Three years ago, “Ann” (not her real name) sat in on a meeting of Families Anonymous held in a local shoreline church basement. The roughly dozen men and women gathered were mostly parents or spouses of people suffering from alcoholism or drug addiction. Ann was neither.

“I’m the problem,” she said.

Through tears, she described relationships with her family that had eroded over the years—not because of Ann’s use of drugs or alcohol, but because of her compulsion to shop.

“All her life my daughter desperately wanted my attention, but all I could focus on was shopping,” she says.

By the time Ann sought help, she and her daughter—now in her 30s—were no longer speaking.

We’ve all heard the expressions—retail therapy, shop ‘til you drop. Whimsical storefront signs tease, “Your husband called. He said to buy anything you want.” But for people with compulsive buying disorder (CBD)—also known as oniomania—compulsive spending is no laughing matter. Though it is not given a separate diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, experts increasingly link compulsive buying—like other impulsive behaviors—to bipolar or other mood/anxiety disorders, problems with impulse control, or clinical addiction. For some people, compulsive shopping appears to go hand in hand with alcoholism or eating disorders, though the connection to substance abuse has been disputed.

While compulsive buying is often thought to affect primarily women, gender differences are still being studied; men are less likely to report that they like shopping and are more inclined to acknowledge that they “collect” objects. According to a 2006 Stanford University study, 6 percent of men and 5.5 percent of women are compulsive buyers.

Why Buy?

How to definitively classify CBD is a source of continued discussion and debate. Researchers and clinicians have variously linked CBD to addiction, obsessive-compulsive disorder (OCD), and mood disorders. University of Sussex psychology professor Dr. Helga Dittmar suggests that “self-discrepancy,” which has been implicated in alcohol abuse, eating disorders, and sexual promiscuity, is a driving force behind compulsive buying. The buying process is deeply psychologically motivated and meaningful, she says, and addictive buying is a way of constructing an identity. The reason problem shoppers invest heavily in status-boosting clothes, shoes, luxury items, body care, and high-end electronics may be that these types of possessions reduce the discrepancy between a person’s self-image and actual self. After a brief boost in self-image, however, the moderating effect wears off—triggering the need to buy more.

Dittmar notes that triggers for compulsive shoppers may be situational (for example, magazine ads or sales), cognitive (feelings of guilt or entitlement), interpersonal (buying after a fight, attempting to impress peers), emotional (feeling excited, sad, lonely, stressed, or euphoric), and physical (as a substitute for eating).

Unlike the occasional shopping spree, CBD is characterized by an obsession with buying—excessive retail activity that has profoundly negative emotional, interpersonal, and often financial consequences. People with CBD experience a preoccupation with shopping, tension or anxiety before buying, and a sense of relief following their purchase. A comparison of the compulsive consumer and the ordinary shopper shows that non-addicted consumers focus more on a product’s use or value, whereas the addicted shopper places a premium on status, and the primary motive is a mood change.

“It’s a form of self-medication,” says Tony Corniello, vice-president of clinical services at BHcare in North Haven, a nonprofit behavioral health organization that specializes in mental health services.

CBD may take the form of gambling, giving extravagant gifts or charitable donations, making irrational investments or business deals, or simply spending significantly more than one can afford. While those who exhibit CBD come from all social backgrounds, studies point to strong gender differences, with females shopping as a form of “identity repair” (for example, buying clothes, shoes, and cosmetics) and males hoarding expensive items or indulging in competitive auctions.

“The true psychological source of a person’s compulsive spending tendencies is difficult to pinpoint,” says Corniello, “and it has been linked to many other psychological conditions. We see it primarily as one of numerous symptoms associated with a diagnosis such as bipolar disorder, while an individual is experiencing mania. It could also be symptom of someone with obsessive compulsive disorder or a type of addictive disorder like excessive gambling.”

Retail Therapy

For compulsive shoppers, financial and employment-related consequences are often severe and include loan default and other credit problems, overdrafts, embezzlement, and poor work performance.

For Ann, however, financial insecurity was not the main issue.

“The problem wasn’t that I couldn’t afford it,” she says. “It’s that we just didn’t need more stuff.”

The aftershocks were interpersonal (secretiveness, fights), emotional (shame and depression), and spiritual (lost community spirit and a mismatch of values and lifestyle). Ann and her daughter eventually became estranged.

Though she tried finding a self-help group for her specific problem, Ann turned up empty-handed.

“I came to Families Anonymous because I didn’t know where else to turn,” she says.

Indeed, support groups for people with compulsive buying disorder (CBD) are not common—only five towns in Connecticut host Debtors Anonymous meetings, none of which are held along the shoreline—and the disorder itself is still not well-understood.

To get to an appropriate diagnosis and the right help, says Corniello, it is important to complete a full psychological/addiction assessment and treat the diagnosis or diagnoses.

“In our experience,” says Corniello, “people usually seek treatment after they experience significant interference in their functioning in one or more areas of their lives. They become motivated to seek treatment when they or a significant other experiences distress related to compulsive buying. They may come in of their own will or because of pressure from a friend or family member. Sometimes it’s pressure from the legal system or child protective services. Someone with this issue should seek out a behavioral health treatment provider to be assessed and to identify and treat both the symptom and other underlying issues.”

Treatment and management of CBD can include a combination of approaches, including medications for the underlying condition, such as bipolar disorder; cognitive behavioral therapy to challenge distorted thinking; couples counseling; financial counseling; and treatments targeted at addictions such as gambling.

“The only way to determine if it’s simply someone who needs financial coaching versus someone who needs treatment,” says Corniello, “is through an assessment.”

Also helpful in understanding and managing CBD is keeping a journal—chronicling your shopping habits in order to better understand how, when, and why you shop. Conduct a self-interview and ask: Why am I here? How do I feel? Do I need this? What if I wait? How will I pay for it? Where will I put it? Develop a shopping pattern checklist that covers things such as when and where you shop, with whom or for whom, what kinds of goods or services you buy, and how you give yourself permission to overshop. A counselor can help you identify your patterns and triggers, demagnetize or resist the pull and pressure to consume, avoid “danger zones,” reduce exposure, counter social pressure, create better alternatives, and shop mindfully—with a plan.

Becoming financially fit also includes learning how to budget, save, track spending by categories, and cut back on the use of credit cards. Free financial literacy coaching is available by appointment to individuals and couples through the Women & Family Life Center in Guilford. Sessions are generally offered on the third Wednesday and Friday of the month. (Upcoming dates are June 16 and 21 and July 19 and 21. To schedule an appointment, call 203-458-6699.) Debt counseling and financial planning services for individuals with an underlying mental health or addiction disorder are also available through BHCare. Your town may also offer free or low-cost financial counseling or referrals; to learn more, contact your local social services department.