Non-Substance Use Disorders (Nursing)

00:01 Now, let's talk about non-substance use disorders, like gambling.

00:07 Behavioral disorders like sex and food, internet, mobile devices, pornography, and shopping.

00:19 Of course, it's really hard to think of any of these as disorders.

00:24 But when you stop and think about the fact that when we're talking about substance use disorders, or eating disorders, it is the misuse of the substance, it is the misuse of the eating.

00:38 And so if we go back, and we think about what I'm saying, gambling, well, if you can go to a horse race and bet a little bit of money and have an afternoon where you are being entertained, that's not a disorder.

00:56 But when your whole paycheck starts going into gambling, when the relationship that you have with gambling takes over the relationship with any of the people in your life, it is a disorder.

01:11 The same with sex.

01:12 When a person is normally having their normal sexual life, that is not a disorder.

01:18 But when sex, attaining sex, and doing things only for the sex becomes the main focus of your life, it is a disorder.

01:29 Same with food, internet, if you can't get off the internet, it's a problem.

01:36 But in this day and age, it's impossible not to use the internet for something even our phones are now connected to the internet.

01:45 What makes it a disorder is the impact it has on our average daily life.

01:52 Our ability to get in and do our activities of daily living, and have the relationships with the people in our life.

02:01 Mobile devices.

02:02 Many people right now have a disorder with their telephone.

02:06 They're on it constantly. They sleep with it.

02:10 And it takes over even if they are sitting at a table with someone they might be texting them.

02:18 Pornography is especially difficult because pornography is accessible now through the internet.

02:25 Now, if you are having a hard time disengaging from the pornography, it is becoming a disorder, well, the more it is easy to access, the more likely you are to fall into that disorder.

02:42 And shopping. Who doesn't like shopping? Shopping and staying within, my mother used to say, "Cut your cloth according to your measure." So, if you know that you have a certain amount of money that you want to spend in shopping, and maybe you have a party coming up or a wedding and you want a new dress or a new suit, then you start saving and you buy what you need.

03:07 If it is a disorder, you can't stop shopping.

03:11 It doesn't matter if you have the money to pay for the things that you want, you will continue.

03:18 So, in that way, and when we start think of it in this way, let's think about what symptoms that we see and see if you can identify, how closely related this is to substance use disorders, when we talk about the criteria and symptoms? Engaging in the behavior more than intended.

03:42 Unsuccessful attempts to cut back on that behavior.

03:47 Spending a lot of time seeking and craving that behavior.

03:54 Continuing to engage in that behavior, despite the negative outcomes and consequences that you're experiencing.

04:03 Making that behavior a priority over all other activities and relationships in your life.

04:11 Increasing risk taking behaviors in order to be able to engage in and hide this behavior.

04:20 Continuing to engage in this behavior, even if there's been loss of relationships, priority relationships, like your family, or maybe social relationships.

04:33 Perhaps you've lost your job or even failed out of school.

04:39 Requiring more frequent runs of this behavior in order to get the same thrill.

04:47 And then, when this behavior is not available to you, experiencing withdrawal symptoms, having mood changes, being excessively irritable if you are unable to engage in the behavior.

05:03 Now that sounds a lot like substance use disorders, doesn't it? It sounds like eating disorders.

05:10 Remember, at the very beginning of this lecture, we were talking about the idea that a substance use disorder varies by substance.

05:22 Well, in this behavioral category, it's the same criteria that now is going to be able to be different secondary to what the behavior is.

05:35 I will share with you a story of a patient that I had, who had a gambling disorder.

05:43 She also had a son.

05:46 She was working very hard on getting the gambling disorder under control.

05:51 And unfortunately, these disorders often are concurrent.

05:57 And she ended up hanging out with somebody who said they wanted to go to Atlantic City.

06:05 They were only going to go for a few hours.

06:07 She lived in South Jersey. It wasn't a big deal.

06:10 It was only maybe an hour from her home.

06:12 So, she asked her mom to come by.

06:17 She said, "I'll be back in a couple of hours.

06:19 You can go home, and I'll be in." Well, a day went by.

06:27 Two days went by.

06:30 Three days went by, her mom had no idea where she was.

06:34 And she was still betting. She was gambling.

06:39 She could not stop.

06:42 This is what we see, when the non-substance use disorder takes over.

06:51 There is that inability to stop.

06:54 And as we say, "One is too many. A thousand is not enough." It is the same, if you have a disorder like this, you must not start the engagement because once you start the engagement, the disengagement is almost impossible.