A process addiction, also known as a behavioral addiction, refers to a pattern of behavior that becomes habitual, compulsive, and potentially harmful. Although there are many similarities and parallels between addiction to a mood-altering substance and process addictions, the latter does not necessarily involve the ingestion of a substance with mood-altering properties. The behavior and the corollaries of engaging in it produce a mood-altering experience. Engaging in addictive behaviors or processes produces mood changes. The mood-altering effects can become addictive and can wreak havoc in a person's life. Many people addicted to mood-altering behaviors such as gambling, sex, spending, (and others) have lost their jobs, their families, and even their lives due to their process addiction.   

Process addictions often co-occur, substitute for one another, and mutually reinforce each other. For instance, problem gambling frequently interacts with other process addictions, such as sexual addiction and compulsive spending. Process addictions can have especially disastrous effects when mixed with substance addictions. Frequently co-occurring with Substance Use Disorder, they may persist long into addiction recovery or, having been inactive, come into the foreground and become the primary addiction when someone has achieved long-term substance use disorder recovery.

There are several factors involved in the interaction process of addictions.  They all share similar reasons, like problems with how the brain's reward system works and imbalances in certain chemicals. When someone gets into one addiction, it can activate the same brain pathways as other addictive behaviors. This makes the person more likely to be vulnerable to different types of addictions. If you have one addiction, the experience of it might make you more sensitive to other addictive activities, making it easier for you to develop new addictions or make the current one worse. This connection between addictions can create a cycle where the behaviors keep getting more intense. Cross-tolerance is another idea here, saying that if you build up a tolerance to one type of addiction, it might open the door for other addictions to show up.

All addictions are rooted in a need for coping mechanisms. People without adequate coping skills often turn to mood-altering drugs or behaviors as coping mechanisms for stress, emotional distress, or life challenges. When one addictive behavior becomes less satisfying or accessible, individuals may substitute it with another to fulfill the exact emotional or psychological needs. This substitution can lead to the co-occurrence of multiple addictions.

Over time, individuals may develop tolerance to the pleasurable effects of a specific process addiction. As a result, they may seek out additional or more intense sources of reward, leading to the adoption of new addictive behaviors. This escalation can involve a shift from one process addiction to another as individuals chase the desired reinforcing effects.

Process addictions, as well as substance addictions, have common triggers.  Specific environmental or situational triggers may be associated with multiple process addictions. For instance, stress, boredom, or social isolation can serve as triggers for various addictive behaviors. Individuals may engage in different process addictions in response to these common triggers, reinforcing the pattern of addictive behavior.

The presence of shared risk factors, such as genetic predisposition, early exposure to addictive behaviors, or underlying mental health conditions, can contribute to the co-occurrence and reinforcement of process addictions. Individuals with these risk factors may be more prone to developing multiple addictive behaviors.

Mood-altering drugs and behavior serve purposes important to the individual. The purposes are common to most addictions. They provide relief from negative emotions. When one addictive behavior fails to fulfill these functions, individuals may turn to alternative behaviors that offer similar rewards.

One mood-altering behavior may compensate for the negative consequences or restrictions imposed by another. For example, someone recovering from substance abuse may turn to smoking, compulsive eating, or shopping as a substitute coping mechanism.

Specific behavioral and personality characteristics such as impaired impulse control have a common thread connecting most types of substance and process addictions. Some potential individual factors related to the development of cross-addictions include:

Genetic and Familial Factors: There can be a genetic predisposition to addiction. A family history of substance abuse or behavioral addictions may predispose an individual to be more susceptible to developing cross-addictions. Someone growing up in a home where a parent compulsively shops when things get rough may choose shopping as their mood-altering behavior.

Psychological Factors: Underlying psychological challenges and disorders such as depression, anxiety, low self-esteem, impaired executive functioning, insecure attachments, trauma, and maladaptive behavior patterns can contribute to the development of addictions. Individuals may turn to substances and different addictive behaviors for self-medication as a way to cope with emotional pain or distress or to compensate for developmental deficits. The absence of healthier coping strategies can contribute to the development of addictions, including process addictions. 

Impulse Control Issues: People with a lack of self-regulation and impulsivity may be more prone to engaging in risky and addictive behaviors and more vulnerable to addiction. Those prone to excitement-seeking behavior are also more prone to addiction.

Environmental and Social Learning Factors: A person's environment, including family dynamics, peer influence, and societal norms, can play a significant role in the development of addictions. Exposure to addictive behaviors within one's social circles may contribute to the adoption of new addictive patterns.

Early Exposure to Addiction: Individuals who have been exposed to addictive substances or behaviors at a young age may be more susceptible to developing cross-addictions.

Neurobiological Factors: Differences in brain structure and function, including reward pathways, may influence the susceptibility to addiction. Individuals with particular neurobiological vulnerabilities may be more prone to developing addictions.

In summary, process addiction, also known as behavioral addiction, is a pattern of habitual and potentially harmful behaviors that do not necessarily involve the ingestion of mood-altering substances but produce mood-altering experiences. Process addictions co-occur and mutually reinforce each other, potentially escalating the sensitivity to other addictive behaviors.