I answered this question briefly in the comments to another post, but it’s such an intriguing (and important) concept that I wanted to treat it in an actual post.
SarahB asked what the difference between an obsession, such as OCD, and an addiction is, and I have many thoughts on the subject. A secondary question is why is one a mental illness and the other not. Before we begin, note that this is my opinion. I’m not a trained psychologist, but I do my best to ground my opinions in reason, logic, and the gospel. Take from it what you will.
The idea of obsessions in relation to mental illness is one that obviously sits close to me. As an OCD-sufferer, I can certainly attest to the effects that obsessions have on my life. However, they are distinctly different from addictions (granted, I’m basing this off my limited addictions… Can anyone say chocolate?).
This is how I see it: Obsessions are nature-driven feelings beyond our realm of control. I did not make me OCD. My genetic makeup, triggers, God, whatever made me OCD. In a very real way, OCD defines, at least in some measure, who I am. It is part of me.
Obsessions are also real needs to do something in order to prevent something from happening. At one point with my OCD, I counted every step I took unless I took measures to occupy my mind in other ways. Why did I count? I don’t know if I can ever explain why, but there was always the thought in the back of my mind that I needed to count, and I don’t think the word need really says what I’m trying to say…. I absolutely NEEDED to count. Something would happen if I didn’t. And it’s important to note that I am fairly mild in my OCD. Others are much, much worse.
Addictions, on the other hand, are self-driven feelings. While they are also beyond our control when they become addictions, we place ourselves in the situations that cause addictions. Heroin addicts once chose to use the drug. Same with cigarettes and pornography and other addictions. And while addictions can certainly become the dominating characteristic in someone’s life (if you don’t believe that, go talk to a serious heroin addict some time), the addiction itself does not define the person.
Addictions also, at least as far as I’m aware, don’t lead to the absolute need that OCD does. Let me clarify, while an addict would certainly suffer withdrawals and needy feelings without the addictive thing and while they’d certainly long for it quite deeply, the driving reasons are different. Addicts need to satisfy a need within their bodies (typically chemical); OCD demands certain things or else…. Again, I don’t think that’s strong enough. OCD demands certain things OR ELSE…. OCD involves a very real feeling of consequences for inaction.
The end result, often times, is somewhat similar in appearance, but the methodology of getting into it, and out of it, is different. There is always a cure for addiction no matter how difficult. The same cannot be said for mental illness and its related obsessions.
Moving on to your next question, I believe that addictions could be classified in the realm of mental illness. They share many effects, especially when the addiction becomes life-dominating. However, I choose not to define addictions wholly as mental illnesses simply because of the personal choices involved with addiction and, probably more importantly, the potential for misunderstanding. Addictions are treatable, curable, and avoidable. Mental illnesses are treatable (manageable might be the best word), they might be curable (overcomeable is probably better here) in some cases, and they are not avoidable. Certainly you can avoid things that trigger reactions, but mental illness picks victims seemingly at random and with an outright disregard for your own preventative measures.
I would hate to lead anyone to believe that personal choices caused a mental illness, as is the case in addictions, just as I would hate to lead anyone to believe that mental illness is resolvable by using the same treatment methods as addiction.
Certainly the effects of both are equally damaging, but I can’t place the two wholly together because it would be an injustice to the victims of mental illness.
On an interesting aside: Why is that alcoholism, drug use, cigarettes, and pornography are all recognized dangers with hosts of treatment programs available, but mental illness still largely occupies a back corner in the public spectrum?
I have my thoughts on that one, but I’m not sure there is any answer that truly satisfies the disservice rendered to the mentally ill.