Kleptomania

Kleptomania (klep-toe-MAY-nee-uh) is a mental health disorder that involves repeatedly being unable to resist urges to steal items that you generally don't really need. Often the items stolen have little value and you could afford to buy them. Kleptomania is rare but can be a serious condition. It can cause much emotional pain to you and your loved ones — and even legal problems — if not treated.

Kleptomania is a type of impulse control disorder — a disorder that involves problems with emotional or behavioral self-control. If you have an impulse control disorder, you have difficulty resisting the temptation or powerful urge to perform an act that's excessive or 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 medicine or skill-building therapy that focuses on dealing with urges may help to end the cycle of compulsive stealing.

Kleptomania symptoms may include:

• Inability to resist powerful urges to steal items that you don't need
• Feeling increased tension, anxiety or arousal leading up to the theft
• Feeling pleasure, relief or satisfaction while stealing
• Feeling terrible guilt, remorse, self-loathing, shame or fear of arrest after the theft
• Return of the urges and a repetition of the kleptomania cycle

Features

People with kleptomania usually have these features or characteristics:

• Unlike most shoplifters, people with kleptomania don't compulsively steal for personal gain, on a dare, for revenge or out of rebellion. They steal simply because the urge is so powerful that they can't resist it.
• Episodes of kleptomania generally happen suddenly, without planning and without help from another person.
• Most people with kleptomania steal from public places, such as stores. Some may steal from friends or acquaintances, such as at a party.
• Often, the stolen items have no value to the person with kleptomania, and the person can afford to buy them.
• The stolen items are usually stashed away, never to be used. Items also may be donated, given away to family or friends, or even secretly returned to the place from which they were stolen.
• Urges to steal may come and go or may occur with greater or lesser intensity over the course of time.

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. However, a mental health provider usually doesn't report your thefts to authorities.

Some people seek medical help because they're afraid they'll get caught and have legal problems. Or they've already been arrested, and they're legally required to seek treatment.

If a loved one has kleptomania

If you suspect a close friend or family member may have kleptomania, gently raise your concerns with that person. Keep in mind that kleptomania is a mental health disorder, not a character flaw, so approach the person without judgment or blame.

It may be helpful to emphasize these points:

• You're concerned because you care about the person'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."
• Treatments are available that may help to minimize the urge to steal and live without addiction and shame.

If you need help preparing for this conversation, talk with your health care provider. Your provider may refer you to a mental health professional who can help you plan a way of raising your concerns without making your friend or relative feel defensive or threatened.

The causes of kleptomania are not known. Several theories suggest that changes in the brain may be at the root of kleptomania, and that learned patterns of stealing items strengthens the problem over time. More research is needed to better understand these possible causes, but kleptomania may be linked to:

• Problems with a naturally occurring brain chemical called serotonin. Serotonin, a neurotransmitter, helps regulate moods and emotions. Low levels of serotonin are common in people prone to impulsive behaviors.
• Addictive disorders. Stealing may cause the release of dopamine — another neurotransmitter. Dopamine causes pleasurable feelings, and some people seek this rewarding feeling again and again.
• The brain's opioid system. Urges are regulated by the brain's opioid system. An imbalance in this system could make it harder to resist urges.
• Learned habit. Urges are very uncomfortable. Responding to these urges by stealing causes a temporary decrease in distress and relief from these urges. This creates a strong habit that becomes hard to break.

Kleptomania is not common. But some cases of kleptomania may never be diagnosed. Some people never seek treatment. Other people are jailed after repeated thefts.

Kleptomania often begins during the teen years or in young adulthood, but it can start later. About two-thirds of people with known kleptomania are female.

Kleptomania risk factors may include:

• Family history. Having a blood relative, such as a parent or sibling, with kleptomania or addictive disorders may increase the risk of kleptomania.
• Having another mental illness. People with kleptomania often have another mental health disorder, such as anxiety, depression or a substance use disorder.

Left untreated, kleptomania can result in severe emotional, family, work, legal and financial problems. For example, you know stealing is wrong but you feel powerless to resist the impulse. As a result, you may be filled with guilt, shame, self-loathing and humiliation. And you may be arrested for stealing. You may otherwise lead a law-abiding life and be confused and upset by your compulsive stealing.

Other complications and conditions associated with kleptomania may include:

• Other impulse-control disorders, such as compulsive gambling or shopping
• Alcohol or other substance misuse
• Personality disorders
• Eating disorders
• Depression
• Bipolar disorder
• Anxiety disorders
• Suicidal thoughts and behaviors

Because the causes of kleptomania aren't clear, it's not yet known how to prevent it with any certainty. Getting treatment as soon as compulsive stealing begins may help prevent kleptomania from becoming worse and prevent some of the negative consequences.

Kleptomania is diagnosed based on your symptoms. When you decide to seek treatment for symptoms of possible kleptomania, you may have both a physical exam and psychological evaluation. The physical exam can determine if there are any medical causes triggering your symptoms.

Because kleptomania is a type of impulse control disorder, to help pinpoint a diagnosis, your mental health provider may:

• Ask questions about your impulses and how they make you feel
• Review a list of situations to ask if these situations trigger your kleptomania episodes
• Discuss problems you have had because of this behavior
• Have you fill out questionnaires or self-assessments
• Use the guidelines in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Although fear, humiliation or embarrassment may make it hard for you to seek treatment for kleptomania, it's important to get help. Kleptomania is difficult to overcome on your own. Without treatment, kleptomania will likely be an ongoing, long-term condition.

Treatment for kleptomania typically involves medicines and psychotherapy, or both, sometimes 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 treatment to find what works well for you.

Medicines

There's little scientific research about using psychiatric medicines to treat kleptomania. And there is no FDA-approved medicine for kleptomania. However, certain medicines may help, depending on your situation and whether you have other mental health disorders, such as depression or substance misuse.

Your provider may consider prescribing:

• An addiction treatment medicine called naltrexone, which may reduce the urges and pleasure associated with stealing
• An antidepressant — specifically a selective serotonin reuptake inhibitor (SSRI)
• Other medicines or a combination of medicines

If medicine is prescribed, ask your health care provider or pharmacist about potential side effects or possible interactions with any other medicines.

Psychotherapy

A form of psychotherapy called cognitive behavioral therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy ones that can be used in different situations when needed. Cognitive behavioral therapy may include these skill-building techniques to help you control kleptomania urges:

• Systematic desensitization and counter-conditioning, in which you practice relaxation techniques and other strategies while in triggering situations to learn how to reduce your urges in a healthy way
• 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

Avoiding relapses

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

You can take steps to care for yourself with healthy coping skills while getting professional treatment:

• Follow your treatment plan. Take medicines as directed and attend scheduled therapy sessions. Remember, it's hard work and you may have occasional setbacks.
• Educate yourself. Learn about kleptomania so that you can better understand risk factors, treatments and triggering events.
• Identify your triggers. Identify situations, thoughts and feelings that may trigger urges to steal so you can take steps to manage them.
• Get treatment for substance misuse or other mental health problems. Your substance use, depression, anxiety and stress can lead to a cycle of emotional pain and unhealthy behavior.
• Find healthy outlets. Explore healthy ways to rechannel your urges to steal or shoplift through exercise and recreational activities.
• Learn relaxation and stress management. Try stress-reduction techniques such as meditation, yoga or tai chi.
• Stay focused on your goal. Recovery from kleptomania can take time. Stay motivated by keeping your recovery goals in mind. Remind yourself that you can work to repair damaged relationships and financial and legal problems.
• Be honest with loved ones. You might initially need help with controlling your urges when in higher-risk situations, such as shopping. Let your loved ones know about your struggles and consider using the "buddy system" for a period of time while you're learning more ways to manage your urges.

Support for loved ones

If your close friend or family member is being treated for kleptomania, make sure you understand the details of the treatment plan and actively support its success. It may be helpful to attend one or more therapy sessions with your friend or relative to learn the factors that seem to trigger the urge to steal and the most effective ways to cope.

You also may benefit from talking with a therapist yourself. Recovering from an impulse control disorder is a challenging, long-term undertaking — both for the person with the disorder and close friends and family. Make sure you're taking care of your own needs with the stress-reduction outlets that work best for you, such as exercise, meditation or time with friends.

Self-help groups

People with kleptomania may benefit from participating in self-help groups based on 12-step programs and those designed for addiction problems. Even if you can't find a group specifically for kleptomania, you may benefit from attending Alcoholics Anonymous or other addiction meetings. Such groups don't suit everyone's tastes, so ask your mental health provider about alternatives.

If you struggle with an irresistible urge to steal, talk to your health care provider. Be honest with your provider about your symptoms. Having that discussion can be scary, but trust that your provider is interested in caring for your health, not in judging you. You may be referred to a mental health provider, such as a psychiatrist or psychologist, with experience diagnosing and treating kleptomania.

You may want to take a trusted family member or friend along to help remember the details. Also, 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.

Here's some information to help you get ready and know what to expect from your provider.

What you can do

To prepare for your appointment, make a list of:

• Any symptoms you're experiencing, and for how long
• Key personal information, including traumatic events in your past and any current, major stressors
• Your medical information, including other physical or mental health conditions
• All medicines you're taking, including any vitamins, herbs or other supplements, and the doses
• Questions to ask your provider so that you can make the most of your appointment

Some questions to ask may include:

• Why can't I stop stealing?
• What treatments are available?
• What treatments are most likely to work for me?
• How quickly might I stop stealing?
• Will I still feel the urge to steal?
• How often do I need therapy sessions and for how long?
• Are there medicines that can help?
• What are the possible side effects of these medicines?
• I have these other health conditions. How can I best manage these conditions together?
• How can my family best support my treatment?
• Are there any brochures or other printed material that I can have? What websites do you recommend?

What to expect from your mental health professional

To better understand your symptoms and how they're affecting your life, your 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?
• In what kinds of situations are you likely to steal?
• What do you do with the items you steal?
• Does anything in particular seem to trigger your urge to steal?
• How is your urge to steal 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 or alcohol or drug misuse?
• Do you use alcohol or recreational drugs? If so, what do you use and how often?
• Have you been treated for any other mental health problems, such as anxiety or depression? If yes, what treatments were most effective?
• Are you currently being treated for any medical conditions?

You may be asked more questions based on your responses, symptoms and needs. Preparing for questions will help you make the most of your appointment.