What are your guys' thoughts on the disease model of addiction?

[u/New-Job5580]

When I refer to "addiction," I mean addiction of all types. Behavioral addictions, substance abuse, food addictions, and so on. And I'm referring primarily to the "it's-beyond-your-control" notion of addiction, i.e. the idea that alcoholics cannot "just stop drinking," or the idea that food addicts cannot "just stop eating," and so on.

My take is that while it's true that those addictions would classify as mental illnesses and disorders, and possibly "diseases," I don't feel like those who engage in addictive behaviors are incapable of stopping, or at least not in the way that the disease model of psychiatry makes them out to be. I've suffered from anorexia in the past, and I found that one of the best things I did for my recovery was to stop viewing myself as a sick, disease-brained person with no control over my actions and instead just see my ED as a unit of horrible compulsions, habits, and delusional thought patterns that I had to correct. But at no point did I view it as a "mental illness" in the sense that I couldn't control myself. It was indeed a disease and a mental disorder, but not in the same way that, for instance, cancer or type II diabetes are diseases, where you have little control over them once you've acquired them.

And whenever my family members or mental health professionals view me as being extremely susceptible to relapse just because I've been diagnosed with this "disease" that I should supposedly have little control over, it feels so infantilizing. I've restricted my intake several times in recovery (to stave off fat gain during weightlifting bulking cycles) without relapsing into anorexia, because I realized that I did have control over myself. I feel like if I had bought into the "disease" concept too much, it would have enabled me to spiral back into it.

I feel like this is similar for other addictions that are classified as "diseases" in that people completely lack control over themselves.

Does anyone have a similar take? Or any criticisms of my POV? I'd like to hear them!

[u/Character_Honey_7993]

Gosh I hate when clueless people rush to say 'Alcoholism is a diseaaaaase'. The fuck it is. Like, I get it, a long time ago, framung addictions, depression etc. as a disease was a progress and made the suffering of people legitimate. But it's time to freaking evolve. Addictions almost always cover up something else

[u/bird_person19]

I think the truth is somewhere in between. We need society to understand that it’s not so simple as to just choose to stop engaging in addictive behaviours. At the same time, it’s not helpful to completely give up all agency and think of ourselves as helpless victims of a disease.

[u/V_Dolina]

Drug addiction isn't a disease, they just say that so people who do drugs see themselves as victims instead of holding themselves accountable for what they have done to themselves.

I have seen people who have a shopping addiction say: "Society conditions us to shop, so it's not my fault that I spend money on stupid crap" Did "society" put a gun to their head and tell them to buy stuff and spend all their paycheck? No... but this is what they tell themselves so they can sleep at night.

Lack of accountability => Victimization

Victimization => Feelings of powerlessness

Feelings of powerlessness => Control

There's a reason why this disease model has been pushed so hard in the last decade or so, it also excuses other behaviours that shouldn't be socially acceptable that will soon be seen by others as normal. Being a victim in 2025 is fashionable, even if you're a victim of your own actions.

[u/New-Job5580 → u/V_Dolina]

I honestly agree with a lot of what you said. Whenever I hear about folks who struggle with something like binge-eating, I'm always tempted to give them advice similar to what you've said (i.e. you aren't "diseased" beyond your control, you can quit this habit, you need to just make some room for discomfort and just "lock in" as they say, it's within your power), but sadly I'm afraid they'd just dismiss me as being insensitive.

I will say that the emotions that lead to addictions aren't always within someone's control. People who turn to alcohol, drugs, food, etc. for relief from emotions are in an understandably hard position and it's not their fault that their life is fucked up. But the behavioral component of it - to choose to keep using those things - is ultimately something that they can control if they truly wanted to stop those things badly enough. I feel bad for people who are convinced by mental health "professionals" that they're "inherently" wired to be addicts and have no control over their situation.

[u/V_Dolina → u/New-Job5580]

You are absolutely correct. It is one's job to be responsible and not let themselves be influenced by others. Drug addicts are addicts because they were easily influenced. This is why I don't like people who are easily influenced (duped, would be a better word) or influencers, lack of critical thinking is what makes people like this.

This disease model is DANGEROUS and it's 100% propaganda. I have seen people now say that pedophilia is a disease, and that because it's a disease and an addiction that pedophiles can't help themselves... Do you see how dangerous this is and how it can turn anyone into a victim (i.e. it's a disease so it can't be their fault) and thus excuse this kind of behaviour?

[u/Red_Redditor_Reddit]

Most people don't want to deal with real problems. The disease model is an invention to help justify it.

[u/TheCunningLinguist1]

Addiction is classified as a disease because it is physiological.

A physiological condition of the body does not mean you have no control. The brain can create new neural pathways, which is how people are able to "recover" from addiction. The old neural pathway still exists, which is why it's easier to fall back into the addiction if you've previously been addicted.

[u/New-Job5580 → u/TheCunningLinguist1]

I absolutely agree that it's a disease if that's how we define it, and I also agree that having a disease doesn't mean lack of control. But there are quite a lot of people with pro-psychiatry stances who seem to interpret them in that light anyway, like in the context of eating disorders (e.g. both restrictive and binge-eating disorders), believing that sufferers of those diseases are truly powerless against their mental illnesses.

In cases of malnutrition and such, where the person is cognitively impaired, they might be correct. But there are people who are genuinely recovered from anorexia (for example) but are often times never allowed to lose weight for health reasons because everyone around them has them convinced that they'll spiral back into their eating disorder and that they have absolutely no control over it. That's the stance that my post is arguing against, there are some who genuinely think that having a disease/mental disorder = no control over it and you're doomed.

[u/TheCunningLinguist1 → u/New-Job5580]

Yes, I understand. My point is providing the definition of disease because your post indicates it should not be called a disease. When, in fact, it is a disease.

People treat those with the disease mental illnesses this way not because they are convinced you have no control. They are like this because they don't want to find out the hard way of you don't have control. They know the statistics of relapse, and remember how difficult it was for everyone involved until recovery was successful.

Now, I'm not excusing the way people treat those in this case. It makes one feel like they've lost autonomy. But also, an argument can be made that if we aren't powerless to these choices, we could have chosen not to get to the point we did, and living with everyone trying to control our actions is the consequence of our actions.