Nearly everyone has had a taste of what it would be like to have an addiction—eating a second (and third) piece of cake, staying out until 4 a.m. drinking when work starts at seven, buying three pairs of shoes when you had just enough cash to cover one.
You know the consequences: the stomachache and spare tire, aching head and lousy day at work, the credit card debt, and above all—the guilt.
But the immediate payoff, whether it’s pleasure or simply a sensation of feeling alive, calls to you like a siren’s song.
In the addicted mind, the urge hijacks the brain, overpowering the analytical part involved in good decision-making. Whether sex, shopping, or heroin, mental health professionals generally distinguish a habit from an addiction when it takes center stage and shoves everything else off, destroying relationships, finances, and careers. As one mental health expert put it, a healthy person plans exercise around their life. An addict plans their life around exercise.
The Making of an Addict
The scientific community has long tried to determine the factors that cause addiction. Why for instance, are an estimated nine of every 100 Americans shopaholics, when presumably we all buy things and could be susceptible? What is it that causes about 15 percent of all people in the United States who drink to become dependent?
Researchers don’t completely understand addiction and perhaps never will, but the majority does agree that the recipes for addiction vary and can include an array of factors including psychological demons, social environment, lack of intellectual stimulation, learned behavior from family members, genetics, and depression. Parsing out the ingredients and determining what causes addiction versus what was caused by it is like trying to decide if the meat was tough before being cooked or if it was tough because it was cooked improperly. But scientists have come a long way in understanding the brain circuitry involved in addiction. The research has raised hopes for medications that will quash insatiable cravings, not simply quench them with another drug as methadone does for heroin.
Much research points to effects of the neurotransmitter dopamine as a key to addiction. The brain chemical involved in motivation, pleasure, and learning, dopamine helps us feel alert and excited about life. For people who don’t derive satisfaction or find joy in everyday life, theorists say that flooding the brain with dopamine provides the “fix” that they don’t normally get. But the excess of dopamine eventually inhibits the function of other stimulating parts of the brain, increasing the need for the substance or activity to recreate the feeling. Environmental factors play a large role in dopamine processing. An experiment demonstrated that when monkeys were relegated to lower social status, they actually lost dopamine receptors.
Scientists have also looked at how methamphetamine addicts’ brains operate. In a meth addict, the portion of the brain involved in the pleasure rewards-system works overtime, while the prefrontal cortex, the more analytical part of the brain crucial for good-decision making is sluggish, hardly showing any activity. In recovery, users’ brains will begin to show more normal patterns, with the prefrontal cortex picking up the pace and exerting its proper authority.
Addiction sans Substance
As experts examine non-substance abuse addictions (and the acceptance that they exist grows), they have found that brains can react to activities the way they do to drugs.
For example, in obese, compulsive eaters, scans have shown hyperactivity in the parts of the brain that interpret food stimuli—the lips, tongue, and mouth. For them, eating is a drug, an otherworldly pleasure. For addictions to gambling and shopping, many experts say that the same feel-good chemicals come into play.
The cycle for nonchemical addictions also mirrors that of substance abusers. They experience the fleeting “high,” the remorse, and then feel so badly that the only respite is to repeat it again.
All this provides the scientific backdrop for understanding why, when psychotherapist April Benson talks about her clients, they sound more like heroin junkies than fashionistas. In her book, To Buy or Not to Buy, Benson examines the roots and impacts of an addiction that devastates millions of Americans.
“I have worked with people who were so addicted to shopping that they faced jail time,” she said. “It crossed over to illegal activity, from falsifying signatures and fraud to charging your business for your own personal purchases. Some have been forced to file bankruptcy; others shoplifted.”
Women are more likely to acquire addictions to buying and eating disorders, while men are twice as likely to become substance abusers. Benson says that’s partly because societal pressure to be attractive bears down hardest on women so they often equate looking good with feeling good. Doing drugs or other substances doesn’t fit into the equation.
Benson and many mental health workers underscore that to overcome addictions, people must address the underlying causes. Our emotions and experiences shape and are shaped by our brain chemistry. Recovering requires people to understand what drives them to their addiction—whether it’s to feel the thrill of life, escape from psychological pain, gain a sense of control, or some combination of these desires. Without understanding the reasons and finding a healthy way to manage them, addicts will often kick a habit only to replace it with another one.
Perhaps, that partly explains why the most common cause of death for Alcoholics Anonymous members is health problems due to cigarette smoking.