Understanding Addiction vs Compulsions: A Guide
- Updated: May 21, 2024
“You’re an addict!”
“You’re absolutely obsessed!”
Now, many people use the words “addict” and “obsessed” loosely, but what are their actual meanings?
As a life coach who specializes in trauma and addiction, word choice is extremely important to me. In this article, we will distinguish between compulsions and addiction. This information is especially helpful if you suspect that you or someone you know may be suffering from an addiction or compulsive disorder.
First, let’s talk about the characteristics of a compulsion.
With obsessive-compulsive disorder, it's not just about the compulsion that keeps them trapped; it's also about the pervasive fears of losing or gaining something scary.
Definitions
To ensure that everyone is on the same page, the American Psychiatric Association created a manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It describes at least 70 conditions and is used by therapists, doctors, and researchers to understand and treat mental health conditions. I will be referring to the DSM occasionally in this article.
There are so many articles about this disorder but the fast definition is that there are two parts. The obsession and the compulsion. With obsessive-compulsive disorder, it’s not just about the compulsion that keeps them trapped; it’s also about the pervasive fears of losing or gaining something scary.
Compulsion
Repetitive behaviors (e.g., hand washing, ordering checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to the rules that must be applied rigidly.
OCD Statistics (USA Only)
Who?
An estimated 2.3% of the U.S. population, or 1 in 40 people, will develop OCD, and that 1.2% of people have OCD in any 12-month period. However, the true prevalence of OCD is likely higher, as social stigma and imperfect assessment tools cause OCD and many other mental illnesses to be under-reported.
Which Age OCD starts?
- Usually, OCD begins around 19 years old. (Molecular Psychiatry, 2008) More boys than girls have OCD before they’re 10.
- Most girls get diagnosed during their teenage years (after they’re 10). (Molecular Psychiatry, 2008)
- People who get OCD when they’re young tend to have more serious symptoms and are more likely to also have ADHD and bipolar disorder. (Psychological Medicine, 2014)
How does OCD start?
We’re not exactly sure why OCD happens, but it might be because of genes or certain chemicals in the brain. Basically, OCD messes with how the brain talks to itself.
People with OCD might not have enough of certain chemicals, like serotonin, to help their brain cells chat the right way.
Bad or stressful stuff that happens to you might also make OCD worse.
In simple terms, someone with OCD might feel like they have to check if the front door is locked over and over because their brain tells them something bad will happen if they don’t. The next part will talk about how this can affect someone in everyday life.
A Tesla Tale
Most people think of OCD symptoms as frequent handwashing or some type of ritualistic behavior used to calm underlying fear or anxiety.
For example, handwashing eases concerns about becoming sick or ill. However, there are numerous other compulsive activities. In this section, I will explain OCD tendencies surrounding owning a Tesla. (I apologize in advance if what you are reading hits too close to home for you.)
Imagine you have a Tesla. You love this car. It is like your baby! Now, you know you need to keep charging your car to make sure you don’t get stranded on the road. But, until you see the stats, up-to-the-minute, feelings of fear and anxiety flood your mind. This fear causes you to check your fuel stats throughout the day.
When the urge becomes overwhelming
However, checking the stats is not enough. You visit the Tesla website multiple times a day to check for manufacturing errors, and regularly visit member forums to scrutinize anyone who works on your car.
Lord help you if you can’t see or drive your car that day. You may even exhibit withdrawal symptoms such as:
- Irritation
- Restlessness
- Difficulty concentrating
- Urge to overeat or disinterest in eating
What is an addiction?
The DSM primarily refers to addiction in relation to substances, but it is possible to become addicted to other things such as money, objects (similar to Gollum’s obsession with the ring in Lord of the Rings), and ideas such as power and fame, which describe many individuals in Wall Street, Hollywood, and Congress.
The table below explains addiction according to the DSM and provides the clinical definition of addiction. Impaired control over substance use refers to how the addict becomes increasingly reliant on their drug/substance of choice.
Social impairment refers to how the addict’s social interactions diminish over time, while risk use refers to how the addict’s behavior under the influence can put themselves and others at risk. Pharmacologic explains how the drug impacts the body during and after use.
Clinical definition of addiction
| Criteria Type | Descriptions |
|---|---|
| Impaired control over substance use |
|
| Social impairment |
|
| Risky use |
|
| Pharmacologic |
|
Important: Addiction is a complex topic, and the table above is not meant, nor should it be used, to diagnose a suspected mental illness. I am simply explaining how the medical community views addiction.
Who it impacts
As mentioned earlier, addiction is not just about substances. It can range from addiction to people or ideas. However, I will now share some brief statistics related to substance abuse.
According to the National Survey on Drug Use and Health (NSDUH), 19.7 million American adults aged 12 and older battled a substance use disorder in 2017. In that same year (2017), 8.5 million American adults suffered from both a mental health disorder and a substance use disorder, or co-occurring disorders.
The National Center for Drug Abuse and American Addiction Centers both feature up-to-date lists of statistics regarding substance abuse and addiction.
What causes of an addiction
Similar to OCD, the causes are unknown. Genetics, stress, and trauma all play a part.
In my personal experience, I am recovering from dual addictions to codependency (an addiction to people) and alcohol. There is no doubt in my mind that I used these coping mechanisms to deal with my unhealed emotional trauma.
In the following section, I will share a story about a man who is recovering from a sex addiction.
So many people are hooked on:
— Denise G. Lee (@DeniseGLee) July 5, 2024
Soap Operas
Hard Core Porn
Romance Novels
Reality TV
even Politics ...
And why?
They are addictive because they are built on betrayal, exploitation, and terror.
The intensity is confused for intimacy and people are constantly fueled by the…
A Physicians Take On Addiction
Kevin McCauley, MD, MPH, who is an expert on neuroscience of addiction and recovery management has these thoughts regarding addiction.
Many people ask me why those with addiction don’t just stop. The answer is that their brain has changed significantly. Alcohol, drugs, or certain behaviors take control, even when they don’t want to indulge and despite their promises to quit. It’s irrational and harmful, but there’s a reason behind it. It involves the brain’s learning and memory functions.
Dopamine is a brain chemical released during pleasurable activities, grabbing our attention and focusing it on what caused its release. For someone with an addiction, drugs or alcohol are marked as crucial for survival.
Glutamate, another brain chemical, works with dopamine to help with brain development, learning, and memory. Glutamate’s job is to remember important things and freeze them into memory. Dopamine signals, “This is important!” and glutamate responds, “I’ll remember it!”
This reward-learning system helps us recognize and remember things essential for survival. Intoxicants, however, overload this system, releasing too much dopamine and glutamate, which overvalues the drug and burns it into memory.
Everything associated with drug use—people, places, sights, smells, and even the time of day—becomes a trigger for relapse. Thankfully, with treatment and our understanding of the brain, relapse can be avoided.
Next, let’s talk about one specific time of addiction – sex addiction.
Sex addiction story
For example, Andy, suffers from sex addiction. As a younger man, he enjoyed watching soft porn. Andy found his dad’s porn stash tucked underneath the mattress. When nobody looked, he went there to “educate” himself about women. Andy did this occasionally throughout his adolescent years.
As an adult, Andy dated and enjoyed the companionship with women. But things started to shift when he moved into a new town. And to make matters worse, he slowly found himself disconnected from friends.
Within six months, he had a premium membership to Pornhub. And two years later, Andy was a regular patron of the local strip club in between visiting prostitutes. Andy told me that he strong and powerful when he could “control” the behavior of women with money.
How did this Andy become addicted to sex?
Beneath the sexual addiction were feelings of unworthiness and deep insecurity. This addiction cost him thousands of dollars, lack of sleep and diminished time with friends and family. The cure to his feelings of loneliness became the curse.
According to Mayo Clinic, approximately 6% to 8% of U.S. adults could be classified as addicted to sex. This equates to up to 24 million people.
Sex addiction is a sad, yet common illness that many suffer from in silence due to the social stigma attached to it. The image below summaries my thoughts. In the final section, I will share my overall thoughts about addiction and compulsions.
Final thoughts
Individuals with addictive or compulsive tendencies share common issues such as distorted reality perception, poor interpersonal and intrapersonal relationship skills at their worst.
If you or someone you know faces such conditions and is struggling to function effectively, reach out to a qualified and experienced mental health or medical professional for guidance. I will not prevent anyone from receiving the necessary care they require.
Nevertheless, if you are stable and would like to continue your journey of healing and recovery, I am a resource for you.
Dig deeper. Click here to listen to this episode from my entrepreneur podcast about healing from addiction or press the play button below.
Written by Denise G. Lee
DISCLAIMER: THIS ARTICLE DOES NOT PROVIDE MENTAL HEALTH ADVICE
The information in this article is for informational purposes only. No material in this article or website is to be a substitute for professional medical and/or mental health advice, diagnosis or treatment.
Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you read from me or anyone else online.
Also, this article is not designed to diagnose or treat you or anyone with a suspected mental health illness. Please, if you need help, seek appropriate help from a lawyer, health care provider or law enforcement officer.
