Is an Addictive Personality Real? If So, Do You Have One?

This is a controversial subject in the field of addiction, and the research gives us mixed messages.

First, it may be helpful if we define addiction. There seems to be a grey, non-discriminate, line between what constitutes an addiction versus doing something habitually or even in excess, without addiction. The DSM-5 (the Bible of psychological diagnoses) states that addiction is marked by:

1. Problematic use. The substance or behavior once helped you to cope, but now it is making things worse for you or your friends and family.

2. There is a predictable pattern or habit to your use or behavior.

3. Your use or behavior warrants professional treatment.

4. Your use or behavior causes distress and impairment. It is interfering in your life in a significant way.

5. The interference in your life caused by your use or behavior is marked by at least 2 of the following:

• Using more than you intended

• Attempting to reduce your use

• Spending a lot of time getting your substance or using (could be doing the behavior if not a substance)

• Craving

• Neglecting obligations or responsibilities

• Social problems

• Reduced participation in activities you once enjoyed

• Using despite physical danger

• Using despite physical or psychological disorder

• Tolerance

• Withdrawal

While the DSM-5 primarily outlines the criteria for substance use disorders, the list above can be applied for behavioral problems as well.

But, back to our original inquiry:

Is there a such thing as an addictive personality?

The short answer is no, there is not one set of personality traits that determine if a person will struggle with addiction.

Truth be told, if you've met one person who has an addiction, then you've met one person who has an addiction.

The idea that all who struggle with addiction have the same problems or pre-disposition is is ridiculous. It is perpetuated, largely, because the symptoms of active addiction look so similar. Yet even the symptoms have great variance in their presentation among those who struggle.

Addiction is finally being recognized by NIDA and other influential organizations as a brain disease. The neuroscience has shown us that structural changes happen in the brain of those addicted to substances. Their brains are literally changed as a result of their use. Even among those with behavioral addictions and compulsions, changes occur in the brain that make it very difficult to simply "stop" (For a more detailed explanation check out the video below).

As Dr. Maryann Amodeo outlines in her 2015 essay on addiction, "Excessive use of psychoactive substances “causes” and/or can be associated with changes in behavior, resulting in a profile of the addicted person that complies with criteria for a Substance Use Disorder (e.g., preoccupation with drug use, compulsive drug use, use despite negative consequences, and choosing drug use over other important activities), and those behavior patterns are common across addicted individuals-–who represent heterogeneity and

not homogeneity-–because they can be and often are associated with the consequence of the addiction process."

As we've established. There is no one personality trait or set of traits that determine if someone will struggle with addiction.

However, longitudinal studies on addiction have found certain traits do put individuals at greater risk for developing addiction. These traits are broken down into three major categories:

1. Impulsivity, novelty or thrill seeking.

2. Proneness to depression, rigidity, or anxiety.

3. A combination of the first (seemingly opposing) two: fearing and desiring novelty, being compulsive and planned at times and impulsive at other times, seeking new experiences while simultaneously being stuck in rigid patterns.

While no single trait predicts addiction, the similar theme among each of the paths outlined above is neuroticism. Neuroticism refers to a person's level of emotional stability, or ability to self-regulate.

Again, just because you may struggle with emotional regulation or be a self-proclaimed neurotic (I'm looking at you Jerry Seinfeld), does not mean you will have an issue with addiction. Emotional regulation, does however, play a role. As do genetics.

I was recently speaking with a friend of mine who is in long-term recovery from a substance use disorder. He telling me a story about going to his grandparents as a kid, and playing with candles. He was probably 8 years old at the time, and his mother called to check in. He answers the phone, and his mom asks, "what are you doing?" He replies, "I'm playing with candles, it's so cool!" She (mortified) responds, "where are your grandma and grandpa?" To which he replies, "they're asleep." It was 6PM. Grandma and grandpa were passed out from taking prescription pills. Genetics are hard to combat.

So it begs the question, is addiction nature or is it nurture?

Addiction happens for many reasons. Sometimes it begins as a coping tool for trauma, sometimes it is a part of our family system, and sometimes we just sort of fall into it without realizing it.

With the horrific outcomes of the opioid epidemic, it seems as though addiction is at the forefront of everyone's brain.

Yet, perhaps it would be more helpful if prevention and recovery were on the brain. How do we stop addiction before it starts? How do we prevent it from taking root in the lives of our children and those we care about?

I think it requires some courage and some difficult conversations. We need to be honest with our children about their family history. We need to explain, in age appropriate ways, that addiction is a disease, it is genetically based, and that pre-disposition exists. When children become teens and adults, it's better for them to play with a full deck. It is better for them to know that it runs in their family so that they can make informed decisions. It also is important that they know they can ask for help.

The old saying "we are only as sick as our secrets" is true. When we stigmatize addiction, we effectually prevent people from asking for and getting the help they need. We are saying, "there is something wrong with you, and it's better to hide it then to let people know."

If we want to change our culture and create a healthier society, than we must start having these conversations. If we know that self-medication is a driving force behind addiction, then we need to start talking about mental health. We need to start telling our children that it's okay to be sad, that we don't have to be upbeat and peppy all the time. We need to let them know that if they ever feel alone, or sad for days on end, that they need to talk to someone they trust, that it's okay, and that there is help.

Addiction is a reality, but so too are prevention and recovery. Let's aim for the latter.