An addiction a persistent need to consume a substance or commit an act—is distinct from a compulsion, which is an overwhelming and irresistible impulse to act. Usually, a compulsive act is preceded by obsessive, intrusive thoughts that compel the person to act, whereas an addiction is more of a habit that is not necessarily accompanied by obsessive thinking. Still, given how often an addict thinks about whatever he or she is addicted to, the line between “addiction” and “compulsion” can be somewhat unclear.
Compulsive behaviors include chronic gambling, substance abuse, sexual addictions, unrestrained shopping and spending, hoarding, excessive exercising, Internet gaming, eating issues, and other behaviors. Any compulsive behavior can become an addiction when the act spirals out of control, impairing a person’s ability to function socially, academically, and professionally.
Determining whether a habitual behavior has become problematic begins with evaluating the benefits associated with the activity and the feelings and beliefs surrounding it. The distinction between a passionate hobby and a compulsive behavior may be difficult to discern. For example, is running 10 miles every day—rain, shine, or snowstorm—an addiction, or is it good athletic discipline? Is a monthly trip to Vegas to play the slots a gambling problem, or just a fun escape from the daily grind? What about binging on ice cream, even when you know you should not? Addiction or compulsivity may be indicated when the behavior results in feelings of distress, guilt, or shame, or when abstaining from the behavior provokes anxiety or proves to be impossible.
Symptoms that suggest a compulsive behavior has become problematic include:
Typically, addictions or compulsions develop as a result of an underlying psychological issue, such as depression, and the behavior can temporarily relieve stress or anxiety for anywhere from several minutes to several days. Compulsive behaviors often trigger the same neurological pathways that specific substances stimulate in the brain of someone with drug addiction, and this cycle of reward can make the activity that much more attractive and, ultimately, addictive.
People with severe mental health conditions, such as bipolar, may experience poor impulse control that makes it difficult or impossible to resist compulsive urges. In addition, a rare side effect associated with dopamine agonist medications, which treat conditions like ADHD and Parkinson’s, can produce extreme compulsive behaviors, even in people who had no such inclinations previously.
Compulsive behaviors and addictions may provide a person with a sense of power, euphoria, confidence, validation or other feelings that may otherwise be lacking in their lives, and psychotherapy is designed to help people identify uncomfortable feelings and sources of distress in order to change and grow. People who struggle with compulsivity and addiction are unlikely to conquer those behaviors unless they work to address underlying causes. Working with a therapist is one of the most effective treatments for managing compulsive behaviors and addictions, and there are many types of therapy suited to addressing behaviors that a person wants to change. It is most important to find a therapist who is qualified to address the issue. In addition, self-help, support groups, and 12-step programs may facilitate recovery from addiction and compulsivity.