Editor's note: Donald W. Black, professor of psychiatry at the University of Iowa, is the author of "Bad Boys Bad Men: Confronting Antisocial Personality Disorder (Sociopathy), Revised and Updated."
(CNN) -- So now the world knows that Buzz Bissinger likes to shop. Really likes it. In a detailed essay in GQ magazine, the famous writer confessed to spending more than $600,000 in the past two years. "Is this for real?" -- you may wonder. Could a man be so into clothing he would shell out that much money to worship at the temple of Gucci?
Believe it or not, shopping can be an addiction. Upwards of 6% of the U.S. adult population shops compulsively, and most are women. It tends to start early in the teen years or early 20s, and it can rapidly become chronic.
For some people, shopping is a major leisure activity. For others, it can be like nicotine, alcohol or other drugs. In other words, those addicted to shopping find it difficult or even impossible to quit. These are the compulsive shoppers whose lives are organized around a variety of shopping experiences.
Buzz may or may not fit the bill, but he acknowledges his shopping is a problem: "It isn't drugs or gambling ... but there are similarities."
Most compulsive shoppers are ordinary people, although the problem has been noted among the rich and powerful for hundreds of years. Famous examples include:
-- Marie Antoinette, during the turbulent time before the French Revolution, was known for her extravagances.
-- Mary Todd Lincoln had spending binges that greatly distressed her husband.
-- Publisher and magnate William Randolph Hearst had an insatiable appetite for art and antiques that nearly drove him to bankruptcy during the Great Depression in the 1930s.
-- Jacqueline Kennedy Onassis, known for her personal charm and great fashion sense, was an obsessive shopper whose uncontrolled behavior dismayed both of her husbands.
Some might assume compulsive shopping is relatively recent -- perhaps a product of Madison Avenue. But the disorder has always been around, manifesting itself in various forms. It is also found worldwide, except perhaps among the world's poor.
It is a clinical disorder?
Compulsive shopping was described over a century ago by German psychiatrist Emil Kraepelin. Even today, his description remains fresh. Apart from the dated language, it could have been written yesterday.
Its hallmark is excessive shopping and spending behavior that leads to a sense of personal distress. It often impairs a person's life in some way (finances, marriage, family).
Compulsive shoppers have reported experiencing a sense of tension or anxiety before buying and feeling a sense of relief after a purchase. They tend to spend many hours each week shopping and spending. Most tend to focus on clothes and shoes and seem to be intensely interested in fashion and design.
Compulsive shopping has little to do with income, though money does determine the shopping venue. Ordinary Iowans, for example, shop compulsively at discount stores rather than Saks Fifth Avenue. And because the Internet allows shopping 24/7, its impact on shopping addiction can be considerable.
Most compulsive shoppers have other problems as well, including depression, anxiety or other addictions, including compulsive sexual behavior, Internet addiction or compulsive gambling. These disorders "travel" together, so to speak. There is no special "shopping" personality, though I hear patients from time to time say they have an "addictive" personality.
The good news is that we know a lot more about compulsive shopping than 20 years ago. The bad news is that we have no standard treatments. That said, cognitive therapy as pioneered by Dr. April Benson can be effective in curbing shopping appetites.
To those who call seeking advice, I tell them: Don't shop alone and get rid of your credit cards and checkbooks. For those who shop on the Internet, either stop your Internet service or put your home computer in the kitchen or other place where family members can see it and will try to temper your enthusiasm.
You must try and find other meaningful ways to spend your time. Get to it!
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The opinions expressed in this commentary are solely those of Donald W. Black.