Compulsive buying disorder
Compulsive buying disorder (CBD), or oniomania (from Greek ὤνιος ṓnios "for sale" and μανία manía "insanity"), is characterized by an obsession with shopping and buying behavior that causes adverse consequences. According to Kellett and Bolton, compulsive buying "is experienced as an irresistible–uncontrollable urge, resulting in excessive, expensive and time-consuming retail activity [that is] typically prompted by negative affectivity" and results in "gross social, personal and/or financial difficulties". Most people with CBD meet the criteria for a personality disorder. Compulsive shopping is classified by ICD-10 (F63.8) as an "impulse control disorder, not otherwise classified." Several authors consider compulsive shopping rather as a variety of dependence disorder.
Emil Kraepelin originally described oniomania 1924, and he and Bleuler both included the syndrome in their influential early psychiatric textbooks. However, little interest was taken in CBD until the 1990s, and, even in the 21st century, compulsive shopping can be considered a barely recognised mental illness.
CBD is frequently comorbid with mood, anxiety, substance abuse and eating disorders. People who score highly on compulsive buying scales tend to understand their feelings poorly and have low tolerance for unpleasant psychological states such as negative moods. Onset of CBD occurs in the late teens and early twenties and is generally chronic. Compulsive buying disorder usually mainly affected young people as several reports put in that most interviewees reported to be in the range of 17.5-19 years. The phenomenon of compulsive buying tends to affect women rather than men. The aforementioned reports on this matter indicated that the dominance of the majority group is so great that it accounts for about more than 90% of the affected demographic.. Zadka and Olajossy, suggest the presence of several similar tendencies between consumer type mannerism and pathologic consumption of psychoactive elements. These tendencies include a constant need to consume, personal dependence, and an affinity to lack of sense of control over self-behavior. Additionally, Zadka and Olajossy stated that one could conclude that individuals ailing from this disorder are often in the second decade to fourth decade of their lives and exhibit mannerisms akin to neurotic personality and impulse control disorders.
CBD is similar to, but distinguished from, OCD hoarding and mania. Compulsive buying is not limited to people who spend beyond their means; it also includes people who spend an inordinate amount of time shopping or who chronically think about buying things but never purchase them. Promising treatments for CBD include medication such as selective serotonin reuptake inhibitors (SSRIs), and support groups such as Debtors Anonymous.
Research revealed that 1.8 to 8.1 percent of the general adult population have CBD and that while the usual onset is late adolescence or early adulthood, it is often recognized as a problem later in life.
Compulsive Buying Disorder is tightly associated with excessive or poorly managed urges related to the purchase of the items and spending of currency in any form; digital, mobile, credit or cash.
The terms compulsive shopping, compulsive buying, and compulsive spending are often used interchangeably, but the behaviors they represent are in fact distinct.  One may buy without shopping, and certainly shop without buying: of compulsive shoppers, some 30 percent described the act of buying itself as providing a buzz, irrespective of the goods purchased.
CBD often has roots in early experience. Perfectionism, general impulsiveness and compulsiveness, dishonesty, insecurity, and the need to gain control have also been linked to the disorder. From a medical perspective, it can be concluded that impulsive control disorder is attributed to the yearning of positive stimulus. The normal method of operation in a healthy brain is that the frontal cortex regulation handles the activity of rewarding. However, in individual with behavior disorders, this particular system malfunctions. Scientists reported compulsive buyers have significant changeable activity in this area of the brain.
Compulsive buying seems to represent a search for self in people whose identity is neither firmly felt nor dependable, as indicated by the way purchases often provide social or personal identity-markers.  Those with associated disorders such as anxiety, depression and poor impulse control are particularly likely to be attempting to treat symptoms of low self-esteem through compulsive shopping.
Others, however, object that such psychological explanations for compulsive buying do not apply to all people with CBD.
Social conditions also play an important role in CBD, the rise of consumer culture contributing to the view of compulsive buying as a specifically postmodern addiction, particularly with regard to internet buying platforms.
Readily available credit cards enable casual spending beyond one's means, and some would suggest that the compulsive buyer should lock up or destroy credit cards altogether. Online shopping also facilitates CBD, with online auction addiction, used to escape feelings of depression or guilt, becoming a recognizable problem.
What differentiates CBD from healthy shopping is the compulsive, destructive and chronic nature of the buying. Where shopping can be a positive route to self-expression, in excess it represents a dangerous threat.
Materialism and image seekingEdit
A social psychological perspective suggests that compulsive buying may be seen as an exaggerated form of a more normal search for validation through purchasing. Also, pressures from the spread of materialist values and consumer culture over the recent decades can drive people into compulsive shopping.
In a global context where we are all encouraged to "shop till we drop"—compulsive shopping inevitably poses the further question, "Minority pathology or Mass problem?" With advertisements offering not so much products as narratives (of success, glamour) to identify with, compulsive buying may seem only an extreme aspect of what consumer culture demands from us all.
Companies have adopted aggressive neuromarketing by associating the identification of a high social status with the purchasing of items. They strive to bring out such an individual as a sort of folk hero for having the ability to buy several items. As a result, according to Zadka and Olajossy, the act of shopping is then associated with the feeling of being of a higher social status or that of one climbing the social ranks. Zadka holds that these companies are taking advantage the frailties of peoples’ egos in an attempt to get them to spend their money.
Symptoms and courseEdit
Diagnostic criteria for compulsive buying have been proposed:
1. Over-preoccupation with buying.
2. Distress or impairment as a result of the activity.
4. Constant obsessing with buying as well as being dissatisfied all the time.
While initially triggered by a perhaps mild need to feel special, the failure of compulsive shopping to actually meet such needs may lead to a vicious cycle of escalation, with sufferers experiencing the highs and lows associated with other addictions. The 'high' of the purchasing may be followed by a sense of disappointment, and of guilt, precipitating a further cycle of impulse buying. With the now addicted person increasingly feeling negative emotions like anger and stress, they may attempt to self-medicate through further purchases, followed again by regret or depression once they return home, leading to an urge for buying more. The aforementioned symptoms are aggravated further by the availability of money through access to credit cards and easy bank loans.
As debt grows, the compulsive shopping may become a more secretive act. At the point where bought goods are hidden or destroyed, because the person concerned feels so ashamed of their addiction, the price of the addiction in mental, financial and emotional terms becomes even higher.
Individuals who can be considered addicted to shopping are observed to exhibit repetitive and obsessive urges to go buy items especially when in the vicinity of an environment that supports this venture such as a mall. In this locations, they mostly purchase things that are cheap and of low value mainly just to satisfy the urge to spend. Normally, these items end up being returned to the shop they were brought from or just disposed of entirely after a while. However, according to Zadka and Olajossy, this rarely works as these individuals are known to have low self-esteem.
The consequences of compulsive buying, which may persist long after a spree, can be devastating, with marriages, long-term relationships, and jobs all feeling the strain. Further problems can include ruined credit history, theft or defalcation of money defaulted loans, general financial trouble and in some cases bankruptcy or extreme debt, as well as anxiety and a sense of life spiraling out of control. The resulting stress can lead to physical health problems and ruined relationships, or even suicide.
Additionally, the ingestion of medication to combat this disorder may lead to more problems. Further issues can come up, for instance; one may take in substances that they are allergic to thereby leading to unwanted developments. Also, Zadka and Olajossy state that it is quite easy for one to develop a tolerance toward these medication which will force the unfortunate individual to take a larger dosage which is detrimental to their health overall. They believe that 60% of patients who have been taking antiviral medication have experienced an occurrence of neuropsychiatric disorders.
Treatment involves becoming conscious of the addiction through studying, therapy and group work. Research done by Michel Lejoyeux and Aviv Weinstein suggests that the best possible treatment for CBD is through cognitive behavioral therapy. They suggest that a patient first be "evaluated for psychiatric comorbidity, especially with depression, so that appropriate pharmacological treatment can be instituted." Their research indicates that patients who received cognitive behavioral therapy over 10 weeks had reduced episodes of compulsive buying and spent less time shopping as opposed to patients who did not receive this treatment (251).
Lejoyeux and Weinstein also write about pharmacological treatment and studies that question the use of drugs on CB. They declare "few controlled studies have assessed the effects of pharmacological treatment on compulsive buying, and none have shown any medication to be effective." (252) The most effective treatment is to attend therapy and group work in order to prevent continuation of this addiction.
Hague et al. reports that group therapy rendered the highest results as far as treatment of compulsive buying disorder is concerned. He states that group therapy contributed to about 72.8% in positive change in the reduction of urges of compulsive spending. Additionally, he notes that psychotherapy may not be the treatment of choice for all compulsive buying disorder patients since the suitability of the treatment method to the patient is also an important consideration. He holds that the treatments of the disorder are required to provide a certain reflection of the context in which this phenomenon manifests. 
Selective serotonin reuptake inhibitors such as fluvoxamine and citalopram may be useful in the treatment of CBD, although current evidence is mixed. Opioid antagonists such as naltrexone and nalmefene are promising potential treatments for CBD. A review concluded that evidence is limited and insufficient to support their use at present, however. Naltrexone and nalmefene have also shown effectiveness in the treatment of gambling addiction, an associated disorder.
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