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Addiction has long been understood to mean an uncontrollable habit of using alcohol or other drugs. Because of the physical effects of these substances on the body, and particularly the brain, people have often thought that “real” addictions only happen when people regularly use these substances in large amounts.

More recently, we have come to realize that people can also develop addictions to behaviors, such as gambling, sex, pornography, computers, video games, internet, idolizing, watching TV or certain types of non-pornographic videos, spiritual obsession, cutting and shopping and even quite ordinary and necessary activities such as exercise, work and eating. What these activities have in common is that the person doing them finds them pleasurable in some way.These behaviors count as 'addictions' as well and cause guilt, shame, fear, hopelessness, failure, rejection, anxiety, or humiliation symptoms associated with, among other medical conditions, depression and epilepsy.

The American Society of Addiction Medicine has this definition for Addiction:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

What’s the Problem If It isn’t Doing Any Harm?
Addictions are harmful both to the person with the addiction, and to the people around them.

The biggest problem is the addicted person’s failure to recognize the harm their addiction is doing. They may have denials about the negative aspects of their addiction, choosing to ignore the effects on their health, life patterns and relationships. Or they may blame outside circumstances or other people in their lives for their difficulties.

The harm caused by addiction is particularly difficult to recognize when the addiction is the person’s main way of coping with the other problems they have. Sometimes other problems are directly related to the addiction, for example, health problems, and sometimes they are indirectly related to the addiction, for example, relationship problems.

Some people who get addicted to substances or activities are very aware of their addictions, and even the harms caused by the addiction, but keep doing the addictive behavior anyway. This can be because they don’t feel they can cope without the addiction, because they are avoiding dealing with some other issue that the addiction distracts them from (such as being abused as a child), or because they do not know how to enjoy life any other way.

The harm of addiction may only be recognized when the addicted person goes through a crisis. This can happen when the addictive substance or behavior is taken away completely, and the person goes into withdrawal and cannot cope. Or it can occur as a consequence of the addiction, such as a serious illness, a partner leaving, or loss of a job.