason for behavioral addictions such as gambling disorder and substance use disorders to be placed in the same category by the American Psychiatric Association.^[2]

Key Differences Between Behavioral and Substance Addiction

Although there are many similarities, there are several important differences such as ^[3]:

• Presence of a substance
  
  • Substance addiction involves ingestion of chemicals such as alcohol, opioids, and nicotine.
  • Behavioral addiction involves compulsive actions but there is no usage of an external substance.
    
• Physical withdrawal
  
  • Substances often cause severe physical symptoms during withdrawal, such as tremors, nausea, and seizures.
  • Behavioral addictions may lead to psychological withdrawal such as anxiety, irritability, and insomnia instead of physical illness.
    
• Health consequences
  
  • Drugs can cause direct damage to internal organs such as cirrhosis from alcohol and lung disease from smoking.
  • Behavioral addictions can harm mental health, finances, and relationships. Although they may not directly cause damage to physical health,they can do so indirectly through poor sleep, sedentary lifestyle, and stress-related illness.
    
• Stigma and recognition
  
  • Substance addictions are widely recognized and treatment facilities are available that target specific substances.
  • However, behavioral addictions are often minimized or misunderstood.
    

Why Behavioral Addictions Develop

There are several factors that are involved in behavioral addictions. A combination of biological, psychological, and social factors can lead to addictive behaviors such as ^[4]: 

• Genetics: Family history of addiction increases risk.
• Mental health: Anxiety, depression, or ADHD often coexist with behavioral addictions.
• Environment: Easy access to gambling, gaming platforms, or shopping apps encourages compulsive use.
• Personality traits: Impulsivity, sensation-seeking, or poor stress coping skills make people more vulnerable.

How to Stop Behavioral Addiction: Treatment Approaches

Like substance addiction, it is absolutely possible to recover from behavioral addiction. However, this often requires structured support that may involve:

Psychotherapy

• Cognitive Behavioral Therapy (CBT) 
• Motivational Interviewing (MI)

Support Groups

• Gamblers Anonymous
• SMART Recovery 

Medication

• SSRIs
• Naltrexone

Lifestyle and coping strategies

• Exercise and mindfulness 
• Engaging in fulfilling alternatives like creative hobbies or volunteering.
  

Professional treatment centers

• Inpatient or outpatient treatment programs 

Conclusion

Behavioral addictions do not involve drugs or alcohol. However, they can be equally harmful. They may engage the same systems in the brain and create similar cycles of craving. But it is something entirely treatable with proper awareness and support.