What's the difference between an addiction and a compulsion?

Dear Alice,

What is the difference between a compulsion and an addiction?

Dear Reader,

The distinction between a compulsion and an addiction is a fine one because the terms are sometimes misused and the medical profession's conception of each changes as new research becomes available. Addiction and compulsion each have biological and psychological components and each involves a perceived lack of control by the individual facing them. However, there are some key differences to keep in mind when using these terms.

A compulsion is a repetitive, ritualistic behavior that a person performs without rational motivation. Compulsive actions and behaviors offer temporary relief from anxiety — in turn, the need to reduce this anxiety is what drives the compulsive behavior. Sometimes this anxiety takes the form of obsessive thoughts related to the compulsive behavior (e.g., fear of germs and hand-washing). Often the compulsive behavior has no clear relation to anything in particular (e.g., the need to walk all the way around the car clockwise before getting in).

Addictions, similar to compulsions, can offer relief from stress or anxiety but are characterized primarily by an inability to discontinue a harmful behavior despite its negative consequences. Common addictions include high-risk and repeated (over)use of alcohol, drugs, gambling, or smoking, for example. Addictions are easily formed to behaviors that provide physical or psychological pleasure or relief from pain.

Many people exhibit habitual behavior, but compulsions and addictions refer to those instances where these behaviors disrupt an individual's ability to function. In fact, compulsions and addictions can be debilitating or damage relationships if untreated, for the individual and their family, friends, and others around them. Folks living with compulsions or addiction may find it beneficial to seek evaluation from a medical or mental health professional. They can recommend behavioral therapy, medication, and group-run recovery programs to help restore a sense of control over their behavior and get them the support they need.

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