Occasionally family meals present the opportunity to choose between two of Grandma’s hand made deserts. What if I can’t choose? Well, maybe I have both. Or, maybe, I start with one and see about the other.
In the end, they both feel irresistible! They both make me salivate and feel satiated. This is a good analogy for co-occurring addictions. Maybe one comes first, but both addictions serve a similar function and help us manage our world.
Sex Addiction and Gambling
There has been growing recognition that addictions co-occur. This really is no surprise when you consider many addictions serve similar purposes. So what drives addiction?
Often, “the same patterns of loss of control or super efforts to control appear repeatedly driven by the same list of internal dynamics including shame, escapism, trauma, and stress.” 
When we are scrambling to find security, control and relief from painful emotional states dopamine boosting behaviors or substances really “do the trick”!
Sex addiction and compulsive gambling are both behavior-focused addictions. They don’t include ingesting a substance, but pertain to a mode of living.
You could partake in either one in a similar manner. For example, you could engage both in a disconnected fashion where you go through the motions to get a high, or you could be hyper-focused and enjoy the rush of anxiety and release. Unfortunately, both sexual behaviors and gambling can be highly addictive.
The brains reward pathways
Both of these behaviors utilize the same reward pathways within the brain. When neurochemicals such as dopamine are released in the reward parts of the brain they are incredibly powerful. The brain learns to automatically seek pleasure and builds strong connections between a stimulus (sex or gambling) and pleasure (dopamine etcetera).
You can imagine it like this: Your brain is building “superhighways” of experience and desire. Over time, it becomes harder to divert attention and focus from these “superhighways” and the brain’s reward pathways are biologically altered. As your brain wants to travel down these pathways you feel compelled towards behaviors or substances that facilitate the travel.
The mood effect
In essence addicts use behaviors as a way to guarantee “producing a reliable and consistent shift in their mood state as a coping strategy to ‘self-medicate’ and make themselves feel better in the process.” 
This can be achieved because of the chemical and physical changes in the brain.
Sadly though, addiction isn’t the innocent home made desert we would like it to be!
Sex addiction and gambling addiction both create instability and an unhealthy pattern of life that sustains the addictions.
Therapists and researchers alike have noted the problems: “If each addiction brings unmanageability to the patient’s life, it would be clinically negligent to think that the resulting chaos from each does not compound the problems of the others.” 
Co-occurring addictions often work to compound and heighten one another. Cross tolerance, is the phenomenon where by addictions can co-increase.  Just as one addiction can increase due to tolerance in the brain, so the pattern is multiplied with co-occurring conditions that both diminish dopamine and pleasure responses.
During recovery from co-occurring addictions that play off of the same brain structures (like sex addiction and gambling) it is critical to acknowledge the role of all dopamine-educing aspects of life. It is common to see addictions being relinquished only to find another behavior stepping into the medicating function. As gambling uses the same brain function as sex addiction, is it apt to replace it, take its place, or support it.
You must remember that, “relapses are common in all addictions including behavioural addictions such as gambling.”  Treatment should account for co-occurring behaviors that can help or inhibit recovery. This can be a complex process and a trained therapist can be incredibly helpful.
A key to dealing with co-occurring behaviors is firstly to acknowledge how they are linked in our attempts to deal and cope with life.
Overcoming denial that one or more behaviors are problematic is an important step in breaking their power over us.
When you look to change behaviors it is good to be aware that, “there is growing evidence that behavioural addictions such as pathological gambling also feature withdrawal symptoms.” 
A hard reality of co-occurring behavioral addictions is working through difficult withdrawals with multiple temptations to return to previous behaviors.
It is highly recommended to restructure life in the following areas to support a healthy recovery: work—life balance, exercise, internet access, sleep, healthy outlets, meeting emotional needs in relationship and giving time to others.
Each of the aforementioned areas significantly boost recovery efforts and benefit from purposeful planning.
Remember, if ‘pie’ is a problem for you right now, it doesn’t mean that you can’t handle ‘ice-cream’. There are many dopamine boosting activities that are healthy, effective and promoted by therapists! Include others as you figure out just what deserts are healthy for you. However, be careful not to activate old rituals or addictive behaviors.
 – Carnes, P., Murray, R., & Charpentier, L. (n.d.). Bargains With Chaos: Sex Addicts And Addiction Interaction Disorder. Sexual Addiction & Compulsivity, 79-120. p. 80.
 – Griffiths, M. (n.d.). A ‘components’ Model Of Addiction Within A Biopsychosocial Framework. Journal of Substance Use, 191-197. p.194
 – Carnes, P. et al. p. 81.
 – Carnes, P. et al. p. 87.
 – Griffiths, M. p. 195.
 – Griffiths, M. p. 194.
About the author: Written by Paul Loosemore, MA PLPC. Paul works as a mental health counselor, and consults with those who wish to recover from Sexual Addiction—He is the founder of www.stopsexualaddiction.com.
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Reviewed By: Jacquelyn Ekern, MS, LPC on January 20, 2016
Published on AddictionHope.com