Q: What's a behavioral addiction? Is it different from, say, drug addiction?

A: Behavioral addiction generally refers to repetitive escalating actions unrelated to the ingestion of substances that effect one's health, work, relationships, school, finance or legal status. These actions tend to escalate or continue in spite of the consequences, causing significant distress in spite of the desire to stop. It is different from a drug addiction in that it is not specifically induced by pharmacological agents acting on the brain. However, in my experience it is often the case when a chemical addiction precedes a behavioral addiction, shall we say priming the brain towards the system to need escalating reinforcement.

The archetypal behavioral addiction is gambling and there appear to be two type of gambling addicts: those that pursue the excitement—and interestingly those people seem to enjoy more the excitement of losing money rather than winning. And those that seem to zone out during their gambling with their gambling addiction. They seem to be drawn to the video gambling machines such as poker, they will sit for long periods at these machines and dissociate to the point that they have been reported to even lose control of their bladder function.

Sexual addiction is altogether the other most addictive behavior. Now with the advent of pornography on the internet, the home computer has been like having a crack pipe in the addict's home. Some who work in the field of treating sexual addicts believe this is the most rapidly increasing diagnostic category in the country. The unfortunate reality of internet pornography addiction is that it tends to escalate, subjects tend to need increasing levels of arousal and will often graduate to more bizarre images and ultimately to accessing dangerous or even illegal activities.

The term behavioral addiction has begun to be applied to a wide variety of behaviors perhaps to the point where the meaning of behavioral addiction has lost its value and impact. A simple definition that I like to use is first assess whether or not you have a risk for addiction per se, is there genetic heritage of alcoholism, for instance is there genetic heritage of alcoholism in your family background, secondly is there evidence of escalated use in spite of deleterious consequences, and finally, is there any degree of denial here, about your behavior and its consequences. If you meet these criteria and are having significant distress or consequences in your life, it might be worth consulting with an expert.