Behaviors can be good or bad, but what happens when they become something outside your power to change? “Addiction occurs when a behavior has become out-of-control and the person can’t seem to quit doing it, cut back, or control it without help,” says Sue Self, a licensed clinical social worker and compulsive gambling counselor with Provident, Inc. “He may say he can control it, may even believe it, and refuses help. He may even cut back but over time, he can’t seem to maintain it.” Self says that the counseling field is changing how it looks at controlling addictions and treating them. Instead of telling patients to quit and go to a support group, they have learned more about the brain and how to use medical treatments to change how the brain works. One of those newer drugs, Chantix, is used to help people quit smoking, a highly addictive practice.
Self says addictions always get worse, not better. But just because a person engages in a behavior doesn’t mean it will become addictive, even if it gets out of control at times, like binge drinking. She explains that there are criteria that define addictions and they have genetic connections. “If you are a child of an alcoholic, you can inherit the ability to become one. If both parents are addicts, that inheritance is pretty solid. We could both engage in a particular behavior, but because of the way my brain is wired, I become addicted and you don’t. It’s also not necessarily about the duration of the behavior, but more about frequency and escalation.”
Whatever the addiction, if friends and family are concerned, they should act on it. Self recommends that they address the problem and the behavior directly. “Say, You are doing this a lot and it’s getting worse. When you do it, this is how it affects me and others.” She says to keep addressing it, not as a character defect, but as a behavior: Don’t shame them. Anything they need to change doesn’t often sink in until they see the consequences for themselves, and sometimes they have to be big consequences. She adds family members need to get help to understand the addictive behavior and why the addict does what he or she does. It’s important to note that it’s not about us. It’s about their helplessness over the need. Self recommends that if you think a loved one has an addiction, get help with a game plan on how to handle it.
Dr. Kim McCallum is the medical director of McCallum Place and Webster Wellness Professionals. She says the big picture is that special reward centers in the brain are activated when a person feels good. Those centers may be stimulated by artificial means like drugs, or compulsive impulsive behaviors. While feeling good is generally good for us, some of these can be maladaptive behaviors; things like binge eating, compulsive exercise, gambling, Internet pornography and sexual promiscuity can be highly addictive.
What researchers have found is that early or high-dose exposure to drugs or alcohol can damage the pleasure centers in the brain, leading to worse problems with addiction. There seem to be many different pathways to activate these centers: dopamine, serotonin and other neurotransmitters may be involved. The mechanisms are not fully understood. What they do know is that the behaviors become automatic and people develop a tolerance, needing more to achieve the same ‘feel good’ sensation. Also certain drugs go straight to the brain: nicotine, alcohol, opiates, methamphetamine and others. Drugs like marijuana can also stimulate that system, especially in young or vulnerable brains, such as in people who’ve had traumatic experiences or who are depressed.
Addictions are also characterized by escalation and withdrawal if the behavior is stopped, says McCallum. “We see this in compulsive exercisers,” she notes. “They have to exercise to the detriment to everything else. When they can’t, they become agitated, tremulous and their blood pressure goes up. Or, people addicted to Internet pornography become numb to normal sexual behavior. It’s a huge problem.”
Addiction affects everyone, and disrupts the whole social and family network. Addicted individuals become less honest, further damaging relationships. When an addiction is present, get help, says McCallum. AA and NA are still free resources, as are gamblers anonymous and overeaters anonymous. Families can get support from Al-Anon or Nar-Anon, and should realize that problems often get worse during times of stress, like the holidays. LN