Kleptomania

Kleptomania is the irresistible urge to steal items that you don’t really need and that usually have little value. It’s a serious mental health disorder that can tear your life apart if not treated. It 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 of kleptomania 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

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.

The cause of kleptomania isn’t known. Some research evidence suggests that kleptomania may be linked to problems with a naturally occurring brain chemical (neurotransmitter) called serotonin. Serotonin helps regulate moods and emotions. There’s also some evidence that kleptomania may be related to addictive disorders or to obsessive-compulsive disorder. But more research is needed to better understand the possible causes of kleptomania.

Kleptomania is thought to be 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 your 20s, but in rare cases it begins during very early childhood or late in life.

Although the cause of kleptomania isn’t known, researchers continue to learn more about the factors that may increase the risk of developing kleptomania. These risk factors may include:

  • Excessive life stressors, such as a major loss
  • Head trauma or brain injuries
  • Having blood relatives with kleptomania, mood disorders, addictions or obsessive-compulsive disorder

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 kleptomania to be diagnosed 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.

Although fear, humiliation or embarrassment may make it difficult for you to seek treatment for kleptomania, it’s important to get help. Kleptomania is very 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, some studies have suggested that 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. Those most commonly used to treat kleptomania are selective serotonin reuptake inhibitors (SSRIs). These include fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Paxil CR), fluvoxamine and others. However, there have been a few case reports of SSRIs actually triggering kleptomania symptoms. Talk to your doctor about your concerns and coping with side effects of antidepressants.
  • 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. Some evidence suggests that lithium (Eskalith, Lithobid) may be helpful.
  • Benzodiazepines. These medications are central nervous system depressants, also called tranquilizers. They include clonazepam (Klonopin) and alprazolam (Xanax, Niravam). The effectiveness of benzodiazepines often varies, and they may be habit-forming — causing mental or physical dependence, especially when taken for a long time or in high doses.
  • Anti-seizure medications. Although originally intended for seizure disorders, these medications have shown benefits in certain mental health disorders, possibly including kleptomania. Some studies have shown benefits from topiramate (Topamax) and valproic acid (Depakene, Stavzor).
  • Addiction medications. Naltrexone (Revia), 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 go away on their own with time.

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. If you’re on probation, you may also consider touching base with a trusted and compassionate probation officer.

It’s not known how to prevent kleptomania with any certainty. Getting treatment as soon as compulsive stealing begins may help prevent kleptomania from becoming worse or becoming a chronic condition that’s difficult to overcome.