Writing on an eating disorders message board, Kristi (not her real name) gives a compelling account of another addiction:

Last night I went to three different stores and spent several hundred dollars in, oh, an hour or so. What did I buy? I have no idea. Lots of clothes. Do I need any clothes? No. I still have shopping bags laying on the floor from my last shopping trip that I haven’t even opened. It’s just like something I feel like I have to do or I’ll literally panic and I’m in almost a trance when I do it. Then I get home and throw the bags on the floor and they stay there until I decide I want to see what’s in them. Last night was like a shopping binge. Just like a food binge or an alcohol binge. I think it serves the same purpose for me. I was completely numbed out when I was buying all this stuff. I have maxed out two Mastercards and I’m well on my way with another. I’m in so much debt it’s not even funny. So, I’m doing well with my eating disorder and drinking right now, but as you can see I’m far from OK. I still need an addiction. Why does it always have to be something? I’m also getting ready to give up all my credit cards to a consumer credit agency, so I hope that will help. Otherwise, I’ll be in even worse trouble bouncing hot checks everywhere.

By whatever name — compulsive shopping, shopping disorder or shopping addiction — Kristi is describing a type of craving that is causing serious problems in her life.

She could be talking about an addiction to alcohol or gambling or sex, says Jerrold Pollak, Ph.D., a psychologist with Seacoast Mental Health Center in Portsmouth, N.H. “Compulsive shopping is not a well-defined disorder, and it’s not a stand-alone condition. It’s usually linked to other problems such as depression, anxiety or self-esteem issues.”

Binge Shopping

Just as Kristi is trying to overcome an eating disorder and drinking problem, shopping is often only one addiction a person is battling.

“It’s not unusual for a person to have several addictions, and one gets worse when another seems to be getting better,” said Tom Horvath, Ph.D., author of “Sex, Drugs, Gambling and Chocolate: A Workbook for Overcoming Addictions.”

The behavior itself, Pollak says, seems to serve to provide relief for depression or anxiety or to bolster self-esteem. In that regard, out-of-control shopping is like a lot of other conditions and can serve as a psychological defense.

“It has the same trajectory cycle as other addictive behaviors. An urge builds to the point that a person gives into it. The activity itself may offer a rush of euphoria. Then comes the crash and remorse, accompanied by a great deal of shame and guilt,” said Pollak, who has treated a number of compulsive spenders. Compulsive shopping may have a biochemical component, Pollak suggests. And one of the first things that needs to occur is a screening for bipolar disorder because excessive spending often is seen in the manic or hypomanic phase of that disorder. However, most compulsive spenders do not have this condition.

Who Is a Compulsive Shopper?

It is s believed that women are more affected by the disorder. However, Pollak points out that men are less likely to join research efforts or acknowledge such problems. In broad categories, women generally buy cosmetics, clothing and jewelry, while men tend to purchase electronics or sports equipment. Some compulsive shoppers buy only certain items. Pollak recalls a patient who was obsessed with purchasing movie promotional items, for example.

“To look at the person, you would have no idea they have a problem,” said Catherine Steinberg, M.A., M.F.T., a marriage and family therapist who facilitates groups for compulsive shoppers in Guilford, Conn. “They tend to be higher energy and generally don’t appear to be depressed.”

But underneath that exterior is someone who, she says, often doesn’t feel good enough, so being dressed well and wearing lots of jewelry is used to enhance a weak self-image.

“Some people,” Steinberg said, “don’t have a lot going on in their lives, so shopping is a way to fill time. Or looking for bargain buys becomes a form of excitement for them. Some women will track prices for months. This is an adventure for them and gives them a sense of accomplishment when they finally purchase something at a rock-bottom price.”

Steinberg adds that other women use spending money as a way to get back at their husbands. It’s a way of exercising power and control and having an effect, she says. She also finds that about 60 percent of the members in her group have an eating disorder. “They’re seeing the outside world as the way to bring them gratification,” Steinberg said.

Some people don’t realize that they’re using shopping as other people use food, alcohol or drugs.

“It’s a societal and cultural issue that’s not taken seriously or seen as an issue. ‘Shop ’til you drop’ is considered a cool thing to do,” Pollak said.

And while compulsive shopping can intensify during the holidays, it’s a problem that is present throughout the year.

Are You Out of Control?

Pollak, Horvath and Steinberg say to look for the following signs to determine if you have a shopping problem:

  • Continuously buying things that aren’t needed.
  • Buying things you can’t afford.
  • Incurring significant debt and other financial problems because of shopping.
  • Having a sense of exhilaration during shopping; feeling guilty after shopping.
  • Dealing with anger from family members about the purchasing and debt incurred.
  • Not feeling right when not shopping.
  • Having problems with relationships over shopping.
  • Hiding purchases or debts.

Another Look at the Disorder

Pollak believes that shopping disorders appear to fall within the impulsive/compulsive spectrum. That is, if it’s an impulsive behavior, a person buys something very quickly, often without thinking, to get rid of or avoid some bad feeling. Others may be burdened with obsessive-compulsive pulls, which are “overwhelming, intrusive urges that they try to fight off and eventually give into,” Pollak said.

Making the Decision to Change

In his experience, Pollak sees the greatest success in overcoming shopping disorders in patients who take responsibility. “They’re not blaming others for their behavior or denying that they have a problem.”

All addictive behaviors stop, according to Horvath, when the person comes to realize that the activity just isn’t worth the agony it causes. “It’s a decision. At some point, you just say ‘enough!'”

In his workbook, Horvath has the patient complete a very careful and thorough cost-benefit analysis. “They are asked to evaluate the problem in terms of its impact on their health, relationships, finances, etc. This exercise helps them make a decision that it’s time to stop.”

Next, the person has to learn how to deal with the craving, Horvath says. “The tension, or craving, will go away if it’s not acted upon. The fact that after fasting from food for 24 hours hunger disappears is proof of this.”

Practical recovery for Horvath’s patients also involves dealing with cravings. He tells patients three things about craving:

  • It’s going to go away.
  • It may be painful, but it’s not harmful.
  • The craving is not forcing a person to do anything.

“I tell patients they are in control. They’ve allowed themselves to believe they’re not,” Horvath said.

If there is a willingness to change, motivation comes from taking a thorough look at the negative consequences. Then once cravings are put into perspective and brought under control, Horvath says, psychotherapy is usually necessary to deal with the underlying problems.

Behavioral Changes

Here are ways to overcome compulsive shopping, according to the experts:

  • Own up to the problem. Let people in your life know that your spending habits are out of control.
  • Acknowledge the accumulated debt situation and seek help in developing a plan for resolving it. Most communities have a consumer credit counseling service.
  • Get rid of credit cards. Buy only what you can pay for with cash or by check.
  • Create a budget and track spending. Pollak likens it to a diet and calorie counting.
  • Develop and stick with a weekly savings plan that is dedicated to nonessential purchases.
  • In the beginning, go shopping with a buddy.
  • Don’t go shopping unless you have list of specific items to buy and avoid malls.
  • Seek an assessment from a qualified mental health professional to rule out bipolar disease and to address the underlying psychological or emotional issues.
  • If there is significant accompanying depression, seek medical help to learn if antidepressants could be helpful. It may be that biochemical factors contribute to the destructive behavior.
  • During counseling, be frank with the professional about the shopping problems as well as other concerns, including other addictive behaviors.
  • Consider attending meetings of self-help groups such as Debtors Anonymous, a 12-step program modeled after Alcoholics Anonymous.

Getting Help

Kristi has been in therapy for two years “trying to recover from all my disorders.” She may be filing bankruptcy to resolve the financial consequences of her binge shopping, and offers this advice to others who may be suffering similarly: “Most of us are using shopping or food to fill an empty hole inside of us. That hole is never going to be filled until you look at yourself and start making changes within you.”