Ill behaviour: the addictions that destroy lives

Compulsive gambling, gaming and sexual activity are not considered to be 'proper' addictions. Yet the medical professionals who treat them say it's time to take them seriously. Will Coldwell reports

Page after page, chapter after chapter, when Lucy started reading she simply couldn't stop. She wouldn't sleep, eat or speak to anyone until she had completed the story. Then, she'd begin another one. Lucy was addicted to ebooks. At her worst, the 23-year-old student would spend 30 hours at a time alone in her bedroom, reading online novels on her laptop. Her head would hurt, her eyes would ache and the hunger would be painful, but she was unable to tear herself away from the screen.

"It wouldn't feel good but I would keep reading," she says. "I just wanted to finish it. I thought if I finished it I could stop. But I'd start again."

Lucy is one of a growing number of people suffering from behavioural addictions. This modern phenomenon manifests itself in the compulsive and repeated actions of an individual, from the seemingly mundane, to the understandably thrilling. Gambling is the most well known; pornography, gaming, shopping and, in Lucy's case, ebooks, are far less known. Despite the serious damage these conditions can do to people's lives, there is little to no public funding for treatment and they are often misunderstood. Many do not consider these to be "proper addictions".

For Dr Neil Smith, clinical psychologist at the Central and North West London NHS Foundation Trust's (CNWL) addictions directorate, who helped treat Lucy, whether it is a proper addiction or not is trivial. "Our evidence is from people who have turned up in distress, have very high levels of anxiety, or people with suicidal thoughts," he says. "So it's a moot point whether there's a real issue here. There are people who are extremely distressed and they're distressed because they've overused certain behaviours."

Likewise, Dr Richard Bowskill, lead addictions consultant and medical director at the Priory Hospital Brighton and Hove, is well aware of the growing prevalence of behavioural addictions. "In the last few years I've definitely seen an increase," he says. "I've seen sex addicts who have had hundreds and hundreds of sexual partners, exposing themselves to sexually transmitted diseases and making themselves very vulnerable. Another person I saw would escape into gaming for six hours a day; he was a bright guy at Oxford University, but failed his second year. With gambling, I've seen people on a £20,000 salary who are in debt for £60,000 and I've seen people getting themselves into an awful state with online porn – moving to more and more extreme things until it crosses into illegal images. I don't need to think back very far."

Behavioural addictions often follow a similar pattern to those caused by drugs or alcohol. "The thing to think about is how certain behaviours can trigger change in your mental state," Dr Bowskill says. "They can cause a buzz, or take you away from your usual world. You don't get a physical dependency, but you can get irritable. Suicide and lack of social functioning can happen."

While online porn addiction is increasingly prevalent – making up around 65 per cent of the patients seen at the CNWL – gaming addiction is also common. Tales of gamers collapsing at their keyboards following a week-long World of Warcraft binge may be rare, but should not diminish the serious implications of the everyday cases. Alex, 18, a college student, is a typical example. He has been receiving treatment for his gaming addiction since he was kicked out of school in January. "I was in denial," he says. "I'd be going home from school and saying to myself, I can do my homework at school the next day, then I'd just go upstairs and play League of Legends with my friends all evening, for nine hours, until 3am."

Consequently Alex was "exhausted" at school. "There were times when I'd actually fall asleep in class," he says. "Rather than thinking about lessons I was thinking about how I'd improve my performance in video games."

The steady rise of consumer technology and the internet lie behind many of these new behavioural addictions, which are generally perceived within the field to be part of a growing societal problem. "Whether it's ebooks, porn or gaming, a lot of these things are technology based," Dr Smith says. "This is about devices being in the home and being used in different ways while becoming integral in our lives as well. There's a huge difference between a BBC Micro in the 1980s and a computer with a mouse or a touch-screen. These things are much more pleasing to us and much more attention-grabbing. They offer a greater degree of escapism."

Still, Dr Smith feels this rise could plateau in the future as we learn to adjust to this technology. "There was a great scare in the 1950s about television and it may have been that some people overused television to begin with and then it levelled out. I think there will be a levelling out as people begin to integrate these things into their lives and realise that they can be problematic.

"A lot of people come here when things get out of control. We talk to them and they get a greater awareness of how that technology can be a risky thing and treat it in a more serious fashion, rather than thinking it's just one of those things in the house. They realise it's something they could overuse and that they've got to be a little more cautious with it."

Treatment for behavioural addictions involves a combination of counselling, therapy and abstinence. This was the case for both Lucy and Alex, who went completely cold turkey after just one meeting with a psychologist.

"My mum took apart my computer and put it away," Alex says.

"I met that with complete anger and was really unhappy about it. I was quite depressed for the next few weeks but there was absolutely no computer use. As far as my interaction with technology went, it was just my phone." Alex started having weekly counselling sessions at Broadway Lodge, a rehabilitation centre that in 2009 became the first clinic in the UK to offer treatment specifically for gaming addicts, based on the 12-step abstinence programme popularised by Alcoholics Anonymous.

"I thought it would be more of a clinical hospital-type session," he says. "But it was just a one-to-one chat and I talked about how I felt about it and what he recommended I did in the future. It just dawned on me how näive I'd been and how much damage had been done because of the overuse of this computer."

Now, six months on, Alex's counselling sessions have been reduced and he is beginning to use his computer on weekends. "It's still a hobby but I wouldn't let it take over everything else, like personal hygiene, or sleep," he says.

For Lucy, the treatment process was a little harder. After giving up ebooks, she filled her time playing computer games for hours instead. "After a few weeks I had another meeting and told my doctor about the games," she says. "He said, 'Perhaps you should find something else'." Lucy shifted from games to watching TV, then to watching musicals, before she finally learned techniques to manage her behaviour. She laughs. "I was told I have an addictive personality."

Some names have been changed.

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