MALAYSIA - The idea of addiction as a brain disease is a fairly new one. Historically, addiction was thought to be a personality flaw or a sign of weakness. Unfortunately, this stigma continues to hound the disease, creating a major problem for addicts, as well as those who treat them.
Addiction is the continued use of a mood-altering substance or behaviour despite adverse dependency consequences. When a person can't stop using drugs even if he wants to, he is likely to be suffering from addiction. It is an urge so strong, that even if an addict knows that regular drug use can cause harm or lead to death, he is unable to stop.
The thing is, when people start using drugs, they don't plan on getting addicted. For some, it is a form of escapism from the harsher realities of life. Drugs just make them feel better. However, as taking drugs or substances will alter the natural chemistry of the brain over time, drug users will start to need the drug just to feel "normal".
At this stage, reducing or discontinuing the use of a substance that the body has grown dependent on can lead to acute withdrawal symptoms. These can include anxiety, irritability, intense cravings for the substance, nausea, hallucinations, headaches, cold sweat and tremors.
Addiction can take over a person's life, replacing even vital aspects, such as the need to eat and sleep. Worse, an addict might resort to doing things like stealing or hurting someone in order to sustain their drug or behavioural habits.
According to Dr Nivashinie Mohan, a neuro-psychologist from Gleneagles Hospital Kuala Lumpur, "All addictive substances or behaviours directly satisfy the pleasure centres in the brain. This causes the person to experience a physical or mental 'high'.
"However, this high will become increasingly difficult to achieve over time. As a result, a person who is addicted will have to keep increasing the frequency or volume of whatever substance or behaviour they have grown dependent to, to achieve the high."
According to Dr Nivashinie, alcohol abuse and drug abuse are among the most common types of addictions in Malaysia. The country's proximity to the notorious 'golden triangle' of drugs makes them relatively easy to obtain, she opines. The golden triangle is infamously known as a production region of drugs.
"Alcohol is another commonly abused substance because it is often considered harmless, and again, it is easy to obtain," she adds.
However, psychological disorders such as having an addiction to shopping, eating, social media, as well as pornographic materials and sex, are also becoming more common.
Let's look at the physical and psychological symptoms that follow these "unassuming" addictions.
Sexual addiction has been described in many terms: hypersexuality, nymphomania, Don Juanism. In essence, it is a conceptual model devised to provide a scientific explanation for sexual urges, behaviours, or thoughts that are extreme in frequency, and may be occurring out of one's control.
The list of behaviours associated with sexual addiction includes consistent use of pornography, engaging in frequent and unsafe sex, having extra-marital affairs, voyeurism and visiting prostitutes.
For some people, the addiction can escalate to involve illegal activities such as exhibitionism (exposing oneself in public) and molestation. However, not all sex addicts will end up becoming sex offenders.
The biggest challenge for sex addicts is that it is often treated as an issue of morality rather than a genuine mental problem. Despite the increase in people seeking therapy, most of those affected by it often try to deal with the addiction alone.
But while some experts regard sexual addiction as a medical form of clinical addiction, there are others who believe it is a myth perpetuated by social and cultural influences.
For the sex addict, their urges are not only real and uncontrollable, they can yield serious and devastating consequences. People have lost their families and homes, and have even become suicidal because they feel that they will never be able to embark on a proper relationship.
With the scorching sun, and a lack of public amenities and facilities available, it is no wonder that shopping malls are such popular hangout places for Malaysians. Just try navigating through a local shopping mall on a weekend and you'll know what we mean.
Most Malaysians enjoy shopping. And let's face it, we've all succumbed to the occasional impulse to buy that perfect pair of heels to complement your little black dress. But when your wardrobe starts to explode with too many shoes or clothes, you could be suffering from a serious shopping addiction.
Oniomania is the technical term for the compulsive desire to shop. The phenomenon is often linked with a preoccupation with buying new things; distress or impairment as a result of the activity; as well as hypo-manic or manic episodes resulting from compulsive buying.
Many balk at the idea of compulsive buying as a real addiction, although it has the potential to create a whirlwind of emotional and financial distress. Like all addictions, these shopping addicts often experience highs and lows associated with their compulsion to buy.
For instance, the "high" derived from buying may be followed by a sense of disappointment or guilt. This could lead to an urge for yet another shopping spree in a never-ending pursuit for satisfaction.
More alarmingly, compulsive shopping could result in serious financial debts, which may lead the habit to become a secretive act. Some shopping addicts end up hiding or destroying their purchases because they feel ashamed of their addiction.
Addiction to social media
By now, most of us would have a Facebook account. In fact, according to an October 2012 report, approximately 13 million out of the 28 million-strong Malaysian population are on Facebook. This suggests that about 45 per cent of Malaysians now have Facebook accounts.
In fact, you are probably refreshing your Facebook page even as you read this. But it is one thing to be a kaypochee (nosy parker) who likes to be in the know about your friends' love lives, gastronomical adventures or work-related rants, and another to be obsessively keeping track of your Facebook newsfeed.
According to Dr Nivashinie, the term Facebook Addiction Disorder (FAD) was coined by American psychologists to describe the addiction to Facebook. Because it is not seen to be as harmful as tobacco or drugs, FAD often goes undetected because most addicts do not realise or want to admit they have a problem.
However, if you prefer to interact on Facebook rather than have a normal real-life conversation, you could be suffering from a real psychological disorder, she warns.
Like any other addiction, being addicted to social media prevents one from participating in daily activities, which could in turn cause anxiety or depression.
"Addicts feel the need to be connected to their Facebook friends all the time as they fear they may miss out something important if they don't cosntantly check out the website," she adds.
According to Dr Nivashinie, research has shown that it is mostly adults in their 20s and 30s who are addicted to social media.
"As these groups make up the working population, the implications are manifold - from the breaking of families to loss of work productivity, isolation and depression, when away from social media," she says.
The doctor concludes: "Technology is important and we cannot deny the benefits of it, but social media should not replace actual social interaction. Excessive use of social media can also turn us into a more individualistic and narcissistic society. People become more self-absorbed and isolated, choosing to be online, rather than out and about."
There is no denying that food and incessant eating are part and parcel of our national culture. Malaysians are, in fact, notorious for stuffing themselves with obscene amounts of food at any given time of the day.
Given these habits, it is no wonder that Malaysia is now the fattest country in South-East Asia. Current findings by the Health Ministry reveal that two in every five adults are either overweight or obese.
However, there is a difference between being just plain greedy and being a compulsive overeater. The latter is often characterised by an individual who has an obsessive-compulsive relationship with food. The food junkie often engages in frequent episodes of uncontrolled eating or binge-eating, during which they may feel overwhelmed or out of control. Often, they may even consume food past the point of being comfortable.
Food addicts eat even when they are not hungry. Their obsession is further exacerbated by spending excessive amounts of time and thought (and often money) on food, and secretly planning or fantasising about their next meal.
Not surprisingly, many individuals suffering from food addiction are overweight or obese. That said, not everyone who has a weight problem is a compulsive overeater. People of normal or average weight can also be affected by this addiction.
During binges, a compulsive overeater may consume up to 15,000 calories daily (an average person needs only about 1,600 calories!). For the food junkie, eating provides a temporary relief from psychological stress through an addictive high that is similarly experienced by drug and alcohol users.
Left untreated, the over-indulgence can lead to serious medical conditions, including high cholesterol, diabetes, hypertension and heart diseases.
Addiction to exercise
Even the seemingly innocuous domain of exercise is not exempt from the grips of addiction. According to the American Running Association, when the commitment to exercise crosses the line to dependency and compulsion, it can create a physical, social and psychological quagmire for the ardent exerciser.
This phenomenon typically affects runners.
To the addict, exercise has become overvalued compared to other important elements in life, including work, family and friends. Anything that comes in between them and exercise is immediately scorned and resented. Signs of addiction to exercise include withdrawal symptoms like anxiety, irritability and depression when one's circumstances prevents one from engaging in physical activity.
Exercise addiction can cost you more than just a night out with friends. The obsession can bite back in the form of osteoarthritis, a lesser-known but equally malignant cousin of osteoporosis, due to trauma and overuse of the joints.
According to the Journal of the American Osteopathic Association, "People who engaged in sports or other physically demanding activities are known to be at an increased risk of osteoarthritis in the joints they use most (eg knees and hips in football players, and hands in boxers).
That's not all, an addict's manic devotion to exercise could end up destroying one's relationship with their family, friends or significant other.
The solution to most of these habits or behavioural problems may be obvious - just cut down or limit whatever acts or vices that could be disrupting your daily life. Of course, in most cases, this is easier said than done.
The road to recovery begins with acknowledging the problem. To do that, a person suffering from addiction must first learn to recognise the signs of addiction, before progressing to seek therapy or medical help.
Change will not occur overnight, but by taking that first step, an addict stands a chance in regaining control of their lives, and with that, a second chance to live.