Shopping Addiction in Post-Stroke Patients: A Case Study

Regarding the shopping symptoms of mothers?

Hello, doctor.
My mother is fifty-six years old and had brain surgery three years ago due to a stroke.
Since the stroke, she has experienced a decline in memory and logical abilities.
Currently, she is taking sleep aids and antidepressants, but she can only sleep two to three hours a day and still feels energetic.
Her emotions are very unstable, and she often misinterprets what others say to her.
She frequently talks non-stop and harshly criticizes people and things she dislikes.
The biggest issue affecting our family recently is her compulsive shopping on television.
She buys several items daily, and when we took her to see a psychiatrist for a follow-up, the doctor asked her how much she spent.
She claimed to only spend two to three thousand NT dollars a month and insisted that there was no problem with storing items in our four-room house.
However, my father informed the doctor that she spends at least seventy to eighty thousand NT dollars each month, and our home is filled with boxes of unused items.
The doctor only advised my mother to reduce her shopping urges.
In the past few days, her shopping has intensified, and she has purchased diamond jewelry from television shopping.
She refuses to return the items, and no matter how we try to persuade her, she feels we are bullying her and becomes angry, believing we owe her.
She thinks my father should earn money for her to spend.
If this continues, our family will face serious financial difficulties.
Doctor, is there any way to help my mother? Thank you.

K, 30~39 year old female. Ask Date: 2015/07/08

Dr. Ding Shuyan reply Psychiatry

Hello,
In your letter, you mentioned that after the stroke and subsequent surgery, there has been a decline in memory and logical abilities, along with a recent pattern of daily shopping.
This suggests that these issues were not present before the stroke and are likely related to the sequelae of the stroke.
This condition is referred to in medicine as an organic mental disorder (as opposed to a psychogenic one), and pharmacological treatment is likely the first choice.
Psychological or behavioral therapies may be less effective and not provide immediate relief.

If you are seeing a doctor, it is important to communicate these symptoms to them.
The physician should actively consider adjusting the medication, and you should see results soon.
The compulsive shopping behavior, which resembles mania, cannot be addressed simply through gentle persuasion.
Controlling her spending may provoke emotional outbursts.

We might try to redirect her attention to other activities, such as arranging outings or finding someone to chat or sing with her about things she enjoys, rather than letting her sit in front of the television.
This approach may help reduce her spending.

Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2015/07/08

More Info

Understanding shopping addiction, particularly in the context of a post-stroke patient, requires a multifaceted approach that considers both the psychological and neurological aspects of the condition. Your mother’s situation is complex, as it involves the aftermath of a stroke, which can significantly affect cognitive functions, emotional regulation, and behavior.

Firstly, it’s important to recognize that your mother’s shopping addiction may be a manifestation of her post-stroke condition. After a stroke, individuals can experience changes in their cognitive abilities, including memory loss, impaired judgment, and difficulties with impulse control. These changes can lead to behaviors that were not present before the stroke. In your mother’s case, her compulsive shopping could be a way to cope with her emotional instability or a result of impaired judgment.

The fact that she is on medications for sleep and depression also complicates the situation. Antidepressants, particularly SSRIs (Selective Serotonin Reuptake Inhibitors), can sometimes lead to increased impulsivity in certain individuals. This could explain her inability to recognize the extent of her shopping habits and the financial strain it places on the family. It’s crucial to communicate these concerns to her psychiatrist or neurologist, as they may need to adjust her medication regimen to address these side effects.

Moreover, your mother’s perception of her shopping habits is skewed. She believes she is spending only a small amount, while the reality is much different. This disconnect can be attributed to cognitive impairments resulting from her stroke, where she may not fully grasp the consequences of her actions. This is often seen in patients with executive function deficits, where individuals struggle to plan, organize, and understand the implications of their decisions.

To address her shopping addiction, a combination of strategies may be necessary:
1. Medication Review: Consult her healthcare provider about her current medications. It may be beneficial to evaluate whether her antidepressants or sleep aids are contributing to her impulsive shopping behavior.

2. Cognitive Behavioral Therapy (CBT): Engaging a psychologist who specializes in cognitive behavioral therapy could help your mother develop better coping mechanisms and address her compulsive shopping behavior. CBT can assist her in understanding the triggers for her shopping and developing healthier habits.

3. Structured Activities: Encourage your mother to engage in structured activities that can occupy her time and attention. This could include hobbies, social activities, or physical exercise, which can help reduce the time she spends watching shopping channels.

4. Financial Management: Implementing a system for managing finances could help control her spending. This might involve setting a strict budget for discretionary spending or having a family member oversee her finances to prevent excessive purchases.

5. Support Groups: Consider finding support groups for compulsive shopping or for caregivers of individuals with cognitive impairments. These groups can provide valuable resources and emotional support for both your mother and your family.

6. Family Involvement: It’s essential for the family to remain involved in her care. Open and honest communication about the impact of her shopping on the family’s finances is crucial. However, it’s important to approach these conversations with empathy, as she may feel attacked or misunderstood.

In conclusion, your mother’s shopping addiction is likely a complex interplay of her post-stroke cognitive changes, emotional instability, and possibly the effects of her medications. A comprehensive approach that includes medical evaluation, psychological support, and family involvement will be key in helping her manage this behavior effectively. It’s important to work closely with her healthcare team to ensure that all aspects of her health are being addressed.

Similar Q&A

How to Manage Impulsive Urges and Anxiety Over Desires?

Doctor, I’m not sure what this situation is. In the past, whenever I saw something I liked, I would really want to buy it, but sometimes I would hold back due to a lack of money. I never experienced symptoms of being a "shopaholic." However, recently, whenever I see som...

Dr. Chen Zhicai reply Psychiatry
So muster the courage to face the issue and bravely seek medical help! Dr. Zhi Cai

Managing Behavioral Changes After Stroke: When to Seek Psychiatric Help

The mother-in-law has had a stroke for about 5 years, and the following behaviors have become increasingly frequent: 1. She often wakes up at night and disturbs others. 2. She forgets that she has already eaten. 3. She is never satisfied and constantly wants to eat. 4. She will g...

Dr. Lin Yuzhong reply Psychiatry
Hello, the issues mentioned above should indeed be addressed by a psychiatrist. In terms of mood, behavior, and sleep, psychiatric medications are effective; however, regarding bladder and bowel control as well as satiety function, it is likely that these are caused by stroke-rel...

Understanding Gambling Addiction and Impulse Control Issues

Hello Doctor, I am a person with obsessive-compulsive disorder, but today's issue may not be closely related to it. Here's the situation: Recently, I came across a foreign website related to an online game I usually play. The website allows users to use credit cards t...

Dr. Wang Yaoting reply Psychiatry
Hello: Your situation does not seem to reach the level of "gambling addiction." Gambling addiction is characterized by a persistent need to gamble, where individuals continue despite being aware of the negative consequences. They may feel restless, depressed, or irritab...

Addressing Sexual Desire in Stroke Patients: A Family's Dilemma

My father is 83 years old and has suffered from diabetes for many years. Last year, he had a cerebral embolism that led to a stroke, and now he is bedridden and completely unable to care for himself. Occasionally, he experiences delusions, and recently he expressed a desire for s...

Dr. Huang Yongquan reply Neurology
Hello: After a brain injury, the control and coordination functions may also be impaired, leading to symptoms such as dementia, hallucinations, disrupted sleep cycles, binge eating, and even abnormal sexual behaviors as you mentioned. These conditions can be treated with certain ...