Addictions

What Is Addiction?

Addiction is a complex condition and can affect anyone differently.

There are two main types of addiction: substance-based addictions and non-substance addictions (also known as behavioural addictions).

Substance-based addictions include alcohol, drug, or nicotine dependence.

On the other hand, people may experience behavioural addictions such as gambling or excessive shopping.

Gambling usually occurs due to the thrill of placing a bet (that eventually might turn into an addiction) despite the financial or emotional consequences.

Similarly, engaging in digital activities excessively has led to internet addiction. Internet addiction is where individuals spend excessive hours online. Due to this, many aspects of their life (eg social and physical health) may be affected.  

Research also shows that there is a strong link between social media addiction and mental health.

Workaholism is another form of addiction (also called work addiction). This occurs when individuals become excessively immersed in their professional lives. Work addiction often leads to them ignoring or simply lacking time for personal relationships and well-being.

It’s important to note that addiction is not simply a lack of willpower or discipline. Addiction is a mental health condition that often has one or more psychological triggers.

Fortunately, addiction is treatable. Professional therapy is one of the most important interventions that can help control and manage your addiction.

This article will look into the symptoms, causes, and treatments for addiction, including therapy. Furthermore, we also answer some of the most asked questions about addiction.

Symptoms of Addiction

Below are some of the most common and easily detectable signs of addiction.

If you or someone you know shows these signs, a professional Therapist can help you.

Do note that your symptoms may be unique to you. For example, some people with addiction find that maintaining social relationships is the hardest part.

On the other hand, some people with addiction can function socially, but some may struggle with other issues like maladaptive behaviours.

Below are some of the common symptoms of addiction:

• Persistent usage: Despite wanting to quit, people may be unable to refrain from the addictive substance or behaviour. The usage often leads to concealment or dishonesty about the intensity of the problem.
• High tolerance: As a person gets more addicted, there is a significant increase in the amount of the substance or intensity of the activity needed to achieve the same satisfaction or relief. Therefore, the person starts becoming more and more addicted as they get used to their tolerance levels.
• Preoccupation: The person constantly thinks about the addictive substance or activity. Preoccupation leads to excessive time spent obtaining, using, or recovering from the substance.
• Loss of autonomy: People experience a feeling of powerlessness, where they perceive their addiction as uncontrollable. Hence, the person may feel guilt, despair, and a sense of being trapped.
• Adverse consequences: The repercussion of addiction affects various areas of life. For example, the person may notice a decline in their physical and mental health, their relationships may become more complicated, and they may find it hard to maintain professional obligations. Yet, the addictive behaviour persists despite these negative outcomes.
• Withdrawal symptoms: Stopping the addictive behaviour can lead to both physical and emotional reactions. Physically, one might experience tremors, nausea, or fatigue. Emotionally, they may notice persistent anxiety (ie generalised anxiety disorder), mood swings, irritability, and restlessness.

Causes of Addiction

Addiction arises from a combination of factors, each playing a distinct role in its onset and progression.

Addressing it requires a holistic approach, considering the intricate interplay of brain chemistry, genetics, mental health, environment, and past traumas.

a) Brain Chemistry Alterations

The brain’s reward centre is particularly a common cause of addiction. While positive experiences like achieving a goal or enjoying a hobby release dopamine (a pleasure-inducing chemical) – certain substances and activities flood the brain with excessive dopamine.

This overstimulation can distort one’s motivation and push them towards the addictive substance and away from healthier activities.

As exposure continues, the brain becomes less responsive. Hence, the person might start having urges to consume excessively to achieve the same dopamine high.

b) Genetic Predisposition

Genetics significantly influence one’s susceptibility to addiction. Research indicates that 40% to 60% of an individual’s vulnerability to substance use disorders (SUD) can be attributed to genetic factors.

Those with a relative or family member with SUD are at a heightened risk of developing addictive tendencies.

c) Mental Health Issues

Addiction and mental health issues are strongly connected. Conditions such as depression, bipolar disorder, and post-traumatic stress disorder (PTSD) often coexist with addiction.

It is estimated that nearly half of those with a mental health disorder will, at some point, struggle with SUD, and vice versa.

d) Environmental Triggers

The environment one is exposed to can either mitigate or increase the risk of addiction.

Easy access to addictive substances or being close to regular users can also increase the risk.

Prescription medications, especially opioids and stimulants, if misused, can also cause addiction.

e) Adverse Childhood Experiences (ACEs)

Childhood traumas, known as ACEs, significantly impact the likelihood of addiction in adulthood.

These include various distressing events, like neglect, avoidance, and abuse. The repercussions of ACEs extend beyond addiction – they influence multiple parts of health throughout an individual’s life.

Types of Addiction

The two types of addictions are substance addictions and non-substance addictions. Substance addictions are known as substance use disorders. On the other hand, non-substance addictions are known as behavioural addictions. 

1) Substance Addictions

Substance addiction, now termed “substance use disorder” by healthcare professionals, is a complex and severe condition. The DSM-5 recognises specific criteria for diagnosing this disorder.

Substances with addictive potential include a broad range. These include:

• Alcohol
• Caffeine
• Cannabis
• Hallucinogens
• Sedatives and anxiolytics, like benzodiazepines
• Inhalants, such as aerosol sprays
• Opioids, both prescription and illicit, like heroin
• Stimulants, including cocaine and methamphetamine
• Tobacco and nicotine products, including e-cigarettes

Despite its unique properties, each substance stimulates the brain’s reward centre, inducing pleasure.

However, not every individual using these substances develops a substance use disorder.

The severity of addiction can be mild, moderate, or severe. 

2) Non-substance Addictions

Non-substance addiction, often termed behavioural addiction, directly engages the brain’s reward system, much like substance-based addictions.

The DSM-5 recognises only gambling disorders under the umbrella of non-substance-related disorders.

Yet, the absence of other behavioural addictions from the DSM-5 is due to limited research and not due to their non-existence.

Such addictions, when unchecked, can profoundly disrupt daily life, leading to mental, social, and even financial distress.

Key activities that lead to behavioural addiction risks include:

• Gambling
• Overeating
• Excessive exercising or dieting
• Compulsive shopping
• Risk-driven behaviours like shoplifting
• Frequent sexual engagements
• Prolonged pornography consumption, which may lead to behaviours like masturbating excessively
• Video gaming, termed ‘internet gaming disorder’
• Overuse of the Internet on devices

How Are Addictions Treated?

Addictions are treated using either just one approach or a combination of medication and psychotherapy.

The type of treatment plan depends on several factors, such as:

• The type of addiction (eg substance or non-substance)
• Intensity of the addiction
• Personal preference
• Social support
• Doctor’s and Therapist’s recommendations

Some of the common types of treatments are:

• Medications: Meds can address underlying mental health issues, such as anxiety or depression, which might contribute to the addiction.
• Psychotherapy: Techniques like cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT) can help people understand their addiction and develop coping strategies. In fact, research shows that DBT is one of the most effective therapeutic approaches to treat addiction.
• Case Management: A mental health professional (eg psychotherapist) may work with other experts, such as medical doctors and counsellors, to provide long-term and effective support. The professionals may exchange notes or clinical impressions to make sure that the treatment plan is constantly updated based on the person’s progress.
• Inpatient Treatment: For severe types of addictions, a controlled environment (especially one that is not triggering) can help reduce and manage symptoms of addiction.  
• Support Groups: Peer support can provide a space to share similar experiences. Knowing that you are not alone is highly important in starting your journey towards recovery. 

Frequently Answered Questions

How to tell if someone is on drugs?

Identifying the signs of drug use in someone is usually the first step towards helping them. While each substance may manifest its effects differently, there are some common signs to be aware of:

• Academic and professional struggles: A decline in academic performance, lack of interest in school or work tasks, and frequent tardiness.
• Appearance changes: Neglect in personal grooming, wearing untidy or unsuitable clothing and visible deterioration in skin health.
• Behavioural shifts: An unusual desire for privacy, defensiveness when questioned, and drastic changes in relationships.
• Physical symptoms: Bloodshot eyes, consistent fatigue, and noticeable changes in appetite leading to weight fluctuations.
• Financial irregularities: Excessive spending, frequent borrowing of money, and consistent inability to manage financial obligations.

If these signs resonate and you are concerned about someone you know, it is essential to approach the situation with empathy and understanding. Addiction is a complex issue, and confronting it requires support.

What is sex addiction?

Sex addiction, often debated in medical and psychological communities, is characterised by a compulsive need to engage in sexual activities.

This is like how someone with alcohol addiction craves a drink.

While it is not listed in the DSM-5, it can be diagnosed using its criteria as “Other specified sexual dysfunction”. Similarly, the ICD-10 classifies it as “Other sexual dysfunction, not due to a substance or known physiological condition”.

It is crucial to distinguish sex addiction from disorders like paedophilia. The primary concern with sex addiction is its potential to harm personal relationships and overall well-being.

Like any addiction, it can detrimentally affect one’s physical and mental health and jeopardise personal relationships, quality of life, and safety.

Additionally, contrary to popular belief, having multiple sexual partners is not a definitive sign of this disorder. Having multiple partners ethically is known as ethical non-monogamous relationships.

In contrast, sex disorder includes a compulsive need to masturbate, consume pornography, or seek sexually stimulating situations.

The main signs of sex addiction are the significant alteration of one’s life to engage in sexual acts frequently, often multiple times a day, and an inability to control such behaviour despite severe repercussions.

Talk Your Heart Out (TYHO) is here to help you. At TYHO, we offer a personalised approach to make sure that individuals receive the care and support tailored to their unique needs.

Our qualified team of therapists, counsellors and psychologists in Singapore and globally are committed to helping those struggling with addiction to guide them towards a path of recovery and well-being.

If you or someone you care about needs help, reach out to TYHO today.

How does unemployment influence addiction?

Unemployment is a distressing life event and has profound impacts on mental well-being.

When people face a job loss, they struggle with financial strain and a negative sense of self-worth. This emotional distress often leads them towards substance use as a coping mechanism.

Despite reduced income, the temporary relief from reality through drugs or alcohol becomes increasingly tempting.

Furthermore, economic downturns have historically seen a surge in alcohol consumption. The financial and personal stress coming from unemployment pushes many to find peace in substance use.

Moreover, employment offers a structured routine, keeping people engaged. Its absence increases the time and opportunity for drug-seeking behaviours.

Furthermore, the loss of a job can lead to stigmatisation. Job loss stigma is particularly more common among males, who often link their self-worth to their professional roles, making them more susceptible to substance use.

Lastly, the workplace encourages social interactions and creates a sense of belonging. Unemployment can increase feelings of isolation. It further drives individuals towards substance use as a means of connection or escape.