I was surprised when I first learned that certain addictions were considered to be a mental illness by the medical community. I had thought of addictions as being about self-control and morals. Maybe genetics.
My definition of addiction is this: when a person cannot manage their emotions or deal with their problems and they turn to something, such as a substance or behavior, to numb or ease the pain. Certain substances and behaviors act on the brain by increasing a sense of pleasure by, for example, upping the amount of dopamine to your brain.
The DSM-5 defines addiction as this: a complex disease of the brain and body, often chronic in nature, involving continued, compulsive use of one or more substances despite serious health and social consequences. It disrupts regions of the brain that are responsible for reward, motivation, learning, judgment and memory. This is in a section called “Substance-Related and Addictive Disorders” which includes substance use disorders for problems with alcohol (which is technically a drug), nicotine (ditto), prescription drugs and illicit drugs.
Also in the book is a category for “Behavioral Addictions” which includes only gambling. What about addictions to food, exercise, pornography, the internet, and so on?
What is the DSM? It is a book, published by the American Psychiatric Association that contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It is the “bible” which doctors, psychologists, counselors and therapists use to diagnose people.
Why is it so important? Doctors and therapists use a diagnosis to advise you on treatment options and future health risks. And a diagnosis matters because it tells health insurance companies that you have a condition requiring medical care.
In other words, doctors will probably not take your addiction to eBay seriously and won’t give you medication until the DSM recognizes it as a legit disorder. And your health insurance won’t cover it either. How do you get treatment for an addiction that technically doesn’t exist?
There is also the matter of stigma. Once the DSM labels something as a mental disorder, will you be more accepted or less accepted by your community, your family and your workplace?
My story of addiction: when my son was very young, I was overwhelmed with responsibilities. I began to abuse alcohol and prescription diet pills. I knew I had a psychological problem and that I was self-medicating. But it took a major breakdown before I saw a psychiatrist to get help.
She told me that I had bipolar and that I was an alcoholic. She scared me by saying that if I didn’t get treatment, I would surely die. She suggested I check myself into a private psychiatric hospital where I’d stay for at least two weeks. I refused.
So she gave me a couple of bipolar meds and instructed me to attend AA meetings. I got sober immediately. The meetings were even scarier that my doctor. At my first meeting, a man pointed at me and said “IF YOU DON’T STAY SOBER YOU WILL DIE!”
I attended meetings several times a week for seven months. But I never felt like I belonged there. There were homeless people, IV drug users, and parolees in my group. One young woman was missing most of her teeth due to meth. One man, who had a shaved head, had bright red flames tattooed all over his head.
They assigned a sponsor to me. She was nice but very strange. Shifty. She took me to lunch and we drove in her car, where she had taped copied pages out of the AA Big Book to every surface of the car interior.
As I read through said book, I saw similarities to the Bible. It was a guide on how to live your life. Followers memorized verses from the book. Carried it everywhere with them. In meetings, we chanted and we prayed. Not to God, but to a “higher power”. It wasn’t like a church. More like a cult.
I found meetings to be depressing. Others seemed uplifted. Some people attended more that one meeting per day. I have no problem with that. If it helps you, by all means do it.
After seven months it occurred to me:wasn’t the fact that I had lived without alcohol or drugs for all that time, proof that I wasn’t an alcoholic?
I decided that Scary Doctor was wrong. I stopped going to AA. I began to drink again but small quantities and not often. I found a new doctor. And I’ve been in treatment for bipolar now for 12 years.
Today, I no longer drink. It wasn’t a decision. I just lost my appetite for it. I never told anyone about my “addiction” except family. What if I had, and then was labeled “addict” by society? Would I have thought less of myself? Would I have stayed in AA forever?
Note: some substance addictions require medical supervision before detoxing. Just going “cold turkey” can cause serious medical problems, even death. See a doctor.