Behavioral Health Hotlines

Behavioral addictions are similar in nature, presentation, and resulting consequences as addictions to substances.¹ Behavioral addictions, like substance addictions, are characterized by recurring patterns of behaviors that you are unable to control and that cause you personal emotional distress, and often harm to others. You typically experience negative effects in other areas of your life as well, such as at work or school.^1,2 Although many behavioral addictions are not formally recognized, research has shown that the foundations of behavioral addictions are related to neurological functioning, as well as trauma or some other negative experience, and therefore can also be treated similarly to other addictions.^1,2

How Does a Hotline Help?

If you believe that you have a behavioral health addiction, a hotline is a good place to start to better understand behavioral addictions and what options are available for treatment. It is important to understand that behavioral health hotlines do not provide therapy, but instead provide education and resources to help people get on the right track when dealing with behavioral health issues.

Hotlines are useful because navigating the behavioral health system can be complicated. Hotlines are a starting point—a place to ask questions and get answers about basic mental health issues. It is also a launching pad, a place that will provide you with the appropriate resources to address your specific behavioral health concerns. This is invaluable because most people do not really understand the intricacies of the behavioral health system, such as:

• Types of professionals and which one will be most helpful in addressing their specific issues.
• Types of treatment such as medication, residential, partial hospitalization, intensive outpatient, individual, group, and 12-step therapies.
• How to pay for each level of care and what types of funding are available for uninsured or indigent people.
• Which types of treatments are available locally.

These topics combined would take hours of independent research for a person who is not familiar with the behavioral health system to understand. The dedicated staff members who answer the phones at hotline centers have already done this research and are ready to provide the resources that will be most helpful for you. This service is always provided for free and is often provided 24/7, adding to its value as a community resource worthy of tapping into.

Behavioral Health Hotline Listings

Behavioral health hotlines are not the same as crisis lines. If you or someone you love is experiencing a medical or psychiatric emergency, call 911 or go to the nearest emergency room for stabilization.

SAMHSA’s National Helpline: 1-800-662-HELP

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides around-the-clock assistance, 24 hours a day, 365 days of the year, to those who want information on mental health or substance use disorders.³ The service is free and provides services in both English and Spanish. Callers can expect to receive information and referrals to local facilities, support groups, and other local organizations that may be able to help. Callers can also request publications, which are free and provide comprehensive information regarding mental health and substance use disorders. SAMHSA does not provide therapy; however, anything you discuss with their representatives will remain confidential.

NAMI Helpline: 1-800-950-NAMI

The National Alliance for Mental Illness provides a helpline Monday through Friday 10 a.m. to 6 p.m. EST. Volunteers will provide information and resources to those who need help in dealing with mental health issues.⁴ They will not provide therapy, but will provide referrals to local organizations that do provide therapy.

Military OneSource: 1-800- 342-9647

The Military OneSource is a free service that is provided 24/7 for service members and their families.⁵ Their representatives help guide callers to resources that are provided to the military community to help with mental health and other concerns.

DCoE Outreach Center: 1-866- 966-1020

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury is a free service provided to service members 24/7. Staff can provide information and resources for dealing with mental health issues.⁵

More About Behavioral Health Disorders

At this time, the Diagnostic and Statistical Manual of Disorders, Fifth Edition (DSM-5) only outlines a set of diagnostic criteria for gambling as a behavioral addiction. However, there are many other patterns of problematic behaviors that are frequently, if unofficially, recognized as being characteristic of a behavioral addiction, including:^1,2

• Stealing.
• Shopping.
• Sex and sex-related behaviors.
• Internet, social media, or gaming.
• Tanning.
• Exercise.
• Working.

There are several signs and symptoms characteristic of behavioral addictions. Some of the signs and symptoms commonly experienced by those dealing with a behavioral addiction include:¹

• Feelings of tension, build-up, or arousal prior to the behavior.
• An urge or craving prior to engaging in the behavior.
• Inability to control the impulse to engage in the behavior.
• Pleasure, gratification, or relief of emotional states during the activity.
• More of the activity or increased intensity of the activity required to receive the same benefit.
• Continued engagement in the activity despite the negative consequences to relationships, occupation, education, or social outlets.

Those who recognize these symptoms in themselves or are otherwise negatively impacted by their problematic behaviors are encouraged to seek help in treating the issue.

In addition to these symptoms, which have been documented by researchers in relation to behavioral addictions in general, the DSM-5 lists the following as criteria specific to gambling disorder:²

• Restlessness, anxiety, or irritability when you try to cut down on the behavior.
• Attempting to quit many times unsuccessfully.
• Preoccupation with thoughts of engaging in the behavior.
• Lying to hide or minimize how much you are engaging in the activity.

Though these criteria have been published specifically for the diagnosis of gambling disorder, they may be generalized for application to some of the aforementioned unrecognized behavioral addictions (e.g., shopping addiction, internet addiction, gaming addiction).

Ultimately, the diagnosis of a behavioral addiction is made with the discretion of the trained mental health professional providing the assessment. However, professionals are likely to use the criteria listed above when coming to their diagnostic conclusions.

Those who struggle with behavioral addictions may be more likely to suffer from some form of mental health disorder.

It is believed that the neurotransmitters serotonin and dopamine play a role in initiating and maintaining the behaviors associated with addiction.¹ Serotonin plays a role in inhibition, so people with lower levels of serotonin may be less able to control their impulses, which could contribute to the development of a behavioral addiction.¹

Dopamine is strongly linked to motivation, learning, and reward.¹ Activities such as gambling, watching pornography, shopping, or any other rewarding behavior will increase the levels of dopamine present in the brain.¹ When dopamine is increased, the body is told that the stimuli (behavior in this case) was directly responsible for the good feelings that followed.¹ Repeating the behavior reinforces this message, which can lead to craving and, eventually, the development of an addiction.¹

The brain cannot sustain this activity with the same result indefinitely, and research actually shows that over time the behavior does not produce the same feel-good response that it once did.¹ At this point the behavior in question is perpetuated less because of its reinforcement of positive states, such as pleasure, and more for its negative reinforcement—meaning that the behavior is enacted to remove something, in this case to relieve withdrawal or feelings of sadness, emptiness, anxiety, or any other negative emotion.¹

Engaging in addictive behaviors can be a result of emotional dysregulation and a person’s attempt to regulate those emotions through the addictive behavior.¹ Additionally, those who struggle with behavioral addictions may be more likely to suffer from some form of mental health disorder such as:¹

• Depression.
• Bipolar disorder.
• Obsessive compulsive disorder.
• Attention deficit hyperactivity disorder.
• Antisocial personality disorder.
• Abuse of other substances such as alcohol, cocaine, and amphetamines.

While research does show that behavioral addictions can stop on their own without treatment, seeking the appropriate level of care to help prevent a relapse and deal with the underlying factors that initially motivated the addiction can increase the chances of sustained recovery from a behavioral addiction.¹ The FDA has not yet approved a medication to treat behavioral addictions; however, practitioners may prescribe other psychotropic medications to deal with the chemical imbalance that may contribute to the addiction.¹ Various therapeutic modalities have been shown to be effective at helping people deal with behavioral addictions and maintain recovery, and each recovery program will use its own approach when treating behavioral addictions.¹

Sources

1. 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.
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders(5th Edition). Arlington, VA: American Psychiatric Publishing.
3. Substance Abuse and Mental Health Administration. (2016). National Helpline.
4. National Alliance on Mental Illness. (n.d.). NAMI Helpline.
5. U.S. Department of Health and Human Services. (n.d.). Help for Service Members and Their Families.