How Do You Know If?

We all think we can intuit when someone we know has a problem.  We want to believe that we’re honest with ourselves about our own failings and addictions.  In truth, recognizing that we or someone we care about has a problem with compulsive behavior is not easy. Addictions don’t happen overnight – occasional use starts to become frequent use, and our brain rewires to adapt to and ultimately depend on the stimulation of drugs, adrenaline, or whatever “high” comes from our compulsive behavior.  As friends and loved ones we become accustomed to the addict’s changed behavior and moods.  And as the person with the problem, our mind learns to rationalize our cravings to maintain feeling normal.

So the treatment profession has come up with simple self-assessment tools to help objectively identify when there is a problem.  One is called the CAGE Assessment and it’s been a mainstay in identifying problem drinking.  However, you can substitute in this questionnaire the words “gambling” or “smoking” or “shopping” to get a handle on whichever behavior you’re concerned about.

CAGE Assessment

Have you ever felt you should Cut down on your drinking … or other behavior?

  • Yes
  • No

Have people Annoyed you by criticizing your drinking … or other behavior?

  • Yes
  • No

Have you ever felt bad of Guilty about your drinking … or other behavior?

  • Yes
  • No

Have you ever had a drink … or engaged in other behavior … first thing in the morning (as an “Eye opener”) to steady your nerves or get rid of a hangover?

  • Yes
  • No

If you answered “yes” to two or more of these questions, then you may have a problem and should get a professional addiction counselor to help you assess yourself.

Here is another question that we at Coastal use to help our clients assess their behavior.


Do you drink, overeat, or engage in other addictive behavior despite significant negative consequences of that behavior in your health, your relationships, your financial well being, your employment or with the law?

  • Yes
  • No

If you answered yes, it’s time to seek help.  The starting point to regaining control of your life is an honest appraisal of what would drive you to do something repeatedly that is harmful to you?

Signs and Symptoms of Compulsive Behavior

We all know the signs and symptoms of coming down with the flu or a cold.  We can look up on-line or ask a physician to help us understand diabetes, arthritis or most other diseases.  But we often overlook the signs and symptoms of  addiction and compulsive behavior because we have a societal bias.  We want to see addiction as a character flaw, rather than a disease.  We place a social stigma on addicts that we don’t to those suffering from heart disease or kidney stones.

Those cultural biases blind us to recognizing when habit becomes compulsion and pleasurable enjoyment becomes a craving.  We need to look beyond those biases and recognize the signs and symptoms of addiction as a disease.  Behavioral diseases — and addictions are a behavioral disease — can be treated, just like any other disease.  Those signs can come in the form of biological changes to our health and appearance; psychological changes to our mood and emotional well-being; social disturbances in our work and friendships; and spiritual or “moral” changes where we start to do things we used to think were wrong.

The following signs and symptoms are borrowed wholesale from Dr. David Amen, the author of “Unchain Your Brain” and the founder of the Amen Clinic.  See if you recognize any of these in yourself or someone you care about.

Biological Signs and Symptoms

  • Sudden increases or decreases in activity level or energy level
  • Weight loss or weight gain
  • A lack of personal hygiene
  • Strange body odor
  • Changes in the health of skin and teeth
  • Red, watery or glassy eyes or a runny nose that is not due to cold or allergies
  • Changes in eating habits
  • Changes in sleeping patterns
  • Feeling sick or hung over
  • Blacking out or forgetting what happened while under the influence
  • Using increasing amounts of the substance or indulging in the behavior more frequently
  • Inability of quit without experiencing cravings or withdrawal
  • Developing diseases and conditions related to you bad habit

Psychological Signs and Symptoms

  • Mood swings
  • Feelings of depression
  • Irritability
  • Anger
  • Negative attitude
  • Inability to focus
  • Lack of motivation
  • Loss of interest in favorite activities
  • Denying or minimizing the consequences of using the substance or engaging in the behavior
  • Feelings of guilt about your bad habits
  • Feeling anxious, depressed or irritable when you are unable to engage in the behavior or use the substance
  • Using the substance or doing the behavior in response to feelings of sadness or to alleviate stress
  • Spending your day thinking about whey you will have your next chance to use the substance or do the behavior
  • Feeling powerless to change your behavior

Social Signs and Symptoms  

  • Negative changes in work performance – calling in sick, showing up late, missing meetings, trouble meeting deadlines, problems with co-workers
  • Negative changes in school performance
  • Withdrawal from family and friends
  • Neglecting responsibilities – not taking care or children or pets, foregoing household chores, forgetting to pay bills
  • Shifting away from former fiends and becoming friends with people who share the same addiction or compulsive behavior
  • Becoming antisocial
  • For teens and children, hanging out with older kids
  • Spending more and more time engaging in the behavior
  • Avoiding situations where you can’t engage in the behavior
  • Your life becoming unmanageable

Spiritual or Moral Signs and Symptoms

This is not about whether you or the person you care about goes to church or has a faith in god.  It’s about your sense of right and wrong and what you wouldn’t have done, but for your compulsive behavior or addiction.  When we become wrapped up in our craving, we rationalize things like stealing, lying and forgetting to do the social norms.  Here are some indicators that we’ve lost our way.

  • Breaking rules at home, school or in the community
  • Keeping secrets
  • Cheating
  • Lying to family, friends and significant others
  • Hiding things and hiding our compulsive behavior
  • Breaking promises and making excuses
  • Stealing to pay for your habits
  • Using jargon or slang that only those who share your addiction or compulsive behavior would say