Kleptomania

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, lists kleptomania in the category “disruptive, impulse-control, and conduct disorders”.³ Specifically, kleptomania is considered an impulse control disorder—a mental health condition characterized by difficulty with self-restraint.

The symptoms of kleptomania can vary among individuals, but some common signs and symptoms may be identified to diagnose the disorder. The main symptom of kleptomania is a consistent and uncontrollable urge to steal. This urge is often accompanied by tension or anxiety before the act of stealing and a sense of relief or pleasure during the theft. Following the act, there may be a feeling of guilt, shame, and self-loathing.

Thefts due to kleptomania often aren't planned out and may happen without a specific strategy. In addition, people with kleptomania often steal from public places, such as stores, rather than from friends or family. Typically, the items stolen don’t have a lot of value, and the person stealing them may be able to afford the items without stealing.

Another symptom of kleptomania is extreme difficulty resisting stealing, even when there are serious consequences like being arrested or damaging personal relationships. Those with kleptomania often steal items with little or no value and may discard the stolen items soon after taking them.

According to the Diagnostic and Statistical Manual of Mental Disorders, conduct disorder, antisocial personality disorder, and mania must be ruled out as the primary causes of symptoms before a diagnosis of kleptomania can be provided.

Some additional signs and symptoms may include:

• Periods of remission, in which the person may not steal for a significant amount of time, only to relapse and begin stealing again
• Guilt, shame, or embarrassment after the theft, which may lead to the individual attempting to return the stolen items or making amends in other ways
• Difficulties with impulse control, possibly leading to other impulsive behaviors such as compulsive shopping or gambling

Note that kleptomania differs from ordinary theft; those who shoplift often do so for personal gain. Contrarily, kleptomania is driven by an uncontrollable psychological desire to steal and often causes significant distress to the affected person.

The symptoms of kleptomania are similar to those of several other conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, including obsessive-compulsive disorder. Like obsessive-compulsive disorder, kleptomania involves urges to engage in certain behaviors. However, people with kleptomania often feel satisfied after stealing, while people with OCD usually experience anxiety when they engage in compulsions. 

Kleptomania has also been compared with antisocial personality disorder, since people with the latter often engage in theft. Individuals with kleptomania, though, usually feel regret or shame after stealing, while people with antisocial personality disorder typically do not. 

According to researchers in one study, people with kleptomania and other impulse control disorders also have “high rates of substance abuse and mood disorders”. Kleptomania has also been compared to eating disorders. Some experts believe that kleptomania and binge eating disorder, for example, should be in the same sub-category of impulse control disorders.

Diagnosing kleptomania can be difficult since those affected might be too ashamed of their actions or embarrassed to talk about their symptoms with a healthcare professional. However, awareness of the potential signs and symptoms may help professionals and individuals identify the disorder and offer or get the most effective treatment.

Kleptomania is a complex disorder with several potential causes that are still not fully understood. Research has identified biological, psychological, and environmental factors as possible causes. 

Biological factors

Below are potential biological causes for kleptomania: 

• Imbalance in brain chemicals: An imbalance in neurotransmitters, specifically serotonin, dopamine, and opioids, could incite the impulsive behaviors associated with kleptomania.
• Brain conditions: Conditions like epilepsy and frontotemporal dementia have been linked to kleptomania.
• Head injuries: Some cases of kleptomania have been observed following head trauma. Therefore, damage to specific brain regions, such as the temporal lobes, might contribute to the disorder.

Psychological factors

Below are a few psychological causes of kleptomania: 

• An impulse to steal: Individuals with kleptomania often experience intense urges to steal, followed by relief after they commit the act. These urges could be related to problems with impulse control, mood regulation, or other challenges.
• Co-existing mental health conditions: Kleptomania can sometimes occur alongside other mental health challenges, such as anxiety, depression, or obsessive-compulsive disorder (OCD), potentially worsening impulsive stealing behavior.

Environmental factors

Potential environmental factors contributing to kleptomania could include: 

• Exposure to traumatic or stressful events: Traumatic experiences, particularly in early life, may increase the risk of developing impulse control disorders, including kleptomania.
• Social and family dynamics: Growing up in dysfunctional families or experiencing neglect or abuse might make an individual more prone to developing kleptomania.

Kleptomania is a multifaceted disorder that may be caused by not one but a combination of these biological, psychological, and environmental factors. As a result, kleptomania can be a challenging disorder to diagnose and treat.

When treating kleptomania, a mental healthcare professional may aim to help individuals control their impulsive behaviors and lower the risk of relapsing into old habits. Common treatments might include therapy, medication, and self-care strategies.

Medication

While no specific medication is approved to treat kleptomania, certain medications may help people manage related symptoms and reduce the urge to steal. These medications may include:

• Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine or sertraline: These antidepressants can balance neurotransmitters in the brain responsible for impulse control. 
• Mood stabilizers, like lithium or valproate: These medications are used to treat bipolar disorder or seizure disorders, but may also help individuals manage impulsive behaviors. 
• Naltrexone: This medication is an opioid antagonist that can be used to reduce the urges and pleasure associated with stealing.

The effectiveness of these medications can vary significantly among individuals with kleptomania. Treatment often involves close monitoring from a healthcare provider.

Other treatment options

For some people, additional treatment options may be beneficial to manage co-occurring disorders or other factors causing kleptomania. These might include:

• Treatment for substance use disorder or other mental health conditions, such as anxiety or depression, which may increase the risk of impulsive behaviors
• Family therapy, which may educate and support individuals and their loved ones in the recovery process
• Relaxation and stress reduction techniques, like mindfulness, yoga, and deep breathing exercises, which may help individuals manage the urge to steal and reduce overall anxiety levels

Self-care

Self-care practices may also be valuable for helping individuals with kleptomania manage their symptoms. Some potential self-care strategies may include:

• Regular exercise, which may reduce stress and maintain overall health 
• Keeping a consistent sleep schedule and eating a healthy diet, as poor sleep and inadequate nutrition may affect physical and mental health 

Treatment can vary depending on the individual, the severity of the disorder, and other underlying health conditions. In some cases, a combination of treatments may be recommended. Individuals can work with mental health professionals to develop a personalized treatment plan that supports their needs and reduces the risk of relapse.

If you believe you’re living with an impulse control disorder or another mental health condition, help is available. There are various resources available that may provide guidance and support for individuals living with kleptomania. One potential resource is an online therapy platform, such as BetterHelp, where users can sign up and seek assistance from licensed mental health professionals. However, online therapy may not be suitable for everyone. In many cases, individuals can search for a local therapist who may specialize in their area of concern. 

In addition to therapy, there are mental health organizations and support groups specifically focused on helping those affected by kleptomania. Certain organizations, such as The Shulman Center, provide information, resources, and community support for individuals and their families. Individuals with kleptomania can join a network of individuals experiencing similar problems, find solidarity, and learn from others' experiences.

These resources may help individuals manage kleptomania and move toward a more stable and fulfilling life. With the proper guidance and support network, individuals with kleptomania can work on overcoming their challenges while improving their overall emotional health and self-control.

If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available 24/7 for support. Call 1-800-799-SAFE (7233) or text “START” to 88788. You can also use the online chat.

Recent studies on kleptomania have sought to advance understanding of its underlying causes. One study investigated how people with kleptomania respond to situational cues. Both healthy adults and individuals with kleptomania were shown images and videos related to shoplifting situations. The results found that those with kleptomania looked at the images and videos differently and had different brain responses than healthy adults. These results suggest that people with kleptomania perceive shoplifting-related cues in a unique way, which may shed light on new treatment approaches.

Another study explored the current treatment options for kleptomania. While there's no cure, the review suggests combining psychotherapy—specifically cognitive-behavioral therapy—and pharmacotherapy may help individuals manage the disorder. The type of treatment used often depends on other disorders that the person might have or traits of their behavior. Medications like naltrexone, mood stabilizers, antidepressants, and benzodiazepines can be used, and in severe cases, electroconvulsive therapy can be applied. However, more specific treatments for kleptomania could be valuable.

Below are several key statistics on kleptomania:

• Kleptomania is a rare condition, with an estimated prevalence rate of 0.6% in the general population. However, among people who have been detained for stealing in stores, the prevalence of kleptomania ranges from 3.8% to as high as 24%.
• There are gender-related differences in individuals with kleptomania, with women with kleptomania being more likely to be married compared to affected men (47.1% vs 25.9%). In addition, the age at shoplifting onset tends to be later in women than in men (20.9 years vs 14 years).
• People with kleptomania often grapple with anxiety and mood disorders, with 6.5% to 60% having obsessive-compulsive disorder (OCD) alongside kleptomania.
• One study estimates that kleptomania is responsible for 5% of all shoplifting cases, which, based on the total shoplifting costs of $10 billion in 2002, equates to an annual loss of $500 million to the economy.