Behavioral Addiction Treatment in Baltimore
Expert Support for Compulsive Behaviors and Process Addictions
When you find yourself unable to stop a behavior despite negative consequences, it can feel deeply confusing and shameful. Unlike drug and alcohol use, behavioral addictions involve compulsive engagement in rewarding activities—gambling, shopping, gaming, sexual behavior, or internet use—that activate the same reward pathways in the brain as substance use disorders. The behavior starts as a source of pleasure or escape but gradually takes control of your life, leading to financial problems, damaged relationships, work difficulties, and mental health issues like anxiety and depression.
Behavioral addiction is a real mental health condition. The brain's reward system responds to these addictive behaviors in ways remarkably similar to substance abuse, creating compulsive patterns that become increasingly difficult to control. You may experience withdrawal symptoms like irritability, anxiety, or restlessness when you try to stop. You might feel guilt or shame after engaging in the behavior, yet find yourself unable to resist urges or temptations to do it again.
At the Baltimore Therapy Group, our licensed therapists provide evidence-based treatment for behavioral addictions. Whether you're struggling with gambling addiction, sex addiction, shopping addiction, internet addiction, video game addiction, or other compulsive behaviors, we offer specialized support to help you regain control and build healthier patterns. Our approach addresses both the behavioral addiction itself and any underlying mental health conditions that may be contributing to the compulsive engagement.
What Are Behavioral Addictions?
Behavioral addiction involves a compulsion to engage in rewarding non-substance-related behaviors despite negative consequences to the person's well-being. The term 'behavioral addiction' has been used since the 1990s to describe compulsive behaviors that lead to rewards, similar to substance addictions. Behavioral addictions are sometimes called process addictions because they involve becoming addicted to a process or activity rather than a chemical substance.
How Behavioral Addictions Affect the Brain
Both types of addiction—substance use disorders and behavioral addictions—activate the same reward pathways in the brain. When you engage in the addictive behavior, your brain releases dopamine, creating feelings of pleasure and reinforcement. Chronic engagement in addictive behaviors can lead to neuroadaptations in the brain, affecting the natural production of dopamine and the number of dopamine receptors. Over time, you may need to engage in the behavior more frequently or intensely to achieve the same pleasurable effects.
The chronic activation of the brain's reward circuitry due to behavioral addictions can lead to neuroadaptations that affect mental health. Individuals with behavioral addictions may experience withdrawal symptoms similar to those seen in substance use disorders when they attempt to stop the behavior, and many also struggle with depression that requires focused therapy and support. This is because the brain has adapted to the repeated dopamine surges and struggles when that stimulation is removed.
Key Differences Between Behavioral and Substance Addiction
While behavioral addictions resemble substance use disorders in their impact on mental health, there are important differences:
Source of addiction: Substance addiction is driven by external chemical substances like drugs or alcohol, while behavioral addiction is triggered by actions that trigger dopamine release through behaviors and activities.
Physical dependence: Substance abuse often causes severe physical dependence and withdrawal symptoms that can be medically dangerous, while behavioral addiction is primarily psychological and behavioral, though withdrawal symptoms like anxiety and irritability do occur.
Visible signs: Substance abuse often leaves visible physical signs such as track marks or bloodshot eyes, while behavioral addictions generally lack such physical effects, making them easier to hide from others.
Treatment approaches: While both benefit from therapy and support groups, substance use disorders may require medical detox and medication, while treating behavioral addictions focuses more on cognitive behavioral therapy, impulse control strategies, and lifestyle changes.
Common Types of Behavioral Addiction
“Behavioral Addictions Are Real and Treatable — Behavioral addictions involve the same brain mechanisms as substance use disorders, even though only gambling disorder is officially recognized in the DSM-5 and gaming disorder in the WHO’s classification. Other behaviors like sex addiction, shopping addiction, and internet addiction disorder also cause real suffering and can be effectively treated. Cognitive behavioral therapy, support groups, and other treatments help people regain control. If a behavior is harming your life despite efforts to stop, professional help is warranted—regardless of diagnostic labels.”
Behavioral addictions can manifest in many forms. Here are the most common specific behavioral addictions, all of which can be addressed by experienced therapists in Baltimore who specialize in addiction and mental health:
Gambling Addiction (Gambling Disorder)
Gambling disorder is the only behavioral addiction officially recognized by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under 'substance-related and addictive disorders.' Gambling addiction is characterized by repetitive gambling behavior despite negative consequences. People with gambling addiction may chase losses, lie about gambling, risk important relationships or job opportunities, and rely on others to bail them out of financial crises. Gamblers Anonymous and other support groups provide valuable resources for those struggling with this addictive disorder.
Sex Addiction (Hypersexual Disorder)
Sex addiction, also known as hypersexual disorder or compulsive sexual behavior, involves continued engagement in sexual activities despite negative consequences. This behavioral addiction may include excessive pornography use, compulsive masturbation, risky sexual encounters, or use of sexual services. Sex addicts often struggle with feelings of guilt or shame after engaging in sexual behavior, yet feel unable to control urges. Sexual addiction can severely damage relationships and lead to legal, financial, or health consequences. Support groups for sex addiction provide confidential environments for recovery.
Internet Addiction and Gaming Disorder
Internet addiction disorder is characterized by excessive preoccupations and urges regarding computer use and internet access. This behavioral addiction can manifest as problematic online gaming, compulsive social media use, or excessive internet use for other purposes. The World Health Organization recognizes gaming disorder in the International Classification of Diseases, acknowledging that video game addiction is defined as problematic, compulsive use of video games that results in significant impairment in various life domains.
Digital platforms that interfere with daily life can lead to internet and gaming addiction, manifesting in social isolation, neglect of responsibilities, and withdrawal symptoms when unable to access the internet or games. Smartphone addiction is fueled by internet overuse and is associated with mental health problems such as anxiety and depression, and in some people can overlap with obsessive-compulsive patterns that benefit from specialized OCD therapy.
Shopping Addiction (Compulsive Buying)
Shopping addiction, also known as compulsive buying disorder or compulsive shopping, involves an overwhelming desire to shop, leading to severe financial distress. People with this behavioral addiction may shop to cope with negative emotions, experience a rush or high while shopping, and feel guilt or embarrassment afterward. Compulsive buying is defined by excessive financial investments that cause distress or dysfunction in the person's life. This addictive behavior can lead to debt, relationship problems, and feelings of being out of control.
Exercise Addiction
Exercise addiction involves compulsive engagement in physical exercise despite negative consequences. While exercise is generally healthy, exercise addiction may lead to injury, neglect of other important life areas, and an obsession with physical activity that disrupts work, relationships, and overall well-being. Individuals with this behavioral addiction may experience withdrawal symptoms like anxiety or irritability when unable to exercise.
Work Addiction
Work addiction, sometimes called workaholism, involves compulsive overworking that negatively impacts the person's life. Unlike being dedicated to one's career, work addiction is characterized by an inability to stop working, neglect of relationships and self-care, and using work as a means to escape from reality or painful emotions. This behavioral addiction can lead to burnout, health problems, and damaged relationships.
Food Addiction and Binge Eating
Food addiction involves compulsive eating behaviors and cravings for specific types of food, particularly highly processed foods high in sugar, fat, or salt. While not universally accepted as a formal diagnosis, many individuals report experiencing food addicts symptoms similar to other addictive behaviors. Binge eating disorder, recognized as a mental health disorder, involves recurrent episodes of eating large amounts of food with a sense of lost control, and often responds well to Cognitive Behavioral Therapy (CBT) focused on thoughts, feelings, and habits around food.
Signs and Symptoms of Behavioral Addiction
Behavioral addictions can lead to significant impairment in various life domains, including mental, social, and financial well-being. Common signs include:
Loss of Control
The inability to control or stop the activity is a key sign of behavioral addiction. Individuals with behavioral addictions often struggle to resist urges or temptations to reduce or stop their behaviors, even when they genuinely want to quit or have lost control over the behavior.
Continued Engagement Despite Consequences
The behavior continues despite clear negative consequences. This might include financial problems, relationship conflicts, job loss, legal issues, or health concerns. People with behavioral addictions may recognize the negative impact but feel powerless to stop.
Preoccupation and Cravings
Individuals may feel a need for constant exposure to the stimuli associated with their addiction. They spend significant mental energy thinking about the behavior, planning when they can engage in it next, or feeling distracted by thoughts about it. These compulsive behaviors can interfere with daily responsibilities and relationships.
Withdrawal Symptoms
Withdrawal from behavioral addiction usually manifests as irritability, anxiety, or restlessness when the behavior is stopped or reduced. The individual's ability to function may be compromised during withdrawal, making it difficult to abstain from the behavior.
Using the Behavior to Cope
Many individuals with behavioral addictions use these behaviors as a means to cope with underlying mental health issues such as anxiety and depression. The addictive behavior serves as a way to escape from reality or painful emotions, providing temporary relief but ultimately worsening mental health problems.
Feelings of Guilt and Shame
Individuals with behavioral addictions often experience feelings of guilt or shame after engaging in the behavior. Despite these negative feelings, the compulsive pattern continues, creating a cycle of engagement, guilt, and repeated behavior.
Troubled Relationships
Compulsive behaviors associated with behavioral addictions can lead to troubled relationships and challenges with interpse control. Family members and friends may express concern, leading to conflict and distance in relationships.
The Connection Between Behavioral Addictions and Mental Health
Behavioral addictions can resemble substance use disorders in their impact on mental health. There is a solid body of evidence linking behavioral addictions to mood disorders and anxiety disorders. The relationship between behavioral addictions and mental health disorders is complex and often involves a cycle of negative emotions and compulsive behaviors.
Co-Occurring Mental Health Conditions
Behavioral addictions often manifest as a means of coping with underlying mental health issues. Depression or anxiety is often tied to compulsive buying or eating, and treating these underlying mental health conditions is essential for recovery from the behavioral addiction. Many individuals with behavioral addictions use these behaviors to temporarily escape symptoms of depression, anxiety, trauma, or other mental disorders, which is why expert counseling in Baltimore that addresses both symptoms and root causes can be so important.
Research indicates that behavioral addictions can lead to significant impairment in various life domains, including mental health. The chronic stress of maintaining the addictive behavior, combined with its negative consequences, can worsen existing mental health conditions or trigger new ones.
The Cycle of Addiction and Mental Health
The relationship between behavioral addictions and mental health is often cyclical. Mental health problems may lead someone to engage in compulsive behaviors as a coping mechanism. The temporary relief reinforces the behavior, but the negative consequences of the addiction then worsen mental health, leading to more compulsive engagement. Breaking this cycle requires addressing both the behavioral addiction and the underlying mental health disorder.
Getting Started at the Baltimore Therapy Group
At the Baltimore Therapy Group, our licensed therapists provide specialized treatment for behavioral addictions in Baltimore, MD. We understand that behavioral addictions can be difficult to talk about due to shame or misunderstanding from others. Our therapists create a safe, nonjudgmental space where you can be honest about your struggles and receive evidence-based support.
Located in Towson, Maryland, we serve clients throughout the Baltimore area. We offer both in-person therapy sessions and teletherapy options for clients who prefer online treatment.
Baltimore Therapy Group Accepting New Patients
Meet the Baltimore Therapy Group's
Process and Behavioral Addiction
Counseling Specialists
Zak Fusciello, LCPC
Behavioral Addiction counselor
Licensed counselor in Baltimore
Zak works with individuals and couples experiencing depression, anxiety, relationship conflict, substance misuse, and compulsive behaviors. His warm style helps clients feel comfortable exploring difficult topics without shame. Zak recognizes that behavioral addictions often serve as a way to escape from stress, boredom, loneliness, or painful emotions, and he helps clients identify what drives the compulsive engagement while building alternative coping skills.
Zak uses Interpersonal Process Therapy, Cognitive Behavioral Therapy and motivational approaches to help clients develop self-awareness about patterns, strengthen impulse control, and reconnect with activities and relationships that provide genuine meaning and satisfaction. He recognizes that recovery from behavioral addiction isn't just about stopping the behavior—it's about building a life that feels fulfilling without relying on compulsive activities for pleasure or escape.
Cassie Ekstrom, LCSW-C
Behavioral Addiction counselor
Licensed social worker in Baltimore
Cassie works with individuals and couples struggling with depression, anxiety, addiction, trauma, and relationship challenges. She brings a direct, grounded approach that helps clients identify concrete steps forward. Cassie understands that behavioral addictions often develop as coping mechanisms for difficult emotions or life circumstances, and she helps clients address both the compulsive behaviors and the underlying issues driving them.
Cassie creates a safe, nonjudgmental space where clients can be honest about compulsive behaviors without fear of judgment. She uses Cognitive Behavioral Therapy and other evidence-based approaches to help clients recognize patterns, develop impulse control skills, and build healthier coping strategies. Cassie is experienced in working with clients who have co-occurring mental health conditions and addictive disorders, understanding how anxiety, depression, and trauma intersect with behavioral addictions.
Treatment for Behavioral Addictions
“You’re Not Alone — Behavioral addictions are real mental health conditions involving changes in brain function. Factors like genetics, environment, and trauma contribute to their development. Effective treatment addresses these factors through therapy and support. You don’t have to face this alone—help is available, and recovery is possible.”
Common treatment options for behavioral addiction include evidence-based psychotherapy, support groups, and in some cases, medication to address co-occurring mental health conditions. The treatment plan is tailored to the specific behavioral addiction and the individual's unique circumstances.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy is the most common form of psychotherapy used in treating behavioral addictions. CBT helps individuals identify patterns that trigger compulsive behavior and make lifestyle changes to promote healthier behaviors. Therapists often lead patients through topics of identifying the issue, becoming aware of one's thoughts surrounding the issue, and reshaping negative thinking during CBT sessions.
CBT for behavioral addictions focuses on:
Recognizing triggers and high-risk situations
Challenging thoughts that justify the addictive behavior
Developing healthier coping strategies for stress and emotions
Building impulse control skills
Creating structured routines and behavioral plans
Addressing cognitive distortions that maintain the addiction
Support Groups and Twelve-Step Programs
Twelve-step programs can be extremely valuable resources for clients with behavioral addictions. Support groups exist for almost every type of behavioral addiction, providing both online and in-person mutual-help options. These groups offer peer support, accountability, shared experiences, and hope for recovery.
Examples include:
Gamblers Anonymous for gambling addiction
Sex Addicts Anonymous for sex addiction
Online Gamers Anonymous for gaming disorder
Debtors Anonymous for compulsive spending
Workaholics Anonymous for work addiction
Addressing Co-Occurring Conditions
Because there is a solid body of evidence linking behavioral addictions to mood disorders and anxiety disorders, effective treatment must address underlying mental health issues. Depression or anxiety is often tied to compulsive buying or eating, and medications like SSRIs may help address these underlying issues when appropriate. Therapy helps individuals develop healthier ways to cope with difficult emotions rather than turning to addictive behaviors for relief.
Medication Considerations
There are no medications currently approved by addiction medicine specifically for the treatment of behavioral addictions, but certain medications used for substance use disorders may be beneficial for specific behavioral addictions. Medications that address co-occurring mental health conditions like depression, anxiety, or ADHD can reduce the urge to engage in compulsive behaviors. Any medication should be prescribed and monitored by a psychiatrist or other clinician with expertise in addiction medicine.
Specialized Approaches
Counselors should become informed about the specific nature of the addictive behavior, including relevant neuroscience, when working with clients with behavioral addictions. Different behavioral addictions may require specialized understanding. For example, treating sex addiction may involve addressing trauma history, while treating gambling disorder might focus more heavily on financial counseling and impulse control. For many clients, thoughtfully navigating in-person therapy options in the Baltimore area is a key step toward finding someone with the right expertise.
Recreational therapy can help individuals struggling with addiction to improve their self-esteem, confidence, motivation, and overall emotional state. This approach uses activities and experiences to promote healing and develop new, healthy ways to experience pleasure and reward, and can be effectively integrated into online teletherapy with Baltimore-based clinicians for added flexibility and access.
What to Expect When You Reach Out
When you contact the Baltimore Therapy Group for behavioral addiction treatment, we'll schedule an initial consultation. Your therapist will learn about the specific behavior causing concern, how long the pattern has been problematic, what negative consequences you've experienced, and what you've tried already. They'll also assess for any co-occurring mental health conditions like anxiety, depression, or trauma that may be contributing to the compulsive behavior.
Together, you'll develop a treatment plan that addresses both the behavioral addiction and any underlying issues. Treatment typically involves weekly therapy sessions using Cognitive Behavioral Therapy and other evidence-based approaches. Your therapist may also recommend support groups as an additional resource for recovery.
We understand that reaching out about behavioral addictions takes courage. Our therapists provide expert, compassionate support without judgment. Whether you're struggling with gambling addiction, sex addiction, shopping addiction, internet addiction, gaming disorder, or other compulsive behaviors, we can help you develop the skills and insights needed for recovery, and make it simple to schedule therapy with a Baltimore counselor who is a good fit for your needs.
If you're ready to regain control over compulsive behaviors and build a healthier life, contact the Baltimore Therapy Group today. Our behavioral addiction treatment services are designed to support your recovery and help you create lasting change.