What is Behavioral Health?

Behavioral health is a person’s state of being and how their behaviors and choices affect their overall health and wellness. Substance abuse and addictions of all kinds fall into the realm of behavioral health. Behavioral health disorders are illnesses that are precipitated or perpetuated by your conscious decisions and which you are unable to resist the urge to repeat, despite negative consequences. Changing these compulsive behaviors directly influences your life, then, by lessening or removing some of the symptoms of the behavioral health disorder.¹

Defining & Differentiating Behavioral Health Issues

Behavioral health is an umbrella term that refers to your overall wellbeing and how it is impacted by your behaviors. Because behavior is something that is generally seen as changeable, people suffering from behavioral health issues can be empowered by knowing that their own choices can prevent, cure, or decrease symptoms of a variety of behavioral health disorders. However, even though relatively simple behavioral modification can translate to great improvements in overall health, the larger issue is often somewhat more complicated; at some point, the underlying causes of the initially maladaptive behaviors may require additional attention. Behavioral health is just as complex as mental health, and the two terms are often used interchangeably.¹

Behavioral Health Issues vs. Mental Health Issues

While behavioral health and mental health tend to overlap, and many organizations substitute one term for the other, distinct differences do exist between the two. The U.S. Department of Health and Human Services defines mental health as a person’s psychological, emotional, and social wellbeing. And while some mental health issues may be impacted by behavior, many mental health disorders have neurological or biological causes, meaning that simply changing a person’s behavior may not cure them of that illness.^1,2,3

Some examples of mental health disorders include:^2,3

• Bipolar disorder.
• Schizophrenia.
• Depression.
• Generalized anxiety.
• Social anxiety.
• Attention-deficit/hyperactivity disorder (ADHD).

Examples of behavioral health disorders include:^2,3

• Substance abuse disorders.
• Eating disorders.
• Behavioral addictions.

Types of Behavioral Health

There are a variety of behavioral addictions and disorders that you may struggle with, such as:⁴

• Eating disorders: Eating disorders, such as anorexia and bulimia nervosa, are characterized by abnormal and destructive eating and related behaviors.
• Exercise addiction: While exercise is generally a healthy practice, it can become problematic for some people. Exercise addiction is characterized by compulsive exercise that continues despite potential negative consequences (e.g., excessive weight loss, injury, neglect of other responsibilities).
• Porn addiction: Porn addiction is becoming an epidemic in the technological age and may develop as you become obsessed or preoccupied with porn so much so that it negatively impacts other areas of your life.
• Sex addiction: Sex addiction generally refers to any compulsive sexual behaviors that you have difficulty controlling despite negative consequences, such as relationship or family problems, divorce, sexually transmitted diseases, unplanned pregnancies, and financial concerns.
• Gambling disorder: Gambling can also be a serious behavioral addiction. If you suffer from gambling addiction and engage in compulsive gambling behaviors, you have poor impulse control, which may result in you losing your life savings, home, or other valuable material items.
• Internet addiction: Internet addiction has also become more widespread in recent years. While many people might be guilty of occasionally spending too much time on the internet, those with serious internet addiction may be unable to control their internet use and may neglect other important areas of their lives, such as personal hygiene, career, and relationships.
• Gaming addiction: While gaming addiction is not officially recognized as a disorder, the symptoms of video game addiction are real. Frequently playing video games does not alone qualify as an addiction: to be considered an addictive behavior, video gaming must be compulsive and you must have difficulty controlling your gameplay, spending most of your waking hours gaming.
• Shopping addiction: Shopping addiction is another behavioral health disorder that can negatively impact your life. While many people may enjoy recreational shopping, for some, it becomes a compulsive and uncontrollable behavior with many undesirable consequences. You may overspend or rack up debt on credit cards in order to keep shopping even when you can’t financially afford it. You may shop as a means of coping with emotional distress or for the rush a new purchase may give you.
• Work addiction: Working is generally considered a normal, productive means of spending your time. However, it is important to remember that anything can be unhealthy in excess. Work addiction may be driven by perfectionism or a significant need for achievement, success, or money. Those who suffer from work addiction may work long hours at the expense of their health, relationships, and emotional wellbeing.

Behavioral Treatment Options

A variety of behavioral addictions were left out of the pages of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders due to a lack of empirical evidence to support their inclusion as diagnostic entities. The only behavioral addiction that was added was gambling disorder.

While other behavioral addictions were not included in the DSM-V, many experts in the field of mental and behavioral health acknowledge that addiction is not restricted to substances. One such expert, R.I.F. Brown, has proposed a set of 6 criteria for diagnosing behavioral addiction:⁴

• Salience: Occurs when your life becomes dominated by the activity of addiction, whether it’s gambling, sex, shopping, or gaming.
• Euphoria: You typically achieve some type of euphoric high when engaging in the addictive activity.
• Tolerance: When you continuously engage in the addictive behavior, the euphoric rush may begin to weaken, and you may need to progressively engage in the activity more intensely or for longer periods of time in order to achieve the initial effect.
• Withdrawal symptoms: Cessation from the activity of choice may result in the onset of withdrawal symptoms such as unpleasant thoughts, emotions, and sensations in your body. These might include obsessive thinking, depression, anxiety, irritability, and difficulty sleeping.
• Conflict: Ultimately, when an activity becomes addictive, the behavior creates some degree of self-conflict or conflict with others.
• Relapse and reinstatement: When you are addicted to a behavior or activity, you may relapse after a period of sustained abstinence. Similar to substance addictions, relapse is often accompanied by a reinstatement of negative life consequences, including neglect of your personal, professional, and social life.

Many people with behavioral health issues have co-occurring mental health disorders or underlying traumas and emotional issues that contribute to their maladaptive behaviors. For this reason, you cannot typically just stop engaging in such behaviors at will. Behavioral addiction treatment is just as complex as the treatment for substance use disorders and other mental and behavioral health issues. Some of the treatment options available for behavioral health addiction include:

• Inpatient treatment: Inpatient treatment may be the best option when you’re suffering from a severe behavioral addiction. Inpatient treatment takes place in a residential setting around the clock for a designated period of time, typically between 30 and 90 days. By isolating yourself in the treatment environment, many of the triggers and stressors from the outside world are removed, making it easier for you to focus exclusively on recovery. Inpatient residential treatment typically consists of a combination of individual and group counseling, support groups, 12-step programs, and alternative or complementary therapies.
• Outpatient treatment: Outpatient treatment programs often use an array of treatment modalities similar to those offered in inpatient facilities, except care takes place on a part-time basis while you continue to live at home. This treatment option may suit those with less-severe addictions who may wish to continue participating in personal and professional duties outside of the treatment environment, such as school, work, or family life.
• Peer support programs: Peer support programs set you up with a mentor who has recovered from a similar addiction. Peer-to-peer support can help you emotionally, psychologically, and socially by empowering you and providing you addiction strength, support, and resources for recovery.
• 12-step programs: There are many 12-step programs that follow the traditional 12 steps for a variety of behavioral addictions. Some of the programs that may be available in your local area include:
  • Gamblers Anonymous.
  • Spenders Anonymous.
  • Sex Addicts Anonymous.
  • Overeaters Anonymous.
  • Online Gamers Anonymous.
  • Computer Gaming Addicts Anonymous.
  • Workaholics Anonymous.

Different types of therapies may be used in treating behavioral health addictions, including these that have proven most effective:

• Cognitive Behavioral Therapy (CBT): CBT is one of the most popular therapies to address both mental and behavioral health issues because it provides a bridge between cognition and behavior. Cognitive behavioral therapists help their clients recognize the connection between their thoughts, emotions, and behavior, and by changing their thinking and behaviors, they experience a reduction in symptoms.
• Motivational Interviewing: Motivational interviewing is a goal-oriented therapy that helps address your uncertainty and ambivalence toward change. It helps you, in your suffering from addiction, to recognize the consequences of your behavior and empowers you to make healthier choices using your intrinsic motivation to do so.
• Reality therapy: Reality therapy can also be incredibly effective at treating behavioral addictions; it operates under the premise of choice, and emphasizes how your choices determine your behavior. When confronted with the reality that your behaviors are not meeting your needs, you become more willing to change and are open to alternative behaviors. Reality therapy focuses on establishing new behaviors and strategies to meet 5 basic needs: survival, love and belonging, freedom, recreation, and power.

Resources for Behavioral Health Care

If you or a loved one has a behavioral health disorder, it’s important to know where to go to find help. These resources are run and staffed by experienced and qualified people who want to guide you toward the best form of treatment for your particular circumstance. They are a safe place to get your questions answered and to get on the road to healing.

• National Alliance on Mental Illness (NAMI) Helpline.
• Crisis Text Line.
• National Suicide Prevention Lifeline.