Generally speaking, “shop till you drop” is a lighthearted expression of the pleasure many consumers feel sauntering through malls and browsing store racks for just the right thing. For some, though, power shopping is not about finding value, and there’s nothing funny about it.

Dr. Timothy Fong, director of the UCLA Addiction Medicine Clinic, has seen people whose lives have been devastated by shopping addiction. There was the middle-aged woman who resorted to criminal activity to fund her habit. The man so hooked on the high he got from getting a good deal on a new car that he had a dozen of them sitting unused at home — along with several hundred thousand dollars in debt. Women with full racks of clothes that still had the price tags, men with garages full of gadgets they used once, if at all.

“When I tell people I study and work with patients who have shopping addiction, they often think it’s a joke,” Fong says. “But when you talk to these patients, it’s a very real problem for them.”

As we enter the peak holiday shopping season, it’s worth noting that there are some for whom compulsive shopping is an addiction as destructive as alcoholism, drug abuse and problem gambling, with consequences that can be equally severe: job loss, financial ruin, child abuse, divorce, suicide. But unlike the more commonly recognized addictions, there has been little to no funding for studies of compulsive shopping — and the “shopaholic” is more likely to be viewed with a chuckle than as someone in need of help.

Because of the dearth of studies, it’s not clear how widespread the problem is, but there are indications that it may be more common than one would assume. A Stanford researcher, applying diagnostic criteria to shopping addiction similar to what is used for drug and alcohol addiction, concluded from a nationwide telephone survey that 1 in 20 Americans could be classified as shopping addicts. Critics argued that this was simply labeling as an addictive disorder something that isn’t such a problem. Who doesn’t occasionally overspend?

To Fong, though, it is likely that as many as 1 in 20 consumers experience harm because of their shopping behavior. For some, it may be a case of the occasional binge to cope with depression or anxiety. For others, there are clear signs of addiction.

“A shopping addiction can be essentially indistinguishable from a cocaine or amphetamine addiction,” he says. “These are people who are struggling with their compulsion. As with any addictive disorder, there is a pathological urge to shop combined with an inability to stop the behavior — even though harm is coming from it.”

Fong offers the following advice for people with compulsive shopping behaviors and their family members:

Recognize the Signs

Fong typically starts with the same line of questioning when people want to know whether their habits should be cause for concern: What impact is the shopping having on the family unit? Is the relationship between spouses deteriorating? Is there depression or personality changes related to the shopping? Is the preoccupation causing the shopper to frequently miss work or pass up social engagements? Are there severe financial problems?

“If they tell me, ‘There’s a little bit of debt, but that’s life,’ that’s something we all experience from time to time,” he explains. “But if they say, ‘I can’t even talk to her about it because there are so many problems, the debt is insurmountable, we’re constantly arguing, and I’m thinking about leaving the marriage,’ that’s pretty obvious.”

Express Concern, Not Anger

Precisely because it is rarely acknowledged as a real problem, shopping addiction is often marked by playful arguments between spouses in the early stages. “And then it escalates and there is yelling, demands are made and not met, and no one ever thinks to seek help,” Fong says. “Many times, family members will personalize it and assume the shopper can control the behavior, but chooses not to out of spite.”

Fong urges anyone who thinks he or she has a shopping problem to tell someone, and for loved ones not to approach the problem shopper by saying “stop” or asking why, but by expressing concern for how the behavior is affecting the family.

Address What’s Driving the Behavior

Once the problem is recognized, the next step is examining the underlying issue driving the shopper’s inability to stop. If it’s depression, for example, often treating that condition is enough to improve the shopping behavior.

Identify the Triggers

Simply recognizing the things that instigate the compulsive behavior can be an important first step in dealing with the problem. Is it an argument with a spouse? A hard day at work? An ad promoting a sale? “We all have times where we are upset or feel angry or depressed, and we look for something to take the edge off,” Fong explains. “That’s when healthy people might turn to exercise, a glass of wine, or talking to their spouse, but those with addictive disorders turn to the behavior they know will help soothe them.”

Make It Difficult

In a consumer-driven society where people have free time and capital, temptations abound for the compulsive shopper. But there are practical steps that can set up barriers to the problem behavior. Fong advises his patients on everything from avoiding shopping alone to structuring their time so that there aren’t vulnerable periods in which they have nothing to do and the malls are open. Other strategies include never using credit cards, window shopping only when stores are closed, and adhering to a strict shopping list rather than going on open-ended excursions.

Seek Professional Help

For some, self-help strategies are not enough. Treatment options for shopping addiction, as with other addictive disorders, include a combination of individual psychotherapy, 12-step support groups, family therapy and medications to reduce the cravings. And as with other addictions, the road to recovery can be challenging.

“Patients will vow never to shop again, but obviously that’s not practical,” Fong says. “It’s important to recognize that change takes time.”