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Commentary: Compulsive buying

Commentary

Compulsive buying

There's no doubt that many people take pleasure in acquiring possessions, and advertisers are getting better all the time at parting us from our cash. But according to a study, for as many as one in 20 people, shopping is something else: a compulsion or addiction. Compulsive shoppers repeatedly buy things they don't need and can't afford, causing guilt feelings, conflict in their personal lives, trouble at work, and financial difficulties. The habit can cause as much distress as psychiatric disorders like depression and anxiety.

Today, most psychiatrists regard compulsive buying as an impulse-control disorder that involves mounting tension before the act and a sense of relief afterward. But some experts prefer to view it as an addiction or a form of obsessive-compulsive disorder. It could also be a way of soothing painful feelings, or the opposite — a result of manic exuberance and recklessness. Some even question whether compulsive buying should be called a mental disorder at all. They suggest that the problem is a social one, produced by easy credit and pervasive advertising.

No doubt social influences are important, but there is strong evidence of a biological vulnerability as well. Compulsive buyers have a high rate of depression, alcoholism, and other psychiatric disorders, and so do their close relatives.

In the study (American Journal of Psychiatry, October 2006), researchers conducted telephone interviews with about 2,500 adults, asking about their spending habits: Were they spending to feel better? Did they feel as though they were losing control? Did they have money troubles as a result of their shopping?

Using a broad definition, the researchers found that about 6% of the population had problems with compulsive buying. That's two to four times higher than the rate of anxiety and depression. By a narrower definition, the rate of compulsive buying was 1.5%. Either way, it adds up to too many people spending too much money.

Incidentally, women and men were affected equally. The popular view that women are more likely to be shopaholics is apparently wrong.

Here are some questions a psychotherapist can ask about a person who may have a problem with compulsive buying:

• Does this person have an underlying depression? Are there mood swings that suggest bipolar disorder?

• Does the person have other problems with impulse control?

• Is the pattern of buying addictive? That is, does the person have an urgent need to shop and feel guilty or remorseful afterward? Does the person suffer from other addictions, such as alcohol, drugs, or gambling?

• Does the person have other obsessions and compulsions, such as a tendency to hoard objects?

• Is the spending causing family conflict?

• Has the person's work or career suffered?

• Does the person recognize the problem?

Researchers have begun to study some of the treatment options:

• Cognitive behavioral therapy was found effective in one small study

• Antidepressants have not proved specifically effective, but they may help if the person is also depressed

• Other addictions should always be treated at the same time

• Education and family support are essential.

If a compulsive shopper's life is unraveling, it may be necessary to try all these approaches at once.

Compulsive buyers can help themselves by combating the temptation of advertisements and packaging. They can find a trustworthy adviser and read a sensible book on managing finances. In severe cases, they may have to ask someone to hold back their paycheck and credit cards. Giving up control to others is tough, but it may be necessary for people who have lost control of themselves.

— Michael Craig Miller, M.D. Editor in Chief, Harvard Mental Health Letter

Last updated:	September 05, 2008