Process Addictions Diagnosis and Treatment

Learn everything you need to know about process addiction, including the causes, symptoms, and treatment for this type of disorder.

Author: J. Flowers Health Staff

What is a Process Addiction?

Most people know it is possible to become addicted to certain substances, but did you know it is also possible to become addicted to a behavior? Process addiction is a mental health condition characterized by a strong impulse to engage in certain behaviors, even if these behaviors cause negative consequences. Those who experience process addiction may feel that their behaviors are uncontrollable, but this is not the case. Just like substance addiction, process addiction can be treated.

How Does a Process Addiction Occur?

Process addictions occur when a habit turns into a compulsion. Contrary to past beliefs that addiction can only involve substances, behavioral scientists now believe that anything that can stimulate a person can be addictive.¹

Stanton Peele popularized the notion of a process addiction with his 1979 book Love and Addiction. According to Peele, addiction occurs when individuals are dependent on a specific set of experiences, and substance addiction is only one example of these experiences.²

When an activity feels good, it can cause someone to repeat that behavior or activity, resulting in a process addiction. Process addictions span many behaviors, from compulsive exercising to hoarding. Because process addictions refer to people who engage in compulsive behaviors, it is sometimes also referred to as behavioral addiction.

What Do Process Addiction and Substance Addiction Have in Common?

Process addiction and substance addiction are more similar than they are different. One primary difference is that process addiction involves a behavior or the feeling brought upon by engaging in the behavior. People with substance abuse disorder are addicted to the substance, not the act of using the substance. Another difference is process addiction’s lack of physical signs—unlike the yellowing fingertips from nicotine use or the sores common to amphetamine abuse, process addiction does not often have physical indications.

Similarly, quitting a process addiction does not typically come with the serious physical withdrawal symptoms associated with substance use disorder withdrawal.

There are several similarities between behavioral addictions and substance addictions, one of them being the gradual loss of control someone has over their compulsion. Behavioral addictions also resemble substance addictions in terms of tolerance, in which people must ramp up the frequency of their behavior to get the same result; comorbidity, in which other addictions or mental health issues are present alongside the process addiction; and response to treatment.³

Lastly, process addiction is just as serious as substance addiction and can impact the affected individual’s life just as much as substance addiction.

Types of Process Addictions

Although there is no comprehensive process addictions list, some of the more common behavioral addiction examples include:

Compulsive gambling
Sex and love addiction
Internet addiction
Exercise addiction
Compulsive buying addiction
Gaming addiction
Food addiction

Compulsive gamblers may get a “high” from the rush of winning money, while those struggling with food addiction may become addicted to the pleasurable feelings derived from eating.

Other behavioral addiction examples include skin-picking, or trichotillomania, which are categorized as process addictions due to the pleasure response that happens in the brain during the addiction process. While the behaviors themselves are different, the compulsive need to engage in the behavior is the same across the board.

Similar to substance use disorder, it is possible to overcome a process addiction and gain back control of your life. Read on to learn more about the symptoms of process addiction and the varying treatment options.

Signs & Symptoms of Process Addiction

Sometimes the signs and symptoms of a behavioral addiction can be difficult to spot. Unlike the physical signs that indicate substance abuse, many people with process addictions have no outward signals that they have an addiction.

Sometimes people with behavioral addictions may even be praised for their addiction by those who do not realize the extent of the problem. An example of this would be exercise addiction. Most people consider exercise a healthy habit, and when it results in muscle tone or weight loss, friends and family may congratulate the individual—unknowingly supporting their behavioral addiction.

With that said, there are some signs and symptoms you may notice in yourself or others who are experiencing a process addiction, including:

Cravings and an Inability to Resist the Impulse

The loss of control that one feels around the behavior is one of the main characteristics of a process addiction. For example, while most people avoid buying clothes that are out of their budget, a shopping addict may feel unable to stop shopping, even when it has serious financial repercussions.

Narrowed Interest Outside the Addiction

Like substance addiction, people with behavioral addiction may find it difficult to focus on anything other than their addictive process, especially as the addiction advances in severity. This issue could look like someone with a gambling addiction feeling compelled to go to the casino instead of an important family event.

Denial That There Is a Problem

Many people struggling with addiction refuse to admit the reality of their situation.⁴ Denial can be a defensive mechanism for people who cannot psychologically cope with the difficult emotions that come with acknowledging addiction, and it can sometimes take therapy and other interventions to overcome denial.

Feelings of Shame and Guilt Associated with the Behavior

After giving in to the need to engage in the process addiction, people may feel a sense of guilt or shame for their actions. Once they have satisfied the need to do the activity, the negative repercussions come to the forefront. These negative emotions can be uncomfortable, and that discomfort drives the person to engage in their behavioral addiction to feel better, and then the cycle repeats.

Gamblers, for example, may feel the intense need to gamble, but after they do so, they feel guilty for losing money. To make themselves feel better, they may go back to gambling with the hopes of making up for the previous financial loss (which usually does not work). This cycle is particularly concerning because studies show a link between feelings of shame and addiction.⁵

Lying About Their Addiction

People with behavior addictions may minimize the extent of their behavior. They may do so to avoid facing their addiction, or they may do this to avoid confrontation from loved ones who are concerned about them. This reaction could include lies about the frequency of their addictive behavior, lies about plans to quit, or lies about what they are doing when they plan to engage in their addictive behavior.

Hiding the Behavior

Like individuals lying about addictions, some individuals may hide their process addiction to avoid confrontation or shame. For example, many people with a food addiction prefer to eat in private because they are ashamed of the quantity of food they are eating. Those with a sex addiction may also hide their behavior out of shame.

Feeling Depressed or Anxious When They Stop Behavior

Although behavioral addictions do not have physical withdrawal symptoms, there is a sort of withdrawal that people experience when trying to quit a process addiction. When people who have process addictions try to stop them, they may find that quitting takes a significant toll on their mood.

This issue can be because their addiction is a coping mechanism, and when that coping mechanism is taken away, the individual is flooded with negative feelings, including:

Fatigue
Anxiety
Mood swings
Excessive crying
Agitation or irritability
Excess sleepiness or insomnia
Appetite changes
Weight loss or gain
Apathy or hopelessness

What Causes Addictive Behavior?

Several factors contribute to the development of addictive behavior. Genetic predisposition, personality traits, and substance use can lead to addiction.

Personality traits like high impulsivity and high sensation-seeking are associated with a higher risk for process addiction. Though there is no specific personality type that can be identified as an addictive personality, there are shared personality traits among people with addiction issues.

Genetics play a much larger role than some people realize—up to 64% of the risk of developing both a gambling addiction and an alcohol addiction comes down to genetics.⁶ Additionally, those who have relatives with addiction issues are more likely to develop an addiction themselves.

Misdiagnosis of a Behavioral Addiction

Process addictions are often misdiagnosed or mistaken for a different mental health condition. Studies show people who struggle with process and/or substance addictions often have at least one other mental health condition—this overlap of mental health conditions can make diagnosis difficult.

According to the 2012 National Survey on Drug Use and Health, 40.7% of the 20.7 million Americans who had a substance use disorder in the previous year were also diagnosed with a co-occurring mental health condition.⁷

In addition to the co-occurring mental conditions, process addictions can be difficult to spot because the symptoms are harder to identify compared to substance addiction. Some process addictions may seem like normal behavior (exercise, internet use, etc.), and unless the patient explicitly tells their doctor that the behavior is excessive, the process addiction may not be identified or treated. The misuse of substances can mask an underlying mood or anxiety disorder. Skilled and caring clinicians understand how common dual diagnosis occurs and go to great lengths to ensure that the treatment will be appropriate for everyone.

Overlapping Symptoms

Process addictions and mental illness are often misdiagnosed as one another because symptoms of each condition overlap and can occur simultaneously. For example, someone with a shopping addiction may also have depression; someone with a sex addiction may also have a substance addiction. Often, process addictions can cause other mental conditions to form or worsen because of the shame and guilt the individual feels around the process addiction.

Differentiating between a process addiction and another mental health condition comes down to a skilled clinician who knows what to look out for and a patient who is willing to be open and honest about their past and their symptoms. Understanding the patient’s history, getting a comprehensive list of the patient’s symptoms, and asking less obvious, more complex questions—about childhood trauma or other traumatic events that could cause mental conditions to develop—can all help to avoid misdiagnosis.

The Effects of Misdiagnosis

Sometimes even the most skilled clinicians will misdiagnose patients, leading to a host of problems for the patient.

Confusion is a main component of misdiagnosis. Someone with undiagnosed hypothyroidism being treated for depression may be confused and frustrated that their symptoms persist despite treatment. Many people don’t know how to differentiate between symptoms of mental health conditions. On top of that, patients typically trust their doctor’s diagnosis, so they may blame themselves if treatment isn’t working.

Another problem that comes with misdiagnosis is the prescription of the wrong medication. It can be ineffective at best and dangerous at worst; people prescribed medications they don’t need can have long-lasting impairments. It can also lead to the patient experiencing the negative side effects of medications without getting any of the benefits. Unsurprisingly, this situation can exacerbate the patient’s confusion and distress.

Perhaps the worst outcome of misdiagnosis is not discovering the root of the patient’s problem, often causing the condition to worsen. When a mental health condition is misdiagnosed—or not diagnosed at all—the patient is likely to experience a worsening of their condition.

Treatment for Process Addictions

Researchers have found that many of the same treatments used for substance abuse disorder are also effective in treating behavioral addictions. Treatment may vary based on the individual’s needs, but often include a combination of therapeutic and medical approaches.

Therapeutic Support

Therapy and counseling can be used to support the patient as they quit their process addiction. Cognitive-behavioral therapy is a problem-oriented type of therapy that combines talk therapy and behavioral therapy. It can be very useful in treating process addictions because it focuses on the thoughts and feeling patients experience which inclines them to engage in their addictive behavior.

Cognitive-behavioral therapy aims to equip the patient with the mental fortitude to shut down self-sabotaging thoughts and ultimately lessen or cease addictive behaviors.⁸

Psychotherapy or talk therapy can also be useful for patients struggling with process addiction, particularly if the patient experienced childhood trauma or other traumatic life events. Psychotherapy focuses less on “solving a problem” and more on the unconscious processes that manifest in the patient’s life through behaviors and thoughts, leading the patient to better understand their problems.

Detox Support

Though more common in substance abuse treatment than process addiction treatment, some medications can be used to help patients with extreme withdrawal symptoms when they stop engaging in addictive behavior. Some common symptoms include anger, insomnia, and panic. Process addiction treatment centers can evaluate patients and administer detox support if needed.

Family Support

A supportive family can make a huge difference in treatment and recovery. Family members are encouraged to understand and support their loved one in their journey to recovery and attend family support groups and therapy sessions. It can be in the form of one-on-one therapy, or a family therapy session with the person in treatment.

Treatment Plan

Every patient is different, meaning treatment plans vary from patient to patient. A combination of therapies will be prescribed based on the patient’s evaluation and diagnosis, the patient’s circumstances, and the patient’s preferences and goals for recovery. For some patients, medication may be enough to treat the behavior, whereas others may seek more intensive help from a process addiction treatment center.

JFHI Bespoke Approach to Diagnosis and Treatment

J. Flowers Health Institute partners with therapeutic consultants and other behavioral health professionals to provide an unparalleled bespoke approach to treating patients. An initial comprehensive evaluation helps specialists uncover patients’ diagnoses, and professionals work to create specialized treatment plans to suit patients’ unique needs. This approach uses a holistic and personalized approach to health and wellness that focuses on finding the root of a patient’s condition.

JFHI provides a comprehensive, customized process addiction assessment to uncover the root cause of a patient’s condition—even in complex situations where diagnoses are hard to pinpoint. Your evaluation at JFHI could also include:

Comprehensive medical evaluation
Spiritual assessment and counsel
Executive blood panel
Chronic pain evaluation
Lifestyle assessment
Psychological diagnostic testing
Neuropsychological testing and brain mapping

There are many more diagnostic tools used by JFHI to uncover an individual’s condition. Once the patient’s condition is identified, one-on-one bespoke medical services are provided for treatment.

Benefits of Bespoke Medical Services

Bespoke medical services provide a long list of benefits that can ultimately result in better care and better treatment. Not only do patients have improved patient-physician relationships, but they also have highly personalized care, which is integral to treating complex cases. Patients who receive bespoke medical care know that their doctors are listening to them and prioritizing their care.

Another benefit of bespoke medical services includes minimal wait times and immediate access to care. Bespoke medicine also provides evidence-based solutions from a team of specialists who work together to get to the root of patients’ problems.

The interdisciplinary treatment team may include:

Medical doctors
Psychiatrists
Neurologists
Interventional pain specialists
Addictionologists
Trauma specialists
Mental health and addiction therapists
Physical therapists
Nutritionists
Fitness professionals
Wellness providers

Bespoke medical services at JFHI are intensively structured, holistic plans of treatment based on a client’s unique recovery needs. They provide evidence-based solutions from top specialists who work together to treat underlying conditions, providing patients with support, guidance, and effective treatment.