The urge to steal- kleptomania: Part 1

Kleptomania is the overwhelming urge to steal items that one really does not need or have little value. Kleptomania is a serious social problem as it can create havoc in a person’s life if it is not treated early. The impulse to steal is very strong and people have no control over it. Unfortunately, because of the taboo associated with the diagnosis of “thief” most people with this disorder remain silent and never seek therapy. Most people only seek treatment when they are caught and in legal difficulties. 

The symptoms of kleptomania may include1) an irresistible urge to steal items not needed 2) a heightened stress just prior to the steeling 3) feeling delight to fulfillment while stealing and 4) feeling intense guilt or disgrace after the theft.

What must be understood is that unlike the typical shoplifter, kleptomaniacs do not steal for personal gain nor do they commit the theft as a means of revenge. The stealing is done because of the intense urge that is beyond control. Until they steal, these individuals feel anxious, tensed, and extremely hypersensitive. To resolve these feelings they steal.

Kleptomania occurs spontaneously and is rarely a planned event. Sometimes a simple argument may trigger an episode of kleptomania. Kleptomaniacs may steal from public places, from friends and family or from work. Men tend to steal “hard” items whereas many women steal jewelry, undergarments or private letters. In many cases, the same items are repeatedly stolen and there may be an ingredient of fetishism.

Schizoaffective Disorder: Part 2

Like most psychiatric disorders, diagnosis is based on clinical features. Most physicians will also perform laboratory tests to ensure that the effects are not due to illicit drugs or any other medical disorder like HIV, temporal lobe epilepsy, hypothyroidism or prolonged steroid usage.

Individuals with schizoaffective disorder usually require both medications and psychotherapy. Both anti psychotics and mood stabilizing drugs are used to treat these individuals. Psychotherapy can help diminish distorted or negative thoughts, improve social skills and boost self-confidence. Family or group therapy has been found to be more effective in helping people deal with real life issues. Family group therapies also provide a decrease in social isolation and helps maintain a check on the psychotic episodes.

The overall prognosis for patients with schizoaffective disorder is better than those with schizophrenia but treatment is life long. Unfortunately, most people tend to develop severe depression or mania and eventually become non-complaint with therapy. Many end up with legal problems and remain confined to psychiatric facilities.

Schizoaffective Disorder: Part 1

Schizoaffective disorder is a mental health disorder where an individual experiences a mixture of schizophrenia symptoms (hallucinations, paranoia or delusions) and of mood disorder symptoms (mania or depression).

The majority of individuals with schizoaffective disorder are loners and have difficulty holding jobs or attending school. Most end up living in a group homes or in a psychiatric facility. The symptoms of schizoaffective disorder are variable and range from paranoia, delusions, strange perceptions, hallucinations, disorganized thinking and paranoid thoughts — as well as a mood disturbance, such as depressed or manic mood. Other features may include bizarre thoughts like suicide or homicide, deficits in attention and memory, lack of concern for hygiene, change in appetite and profound sleep disturbances. These individuals are very antisocial and are usually shunned by people around them.  Most of these individuals are simply not able to function in society because the variety of symptoms which can be quite intense.

In many cases, the psychotic features and mood disturbances may appear in the same setting or may cycle on regular intervals. The major problem with schizoaffective individuals is that they rarely seek treatment on their own; most are brought to medical attention by concerned family members or law enforcement.

The cause of schizoaffective disorder is not known but believed to be due to an imbalance of certain brain neurotransmitters. Some experts speculate that exposure to chemicals during pregnancy or a viral illness may be responsible for the illness.

Agoraphobia: Fear of Spaces Part 2

While agoraphobia is not life threatening, it can severely limit one’s life style. Without treatment, many people are not able to leave their home. These individuals become entirely dependent on others for food, money or any other type of daily living activity. With time, depression and anxiety set in and many of these individuals turn to alcohol/substance abuse to help cope with the loneliness, seclusion and shame.

The treatment of agoraphobia is taxing and usually means facing one’s fears. The basic treatments include medications and psychotherapy. Current medications used to treat these individuals include SSRIs like Paxil, Zoloft or Prozac. Additional medications may include an anti anxiety medication like xanax or clonazepam. Drug treatment alone is seldom sufficient for control of agoraphobia and several types of psychotherapy may help. Cognitive behavior therapy helps change detrimental behaviors through desensitization. One also learns methods to cope with symptoms via relaxation techniques. For those who are afraid to leave the home to visit a psychotherapist, one can arrange treatment sessions at home or in a safe neighborhood.  Of course, this also adds to the expense and more importantly, psychotherapy is not cheap.
Self-care remedies that may help cope with agoraphobia include learning reassuring skills, practicing relaxation techniques, and not avoiding feared spaces. There are many online support groups where one can reach out for help. 

The overall prognosis of individuals with agoraphobia depends on the severity of symptoms. If medications are discontinued, relapse is common. Transient improvements do occur but overall most individuals lead a poor quality of life.

Agoraphobia: Fear of Spaces Part 1

Agoraphobia is a type of anxiety disorder that is linked to fear. Individuals who have agoraphobia generally have fear of being in a place where they do not feel safe. Individuals with agoraphobia usually avoid places where they feel they may develop a panic attack. In general, most public places are avoided because of the irresistible fear that they may not be able to seek help. The majority of these individuals remain trapped in their homes, where they feel safe and live a life of seclusion.

The typical symptoms of agoraphobia include extreme fear of being alone, fear of being in a crowded places, fear of losing control in a public place, feelings of insecurity when leaving the home, a dreadful sense of helplessness when outside the home, extreme dependence on others and a feeling that body is imaginary. The physical symptoms are similar to a panic attack and may include dizziness, fast heart rate, difficulty breathing, nausea, flushing, chest pain, feeling a loss of control, difficulty swallowing and stomach upset.
Some experts believe that agoraphobia is simply an extension of panic disorder. However not all individuals with a panic disorder develop agoraphobia.

Agoraphobia usually starts in late adolescence and peaks in the 2/3^rd decade of life. It is estimated that nearly 1-5 percent of individuals develop some degree of agoraphobia during their lifetime. The disorder tends to affect women more than men. Like most mental disorders, the exact cause of agoraphobia is a mystery. Rick factors for agoraphobia include having a diagnosis of panic disorder, having experienced physical, sexual or emotional abuse during childhood, tendency of being edgy or anxious, having a history of alcohol/substance abuse, and being a female.

Antisocial Personality Disorder Part 2

Antisocial personality disorder occurs in 5 % of men and about 1% of women, but these numbers are believed to be under estimates. As the disorder progresses, there is severe depression, anxiety, suicidal and reckless behavior, violence, risky and impulsive behavior, incarceration, alcohol and drug abuse and difficult interpersonal relationships. The majority end up being loners. The diagnosis of antisocial personality is based on the history.


Like many mental disorders, the treatment of anti social personality disorder is multidisciplinary. Treatment options vary from psychotherapy, stress and anger management and use of medications.

Psychotherapy and anger management are widely used to treat antisocial personality disorder but most of these individual have very little insight into their behavior and are not compliant with therapy. These individuals never voluntary seek treatment but only come to treatment when compelled to do so by law enforcement or risk incarceration.

Unfortunately there are no medications to cure this disorder. However, those who are depressed or anxious may be prescribed anti depressants or mood stabilizers. Extreme agitation or psychosis is often treated with anti psychotics. Those who are not able to manage themselves or in danger of harming themselves or others are often admitted to the hospital.

The prognosis for antisocial personality disorder is poor. Most treatments do not work chiefly because these individuals are not compliant with therapy and refuse to seek help. Because there is no way to prevent this disorder, experts recommend identifying those at the highest risk such as children who are abused or neglected. Taking steps at an early age can help boost self esteem and increase confidence. Both parents and teachers may be able to spot signs of trouble in early childhood and this is the point in time when behaviour therapy can help make a big difference in outcomes.