Addiction is a word that is commonly used in the English language. It means, literally, dependence. A person who is addicted to something is dependent on it either psychologically or physically. An addict has an overwhelming compulsion to take a substance or to behave in a certain way, regardless of negative consequences. This can be anything from mildly debilitating to dangerous or fatal. It is almost always difficult at best for an addict to modify his behavior himself, and often impossible without help. Not only has he come to rely on the addiction to feel better psychologically, but many addictions are physical too and withdrawal painful and prolonged.
Types of addiction
Some types of addiction are better known and easier to understand than others. Everyone is aware that people can become addicted to alcohol or drugs. But some addictions are less well known. In recent times, for example, many celebrities are said to be addicted to sex. While psychologists say that this is a real addiction problem and not just bad behavior, opinions differ. Then there are addictions to chocolate, addictions to exercise, or addictions to eating strange things. While anyone, it seems can become addicted to anything, among the most common types of addiction are the following:
Along with drug addiction and nicotine addiction, alcohol addiction is one of the most common addictions in the modern world. Alcohol is the world’s number one addiction. It can have devastating effects on the addict, his or her immediate family and social circle, and on the world around him. Alcohol abuse can cause actual physical harm and illness to the addict in an number of ways. It causes heart and liver disease among other health problems, and withdrawal is fraught with dangers. Alcohol, taken in large amounts over a period of time has a physiological effect on the body, and causes the addict to require more and more alcohol in order to achieve the desired sensation. A person who is addicted to alcohol can also become difficult or dangerous to live with, as excess drinking can cause a person to become violent and unpredictable in their behavior. Someone who is drunk may become uncoordinated and fall and walk into dangerous situations. Knock on effects of alcohol addiction can also include causing death or injury by drink driving and crime and financial problems brought on through the addict’s incessant need to obtain alcohol.
The term drug addiction covers many different types of drugs. There are legal drugs, such as painkillers and anti depressants that can have addictive side effects, and illegal drugs taken for recreational use. When a person becomes addicted to, or dependent upon drugs, the addiction is physiological. This means that the body has adjusted to the substance in order to maintain normal functioning. Thus higher and higher doses of drugs are needed to have any noticeable effect, and withdrawal can make the addict physically ill. This applies to both legal (prescription) drugs and illegal (recreational drugs). Drugs can also have effects on a person’s mental health, causing depression, psychosis and unstable emotions and behavior. Under the influence of mind altering drugs people can behave very irrationally and dangerously.
Nicotine is the addictive substance in cigarettes. Addiction grows over time, with cigarette consumption increasing with tolerance. Addiction to cigarettes is often both physical and emotional. Nicotine causes a chemical reaction in the brain, and is highly addictive. It is, however, possible to quit by going ‘cold turkey’ without the serious side effects caused by such withdrawal from drugs and alcohol.
Gambling addiction is purely a behavioral pattern addiction, as no substance is taken into the body. Hence it is believed by the American Psychological Association to be an ‘impulse control disorder’ rather than a true addiction. However, addicts experience sensations of excitement and elation through gambling, and frequently need a program of help such as that provided by Gamblers Anonymous to bring the problem to an end. Gambling can cause family, social and financial problems.
This is similar to gambling addiction. Addicts…or those suffering from an impulse control disorder’ use shopping to alleviate other problems in their lives. They become excited at the prospect of shopping, and compelled to go. Once there, the excitement takes over and they have no control over their spending. A shopping addict may rationalize the behavior to herself during the shopping spree, perhaps telling herself that by buying something from the sales she is actually saving money rather than spending it. Although the buzz gained from shopping sprees usually lasts until the shopper has arrived home and unpacked her purchases, it is short lived and soon the need to go and spend more will resurface. Compulsive shoppers will often hide their purchases and credit card notices from their families or partners. Shopping addiction can cause great financial problems.
While gambling, nicotine consumption, drug consumption (except in the case of some legal prescription drugs) and alcohol consumption are not normal, healthy pursuits, sex is different. Even a person who enjoys a lot of sex is not abnormal or putting himself or others at risk…under normal circumstances. However, if the person’s desire for sex or porn becomes uncontrollable, compulsive and escalating in intensity, and has negative effects either on the person, his family or sexual partners, sex addiction could be diagnosed. Sex addiction can also break up families especially if the addict is married and unfaithful or demanding unreasonable amounts of sex from his partner.
Eating is another normal, healthy, necessary human activity. Food, in the normal run of things, is good. It keeps us alive, and in proper proportions, keeps us healthy. Food is fuel for the body. However, because food is also enjoyable, sometimes people turn to it for comfort in times of stress because food can trigger feel good brain chemicals. At this point a real addiction can set in. Foods that are especially addictive include sugar, chocolate, fat and salt. Any foods high in these can be addictive.
Unusual eating addictions
While developing an appetite for usual foods during pregnancy is considered part of the process as long as the foods are not harmful to mother or baby, some very strange food addictions have been reported. Toilet tissue, soap, coal, dog food…all these and more can be the objects of a compulsive desire to eat. Known as ‘pica’, this addiction to weird ‘foods’ can be a result of a physical condition, like malnutrition or mineral deficiency, a mental illness or an actual physiological addiction to a substance in the ‘food’.
Essentially a behavioral addiction, addiction to exercise, like addiction to certain foods, exerts a stronger effect as it releases brain chemicals that make the addict feel good, thus increasing the need and desire to perpetuate the activity to excess. Exercise addicts may not only spend so much time and energy exercising that they cause family and social problems, but can become unable to concentrate properly at work too. Physical effects can include weight loss and joint and muscle strain. Exercise addicts may also go on to become addicted to chemicals and substances that aid muscle gain or energy levels enabling them to exercise more and harder.
A behavioral addiction, computer addiction frequently affects children and teenagers who spend every free minute sitting at a computer, playing games, using social networking sites or online chat rooms. This ‘virtual life’ can take over from real life leaving them socially deprived, taking insufficient exercise or sunlight and at risk of contact with cyber bullies, internet trolls or child abusers.
Symptoms of addiction
There are many possible symptoms and signs of addiction, and not all will be exhibited by any one addict. Symptoms also can relate to the type of addiction suffered. However, the following are accepted to be reliable signs that a person may be an addict:
- Increased tolerance: This is particularly relevant to alcohol and drug addictions. As the body adjusts, making physiological changes to adapt to the presence of the substance, higher tolerance levels are noted. An alcohol addict, for example, may find that instead of experiencing the pleasurable effects of alcohol after one or two drinks, as at first, he needs four or five to achieve the same effect as the addiction takes hold.
- Withdrawal symptoms: If, when a person abstains from the substance or behavior that is at the root of the problem, he or she suffers withdrawal symptoms, addiction is likely. Withdrawal symptoms may include shaking, headaches, mood changes or anxiety.
- Difficulty in abstaining: If a person finds it difficult to abstain from or to cut down the amount of the addictive substance or behavior, addiction must be suspected.
- Social problems: A person who is addicted to something, be it a substance or behavior, may find he is withdrawing from normal social activities due to a preoccupation with his addiction. For example, an alcoholic may avoid social gatherings in order to stay home and indulge in more alcohol than he would be able to in a social setting.
- Preoccupation with the addiction: An addict may spend increasing amounts of time planning how to indulge in his addiction. He may also experience feelings of panic if the supply of the addictive substance or opportunity to indulge in an addictive behavior is withdrawn.
- Mood swings: If a person experiences extreme mood swings, it can be a sign of addiction.
- Disruption of normal sleep patterns: Addicts may find that they sleep more or less than usual as the addiction takes hold. They may also wake at unusual times, sometimes with a craving to satisfy the addiction.
- Changes in energy levels: Addiction can lead to changes in normal energy levels, leaving the addict abnormally tired or energetic for no apparent reason.
- Weight loss or weight gain: Both weight loss and gain, without obvious other cause can be a sign of addiction.
- Chronic illness: Addicts often suffer low level chronic illnesses like coughs and runny noses.
- Eye changes: Some substance addictions like drugs can cause changes in the appearance of the eyes, with the pupils appearing noticeably larger or smaller than usual.
Further signs of addiction problems may include secretiveness. An addict will often go to extreme lengths to hide the extent of his addiction. So, someone making excuses to leave the house at odd times, giving a weak excuse, may be trying to cover up an addiction. Alcohol, drugs, foods or cigarettes are often hidden away by addicts in a secret stash. By the same token, addicts often become very deceitful, telling outright lies to cover their addictions and to allow them to indulge. Changes in the addict’s financial status may also be noticed. He may be spending too much money on feeding the addiction, or may even appear to have more cash than usual at times as a result of a gambling win, theft or extra activity undertaken to fund the habit. Addicts may also make unexplained changes in their social habits, dropping old friends for no obvious reason and taking up with new ones. Secretive and frequent telephone calls may also be signs of addiction.
Finally, another common sign of addiction is denial. Many addicts do not want to confront their problems and deny the addiction to themselves as well as to others.
Diagnosis of addiction
The diagnosis of an addiction is usually made after consultation with professionals who use a range of criteria to evaluate the problem. In most cases, the diagnostic process will begin with a visit to the family doctor. The patient will then be referred to a psychiatrist, psychologist or a trained addictions counselor.
It is important to understand that whatever you are addicted to, you will always be treated with respect by these professionals. Their aim is to help you to conquer the addiction, if it exists, not to judge you.
There are objective criteria applied to the diagnosis of addiction, according to the Diagnostic and Statistical Manual of Mental Health, which covers addictions to substances. Behavioral addictions are evaluated according to the most recent and respected research in the field.
The diagnostic process will probably involve the following:
- Informal chat with your doctor. He may ask about your current situation, emotional matters, stresses you may be under and any family history of addictions. He will also ask you to be honest about the extent of your problem and symptoms.
- Forms and questionnaires. This may be with your doctor or after referral to a specialized health professional.
- Face to face ‘open’ interview with a trained addiction counselor, psychiatrist or psychologist. The health professional will ask you to speak freely while taking notes.
- A more structured interview: Following the ‘open’ interview you may have a more structured interview with the health professional. This involves being asked a set of standard questions and your answers being recorded by the clinician.
Questions you will be asked during the interview and diagnostic process are likely to include:
- The history of your addiction. You will be asked how and when the problem began, how it developed and if you are able to pinpoint any factors that have encouraged or caused the addiction and its escalation.
- The pattern of your addictive behavior. The clinician will need to know what patterns your addiction follows. This means what your addiction actually involves in terms of how often you indulge, if there are any recognizable triggers to your addictive behavior and the nature of your behavior.
- Your symptoms of addiction: The clinician will ask you what symptoms you experience in relation to your addiction. For example, he may ask if you suffer withdrawal symptoms if you abstain, and what these are.
- Wider effects of your addiction. You will be asked if you are aware of the more far reaching effects of your addiction on your family, friends, finances and working life.
- Finally, you will be asked about your motivation to beat the addiction. Are you really committed to changing?
The clinician may also ask you to submit urine samples and take blood samples for testing. The entire process should also take into account your mental, emotional and physical state of health. If there are signs of physical illness present, for example, liver disease, you will be referred to a relevant clinic, doctor or hospital for treatment in addition to the counselling or treatment for the addiction. If you are presenting signs of mental illness above or beyond (even if caused by) the addiction, you will be referred for help with this also.
To be sure that you receive an accurate diagnosis, its is important to:
- Be truthful at all points during the diagnosis. An experienced clinician may be able to tell if you are lying, but any deceit only hampers the process of finding a cure for your problems. Ultimately, not being truthful harms you.
- Speak freely and ask questions. If you have any concerns about what is happening, speak up.
- Ask for assistance if you need it. If you are given complex forms to complete or there is anything that you do not understand about the diagnostic process, request assistance.
- Allow yourself to become emotional. Accepting that you are an addict and facing up to the rigors of change can be deeply emotional. It’s normal, and you need to allow yourself to express your feelings.
- Be co-operative. Co operating with the staff who are trying to help you is essential for best results. Sometimes you may have to be patient, but understanding the process and what it involves helps with accepting this.
You may or may not be given an immediate diagnosis. Sometimes the diagnosis is delayed if tests and the information that you have supplied need to be sent away to another specialist. Once diagnosed, a personal treatment plan will be drawn up for you. You also need to understand that getting the diagnosis and treatment plan does not bind you into it. You are free to stop the treatment if you want to…but if you are serious about conquering the addiction it is strongly advised that you follow the whole process through with commitment.
Treatment for addiction
The specific treatment that you will be offered once your addiction has been diagnosed will vary according to the problem. Treatment for substance abuse will be different from treatment for purely behavioural disorders due to the physiological nature of substance addictions. It will also vary according to you personal situation, state of emotional, mental or physical health and level of addiction. That said, common treatments for addiction may involve:
- Counselling: Counselling sessions with a specialised addictions counsellor are often very effective. Often referred to as ‘talking therapy’, sessions will involve face to face interaction with a counsellor.
- Behaviour modification sessions: Often part of counselling sessions, behaviour modification involves learning how to substitute new behaviours for the old, addictive behaviours.
- Involvement of family members: Some treatment sessions may involve family members who can not only increase your motivation to succeed in kicking the addiction but who can also learn effective ways to help and support you as you go through the process.
- Participation in support groups: Support groups are well known to be effective. Some of the most well known are Alcoholics Anonymous and Narcotics Anonymous, but there are many more specific to different addictions.
- Hospitalisation or residential clinic pogrammes: Some addictions are better solved by a stay in a special hospital or clinic with expertise in addiction disorders. These involve addictions where physical withdrawal symptoms can be a real health problem, such as drugs and alcohol.
Treatment of addiction should always be undertaken under the guidance of trained professionals.
- The first and most important step in escaping addiction is to recognise and accept that the problem exists. As a feature of addiction is often denial, this can be difficult to do in many cases. If you have trouble accepting your addiction for what it is, try talking to those close to you for a real wake up call. You may be able to kid yourself that drinking two bottles of wine a night is not an addiction, but your family, who watch you drink yourself into a stupor every night may tell you differently. Look closely at the signs and symptoms of addiction, and apply them to yourself. Don’t fool yourself that just because you don’t display every possible characteristic of an addict it means that you do not have an addiction problem.
- Next, plan your escape from addiction. Make a plan and stick to it. If necessary, tell yourself that you will commit to the plan for a period of time…a year, two years or whatever seems achievable to you. This can make the process seem more manageable and less daunting. While you are feeling positive about ending the addiction, make an appointment to see your doctor. It may be useful to write a brief letter to him ecxlaining why you want to see him and delivering it at the time that you book the appointment so that you can’t back out and give another excuse for seeing him when the time comes!
- Quit. Use whatever help is offered by your doctor and other health pofessionals, and commit to it.
- Stay clean, even after the programme ends. This is the hard part. Use everything that you have learned through the withdrawal and treatment programmes. Don’t allow yourself to believe that now you have cracked the problem you can indulge every now and then. You can’t. Once an addict, always an addict. One social drink will soon lead to bottles every night. Keep attending the support groups, even if you think you are cured. Have support telephone contacts to hand for moments of temptation.
- Change your social circle and habits. This can help you to rid yourself of the old triggers to addiction and addictive behaviour. You don’t have to drop the friends that you used to go to the bar with, but try suggesting get togethers in different setting instead. Take up a physical activity or sport, as this emphasises your new, healthier lifestyle and rids you of negative energy.
- Keep a journal: Keeping a journal of your experiences and road to recovery can help you in several ways. It allows you to express, honestly, your feelings and this in itself is therapeutic. It also acts as a reminder of how far you have come on your journey, and as an incentive not to go back to the old, destructive ways.
If someone you know is an addict
Of course, it may not be you yourself who is the addict. It may be a family member whose drinking has become out of control, or a friend whose furtive behavior and physical demeanor suggests a drug problem.
You want to help, but it’s all a bit of a minefield. Addicts are unpredictable, usually in denial and even sometimes dangerous if crossed. So, what can you do to help?
- Start by speaking to the person. Tell them you are concerned for them, and also explain, honestly, the effects their behaviour is having on you and your family.
- Have a prepared list of answers to their possible excuses in advance. Addicts in denial may claim that their drinking, for example, is far less than you know it is, so make a record of what they have been drinking and be ready to prove it to them.
- Look after yourself. Helping an addict to recover is emotionally and sometimes physically exhausting, so take time to take care of your own needs during the process of supporting them.
- Accept that ultimately, however much support you give them, an addict has to take responsibility for him or herself. You cannot force them to stop their addictive behaviour, you can only support and encourage.
- Don’t make threats, or become preachy. Avoid bribes too.
- Stop making excuses for the behaviour of an addict to others. Don’t cover up the negative ffects of their addiction, however tempting this may be.
- Don’t hide or throw way the addictive substance. This will only panic the addict into getting more supplies.
- Wait until the person is sober or not under the effects of drugs before you speak to them about the problem.
- Do offer to go along and get involved in support groups or treatment where appropriate.
Resources for Addition Help
Addiction, in any of its forms, is unhealthy and can have negative effects on close family, friends and society as well as on the addict. Help is available. The first step is to see your family doctor, or call a support group. Some useful resources follow:
- http://www.aa.org/?Media=PlayFlash Alcoholics Anonymous
- http://www.na.org/ Narcotics Anonymous
- http://www.gamblersanonymous.org/ga/ Gamblers Anonymous
- http://www.foodaddictsanonymous.org/ Food Addicts Anonymous