In the past, the American Psychiatric Association (APA) diagnosed addiction using the terminology substance abuse and substance dependence. Because of the wide range of the severity and complexity of substance use, in 2013 the APA revised its recommended diagnostic criteria and terminology.
The ‘Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition – DSM-5’ now recommends using the terminology substance use disorders, encompassing the previous terminology of substance abuse and substance dependence.
Currently, gambling is the only non-substance addiction that is listed in the DSM-5 under the category Substance-Related and Addictive Disorders. It was placed there due to the similarities between gambling addiction and substance addiction.
Researchers have discovered that gambling affects the brain in a manner that closely resembles the neurologic effects of drug addiction and alcoholism. The DSM – 5 also lists proposed criteria for the diagnosis of internet gaming disorder.
Non-substance addictions are called behavioral addictions or process addictions and occur when a person is dependent upon a specific behavior. These behaviors are compulsive and are currently considered to fall under the spectrum of obsessive-compulsive or impulse control disorders. However, changes may be made to the diagnostic category for behavioral addictions in the future, as was done with gambling disorder, as researchers continue to learn more about how these addictions develop and how they affect the brain. Behavioral addictions include food, sex, eating, exercise, shopping, internet usage, and internet gaming among others.
The basic premise of addiction is that a person continually engages in a behavior or takes a substance, despite the negative consequences that are experienced by the addict and by those around them. Oftentimes, periods of engagement in the behavior are followed by periods of guilt and remorse. The negative consequences can include social, financial, legal, and mental and physical health problems. Those with drug addiction and alcoholism, as well as behavioral addictions, tend to minimize, deny, and hide the behavior.
Whatever the addiction, consequences will follow. Help is available for addiction by participating in 12 step or other self-help groups, therapy, psychiatry, and inpatient or outpatient addiction treatment. Throughout the rest of this site, the various addictive and mental health disorders and their treatment will be covered in more detail. For the purposes of this site, when speaking of addiction, it is assumed to refer to drug addiction and alcoholism, unless otherwise stated.