Behavioral Addiction and Bad HabitsWhat it is, how a habit differs from an addiction, and when it needs treatment

1What is behavioral addiction?

We are used to linking the word “addiction” with drugs and alcohol. But for years, doctors have observed that certain behaviors, with no substance entering the body, can take hold of a person in almost the same way: an intense craving, increasing repetition, loss of control, and persistence despite losses.

Behavioral addiction, then, means a repeated pattern of behavior that starts out pleasurable or comforting and gradually becomes something the person needs in order to feel “normal” or to escape stress, boredom and sadness. It becomes a real problem when it takes priority over sleep, studies, work and relationships, and continues even though the person clearly sees the harm and tries to stop but fails.

The measure here is not the number of hours alone. A young man who plays for long hours during the summer break with his friends is not necessarily addicted, while another person who bets for only a few minutes a day may have fallen into addiction because he is chasing his losses and hiding his debts from his family. What decides it is control, priority and harm.

These three features are roughly what the World Health Organization relies on to define gambling disorder and gaming disorder in the international classification ICD-11, with the requirement that the pattern causes clear harm in the person’s life and that it usually continues for at least twelve months before diagnosis.

2What is the difference between a bad habit and a behavioral addiction?

Not every annoying habit is an addiction. Bad habits are part of almost everyone’s life: staying up late on the phone, biting nails under stress, or sometimes shopping without a need. The difference between a habit and an addiction is one of degree, control and impact, and the following table sums it up:

A habit can start out simple and then gradually slide toward addiction, especially during periods of pressure, loneliness or depression. So noticing these signs early is much easier than treating the problem once it has become entrenched.

3What happens in the brain in behavioral addiction?

Deep in the brain there is a circuit known as the reward system. Its job is to make us repeat what helps us survive, such as eating and connecting with other people. When we have a pleasurable experience, or expect one, dopamine signals rise in this circuit, and the brain learns that this behavior is “worth repeating.”

The problem is that some modern behaviors are designed to stimulate this circuit powerfully and without pause: a reward that arrives at unpredictable moments in betting, a new notification, a higher level in a game, or a short video followed by another. This kind of unpredictable variable reward is among the strongest things for cementing repetition in the brain.

With repetition the brain adapts: the pleasure the behavior itself gives decreases, so the person needs more time or more risk, while the frontal cortex, the area of planning and impulse control, becomes less able to restrain the urge. These changes are broadly similar to what happens in substance addiction, although they are often milder and more likely to recover.

4What are the types of behavioral addiction?

In the Eradah guide we have gathered eleven behaviors that are the most searched for in Egypt and the most closely related to mental health, in three families. Each behavior has a full page explaining its signs, causes, harms and treatment:

• Screen addiction: includes video game addiction, social media addiction, smartphone addiction and pornography addiction.
• Behavioral addictions: include smoking and nicotine addiction, gambling and betting addiction, compulsive shopping, masturbation and food addiction.
• Compulsive habits: such as nail biting and hair-pulling disorder, which are repetitive behaviors directed at the body.

We placed smoking in this section because in people’s lives it is a daily habit tied to situations and rituals, such as the morning cigarette or a shisha session with friends, even though in reality it is an addiction to a substance, nicotine. This is why quitting needs a plan that deals with both sides together.

5Screen addiction

Compulsive patterns of using digital devices and platforms. They are the fastest-spreading among children and teenagers, and they steal sleep, focus and relationships.

Complete guide to screen addiction ←

6Behavioral addictions

Behaviors that start out ordinary and then turn into a cycle of craving, repetition and regret, some of which carry major financial or health risks.

Complete guide to behavioral addictions ←

7Compulsive habits

Repetitive behaviors directed at the body that are linked to stress, belong medically to the obsessive-compulsive spectrum, and respond well to behavioral therapy.

Complete guide to compulsive habits ←

8Is behavioral addiction a recognized medical diagnosis?

Here we need to be candid, because the word “addiction” is used easily in everyday speech. Medical recognition differs from one behavior to another and can be divided into three levels:

That a behavior is not officially listed does not mean the suffering is not real. The psychiatrist assesses the impact of the behavior on the person’s life, looks for what may lie behind it, such as anxiety, depression or attention-deficit/hyperactivity disorder, and builds a treatment plan accordingly, whether or not the behavior has an official name.

9Why is behavioral addiction spreading in recent years?

Human nature has not changed, but the environment around us has changed very quickly. The smartphone has put games, platforms, betting and shops in everyone’s pocket, available day and night and often without supervision.

The World Health Organization estimates that about 1.2% of adults worldwide have gambling disorder, and that each person who gambles at a high-risk level affects, on average, about six other people in their family and surroundings. A large European survey of adolescents also recorded a rise in the share of problematic social media use from 7% to 11% between 2018 and 2022, with about 12% at risk of problematic gaming. There are no precise, unified Egyptian figures for these behaviors, so we rely only on documented international figures.

Sources: the World Health Organization gambling fact sheet, and the HBSC survey of the WHO Regional Office for Europe.

10How does behavioral addiction affect children and teenagers?

Children and teenagers are the most vulnerable group, because their brains are still developing and because they spend long hours on devices, often without clear rules. The World Health Organization advises that infants under one year should not be exposed to screens, and that sedentary screen time for children aged two to four should not exceed one hour a day, with less being better.

Signs parents should pay attention to include: declining school performance, frequent late nights, intense irritability when the device is taken away, withdrawal from family and friends, loss of interest in activities they used to enjoy, asking for money or unexplained disappearance of sums, or bald patches in the hair or wounds around the nails in younger children.

11How is behavioral addiction related to drug addiction and mental illness?

Behavioral addiction does not live apart from the rest of mental health. Many people who experience it also have anxiety, depression or attention-deficit/hyperactivity disorder, and use the behavior as a way to soothe difficult feelings. Behavioral addiction in turn increases insomnia, anxiety and depression, creating a vicious circle.

The link with substances is clear too: betting often goes together with alcohol or smoking, long late nights gaming may push some young people toward stimulants, and someone recovering from a substance addiction may shift the addiction to a substitute behavior such as betting or heavy smoking. This is why the doctor assesses the whole picture. Browse the guide to drugs and their types and the guide to mental illnesses to understand these links.

12Common myths about behavioral addiction

13When should you seek specialist help?

Start with a specialist assessment if you notice any of the following in yourself or someone close to you. This list is for awareness and is not a diagnosis.

• Repeated attempts to cut down or stop that end in failure.
• A clear decline in studies, work or sleep because of the behavior.
• Lying to the family or hiding the time or money spent.
• Debts, borrowing or selling belongings to cover betting or spending.
• Severe irritability, anxiety or sadness when away from the behavior.
• Depression, anxiety or substance use appearing alongside the behavior.
• Any talk of death or self-harm; here help must be sought immediately.

In most cases treatment does not require a hospital stay; it relies mainly on cognitive behavioral therapy, which helps the person understand their triggers, change their thoughts and build alternatives, along with reorganizing the environment, involving the family, and treating any accompanying psychiatric disorder. Medication is used only where there is evidence, such as nicotine replacement and smoking-cessation drugs, or to treat accompanying depression or anxiety, and only on a doctor’s prescription.

14How can the family help a person with a behavioral addiction?

1. Start a calm conversation away from moments of anger, and talk about the changes you have noticed rather than about their “failure.”
2. Understand what they are escaping from: boredom, loneliness, study pressure, anxiety, or a problem they could not put into words.
3. Set clear, shared rules for devices at home, and apply them to the adults before the children.
4. With betting and debts, do not pay off the debts without a treatment plan, and quietly protect the family’s money.
5. Encourage a specialist assessment, and offer to book the appointment or go with them.
6. Praise every small step forward, and expect setbacks without treating them as the end of the road.
7. Look after your own mental health too, and seek family support if you need it.

At Eradah we offer a confidential assessment for behavioral addiction, and individual and family treatment plans that deal with the behavior and with what lies behind it, such as anxiety, depression or substance addiction, at the same time.