SciTech

Should Shopaholism Be A Mental Disorder?

MayorBob.

Posted to SciTech on Wed Aug 20, 2008 at 07:24:57 AM EST (promoted by port1080). RSS.

Just like every other group of specialists, mental health professionals must rely upon an accurate, complete and up-to-date user manual to help them do their jobs. One of those jobs is the correct diagnosis of what's ailing the various patients they encounter. The manual they refer to is the Diagnostic and Statistical Manual of Mental Disorders (DSM). These mental health community is eagerly looking forward to the next edition of the DSM. But as the prep work is ongoing for this next edition, one of the debates raging now in this community is "should compulsive shopping be listed as a disorder?"

An early draft of DSM-V will be out for review early next year. This all leads up to an anticipated publication date sometime in 2012. Compulsive shopping is one condition which might end up specifically cited as a disorder in DSM-V. Other behavioral addictions, such as hypersexuality, compulsive gambling and internet addiction might also find their way into the list of formal disorders, as identified by DSM-V. Just like all of those other conditions, compulsive shopping causes "severe impairment and distress" - two key criteria of any mental disorder. But, the problem with compulsive shopping is that another already recognized mental disorder is associated so closely with the addiction that the psychiatric community is unsure of what causes what.

As a matter of fact, Dr. Timothy Fong finds 40 to 50 percent of patients he treats for compulsive buying have some other associated mental disorder. Generally, psychiatrists find a close correlation between compulsive buying and depression. Studies have been published, going back as far as the early 1990s, showing that compulsive buyers also exhibited symptoms of other disorders such as depression, anxiety and obsessive compulsive disorder. Pharmacological treatments such as anti-depressants and an anti-alcohol drug have shown "modest effectiveness" in reducing urges to overbuy. But, not everyone agrees the answer to compulsive shopping is a pill. Dr. Lorrin Koran, who specializes in obsessive compulsive disorders, believes medicating for compulsive shopping may be a waste of time and money - that the only effective way of treating the condition is to identify the disorders which may lie at the root of the behavior.

How prevalent a condition is compulsive shopping anyhow? By some estimates, eight percent of the population are compulsive shoppers, with 90 percent of shopaholics being women. One of the outcomes of formally making the condition a diagnosable mental disorder would be to make healthcare insurance carriers cover the treatments. Of course, this would increase the cost of health insurance for most policies with psychiatric coverage. Also, as with any diagnosis of mental disorder or illness, there is an unfortunate tendency to label those diagnosed.

Tags: edited by Port1080, written by MayorBob, mental illness, mental disorder, DSM, compulsive shopping, depression (all tags)

This story: 17 comments (1 from subqueue)
Post a Comment
1

A disorder for everyone, and everyone disordered..

port1080.

Wed Aug 20, 2008 at 08:23:02 AM EST

5.00

Whatever happened to the notions of personal responsibility and self control?  Perhaps we should create a new DSM diagnosis for all those folks who got an ARM mortgage they couldn't afford?  Maybe another one for Congressmen that cheat on their wives?  It's not their fault, they were crazy!

2

^ 1

Re: A disorder for everyone

skeptic.

Wed Aug 20, 2008 at 11:47:49 AM EST

4.00 (astute)

It is well to remember that many people make unwise purchases without necessarily having a compulsive shopping disorder.  It is always possible to make a wrong decision, since we seldom have all the relevant information which might bear on any given decision (even if we have discussed it on this site) and our analysis can also be faulty, even when we are fully informed, because we are all fallible human beings.  And of course, sometimes we are just irresponsible and lacking in self control, as port1080 points out.  Anyone can be guilty of those things, without necessarily having a mental disorder, just by being an imperfect human being.

Nonetheless, there are some people whose shopping is noticeably more irresponsible than normal.  There are people who spend the rent money on new earrings, who wind up having no food to eat because of the completely unnecessary luxuries that they bought, who buy things that they can't afford and for which they have no possible use and which they will never use.  I have known some of these people personally.  Typically, after wasting all of their own money and then running into dire financial emergencies, they want to borrow your money so they can waste that too.  Whether we would describe such people as mentally ill or merely as severely irresponsible, it is clear that they have a problem.

My personal opinion, based upon the people I have known with this kind of problem, is that compulsive shopping is not a mental disorder in itself, but is a symptom of one of a number of more fundamental disorders.  These people are indeed mentally ill, but their illness is not specifically about shopping, shopping is just one aspect of the problem.

4

^ 1

Re: A disorder for everyone, and everyone disorder

JimmyHavok.

Wed Aug 20, 2008 at 05:16:59 PM EST

none

How much personal responsibility do people with obsessive compulsive disorder have?  Should they just man up and stop washing their hands so much?

5

^ 4

Re: A disorder for everyone, and everyone disorder

port1080.

Wed Aug 20, 2008 at 06:26:30 PM EST

5.00 (interesting)

How much personal responsibility do people with obsessive compulsive disorder have?  Should they just man up and stop washing their hands so much?

Maybe.  I suppose I should be more sympathetic, but I've experienced a lot of people in my life who seem to use mental disorders as some kind of excuse or cop-out.  I don't doubt that there are lots of people who do have legitimate mental disorders, but it beats me how to tell who's legit from who's not, and I'm not sure psychologists have figured it out either.  I guess it's not charitable of me, but it irks me to no end when I see people getting a pass for behavior that anyone else would be punished for because they have a "disease" that they "can't control".  My wife's father, for example, is an alcoholic.  All the way.  Uncontrollable drinking since before she was born.  Does he have a disease, or is he just a shit that can't control himself?  Where do you draw the line?  It seems to me that there are millions of people out there who continually make bad, counterproductive, destructive decisions that are outside the norm, but are those people all mentally ill, or are some of them just assholes with no self control?  By some of these loose definitions, couldn't lack of self control itself be an "illness"?

To be frankly honest, I think it bothers me the most because I see in myself a lot of these "illnesses".  At various times in my life I've probably be clinically depressed.  It wouldn't shock me if I could have gotten an ADHD diagnosis in elementary school.  I've often had problems with impulse buying.  These are all things I got through without any help or medication or special favors.  When I've brought this up in the past, I've had people say to me that since I never went for help, then it "wasn't really all that bad" and that I should have sympathy for those that had it worse than me...which isn't really something I buy, because it's circular logic.  If you go for help, you needed it.  If you don't, you didn't.  Does that make any sense?  

That's the kind of thing that makes me so damn skeptical about psychological diagnoses, and about those who want special exceptions because of their claimed disorders.  I did "man up and get over it", and I feel like it's somewhat problematic if we don't start out with a strong expectation that everyone should do that, and then just offer help to those that really, truly can't.  Of course, the problem (which I'm sure you'll point out to me) is that there are some people who need help right away and who will become so discouraged if they have to jump hurdles that they'll just do something foolish (commit suicide, etc.) instead of getting the help that they could have.  So perhaps it is better to live with the knowledge that we'll be giving exceptions to some "cheats", as long as we are helping those who truly need it.  I don't know what the answer is, and that makes it doubly frustrating.

6

^ 5

disorder vs character flaw

JimmyHavok.

Wed Aug 20, 2008 at 07:58:13 PM EST

5.00 (interesting)

Having a mental disorder doesn't give you a free pass, but realizing it can help you deal with it.  For example, your alcoholic in-law: being alcoholic doesn't give him a free pass for all the harm he's done, but realizing he's alcoholic could lead him to treatment and abstinence.  If he doesn't want to be treated for his illness, then he doesn't deserve any sympathy for the problems it causes, especially those it causes for others.

My  mother-in-law is badly depressed, but instead of seeking help, she sits in the dark living room and does the absolute minimum to maintain her life, while complaining about how bad it is, and blaming her husband for it (he had a stroke that gave him aphasia about four years ago, and recently, had his leg amputated).  When he first had his stroke, she refused to go to counseling.  She won't talk to her doctor about it because if she does, that means she's crazy.  Instead, she insists there's nothing wrong with her while scratching open sores into her legs and shoulders, which she insists are due to bird mites which bite no one else (her husband enjoys watching the birds at a feeder outside the house, so that is his fault as well).

We spend most of our free time at their house, maintaining it so that they have a decent life, and the more time we spend with her, the better she gets.  But if she'd recognize that she has a problem and deal with it, she and everyone around her would be a lot happier.  I sympathize with her plight, having suffered from depression myself, but I also continue to tell her that she is not bad off, and that she needs to deal with her mood in a practical way.  A large part of my motivation is protecting her husband and her daughter from her.

If someone has a compulsive shopping habit, they need to recognize it and take responsibility for it by dealing with it, not by asking for their debts to be forgiven.  The people around them need to take responsibility and recognize it as well, and not act as enablers.

Conceptualizing the problem as one of character failure and lack of will is usually very satisfying for outside observers, but is rarely helpful to those who actually have to deal with it, both the sufferer and those with emotional attachments to them.

10

^ 6

Re: disorder vs character flaw

skeptic.

Thu Aug 21, 2008 at 12:03:49 PM EST

none

That is very sad, that your mother-in-law has such a terrible life and that you and your wife also suffer as a result.  She is a good example of a person who really is mentally ill, not merely irresponsible or using mental illness as an excuse for bad behavior, and she should be under psychiatric care; it is likely that the right psychiatric medication could help her a great deal.  But of course, the trick is getting her to seek help (although it might also be possible to have her committed).

11

^ 10

Re: disorder vs character flaw

JimmyHavok.

Thu Aug 21, 2008 at 03:51:43 PM EST

none

The reality is that she isn't bad off enough to be committed.  She still does the minimum necessary to maintain her life, and she's merely miserable.

Lately she's been showing some signs of progress.  I hope it isn't a false start.

But it illustrates the problem of "man up and take responsibility" as a solution.  If I blamed her, things would be a lot worse.  Instead, I have a lot of patience and sympathy for her, even when she's utterly foul.

12

^ 11

Re: disorder vs character flaw

skeptic.

Fri Aug 22, 2008 at 08:47:58 AM EST

none

I agree that your situation with your mother-in-law is a good example of how some people really do need help, they can't just be told to straighten up and fly right.  I also think that given your observation that she injures herself in the false belief that she is infested with bird mites, she has crossed the line from being merely depressed to actually insane, and could be committed to a mental institution.  The legal definition of insanity is, being dangerous to oneself or others, and your mother-in-law seems to fit that definition.  But if you can help her yourself, that may be the better approach.

7

^ 5

Re: A disorder for everyone?

skeeter1.

Thu Aug 21, 2008 at 04:14:14 AM EST

none

"Maybe.  I suppose I should be more sympathetic, but I've experienced a lot of people in my life who seem to use mental disorders as some kind of excuse or cop-out."

I don't consider it a mental disorder, but the internet and a credit card have made it too easy to get in trouble.  I have to stay away from eBay, because I often find something that I needed like another hole in my head, and have often been ripped off on shipping charges.  Having a PayPal account makes it all too easy.

Amazon made it even easier to spend too much, with their "one-click" purchasing.

I've gotten some great things from many vendors, but I have to watch myself, but do I consider it a mental illness?  No, I don't.  I just have to exhibit a little self-restraint.  When you get a >$1K credit card bill for the stuff you've purchased, it's a kick in the butt.  

there's only one way to find out...

3

Make up your mind.

pO157.

Wed Aug 20, 2008 at 01:36:30 PM EST

none

I thought it was socially acceptable for people (particularly one gender) to engage in "retail therapy." Now that popular home remedy is actually a disease?

9

^ 3

Re: Make up your mind.

skeptic.

Thu Aug 21, 2008 at 11:59:09 AM EST

none

Yes, and smoking cigarettes was once considered a good remedy for gaining weight, since it suppresses appetite, even as it causes lung cancer!  

I do think that there are times when it is good for someone to raise their spirits by going out and indulging in some enjoyable shopping, and it is also true that people who do this to excess are sick.  There are a great many things which are healthy in moderation but unhealthy in excess.  Nothing unusual about that.

13

^ 9

Re: Make up your mind.

skeeter1.

Fri Aug 22, 2008 at 07:18:10 PM EST

none

"I do think that there are times when it is good for someone to raise their spirits by going out and indulging in some enjoyable shopping"

That sort of made me think.  I used to have a girlfriend who, whenever she was feeling down, would go buy a pair of shoes.  Most of the time, she'd be more chipper the next day and return them.  

Me?  I'm a foodaholic.  I love going to the grocery store.  I must have enough food here to last at least 3 months, but when I need a pick-me-up, I buy something else that sounds good.  Problem is, I never buy just one.  I always buy two of anything, one for now and another to stick in the freezer or on the pantry shelf.  

Is that a disease?  I don't think so, just my little bit of eccentricity.  

there's only one way to find out...

14

^ 13

Re: Make up your mind.

skeptic.

Sat Aug 23, 2008 at 08:51:07 AM EST

none

I see nothing wrong with having a lot of food in stock, provided that you do eventually eat it.  If you are buying so much food that you will never eat all of it, and some significant portion of it will eventually become too old to be safely edible and will be thrown out, then you are overdoing the food shopping.  I would also say that your former girlfriend who used to buy shoes that she would usually return the next day, does have a shopping problem.  While it can be therapeutic to go shopping, even then you should be shopping for something that you actually need and want, not something that you will probably return.  Otherwise you are just wasting the time of both yourself and the retail clerks involved.  And if there is absolutely nothing that you actually need, then don't go shopping.  There are lots of other things we can do to raise our spirits.

15

^ 14

Re: Make up your mind.

skeeter1.

Sat Aug 23, 2008 at 07:13:04 PM EST

none

Skeptic,

"I see nothing wrong with having a lot of food in stock, provided that you do eventually eat it. "

You don't know me very well.  I'm a retired microbiologist.  Almost nothing here goes to waste, unless I fuck up in the kitchen like I did last week.  I tried making oven-baked potato chips using redskin potatoes and olive oil.  They were terrible, and most got fed to the garbage disposal.  Perhaps a long soak in some acidulated-water would have helped.  Maybe next time.

Much of the food I have on hand at the moment is

1).  Fresh from the garden
2).  Canned
3).  Dried
4).  US Army MREs.
5).  Frozen

Canning I've done for many years.  Dried foods I got used to from backpacking.  MREs I was introduced to by a friend in the Army, and I happen to like them (sometimes they need some hot sauce).  Occasionally, I'll splurge and get some carry-out Chinese food, but I can get 5 meals out of that for $6.  

BTW, when I go hunting, I only hunt and shoot what I can eat.  I'd like to have another hassenpfeffer.

Tonight's snack is going to be the leftover chow mein noodles that I got with the last carry-out order.

No, very little food here goes to waste.  

there's only one way to find out...

16

^ 15

food supplies

skeptic.

Mon Aug 25, 2008 at 08:47:59 AM EST

none

Since there are many possible types of emergencies which can cause temporary or even prolonged food shortages or disruptions in existing routes of food distribution, there is something to be said for having lots of food in storage at one's home.  There is also the advantage that it gives you a large range of possible meals that you can prepare without having to go out for more shopping.  You can indulge your dietary whims at any given time.  And since the food is not going to go to waste, then I would have to conclude that despite your tendency to buy and store large quantities of food, this is not a form of shopaholism.

8

Re: Should Shopaholism Be A Mental Disorder?

Lou.

Thu Aug 21, 2008 at 07:48:44 AM EST

none

I'm wondering why it needs to be its own disorder...wouldn't it be more accurate to note it as a symptom of compulsive behavior?

It's the end of the world as we know it, and I feel fine

17

In Oprah-world 'shopaholism' is a real disease...

WMK.

Tue Aug 26, 2008 at 09:41:18 AM EST

none

From what I could find in Wiki many psychological addictions are popularly thought of as 'diseases' or it's believed they should be considered a medical condition of some kind - but in actuality it seems like there are seldom any clear medical causes for the behavior and so it could just be people acting like assholes.  Oprah seems like a good symbol for the age of everyone demanding that their made up rationalization for behaving like a destructive idiot should have some kind of medical sounding name and corresponding 'experts' to go on Oprah and pretend to be speaking for medical/psychiatric 'authority' when in fact they are Dr. Phil wannabes doing their snake oil sales pitch.  Oprah's show has been a platform for many author's of books who try like mad to seem as if they really know what they are talking about and draw authority from some nebulous legitimizing area of 'science' when really they are people with opinions who wrote a book about it.  They may even in some cases have useful or helpful things to say, but the overall effect is to encourage the subject of this post - the proliferation of belief in fictitious 'diseases'.

Once upon a time I was an idealistic little psych majoring undergrad who went on to work with a population of seriously messed up future psychopaths of America.  After a few years of that I had to get out - idealism and compassion get burned out of you if you are exposed to the constant awfulness of how truly broken little psyches behave.  Well, not 'burned out of you ' entirely in the sense that you become so embittered that you can't feel compassion or empathy but more like 'exhausted' after exposure to a constant drumbeat of suffering and pain amidst the human wreckage of nuclear families detonating due to parental drug addictions/violence/sexual abuse and just seeing the results of kids getting the plain old short end of the genetic stick (both branches of family tree with histories of severe mental illness & attendant problems).  The point of me mentioning this is that I've seen real mental illness and IMO 'shopaholism' ain't it.  

I followed the DSM links last week and read about a bunch of things - revisiting the DSM sections where they jump through hoops to delicately describe the conditions that appear in children that are highly predictive of psychopath/sociopath diagnosis in adulthood.  I didn't find any sections in the DSM where psychologically addictive behavior was clearly given its own place in the diagnostic schema - whereas physical addiction/dependency/compulsion/obsession was.

I am not saying the damage done by people with 'psychological addictions' isn't very real, it is, and entire families can be destroyed by it.  The need to address these sorts of things has given rise to powerful organizations like AA (or any 'anonymous' anti-dependency 12 stepper type group) - who maintain their own system of beliefs about what addiction is and how to fight it - but they are not part of the medical/psychiatric community.

I suppose the real importance of a discussion like this to point out how society deals with these unofficial diseases.  If 'shopaholism' becomes an official and legitimate disease - then it would become the basis of a slew of 'I wasn't responsible for my actions at the time - I have a disease!' kind of defense against creditors (I am sure the creditors have made sure US law is rigged to prevent that tactic for evading debt responsibility) - or against employers seeking to discharge employees for financial behavior related problems/risk taking behaviors that are strong predictors for poor job performance/crimes against the employer (I don't know what the laws are like everywhere - but I'd imagine every 'right-to-work' type state has protected the employers right to fire anyone seeking to file insurance/benefit claims to help fight their 'shopaholism' - for whatever argument they want to make - including immorality).  Most of all - if every 'addiction' type behavior becomes completely mainstream and recognized as a 'disease' then insurance companies will largely be compelled to offer some kind of benefit/honor claims to pay for treatment as part of the benefit packages they sell to businesses.  Keeping a host of addictive behaviors in a medical/psychiatric twilight zone allows insurers and employers to conveniently exclude and evade costs associated with combating these problems - or if they do provide benefits to combat addiction problems it is entirely at the discretion of the insurer.

I wish curing someone's addiction was as simple as giving them a stern talking to and reminding them that we all have our responsibilities to attend to and circumstances to deal with in a realistic manner and blah, blah, blah ... have moral fiber, stand up straight, take responsibility, be good... but it isn't really that simple.  Saying 'F.U. you are weak and disgusting and not my problem' is a convenient way to dismiss addicts and addiction - until it's someone in your family (and then it isn't nearly as convenient or easy to dismiss them), or a coworker's family, or it winds up affecting you in one of the less obvious/direct ways addiction can damage your life - and then maybe you'd appreciate living in a world where society has implemented an effective and humane method of dealing with addictions that limits the damage they cause.  

"...when theft and high crime becomes obscenely obvious to even the blindest beer sucking idiot, it is always the Republicans who are in office." -- Joe Bageant

This story: 17 comments (1 from subqueue)
Post a Comment