Today I am going into some detail regarding the behaviors that can, in some people, become addictions and hopefully explain why.

    Article IV explained how different chemicals can be taken into our bodies and go to the "feeling center" in our brains. There, these chemicals, either directly hit the receptors of the nerves, or cause our own neurotransmitters (dopamine, norepinephrine, GABA, endorphins, enkephalins and serotonin) to hit their receptors in higher concentrations that without these chemicals, causing us to get high, mellow, loaded, drunk, spaced etc..

    Now the food we eat and our behaviors can also affect this same neurotransmitter system.FOOD - Sugar acts as a stimulant. A burst of glucose (the sugar our body uses as fuel) can go through the blood stream causing immediate stimulation of the brain similar to the effect of cocaine, nicotine and methamphetamine. This is why many of the best treatment centers try to keep their patients' use of sugar to a minimum. Sugars are carbohydrates and the best way to take in carbohydrates is therefore not in the form of sugar but in the form of complex carbohydrates - especially fresh fruits and vegetables. The other way that carbohydrates (again especially sugars) affect the way we feel is their action on insulin. Carbohydrates cause an increase in insulin, which causes the sugar to enter the cells faster. This leads to a drop in sugar levels that can lead to low blood sugar and the feeling of tiredness. Therefore, sugar can lead to initial stimulation and energy followed 2 - 3 hours later by lethargy and sleep.

    Fats tend to lead to sedation. Proteins cause your sugar level to be more balanced. Neurotransmitters are all made from proteins and so a protein meal causes an increase in all the neurotransmitters at the same time, leading you to be in balance in your feeling center.   

    What is the ideal balance of foods in recovery? Low pure sugars. No caffeine (it is a direct stimulant). Slightly less grams of protein than complex carbohydrates like fruits and vegetables. Low fat especially saturated fat.

    There is a tendency to overeat in early recovery - beware - eat three small meals per day - remember sugared sodas with caffeine are stimulant drinks. Soy protein has a lot of healthy properties.

    BEHAVIORS - Exercise, gambling, shopping and work are all behaviors that can be addicting. To be addicting these behaviors have to cause chemical changes in our feeling center which in turn gets us "high". These behaviors are stimulating and effect the dopamine/norepinephrine system.

    Let's pick gambling. Most people feel excited, nervous, jittery, scared when they gamble. This is because of an increase in the dopamine and norepinephrine neurotransmitters in the feeling center caused by this behavior. Most people can stop gambling any time they want. Some people gamble compulsively, lose control, get into trouble, but continue to go back to it. This fits perfectly into my definition of Addiction explained in Article I.

    Behavioral addictions tend to be stimulant/performance addictions. Exercise is an obvious stimulant-inducing behavior but after a lot of exercise especially if you get some physical pain from the exercise (release of endorphins/enkephalins - opiates), you can get an additional high. First the stimulants (dopamine, norepinephrine) then the downer (endorphins, enkephalins) leading you to be tired and "relaxed".

    SEX - has two effects on the neurotransmitter system. Initially it is all excitement and stimulation then it often leads to relaxation, the whole thing being addictive in some people. Doing it compulsively, losing control, having problems but continuously doing it again.

    By the way, starvation - as in anorexia - when a person severely restricts the total food they eat and when they do eat it is often sugar/carbohydrates, causes them to feel high. Starvation leads to a condition in the body called ketosis, which causes a person to feel "high".  So food, especially sugar and carbohydrates, can be addicting. Behaviors - exercise, gambling, sex and work can also cause chemical changes in the feeling center leading to classical addiction.

    Whether the addict is using chemicals, food or behaviors to get "high" the treatment is basically the same for all, with some exceptions/modifications. It is perhaps easier to think of completely giving up alcohol or valium or vicodin or cocaine than it is to give up food, work and sex.

    I never said this is an easy area of medicine. The treatment of all addictions is similar. It should involve a team of helpers, be mostly performed in a group setting and will need to be life-long.