Psychological Adaptation / 06

Make sure to:

  • Learn the definitions of substance abuse disorders, eating disorders, sleep disorders and different personality disorders.
  • Identify the significant differences between substance abuse disorders, eating disorders, sleep disorders and different personality disorders.
  • Analyze the symptoms of substance abuse disorders, eating disorders, sleep disorders and different personality disorders.

As part of their training, a group of students was assigned to aid at a rehabilitation clinic. After their first day, an interesting debate began: while some understood that addiction should be seen as a disease, others were of the view that it was a disease caused by a personal choice. A third classmate presented the idea that many diseases could be considered the same, then: what difference was there from someone who had a heart attack from cocaine use from the one who had it because of a diet high in cholesterol? They concluded that assigning sole responsibility for a condition resulting from a mental disease is complicated.

When talking about psychological disorders or mental health diseases, it is important to take into consideration those deviations caused by the lifestyle of patients immersed in bad eating habits, and addictions, and other factors that contribute to these pathologies and that currently represent a serious public health problem worldwide.

International studies carried out in 2019 indicate that 14 million people suffered from some type of eating disorder, of which almost 3 million were children and teenagers (World Health Organization, 2022).

Meanwhile, studies carried out in the United States in 2020 indicated that 6.2 million Hispanics or Latinos aged 12 and older had a substance abuse disorder (American Psychiatric Association, 2022).

For any nurse, understanding in detail the definitions, characteristics and types of disorders associated with eating, substance abuse and those related to personality will aid in providing the most proper care for a wide range of patients.

4.1 Substance Abuse Disorders

A substance abuse disorder is a condition characterized by the use of a substance that is harmful to one’s health (such as tobacco, drugs, alcohol or controlled-use medications), leading to addiction and affecting the development and daily functional capacity of the individual.

Patients with addictions and substance abuse disorders commonly present altered thoughts or behaviors caused by changes in the function and structure of the brain. They also present insatiable desires to consume harmful substances, changes in personality, abnormal movements, altered decision making, poor behavior control as well as memory and learning difficulties.

The period of intoxication is the time in which the individual feels the effects of the substance consumed. This may include intensification of pleasure, euphoria, and tranquility. It is said that some people can develop an effect called tolerance, characterized by the need to increase the dose of the substance over time to perceive its effects.

Some people report that the reason for consuming harmful substances is to feel pleasure, relieve stress, improve performance in carrying out some specific activities or just out of mere curiosity, which then generates uncontrolled consumption that leads to an addiction and substance abuse disorders.

The main symptoms focus on 4 large categories:

  1. Lack of Self-control: Sensation of urgency to consume harmful substances, followed by failed attempts to reduce or abandon this bad habit.
  2. Social and Family Problems: Substance consumption decreases involvement at work, school, family, individual tasks and activities, causing problems in these areas.
  3. Risky Consumption: To obtain the substance, the person exposes themselves to risky environments that endanger them and those close to them.
  4. Effects of the Drug: Abstinence is characterized by chills, cramps, diarrhea, vomiting, anxiety, insomnia and an insatiable urge to consume.

For this type of disorder, the treatment aims at the comprehensive and functional recovery of the patient and consists of medical, social and psychological care assisted by some drugs that reduce the desire to consume drugs, as well as aid in reducing the withdrawal symptoms and prevent relapses of consumption (American Psychiatric Association, 2022).

4.2 Personality Disorders

A personality disorder is defined as a maladaptive pattern of behavior and internal experience significantly divergent from the expectations of a person's culture of origin, typically manifesting in adolescence and persisting throughout the individual's life. The main characteristic of this disorder is that the patient demonstrates a poor ability to adapt to the changing circumstances of life, affecting their social, work and family activities, generating significant discomfort, which conditions their day-to-day development. Personality disorders affect primarily four areas of the individual.

Table 1

Areas Affected by Personality Disorders

Adapted from López. (2022). Personality Disorder. Mente a Mente. https://www.menteamente.com/trastorno-de-personalidad

Types of personality disorders:

  • Paranoid Personality Disorder: A pattern of generalized distrust where the individual perceives others as malicious.
  • Schizoid Personality Disorder: It is characterized by social distancing and limitation of the expression of emotions.
  • Schizotypal Personality Disorder: Eccentric thoughts and behaviors predominate in this disorder.
  • Antisocial Personality Disorder: The patient presents continuous contempt for others, accompanied by insults and humiliation.
  • Borderline Personality Disorder: Characterized by emotional instability, troubled relationships, and a negative self-image.
  • Histrionic Personality Disorder: The patient presents an excessive pattern of attention-seeking often accompanied by heightened emotionality.
  • Narcissistic Personality Disorder: It is characterized by a pattern of self-admiration and grandiosity, coupled with a lack of empathy towards others.
  • Avoidant Personality Disorder: The individual is very sensitive to the negative opinion of others, withdraws socially.
  • Dependent Personality Disorder: Disorder characterized by having an abnormal attachment to another person. The patient seeks protection and excessive care.
  • Obsessive-compulsive Personality Disorder: Order, control and perfectionism characterize this disorder.

Psychotherapy has become the main treatment for personality disorders. Such patient management is effective although it requires a lot of time and effort to achieve positive effects on the patient's personality. Unlike some other psychological conditions, medications are not usually the primary treatment for this type of disorder, which is why psychological therapy is the primary method for fully reintegrating the patient into daily life (López, 2022).

4.3 Eating and Sleeping Disorders

Eating disorders are behavioral deviations characterized by a serious alteration in eating habits accompanied by distressing thoughts and emotions.

Among the main and most common eating disorders are anorexia, bulimia, and binge eating. Adolescence is the stage in which it occurs most, with women tending to be more vulnerable to developing them.

Epidemiological studies report that eating disorders have the highest mortality rate among psychiatric pathologies, with serious consequences at the physical, psychological, and social levels.

People affected by this type of disorder commonly coexist with other psychiatric disorders, such as mood disorders, anxiety, obsessive-compulsive disorders, and addictions.

Types of disorders:

  • Anorexia Nervosa: There are 2 types of anorexia nervosa, the restrictive type which is characterized by weight loss through diet, fasting or excess physical activity; and the binge type characterized by excessive food intake followed by self-inflicted vomiting.
  • Bulimia Nervosa: It is characterized by cycles of low-calorie food intake followed by high-calorie binges. These people who suffer from it may present a variation in body weight, ranging from extreme thinness to obesity.

The main symptoms may include dizziness or fainting due to dehydration, heartburn and reflux, severe constipation, depression, irritability, using the bathroom immediately after meals, large amounts of food disappearing, unexplained diarrhea, and diuretic abuse.

Treatment must be comprehensive, addressing the medical, psychological, behavioral and nutritional complications derived from the disorder, which is why multidisciplinary health care is required as well as great support from the family to recover the patients’ physical and mental health. (National Commission on Mental Health and Addictions in Mexico, 2023)

Sleep disorders are alterations that generate changes in the way of sleeping, affecting the development of the individual, their safety and quality of life in general.

The most characteristic symptoms of these disorders include daytime sleepiness, irregular breathing and sleep-wake cycles, as well as difficulty falling asleep.

The most common sleep disorders are:

  • Insomnia: Difficulty falling asleep or staying asleep during the night.
  • Sleep Apnea: Abnormal breathing patterns occur during rest time.
  • Restless Legs Syndrome: Characterized by an uncontrollable urge to move the legs during periods of rest.
  • Narcolepsy: Insomnia during the night and falling asleep suddenly during the day.

The main treatment for the care of these disorders is based on the use of medications that help the patients fall asleep. There are also adjuvant therapies such as orofacial therapy and light therapy, and finally, devices such as CPAP, which aim to keep the airway open to facilitate breathing during sleep (National Heart, Lung, and Blood Institute, 2022).

It is important that the nursing professional manages to make the distinction between the different psychiatric disorders, that they are able to identify the symptomatology and have a clear and specific notion of the ideal treatment for the care of each of these conditions. In their everyday practice, the possibility to treat patients dealing with these conditions will be high. Having the knowledge and skill to provide the best care possible will be an important asset for a good nursing professional. Going back to the story of the student volunteers, the question is not so much about the origin and responsibility of every mental disorder, but rather the timely and proper care provided. At the end of the day, it is in the nurse’s best interest to provide support for a suffering patient so they can feel better.

  • American Psychiatric Association. (2022, September). Addiction and Substance Use Disorders. https://www.psychiatry.org/Patients-Families/Addiction-Substance-Use-Disorders
  • National Commission on Mental Health and Addictions in Mexico. (2023, September 11). Eating Disorders. https://www.gob.mx/conasama/articulos/trastornos-alimenticios
  • López, D. (2022, February 15). Personality Disorder: Traits, Types and Treatment. Mente a mente. https://www.menteamente.com/trastorno-de-personalidad
  • National Heart, Lung, and Blood Institute. (2022, March 30). Sleep Disorder Treatments. https://www.nhlbi.nih.gov/health/sleep-disorder-treatments
  • World Health Organization. (2022, June 8). Mental Disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders

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