Behavioral & Process Addiction | Co-Occurring Disorders

Process addiction, also known as behavioral addiction, refers to compulsive behaviors that persist despite negative consequences. Unlike substance addictions involving drugs or alcohol, process addictions center on activities like gambling, shopping, eating, gaming, or internet use. These behaviors trigger the brain’s reward system in ways similar to substance abuse, creating a cycle of addiction.

Understanding process addictions and their link to substance use disorders is vital for effective treatment. Recognizing these patterns allows individuals to take steps toward recovery and regain control over their lives.

Types of Process Addictions

Almost any activity could, in theory, trigger a process addiction. But typically, experts are talking about just a few specific tasks when they’re discussing this topic. And sometimes, these acts are part of a larger disease process.

Common process addictions include:

Problem gambling. Close to 3 percent of Americans struggle with a gambling addiction. It’s more common among men than women, and people with this issue can lose thousands of dollars in just one night due to their illness, says the North American Foundation for Gambling Addiction Help.
Sexual addiction. People with this issue engage in sexual activity compulsively, often without joy. Research published in Current Pharmaceutical Design suggests that between 3 percent and 6 percent of adults have this disorder.
Internet addiction. This disorder is defined by compulsive, problematic use of technology, even when the person wants to spend time doing something else. Between 1.5 percent and 8.2 percent of Americans and Europeans have this issue, say researchers writing for Current Psychiatry Reviews.
Kleptomania. People with this issue steal items for the sake of theft. They don’t need the things they take, and they often don’t even want them. But they can’t resist the urge to take something. Less than 1 percent of adults have kleptomania, says the Cleveland Clinic.
Skin picking. As many as 1 in 20 people have this disorder, says the International OCD Foundation. People with it pick their skin cells over and over, and often, it’s bad enough to cause deep damage to the skin.
Hair pulling. People with this disorder pull, twist, or scratch out their hair follicles, leaving bare, bleeding patches. Up to 2 percent of adults have this issue, per research cited by National Public Radio.

Recognizing the signs of process addiction is crucial for seeking help. Common signs include:

Spending excessive time on the behavior
Neglecting responsibilities or relationships
Lying about the activity
Experiencing mental discomfort (psychological withdrawal) when trying to stop

Process Addiction vs Drug Addiction

A process addiction, like other forms of addiction, focuses on an unhealthy relationship with a pattern of behavior. Unlike a substance use disorder, process addictions center around an action, not a substance, that the person can’t control.

Substance abuse and process addictions start with chemical changes in the brain. Researchers explain that a person with an addiction:

Anticipates the hit. Right before the target activity, brain cells trigger cravings.
Experiences a release. When the act is complete, brain cells release a flood of feel-good chemicals.
Undergoes damage. That flood isn’t normal for the brain. Receptors burn out. Portions of the brain associated with decision-making and control are impaired.
Feels unwell without the activity. Altered brain cells can’t perform properly without the rush of chemicals.

Similar to substance use disorder, people with process addictions can’t easily “just stop” their activities. However, people struggling with a process addiction can learn to control the craving with the help of mental health professionals. When they do, their brain cells can heal and stop participating in addictive behaviors.

Co-Occurring Conditions

For some people, these are standalone issues. They have no other mental health challenges, and their need to complete these tasks seems to come on suddenly. But others feel compelled to act due to obsessive-compulsive disorder (OCD).

OCD often prompts intrusive thoughts about disease, distress, or infection. People with OCD may engage in compulsive behaviors to ease those thoughts. Without the intrusive thoughts, the activity would stop. But since it’s always present, they feel the need to keep acting.

For example, you might have the intrusive thought that you’ll harm your family. You tell yourself you must pull five hairs from your head to keep them safe. You know the two things aren’t connected, but you can’t resist the urge to comply. You might spend hours every day pulling your hair and doing other repeated tasks, and you think that if you stop, you’ll hurt your family.

Many individuals with process addictions may also struggle with substance abuse, as these conditions often overlap and worsen each other. When this is the case, people struggling with a process addiction as well as alcohol or drug abuse require a program that is equipped to treat co-occurring conditions, also known as dual diagnosis treatment.

Treating a Process Addiction

Treatment for process addictions is designed to heal brain changes and give you control over your choices. Typically, a program combines medication management, therapy, and support group work to help you heal.

According to the Anxiety and Depression Association of America, antidepressant medications can soothe the disruptive thoughts that come with OCD, which could reduce the urge to act. But medication alone won’t solve the problem. You’ll also need to work with a counselor to build up skills for long-term control.

In therapy, experts say, you’ll build relapse-prevention skills. That means you’ll:

Identify triggers. What makes the urge to act grow stronger? Does spending time with certain people or in a specific place make the need grow?
Learn to cope. What should you do when you can’t avoid a high-risk situation? What skills must you build to help you push through?
Support a healthy lifestyle. Your acts can be an outlet for stress, depression, loneliness, or even hunger. How can you restructure your life so you’re not vulnerable to relapse?

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Where to Get Help

It’s not easy to talk about process addictions. Often, the activities you engage in seem unusual or embarrassing. Remember that you’re not choosing to act this way, and mental health professionals won’t blame you for it. By admitting to a problem, you can get the help you’ll need to live a healthier life.

Support groups (like a 12 step based meeting) can be very helpful for process addictions. Here, you’ll meet other people who engage in the same activities you do. If you’re feeling isolated and alone due to your mental health, connecting with this community could be an amazing source of relief. You can also ask the people in your meetings to refer you to a treatment provider you can trust.

Good support group choices include:

Gambler’s Anonymous. This organization keeps an online listing of meetings held all across the United States. You’ll find out where meetings are held, when they start, and what format the meeting will follow.
Sex Addict Anonymous. This organization is designed for people living with or touched by sex addiction. Meetings follow a 12-step format, and people who participate are encouraged to meet regularly to learn from and support others as they recover. Some meetings are held face to face, but others are conducted online or via teleconference.
Kleptomania Support Group. This is a virtual community. You can create a profile and start sharing information with people who share your diagnosis. Your information is kept confidential.

These meetings are free to attend, but note that there are no mental health professionals in charge of the work. You will likely need to step outside of the meeting format and do some work in therapy to truly heal.