Kleptomania | Impulse control disorder

DEFINITION

Kleptomania is the irresistible urge to steal items that you generally don't really need and that usually have little value. Kleptomania (klep-toe-MAY-knee-uh) is a serious mental health disorder that can cause much emotional pain to you and your loved ones if not treated.

Kleptomania is a type of impulse control disorder — a disorder in which you can't resist the temptation or drive to perform an act that's harmful to you or someone else. 

Many people with kleptomania live lives of secret shame because they're afraid to seek mental health treatment. Although there's no cure for kleptomania, treatment with medication or psychotherapy may be able to help end the cycle of compulsive stealing.

SYMPTOMS

Kleptomania symptoms may include:

• Powerful urges to steal items that you don't need 
• Feeling increased tension leading up to the theft 
• Feeling pleasure or gratification while stealing 
• Feeling terrible guilt or shame after the theft 

A powerful urge

Unlike typical shoplifters, people with kleptomania don't compulsively steal for personal gain. Nor do they steal as a way to exact revenge. They steal simply because the urge is so powerful that they can't resist it. This urge makes them feel uncomfortably anxious, tense or aroused. To soothe these feelings, they steal.

During the theft, they feel relief and gratification. Afterward, though, they may feel enormous guilt, remorse, self-loathing and fear of arrest. But the urge comes back, and the kleptomania cycle repeats itself.

Spontaneous occurrences and public places
Episodes of kleptomania generally occur spontaneously, without planning. Most people with kleptomania steal from public places, such as stores and supermarkets. Some may steal from friends or acquaintances, such as at a party. Often, the stolen items have no value to the person with kleptomania. The stolen items are usually stashed away, never to be used. Items may also be donated, given away to family or friends, or even secretly returned to the place from which they were stolen. 

When to see a doctor

If you can't stop shoplifting or stealing, seek medical advice. Many people who may have kleptomania don't want to seek treatment because they're afraid they'll be arrested or jailed. A mental health provider doesn't have to report your thefts to authorities, however. Getting treatment may help you gain control over your kleptomania.

If a loved one has kleptomania

If you suspect a close friend or family member may have kleptomania, gently raise your concerns with your loved one. Keep in mind that kleptomania is a mental health condition, not a character flaw, and approach your loved one without blame or accusation.

It may be helpful to emphasize the following points:

• You're concerned because you care about your loved one's health and well-being. 
• You're worried about the risks of compulsive stealing, such as being arrested, losing a job or damaging a valued relationship. 
• You understand that, with kleptomania, the urge to steal may be too strong to resist just by \"putting your mind to it.\" 
• Effective treatments are available to minimize the urge to steal and help your loved one live without addiction and shame. 

If you need help preparing for this conversation, talk with your doctor. He or she may refer you to a mental health provider who can help you plan a way of raising your concerns without making your loved one feel defensive or threatened.

CAUSES

The cause of kleptomania isn't known. There are several theories that suggest that changes in the brain may be at the root of kleptomania. Kleptomania may be linked to problems with a naturally occurring brain chemical (neurotransmitter) called serotonin. Serotonin helps regulate moods and emotions. Low levels of serotonin are common in people prone to impulsive behaviors.

Kleptomania also may be related to addictive disorders, and stealing may cause the release of dopamine (another neurotransmitter). Dopamine causes pleasurable feelings, and some people seek this rewarding feeling again and again.

Other research has found that kleptomania can occur after someone sustains a head injury. More research is needed to better understand all of these possible causes of kleptomania.

RISK FACTORS

Kleptomania is considered uncommon. However because many people with kleptomania never seek treatment, or they're simply jailed after repeated thefts, many cases of kleptomania may never be diagnosed. It's thought that fewer than 5 percent of shoplifters have kleptomania. Kleptomania often begins during adolescence or in young adulthood, but in rare cases it begins after 50 years of age.

Kleptomania risk factors may include:

• Family history. Having a first-degree blood relative, such as a parent or sibling, with kleptomania or obsessive-compulsive disorder may increase your risk of kleptomania. 
• Being female. Approximately two-thirds of people with known kleptomania are women. 
• Having another mental illness. People with kleptomania often have other mental illnesses, such as bipolar disorder, anxiety disorder, eating disorders, substance abuse or personality disorders. 
• Head trauma or brain injuries. People who've experienced a head trauma may develop kleptomania. 

COMPLICATIONS

Left untreated, kleptomania can result in severe emotional, legal and financial problems. For example, many people with known kleptomania have been arrested for shoplifting. Because you know stealing is wrong but you feel powerless to resist the impulse, you may be wracked by guilt, shame, self-loathing and humiliation. You may otherwise lead a moral, upstanding life and be confused and upset by your compulsive stealing.

Complications that kleptomania may cause or be associated with include:

• Arrest 
• Imprisonment 
• Depression 
• Alcohol and substance abuse 
• Eating disorders 
• Anxiety 
• Compulsive gambling or shopping 
• Suicidal thoughts or behavior 
• Social isolation 

PREPARING FOR YOUR APPOINTMENT

If you struggle with an irresistible urge to steal, call your doctor. Making that call will undoubtedly be scary, but trust that your doctor is interested in caring for your health, not in judging you. Your doctor may refer you to a mental health provider, such as a psychiatrist, with experience diagnosing and treating kleptomania.

Use the information below to prepare for your first appointment and learn what to expect from the mental health provider.

What you can do:

• Write down any symptoms you're experiencing, and for how long. It will help the mental health provider to know what kinds of events seem to trigger your urge to steal. 
• Write down key personal information,including traumatic events in your past and any current, major stressors. 
• Make a list of your medical information, including other physical or mental health conditions with which you've been diagnosed. Also write down the names of any medications or supplements you're taking. 
• Take a trusted family member or friend along, if possible. It can be difficult to remember everything your mental health provider says, and a loved one can help remember the details. In addition, someone who has known you for a long time may be able to ask questions or share information with the mental health provider that you don't remember to bring up. 
• Write down questions to ask your mental health provider in advance so that you can make the most of your appointment. 

For kleptomania, some basic questions to ask your mental health provider include:

• Why can't I stop stealing? 
• What treatments are available? 
• What treatments are most likely to work for me? 
• How quickly will I stop stealing? 
• Will I still feel the urge to steal? 
• How often do I need therapy sessions, and for how long? 
• Would family therapy be helpful in my case? 
• Are there medications that can help? 
• What are the possible side effects of these medications? 
• I have these other health conditions. How can I best manage these conditions together? 
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting? 

What to expect from your mental health provider

The mental health provider will likely ask you a number of questions to better understand your symptoms and how they're affecting your life. The mental health provider may ask:

• At what age did you first experience an irresistible urge to steal? 
• How often do you experience the urge to steal? 
• Have you ever been caught or arrested for stealing? 
• How would you describe your feelings before, during and after you steal something? 
• What kinds of items do you steal? Are they things you need? 
• From whom do you steal? 
• What do you do with the items you steal? 
• Does anything in particular seem to trigger your urge to steal? 
• How would you say your urge to steal is affecting your life, including school, work and personal relationships? 
• Have any of your close relatives had a problem with compulsive stealing, or with other mental health conditions such as depression, addiction or obsessive-compulsive disorder? 
• Have you been treated for any other mental health problems, including eating disorders? If yes, what treatments were most effective? 
• Do you use alcohol or illegal drugs? How often? 
• Are you currently being treated for any other medical conditions? 

TESTS AND DIAGNOSIS

When you decide to seek treatment for symptoms of possible kleptomania, you may have both a physical and psychological evaluation. The physical exam can determine if there may be any physical causes triggering your symptoms.

There's no laboratory test to diagnose kleptomania. Instead, kleptomania is diagnosed based on your signs and symptoms. Kleptomania is a type of impulse control disorder. In addition to asking questions about your impulses and how they make you feel, your doctor may review a list of situations to see if they trigger kleptomania episodes. You may also fill out psychological questionnaires or self-assessments to help pinpoint a diagnosis.

To be diagnosed with kleptomania, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment. Criteria for a kleptomania diagnosis include:

• You have an inability to resist urges to steal objects that aren't needed for personal use or monetary value 
• You feel increasing tension leading up to the theft 
• You sense feelings of pleasure, relief or gratification during the act of stealing 
• The theft isn't committed as a way to exact revenge or to express anger, and isn't done while hallucinating or delusional 
• The stealing isn't related to manic episodes of bipolar disorder or other mental health disorders, such as antisocial personality disorder 

TREATMENTS AND DRUGS

Although fear, humiliation or embarrassment may make it difficult for you to seek treatment for kleptomania, it's important to get help. Kleptomania is difficult to overcome on your own. Treatment of kleptomania typically involves medications and psychotherapy, perhaps along with self-help groups. However, there's no standard kleptomania treatment, and researchers are still trying to understand what may work best. You may have to try several types of kleptomania treatment to find something that works well for your situation.

Medications

There's little solid scientific research about using psychiatric medications to treat kleptomania. However, certain medications may be helpful. Which medication is best for you depends on your overall situation and other conditions you may have, such as depression or obsessive-compulsive disorder. You may benefit from taking a combination of medications. Medications to consider include:

• Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat kleptomania. These include fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Paxil CR), fluvoxamine (Luvox, Luvox CR) and others. 
• Mood stabilizers. These medications are meant to even out your mood so that you don't have rapid or uneven changes that may trigger urges to steal. One mood stabilizer used to treat kleptomania is lithium (Lithobid). 
• Anti-seizure medications. Although originally intended for seizure disorders, these medications have shown benefits in certain mental health disorders, possibly including kleptomania. Examples include topiramate (Topamax) and valproic acid (Depakene, Stavzor). 
• Addiction medications. Naltrexone (Revia, Vivitrol), known technically as an opioid antagonist, blocks the part of your brain that feels pleasure with certain addictive behaviors. It may reduce the urges and pleasure associated with stealing. 

You may have to try several different medications or combinations of medications to see what works best for you with the fewest side effects. Keep in mind that it may take several weeks to notice full benefits. Talk to your doctor or mental health provider if you're bothered by side effects. Under his or her guidance, you may be able to switch medications or change your dosage. Many side effects eventually go away.

Psychotherapy

Cognitive behavioral therapy has become the psychotherapy of choice for kleptomania. In general, cognitive behavioral therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. Cognitive behavioral therapy may include these techniques to help you overcome kleptomania urges:

• Covert sensitization, in which you picture yourself stealing and then facing negative consequences, such as being caught 
• Aversion therapy, in which you practice mildly painful techniques, such as holding your breath until you become uncomfortable, when you get an urge to steal 
• Systematic desensitization, in which you practice relaxation techniques and picture yourself controlling urges to steal 

Other forms of therapy, such as psychodynamic therapy, family therapy or marriage counseling, also may be helpful.

Avoiding relapses

It's not unusual to have relapses of kleptomania. To help avoid relapses, be sure to stick to your treatment plan. If you feel urges to steal, contact your mental health provider or reach out to a trusted support group.

LIFESTYLE AND HOME REMEDIES

Kleptomania is the irresistible urge to steal items that you generally don't really need and that usually have little value. Kleptomania (klep-toe-MAY-knee-uh) is a serious mental health disorder that can cause much emotional pain to you and your loved ones if not treated.

Kleptomania is a type of impulse control disorder — a disorder in which you can't resist the temptation or drive to perform an act that's harmful to you or someone else.

Many people with kleptomania live lives of secret shame because they're afraid to seek mental health treatment. Although there's no cure for kleptomania, treatment with medication or psychotherapy may be able to help end the cycle of compulsive stealing.