When the Behavior Becomes the Problem: Understanding Process Disorders (Part 1 of 3)

You know you should put down the phone, but you keep scrolling anyway. You told yourself you wouldn't buy anything else this month, but there's another package on your doorstep. You're at the gym again—even though your knee is screaming and your family is waiting at home. Or maybe work has become less about productivity and more about avoiding everything else in your life.

The behavior started as something enjoyable, maybe even helpful. Now it feels like it's controlling you instead of the other way around.

If this sounds familiar, you're dealing with what researchers call process disorders—also known as behavioral addictions (Grant et al., 2010). And understanding how they work is the first step toward taking back control.

What Are Process Disorders?

Process disorders involve compulsive engagement with activities or behaviors that trigger your brain's reward system. Unlike a one-time bad habit, these patterns create a cycle that can feel impossible to break—even when you can clearly see the damage they're causing (Grant et al., 2010).

In his work on maladaptive behavior, Gabor Maté speaks of "Hungry Ghosts"— Hungry ghosts are entities in Buddhist and Asian folk traditions, representing beings driven by insatiable greed, addiction, or unfulfilled desire. Often depicted with enormous bellies but tiny, narrow necks, they are eternally starving and unable to consume, symbolizing a state of endless, unquenched craving or spiritual emptiness. He compares this to the struggle of compulsive behavior, where people are constantly seeking and never feeling any relief.

What makes process disorders particularly tricky is that you often can't simply abstain from the behavior. You can't stop eating entirely, working, moving your body, or connecting with others. These are necessary parts of modern life—which makes finding balance both more complicated and more essential.

The common thread across all process disorders? A loss of control despite negative consequences, the development of tolerance (needing more to feel the same effect), and withdrawal-like symptoms when you can't engage (Brand et al., 2019). Let's look at how this plays out across different behaviors.

Gambling Disorder

Gambling disorder is the most formally recognized process disorder, included in the DSM-5 as a diagnosable condition (American Psychiatric Association, 2022). It involves persistent and recurrent problematic gambling that leads to significant distress or impairment. The cycle is familiar to those who experience it: the thrill of the bet, the chase of losses, the promises to stop that don't stick.

Since the 2018 Supreme Court ruling legalizing sports betting, internet searches for gambling addiction help have increased 23% nationally—representing approximately 6.5 to 7.3 million searches. Online sportsbooks show substantially greater impact than brick-and-mortar venues, with some states seeing 67% increases in help-seeking searches (Ayers et al., 2025).

Research shows that people with gambling disorder make decisions differently—they discount future rewards more rapidly and struggle with risk-reward assessments (Grant et al., 2010). The brain's reward system gets hijacked by the anticipation of winning, making it incredibly difficult to walk away even when the losses mount.

Compulsive Sexual Behavior

Compulsive sexual behavior disorder (CSBD) was recently included in the ICD-11 as an impulse control disorder (World Health Organization, 2019). It's characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior over an extended period.

This can include pornography use, multiple sexual partners, or other sexual behaviors that continue despite negative consequences to relationships, work, or wellbeing. Research shows those with CSBD score higher on obsessive-compulsive measures compared to those with gambling or gaming disorders (Mestre-Bach et al., 2023). The shame and secrecy often surrounding this disorder can make it particularly isolating—and that isolation often feeds the cycle.

Compulsive Buying-Shopping

The rush of a purchase, the temporary high, followed by guilt, financial stress, and closets full of things you don't need—compulsive buying-shopping disorder affects an estimated 5-8% of adults (Maraz et al., 2016). Research shows it's characterized by higher levels of harm avoidance and overall psychopathology compared to other behavioral patterns (Mestre-Bach et al., 2023).

I know this one intimately. For years, I would buy and buy, only to feel ambivalent about the purchase once it was home—never feeling "full." It took me a long time to recognize and understand the cycle. In the meantime, I racked up massive amounts of debt and carried an intense amount of guilt and shame about my habit. It continues to be a struggle for me.

Compulsive Eating

Compulsive eating involves patterns of consuming highly processed foods that mirror other maladaptive behaviors: tolerance (needing more to feel satisfied), withdrawal (emotional and physical distress when you can't access certain foods), and continued consumption despite negative consequences (Gearhardt et al., 2016). Approximately 8-15% of adults in community samples report symptoms that meet criteria for food-related compulsive behaviors (Oliveira et al., 2021).

My first struggle with compulsive behavior was with food. If I could just feel full, I thought I might feel safe and okay. I don't even think this was a conscious thought—but I believe this might be an urge we're born with–we’re fed for sustenance and for comfort in those newborn days–and when we don't develop other coping skills and are exposed to trauma, it's the one many of us return to.

What makes compulsive eating particularly challenging is that you can't simply abstain from eating. You need food to survive. The work isn't about elimination—it's about finding a different relationship with food, one where you're making choices rather than being driven by compulsion.

Social Media and Internet Overuse

Problematic social media use is rapidly becoming a major public health concern (Moretta & Wegmann, 2025). The endless scroll, the dopamine hit of notifications, the comparison trap—these platforms are literally designed by teams of engineers to capture and hold your attention.

When social media use starts interfering with sleep, relationships, work, or your sense of self-worth, it's crossed from habit into problem territory. The preference for online social interaction over face-to-face connection and fear of missing out (FOMO) are increasingly recognized as key warning signs (Moretta & Wegmann, 2025). You might find yourself reaching for your phone before you're even aware you've done it—that's your brain on autopilot, chasing the next small hit of dopamine.

Gaming Disorder

Gaming disorder is now recognized by the World Health Organization (2019). It involves impaired control over gaming, increasing priority given to gaming over other activities, and continuation despite negative consequences.

Research shows that people with gaming disorder tend to score lower on persistence—the ability to maintain effort toward long-term goals (Mestre-Bach et al., 2023). This may explain why the immediate rewards of gaming become so compelling compared to real-world achievements that require sustained effort. When leveling up in a game feels more rewarding than working toward life goals, that's a signal worth paying attention to.

Exercise Addiction

This one can be tricky because exercise is widely celebrated as healthy—and it is, in appropriate amounts. But when working out becomes compulsive, the line between healthy and harmful blurs. Warning signs include: exercising through injuries, missing important life events to work out, feeling intense anxiety or guilt if you skip a session, and needing more and more exercise to feel the same effect (Lichtenstein et al., 2017).

Exercise activates the dopamine reward system and produces natural highs through endorphins and cannabinoids (Ertl, 2024). When exercise shifts from something that adds to your life to something that controls it—when rest feels impossible and relationships suffer—you've crossed into problematic territory. The goal of movement should be health and vitality, not punishment or escape.

Workaholism

In a culture that often celebrates overwork, workaholism can hide in plain sight—even earn you praise. It's defined by excessive devotion to work at the expense of personal relationships and self-care. Approximately 30% of workers are classified as workaholics (Andreassen et al., 2013).

The key distinction: unlike being highly driven or ambitious, workaholics feel compelled to work excessively due to underlying psychological needs. Work becomes a way to avoid uncomfortable emotions, escape relationship difficulties, or maintain a sense of worth that feels too fragile without constant achievement. Workaholism is closely associated with obsessive-compulsive personality traits and can lead to burnout, strained relationships, and serious health problems (Burwell & Chen, 2006).

What's Really Happening?

If you recognized yourself in any of these descriptions, you might be wondering: Why? Why do these patterns form, and why are they so hard to break?

The answer lies in your brain. In Part 2 of this series, we'll explore the neuroscience behind process disorders—why your brain gets hijacked by these behaviors, and what research tells us about the different psychological profiles that make each pattern unique. Understanding the "why" is essential groundwork for finding your way out. In Part 3, we’ll talk about solutions.

Want a helpful tool to visulaize the behaviors behind your behavior? Check out our worksheet.

Citations

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association. https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787

Andreassen, Cecilie & Griffiths, Mark & Hetland, Jørn & Pallesen, Ståle. (2012). Development of a work addiction scale. Scandinavian journal of psychology. 53. 265-72. 10.1111/j.1467-9450.2012.00947.x. https://www.researchgate.net/publication/223971523_Development_of_a_work_addiction_scale

Brand, M., Wegmann, E., Stark, R., Müller, A., Wölfling, K., Robbins, T. W., & Potenza, M. N. (2019). The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neuroscience & Biobehavioral Reviews, 104, 1-10. https://www.sciencedirect.com/science/article/pii/S0149763419303707

Burwell, R., & Chen, C. P. (2006). Applying the principles and techniques of solution-focused therapy to career counseling. Counselling Psychology Quarterly, 19(2), 189-203. https://www.academia.edu/6326779/Applying_the_principles_and_techniques_of_solution_focused_therapy_to_career_counselling

Ertl, M. (2024). When exercise becomes too much of a good thing. Columbia University Department of Psychiatry. https://www.columbiapsychiatry.org/news/when-exercise-becomes-too-much-good-thing

Gearhardt, A. N., Corbin, W. R., & Brownell, K. D. (2016). Development of the Yale Food Addiction Scale Version 2.0. Psychology of Addictive Behaviors, 30(1), 113-121. https://psycnet.apa.org/record/2016-06978-001

Grant, J. E., Potenza, M. N., Weinstein, A., & Gorelick, D. A. (2010). Introduction to behavioral addictions. The American Journal of Drug and Alcohol Abuse, 36(5), 233-241. https://pubmed.ncbi.nlm.nih.gov/20560821/

Lichtenstein, M. B., Hinze, C. J., Emborg, B., Thomsen, F., & Hemmingsen, S. D. (2017). Compulsive exercise: Links, risks and challenges faced. Psychology Research and Behavior Management, 10, 85-95. https://pubmed.ncbi.nlm.nih.gov/28435339/

Maraz, A., Griffiths, M. D., & Demetrovics, Z. (2016). The prevalence of compulsive buying: A meta-analysis. Addiction, 111(3), 408-419. https://pubmed.ncbi.nlm.nih.gov/26517309/

Mestre-Bach, G., Granero, R., Fernández-Aranda, F., Potenza, M. N., & Jiménez-Murcia, S. (2023). Obsessive-compulsive, harm-avoidance and persistence tendencies in patients with gambling, gaming, compulsive sexual behavior and compulsive buying-shopping disorders/concerns. Addictive Behaviors, 139, 107591. https://pubmed.ncbi.nlm.nih.gov/36587418/

Moretta, T., & Wegmann, E. (2025). Diagnostic and conceptual controversies in problematic social media use. Addictive Behaviors Reports, 22, 100631.

Oliveira, J., Sousa, M., & Gearhardt, A. N. (2021). Food addiction: A review of the evidence and implications for clinical practice. Current Addiction Reports, 8, 239-248. https://link.springer.com/article/10.1007/s40473-018-0169-2

World Health Organization. (2019). International classification of diseases (11th ed.). World Health Organization. https://www.who.int/standards/classifications/classification-of-diseases

Yeola, A., Allen, M., Desai, N., Poliak, A., Yang, K., Smith, D., & Ayers, J. W. (2025). Growing health concern regarding gambling addiction in the age of sportsbooks. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.8193