Kleptomania

Kleptomania (klep-toe-MAY-nee-uh) is the repeated inability to resist the urge to steal. The DSM-5 * classifies kleptomania as an impulse control disorder.

Thirteen-year-old Jennifer went to the pharmacy to pick up a prescription for her little brother who had strep throat. When she got to the pharmacy, the prescription was not ready. While she waited, Jennifer cruised the aisle of hair supplies. The longer she waited, the more tense she felt. She was attracted to a package of cheap red plastic barrettes. The urge to take the barrettes was very strong. No one was watching, so she slipped them into her pocket and immediately felt a surge of pleasure.

When the prescription was ready, Jennifer paid for it and started home. On the way, she felt guilty for taking the barrettes. She had plenty of money to pay for them, and she knew she would never wear them. She didn't know why she had taken them, except that when she was stealing them, she felt good.

Kleptomania is an impulse control disorder. People with kleptomania cannot resist the urge to steal. Most often they steal from stores, although sometimes they steal from friends. The items they take usually have little value or are useless to the person who takes them. Often the person has enough money to pay for the item, but steals it anyway. People with kleptomania will steal repeatedly even after they are caught and get in trouble.

People with kleptomania experience a consistent cycle of events surrounding the act of stealing. Before the theft, anxiety or tension increases to an almost unbearable level along with the urge to steal. During the theft, the individual feels gratification, pleasure, or a sense of relief. Later, the thief feels intense guilt, self-loathing, remorse, worry, and/or shame until the urge to steal and tension begins to build again and the cycle repeats.

People with kleptomania are not chronic law-breakers. They know that stealing is wrong, but cannot help themselves. In this sense, kleptomania is like an addiction to gambling or drugs, where the need to perform an activity overcomes logical and moral reasoning. People with kleptomania often lead law-abiding lives except for their inability to control their compulsion to steal.

People with kleptomania do not plan to steal. Their theft is impulsive, and they are usually alone when they steal. The items they take have little value and often are not used. Sometimes they are hoarded. Other times they may be thrown away or given to friends. People with kleptomania steal because they can't help themselves, and they can't rationally explain why they keep doing it.

Shoplifters often work in groups and plan what and how they will steal. Their motivation may be to get items they want or need that they can't afford to buy, or they may steal in order to sell the items they take. Many teens are not chronic thieves but shoplift on a dare or as a form of rebellion. Some shoplifters steal for revenge or to get back at a store or person they feel has treated them badly.

Although shoplifting is extremely common, true kleptomania is rare and is found in less than 1 percent of the population. The exact percentage is difficult to determine because most people with kleptomania, when caught stealing, are simply treated as shoplifters. The disorder usually begins during adolescence but can arise in childhood and can continue into adulthood. Three times more women have kleptomania than men.

Researchers do not know the exact cause of kleptomania, although there appears to be a genetic component to the disorder. Other risk factors include:

Some research suggests that kleptomania is associated with an imbalance in the neurotransmitters * serotonin * and dopamine * in the brain. These chemicals also are thought to play a role in mood disorders such as major depression, which is common in people with kleptomania.

According to the DSM-5, to be diagnosed with kleptomania, an individual must:

Many people with kleptomania recognize that they have a problem but are ashamed of their stealing or are afraid to seek help for fear that they will be in trouble with the law. Medical confidentiality laws normally prevent therapists from reporting theft activities to the police, so concern about legal complications should not be a barrier to getting treatment. People who have been arrested for repeatedly stealing small items may be forced by the court to get treatment in order to avoid jail time. When people with kleptomania are arrested for stealing, family members are often brought into the picture and insist that the individual seek treatment.

The main treatment for kleptomania is cognitive behavioral therapy. This is a type of psychotherapy in which people learn to recognize and change negative and self-defeating patterns of thinking and behavior. For example, people with kleptomania may be taught to picture themselves stealing and then facing the negative consequences of being caught. They may also be taught to practice a mildly painful activity such as holding their breath or pinching themselves whenever they get the urge to steal. Relaxation techniques are taught to help defuse feelings of tension and anxiety that arise before the theft.

It is essential for people with kleptomania who have another mental disorder such as major depression or obsessive-compulsive disorder to receive treatment for both kleptomania and their other conditions. No drugs have been approved by the U.S. Food and Drug Administration specifically to treat kleptomania. However, since the disorder often occurs along with other mental health disorders, drugs that treat those disorders may help reduce the urge to steal. Many drugs that treat mood disorders alter the balance of neurotransmitters in the brain and seem to help people with kleptomania control their theft impulses.

Recovering from kleptomania is a long and difficult process. Relapses in stealing behavior often occur. Family therapy may help loved ones better understand the dynamics of kleptomania and teach them ways to support the kleptomaniac's recovery efforts.

Since scientists do not understand why some people develop kleptomania, there is no way to prevent the disorder. Treatment can, however, teach people how to prevent relapses. Some ways to help control the urge to steal include understanding what specific triggers cause anxiety and tension that precede the theft, getting appropriate treatment for other mental or physical disorders, getting plenty of exercise, practicing stressreduction techniques such as meditation or yoga, and participating in a self-help group.

See also Anxiety and Anxiety Disorders: Overview • Obsessive-Compulsive Disorder

* DSM-5 is the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, published by the American Psychiatric Association. This book is used by physicians in the United States for classification and diagnosis of mental conditions.

* bipolar disorder is a mood disorder characterized by alternating periods of overconfidence and activity (manic highs) and depressive lows.

* neurotransmitters are chemicals secreted by nerve cells that carry a chemical message to another nerve cell, often as a way of transmitting a nerve impulse.

* serotonin (ser-uh-TOH-nin) is a chemical that occurs throughout the body with many effects including transmission of nerve impulses. Low serotonin levels are associated with mood disorders, particularly depression and obsessive-compulsive disorder.

* dopamine (DOH-puh-meen) is a chemical made in the brain that is involved in many brain activities, including movement and emotion.