Multiple addictions can have an iron grip on their victims, prompting them to ingest, imbibe, gamble, or buy beyond reason.

“The part of the brain affected by addiction is not regulated by cognitive thought,” says Nancy Waite-O’Brien, Ph.D., a spokesperson for the Betty Ford Center in Rancho Mirage, California. “Addicts can act like they’re crazy because logic has nothing to do with their behavior. Their drive to numb their feelings overrides rational behavior.”

Consider recent reports of bariatric surgery patients who have their stomachs stapled, shed hundreds of pounds, then, in lieu of binge eating, develop addictions to anything from slot machines to shoe-buying. Consider the stories we’ve all heard of women spiraling out of control: the college student who blows her tuition on methamphetamine, or the junior accountant who cooks the books to fund her own shopping sprees.

Your Brain on Drugs

Why do some people develop depression, post-traumatic stress disorder, and other emotional problems that can lead to multiple addictions? “The answer depends on a whole host of factors,” says Lisa Najavits, Ph.D., an associate professor of psychiatry at Harvard Medical School and the author of A Woman’s Addiction Workbook. “It’s partly genetic, partly social, partly upbringing, and partly triggered by trauma or stress that can lead people to cope in ineffective ways.”

Though addiction can strike nearly anyone, studies show that certain groups of women are especially vulnerable: rural women, female veterans, college-aged students, bisexual or lesbian women, and women in helping professions. Further, “between 70 and 80 percent of women who develop addictions have a history of childhood abuse,” says Dr. Waite-O’Brien. “These problems are especially common among those who were sexually abused.”

Regardless of what triggers an addiction, the same brain chemistry lies behind it. “Addiction is all about dopamine, a neurotransmitter in the brain that gives us the sensation of pleasure and spurs us to form regular habits,” says Gene-Jack Wang, M.D., chairman of the medical department at Brookhaven National Laboratory in Upton, New York. “Something happens to lower an addict’s dopamine level, and she discovers that compulsive behavior will elevate it and give her a feeling of pleasure.”

When Wang and his colleagues studied addiction in the lab, they discovered that binge eating elevates dopamine by 150 percent; cocaine does so by 500 percent; and methamphetamine raises it by 1,100 percent.

Whether an addict boosts her dopamine level five- or eleven-fold, it eventually comes crashing down again — usually to below its original baseline level. “As this cycle continues, addicts can come to have lower dopamine than other people,” says Wang. “In an effort to raise their dopamine again, they may shift from one addiction to another that has a different — or more dramatic — effect.”

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