An Overview of Addiction By Elizabeth Hartney, PhD - Reviewed by a board-certified physician. Updated July 13, 2016 For a long time, addiction meant an uncontrollable habit of using alcohol or other drugs. More recently, the concept of addiction has expanded to include behaviors, such as gambling, as well as substances, and even ordinary and necessary activities, such as exercise and eating. The key is that the person finds the behavior pleasurable in some way and engages excessively in the behavior as a way of coping with life. By the time a person is addicted, the behavior will be causing more problems in the person's life than it solves.Top 5 Things to Know About AddictionsWhile addiction to substances has often appeared clear-cut, there's some controversy about which substances are truly addictive. Current guidelines through the Diagnostic and Statistical Manual of Mental Disorders, or DSM 5, indicate that most psychoactive substances, including medications, have the potential to be addictive. Article DSM 5 Criteria for Substance Use Disorders Article The Self Medication Theory of Addiction and Addictive Behavior There is still much debate about whether many “behavioral” addictions are “true” addictions. More research is needed to clarify this issue. Gambling addiction is a behavioral addiction that has been recognized for many years as an impulse control disorder. It is now categorized as Gambling Disorder in the DSM.Addictions take time to develop. It is unlikely that a person will become addicted after using a substance once, although it is possible to develop a mental health problem, or to die of an overdose or another complication after one use of some substances.Although there are some schools of thought that preach the need for complete abstinence, many people are able to learn to control addictive behaviors, such as drinking, eating, shopping, and sex. Whether this is a good idea for you depends on many factors and is best decided in collaboration with your doctor or therapist. Substance use is not always an indication of addiction, although drug use carries numerous health and social risks as well as addiction. Parents shouldn't automatically assume their child has an addiction if they discover their child has used a drug.So If You Can Be Addicted to Anything, What Makes It an Addiction?Symptoms of addiction can vary, but there are two aspects that all addictions have in common:The addictive behavior is maladaptive or causes problems for the individual, or those around them. So instead of helping the person cope with situations or overcome problems, it tends to undermine these abilities. For example, a gambler might wish he had more money, yet gambling is more likely to drain his financial resources. A heavy drinker might want to cheer herself up, yet alcohol use can lead to or intensify depression. A sex addict may crave intimacy, yet the focus on sexual acts may prevent real closeness from developing.The behavior is persistent. When someone is addicted, he will continue to engage in the addictive behavior, despite the trouble it causes him. So an occasional weekend of self-indulgence is not addiction, although it may cause different kinds of problems. Addiction is characterized by frequent engagement in the behavior. Article How Substance Abuse Impacts Your Mood Article When Drug Use Causes OCD But If You Still Enjoy It, It Can’t Be an Addiction, Right?Wrong. Because the media, in particular, have portrayed addicts as hopeless, unhappy people whose lives are falling apart, many people with addictions do not believe they are addicted as long as they are enjoying themselves and holding their lives together.Often people’s addictions become ingrained in their lifestyle, to the point where they never or rarely feel withdrawal symptoms. Or they may not recognize their withdrawal symptoms for what they are, putting them down to aging, working too hard, or just not liking mornings. People can go for years without realizing how dependent they are on their addiction.People with illicit addictions may enjoy the secretive nature of their behavior. They may blame society for its narrow-mindedness, choosing to see themselves as free-willed and independent individuals. In reality, addictions tend to limit people’s individuality and freedom as they become more restricted in their behaviors. Going to prison for engaging in an illegal addiction restricts their freedom even more. When people are addicted, their enjoyment often becomes focused on carrying out the addictive behavior and relieving withdrawal, rather than the full range of experiences which form the person’s full potential for happiness. At some point, the addicted person may realize that life has passed them by, and that they have missed out on enjoying experiences other than the addiction. This awareness often occurs when people overcome addiction.What’s the Problem if It Isn’t Doing Any Harm?Addictions harm the person with the addiction and the people around them.The biggest problem is the addicted person’s failure to recognize the harm their addiction is doing. He may be in denial about the negative aspects of his addiction, choosing to ignore the effects on his health, life patterns and relationships. Or he may blame outside circumstances or other people in his lives for his difficulties.The harm caused by addiction is particularly difficult to recognize when the addiction is the person’s main way of coping with other problems. Article Can Substance Abuse Cause Anxiety? Article Feeling Delirious Because of Substance Abuse Sometimes other problems are directly related to the addiction, such as health problems, and sometimes they are indirectly related to the addiction, for example, relationship problems.Some people who get addicted to substances or activities are very aware of their addictions, and even the harm caused by the addiction, but keep doing the addictive behavior anyway. This can be because they don’t feel they can cope without the addiction, because they are avoiding dealing with some other issue that the addiction distracts them from (such as being abused as a child), or because they do not know how to enjoy life any other way.The harm of addiction may only be recognized when the addicted person goes through a crisis. This can happen when the addictive substance or behavior is taken away completely and the person goes into withdrawal and cannot cope. Or it can occur as a consequence of the addiction, such as a serious illness, a partner leaving, or loss of a job.If You Think You Might Have an AddictionIt is common, if not normal, to go through a stage of engaging in substance use or an addictive behavior without believing you are addicted. This is so common, in fact, that it has a name, the precontemplation stage. If you are starting to think you might have an addiction, you have probably moved into the contemplation stage. This is a great time to find out more about the substance or behavior that you have been engaging in, and to reflect honestly on whether you are experiencing any signs or symptoms of addiction.These signs and symptoms vary from one addiction to another, but the most common indicators are that you are engaging in the behavior, or taking more of the substance, than you originally intended; that you are preoccupied with the next time you can engage in the behavior or use the substance; and you are putting it ahead of other important parts of your life, such as family, work, and responsibilities. You might also find you are losing interest in other pleasurable activities, compared to the addictive behavior.Many people then decide to make changes. For some people, this is easy and manageable. For many others, quitting can lead to unpleasant withdrawal symptoms, even with behaviors, and can open up uncomfortable feelings that were being soothed or suppressed by the addictive behavior. If this happens, or if you have been drinking or using drugs, such as opioids—illicit or prescribed, other prescription medications, simulants, cocaine, or meth—you should seek medical help immediately. Stopping some drugs then relapsing can heighten your risk of overdose, mental health problems, or other life-threatening medical complications, and should be done under medical supervision. Living With AddictionSome people don't want to change their addictive behavior, or try and try but never seem to be successful at quitting. These people often do better with a harm reduction goal, or use self-help resources to manage their addiction.If this sounds like you, remember help is always available. Educating yourself is a good start. You can greatly reduce the amount of harm to yourself and those around you, and maybe one day, you will be ready to change for good.Next Steps to ConsiderAlthough it can seem scary, getting an assessment and diagnosis is a good step in terms of getting help. If this isn't for you, you can try self-help groups and connect with others dealing with the same problem. Finding out more about your addiction and what has helped others can also be a good step, and it doesn't require you to talk to anyone else.A Word From VerywellMany people fear the term addiction and believe it is an indication of failure or worthlessness. People with addictions often carry stigma about their behavior, leading to shame and fear of seeking help. The world is changing, and you may find that getting help for your addiction is the best thing you ever do for yourself. In the meantime, we hope that educating yourself will help on your journey to wellness.Sources: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th Edition), Washington DC, American Psychiatric Association. 2013.American Psychiatric Association. 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