Recognizing and Addressing Addictive Behaviors: Prevention, Consequences, and Solutions

2023-11-30 05:41:47

More than eight out of ten 15-year-olds consult social networks every day and 7% of 11-15 year-olds even use them excessively. Overall, nearly 3% of the Swiss population are addicted to gambling, chance or video. When can we talk about addiction? When the need to play or consult a social network becomes difficult to control and this activity comes before all others. The notion of priority is distorted and control is very limited.

Serious consequences

An officially recognized disease

Since 2019, “disorders due to addictive behaviors” have been recognized as a psychological disorder and included in the international classification of diseases (ICD-11) of the World Health Organization (WHO). Disorders linked to the use of video games and games of chance and gambling are mentioned there. “This recognition is a step forward for everyone,” rejoices Professor Yasser Khazaal of CHUV. It opens rights to patients, who see that they are not the only ones to suffer. And, on the doctors’ side, unified research protocols, with harmonized data, can be put in place. We are making progress in terms of knowledge of the disorder, treatments, epidemiology and even public health.”

“What should be a leisure activity then comes before an outing with friends, a family meal or a professional obligation, which can become problematic,” illustrates Professor Yasser Khazaal, psychiatrist in the Addiction Medicine Department of the Vaud University Hospital Center ( CHUV). Often, a person suffering from a behavioral addiction experiences difficulties at work or school. Homework is no longer done or professional meetings are missed.

In addition to these consequences on social and professional life, addictive behaviors can have repercussions on overall health (weight gain due to an unbalanced diet and a lack of sport, sleep problems and therefore fatigue, vision problems) and generate depressive state, stress and anxiety.

The effects can also be financial. With gambling for example, and because the player always hopes to “make a comeback”, it is not uncommon to lose very large sums, leading to over-indebtedness, from which it is difficult to escape. “Most of those affected find it a relief to break the silence and call on someone they trust. The weight of concealment and lies disappears and opens the way to solutions,” explains Monique Portner-Helfer, spokesperson for the Swiss Addiction Foundation.

Prevention measures

Could prevention avoid certain excesses and dramatic consequences such as over-indebtedness? “Various studies have shown that prevention in the field of addictions is not very effective on an individual level,” notes Professor Daniele Zullino, psychiatrist at the University Hospitals of Geneva (HUG). However, in terms of public health, it is possible to take relevant actions, for example by reducing accessibility to the product or game, or by defining societal rules. This was done with tobacco and alcohol. The best prevention in addiction remains early detection to be able to intervene early.”

This early detection can be done by loved ones, who can notice variations in the player’s behavior or changes in mood. “But, particularly because of the intergenerational gap, including in terms of IT, it is not always the family that will be best placed to help a young person, for example,” believes Professor Zullino. Teachers, who can quickly spot a change in a student’s grades or behavior, a sports coach or the family doctor can also spot addictive behavior, then help and support the person. Those around you can thus take on an important supporting role. “Addiction Suisse advises them to speak openly with the person concerned and express their own concerns and observations. Possibilities for help may be mentioned,” underlines its spokesperson.

Solutions to get out of it

It is also possible to get out of an addiction on your own. “The objective is in fact to find better harmony on a daily basis between its different activities,” describes Professor Khazaal. For example, it is helpful if the person in difficulty can reconnect with a past activity that gave them joy. With time, perseverance and the support of those close to them, by gradually regaining self-confidence, the person will be able to decide for themselves to modify their practices to diversify their sources of pleasure and fulfillment.

The intervention of a doctor, pediatrician or general practitioner, proves essential in certain cases. “Therapy can help to find reasoning where there are only automatisms,” explains Professor Zullino. Because, it must be emphasized, addictive behaviors, whatever the type of addiction, correspond to automated behaviors, fixed habits, triggered by a stimulus. They happen without us thinking about them.”

A medical assessment also allows us to better understand what addictive behavior brings to the person suffering from excessive behavior. “There are positives, because there always are, which must be compared to the negative aspects,” explains the Geneva psychiatrist. Depending on the scale, the patient makes a choice. He must decide his own life goals.” Since addiction always encourages short-term thinking, treatment also involves developing a medium- and long-term life plan that takes into account the possible risks of relapse and failure.

No treatment available

Pharmacologically, there is no effective solution to help get rid of an addiction to gaming or social networks. On the other hand, medications can be useful to alleviate certain comorbidities associated with addictive behaviors such as depression and anxiety disorders. “Medical treatment for addictions and its comorbidities does not have to be long,” recalls Professor Zullino, “but in all cases, the earlier the addiction is caught, the better.”

Tous addicts?

A very small minority of players lose control and become addicted. But who are these inveterate gamblers who only think about their games or their winnings and forget everything else? In reality, anyone can one day find themselves facing addictive behaviors. “As addiction is linked to a physiological process, we can all suffer from it, just as we can all have a fever,” explains Professor Daniele Zullino, psychiatrist at HUG. But there are vulnerability factors.” These factors increasing the risk of addiction are social problems, insecurity (whether moral, physical or financial), impulsivity, susceptibility to negative emotions, depression, anxiety or even chronic stress. “There is also age,” explains Monique Portner-Helfer, of Addiction Suisse. Thus, adolescence can be a vulnerable phase, during which many things are at stake.” And Professor Zullino clarifies that “teenagers are not, however, the only ones concerned. The elderly are also very affected by addictions, we must not forget this. In retirement, we have time but the risk of social isolation, and therefore addiction, is significant.”

Conversely, there are protective factors: “Feeling that you are surrounded and that you can count on others is one of them, illustrates Professor Yasser Khazaal, psychiatrist at CHUV, as is having good self-esteem and evolve in a stable and secure world.”