Can you really be "addicted" to shopping or using the Internet?

The state of the universe.
Dec. 18 2009 12:07 PM

The Addiction Habit

Do we really need rehab centers for people who spend too much time shopping or using the Internet?

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The idea that all these behavioral problems can be reduced to brain chemistry is also linked to a vacuous piece of pseudo-neuroscience. According to many popular discussions of the topic, dopamine equals addiction. That fallacy is often touted by mental health professionals as a substantive explanation when it is nothing of the sort. The popular myth goes something like this: Dopamine levels increase when we do something pleasurable, and this is what causes the addiction. When anyone wants to convince you that something should really count as an addiction, they'll quote the fact that it "raises dopamine levels."

The myth does have some basis in fact: We know that dopamine is involved in pleasure and desire, and that drug addiction causes long-term changes to the dopamine system that likely weaken our impulse control and draw our attention to reminders of drugs and drug-taking. There are subtle but important differences between these two statements, though. The former refers to an instant reaction to any pleasurable activity, while the latter indicates a possibly permanent change in how the brain reacts to the world owing to the use of substances which artificially alter it. There's no direct one-to-one relationship between dopamine and addiction, and knowing that this particular brain chemical is released during an activity predicts nothing about how problematic the activity might be. As the dopamine system starts working when we encounter anything pleasurable, the popular myth would suggest everything we like could be addictive: reading books, scratching an itch, building model steamships out of matchsticks, whatever floats your boat. A recent article on extended and unresolved grieving for the New York Times cited a study on how dopamine is released when affected people looked at a picture of their late family member, suggesting that even thoughts of the deceased could be addictive.

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The fact that the dopamine fallacy is used to prop up our dubious assumptions rather than test them can be seen in how some pleasurable, repetitive, and likely dopamine-fueled behaviors are never described as an addiction. A study by psychologists Kirk Wakefield and Daniel Wann found that while most sports fans are well-adjusted, others are preoccupied with their fandom, excessively motivated to follow their team, and abusive in response to outcomes on the field. What's more, sports fandom has a clear and well-researched link to violence, social disorder, and alcohol abuse. But despite the fact that following a sports team could have serious personal and social consequences, and seems to fulfill all the criteria for a diagnosis of behavioral addiction, it is never considered as such. Being a fan of an online computer game, however, can get you placed in an expensive private clinic for "addiction therapy."

Currently, we are concerned about young people using the Internet, eating too much, spending irresponsibly, and being promiscuous, and these worries are being expressed in the language of addiction. The medical terminology helps us to believe we're avoiding moralization or blame, and popular science has given us a sound bite of pseudo-neurology to support our prejudices. For these problems, addiction is little more than a fig leaf for a realistic understanding that would address why people return to unhelpful ways of coping with isolation, stress, and depression. Instead, we prefer to rely on a trite and unhelpful catch-all label that prevents people from getting appropriate help for their difficulties. We need to break the addiction habit, before it breaks us.

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Vaughan Bell is a clinical and neuropsychologist at the Universidad de Antioquia, Colombia, and King's College London.