Kleptomania

Kleptomania is a condition characterized by an irresistible urge to steal. People will steal items that they do not need, that they could afford to buy, or that have little to no monetary value. Kleptomania often emerges sometime during adolescence and appears more commonly in women than in men.
Symptoms –
The main symptom of kleptomania is that a person acts on an irresistible urge or need to steal items or objects. That often involves one or more of the following:
• The items aren’t stolen out of necessity or for their value.
• A person feels tension or anticipation before stealing, followed by pleasure, relief or other positive emotions immediately afterward.
• Once the positive emotions fade, most people with kleptomania feel guilt, shame or regret.
• Some people throw stolen items away, give them to others or donate them to charity. Less commonly, a person will hoard stolen items, secretly return them or return and pay for them.

• Stealing isn’t planned, and a person with kleptomania does it alone. Most people who are married with kleptomania keep it a secret from their spouse.
Causes –
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. 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.
Risk Factors –
Different factors can contribute to kleptomania. Genetics and biology may account for a portion of the root causes, which include:
• having other mental illnesses, including bipolar disorder, anxiety disorders, substance use disorders, or personality disorders (The link seems to be strongest with obsessive-compulsive disorder.)
• problems with low levels of serotonin, leading to an increase in impulsive behaviors
• relations with addictive disorders, since stealing can release the rush of dopamine that becomes addictive
• an imbalance in the brain’s opioid system, which controls urges
• a family history of kleptomania or addiction
• being female, as two-thirds of people diagnosed with kleptomania are women
• head trauma, like concussions
Psychological trauma, especially trauma at a young age, may also contribute to the development of kleptomania. Family dysfunction can also cause children to steal, which can set the stage for kleptomania tendencies when combined with other mood or addiction disorders.

Diagnosis –
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
Treatment –
Kleptomania is extremely difficult to treat alone, so getting medical help is a necessity for most who experience it. Treatment typically involves a combination of psychotherapy and medications, which can address triggers and causes.
Cognitive behavioral therapy is most commonly used to treat kleptomania. With this type of treatment, your therapist will help you learn to stop detrimental behavior and address the cognition that causes them. In cognitive therapy, your therapist may use:

• systematic desensitization, in which you practice relaxation techniques to learn to control the urges to steal
• covert sensitization, in which you imagine yourself stealing and then facing negative consequences like being arrested
Medications may be prescribed to address related mood or mental health disorders, like depression or obsessive-compulsive disorder. Your doctor may prescribe a selective serotonin reuptake inhibitor or an addiction medication that balances opioids to balance the brain chemistry that causes the urges to steal.
While kleptomania can’t be cured, it can be treated. Continual treatment and caution is required to avoid kleptomaniac relapses.
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