Woah, big question! But I think its a big one for a reason, and its a question I hear a lot. I want to start with a small disclaimer. You are the expert on your life, and only you can determine whether or not a substance, behaviour, or otherwise has become an addiction. This is a topic that requires nuance and curiosity (ideally with compassion) because it is so complex! Below are some of thoughts that have been percolating over many years working with addiction in public health and private practice. My ideas come from experts before me, and so I will try to find a balance of what the research says and what I have seen in my personal and professional world.
So first things first, how do we even define addiction? Like many things in the mental health world, there are many schools of thought here. One commonly used definition is from Vancouver’s own Gabor Mate, who says: addiction is any behaviour that offers temporary relief or pleasure but causes negative consequences and is difficult to give up. Within this definition you can glean that there is a wide spectrum that could vary from person to person. What is “negative” in consequence for me might be different than what it is for you. What is “difficult” to give up for me might be different than it is for you.
Another frame of reference that some experts use is that for there to be “addiction”, The Four Cs must be present: compulsion, craving, (lack of) control, and (ignoring the) consequences. With this explanation, we can acknowledge that it is not only substances that can be addictions, but it can apply to behaviours such as gambling, spending, or sex related habits as well.
Now that we’ve gotten a definition out of the way, I would like to bring in a little bit of compassionate curiosity. I’m a broken record, I know. If you are resonating with parts of this definition, can we check into how this behaviour has served you in the past? Or maybe parts of this behaviour serve you still? These things come from somewhere, and I believe that any behaviours we get caught up in develop with the best intentions in mind. Mate asks not why the addiction, but why the pain? Addiction is often attempting to cope with pain, even if the results have left you in a place you don’t want to be.
If you do some digging on this topic, you will find some other definitions that may or may not resonate with you. I think a lot of those models have good points, such as the Brain Disease Model which has found links between genetics and addiction, as well as seen how addiction changes the brain. Not to say this is hopeless, our brains are plastic and capable of healing. I think there are also definitions out there that are steeped in years of stigma and haven’t held up in the science or in what I have seen in people, so be mindful in your internet sleuthing here.
I’m a firm believer that, definitions aside, if something is causing you distress in your life and you want to make a change you should be able to get support* for that. For some it is less about the label this and more about checking into if you want something to change. If we find ourselves falling into a comparison trap where we think our problems are not serious enough (or vice versa), we can become trapped. If you had a broken arm would you still go to the hospital even though there are people in that hospital with life threatening concerns? I hope your answer here is: yes!
Now to answer this question for yourself, consider some of these other points first:
Is this substance or behaviour negatively impacting my life?
Could I stop easily?
Why haven’t I stopped?
Do I crave it? Does that craving happen outside of my awareness, almost like I am on autopilot?
Do I notice I’m doing it in the moment? Am I mindful about this substance or behaviour?
Is there anyone I love or trust that is worried?
Am I no longer being served by this substance or behaviour? Was it helpful once but harmful now?
What do I lose or gain from this substance or behaviour?
What happens if I stop?
In short, this blog is (attempting to) summarize an incredibly complex topic. There is no simple answer to this question in the same way there is no simple solution to addiction. It is often a topic with more questions than answers, which is why I so strongly continue to believe in looking at this through the lens of compassionate curiosity and conversation. If you are left wondering what to do now, please feel free to reach out!
* I acknowledge that this is an idealistic and privileged view on mental healthcare. I recognize that while addiction doesn’t discriminate treatment does, and many people are not in a position to get support here when they need it.*
TLDR:It’s about how it affects your life: Addiction isn't just about what you're using or doing. It's about feeling out of control, having intense cravings, and continuing even when it causes harm.
It usually starts as a way to cope: People don't fall into addiction because of a lack of willpower. It’s usually an attempt to dull pain or meet an unfulfilled need.
You don't have to hit "rock bottom": If a habit is causing you distress or getting in the way of your life, that's reason enough to seek support.
