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Pyromania is an obsession with fire and starting fires in an intentional fashion. An individual with pyromania is referred to as a pyromaniac. In colloquial English, the synonyms "firebug" and "firestarter" are sometimes used. Pyromaniacs are identified specifically as not having any other symptoms but obsession with fire causing their behavior. It is distinct from arson, and pyromaniacs are also distinct from those who start fires because of psychoses, for personal, monetary or political gain, or for acts of revenge. Pyromaniacs start fires to induce euphoria, and often tend to fixate on institutions of fire control: fire stations, firefighters, etc.

Etiology
There is little known about this impulse control disorder, except some research suggesting there is an environmental component arising in early childhood. Few scientifically rigorous studies have been done on the subject, but psychosocial hypotheses suggest pyromania may be a form of communication from those with few social skills, or an ungratified sexuality for which setting fires is a symbolic solution. Medical research also suggests a possible link to reactive hypoglycemia or a decreased concentration of 3-methoxy-4-hydroxyphenylglycol and 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid. Some biological similarities have been discovered, such as abnormalities in the levels of the neurotransmitters norepinephrine and serotonin, which could be related to problems of impulse control, and also low blood sugar levels. Children who are pyromaniacs often have a history of cruelty to animals. They also frequently suffer from other behavior disorders and have learning disabilities and attention disorders. Other studies have linked pyromania to child abuse.

Symptoms and diagnosis
Pyromaniacs are known to have feelings of sadness and loneliness, followed by rage, which leads to the setting of fires as an outlet. For a positive diagnosis, there must be purposeful setting of fire on at least two occasions. There is tension or arousal prior to the act, and gratification or relief when it is over. It is done for its own sake, and not for any other motivation. It is all about the pleasure of seeing what other people have to do to extinguish the fire, and the pyromaniac may enjoy reading of the effects of what they have done.

Incidence and demographics
Pyromania is a very rare disorder, and the incident of it is less than one percent in most studies; also, pyromaniacs are a very small proportion of psychiatric hospital admissions. Pyromania can occur in children as young as age three, but it is rare in adults and rarer in children. Only a small percentage of children and adolescents arrested for arson have pyromania. Ninety percent of those diagnosed with Pyromania are male. Based on a survey of 9282 Americans using the Diagnostic & Statistical Manual on Mental Disorders, 4th edition, impulse-control problems such as gambling and pyromania affect 9% of the population. And a 1979 study by the Law Enforcement Assistance Administration found that only 14 percent of fires were started by pyromaniacs and others with mental illness.

Treatment
Behavior modification is the usual treatment for pyromania. Other treatments include seeing the patients actions as an unconscious process and analyzing it to help the patient extinguish the behavior. Often, this treatment is followed by a more psychodynamic approach that addresses the underlying problems that generated the negative emotions causing the mania. The prognosis for treatment is generally fair to poor. Treatment appears to work in 95% of children that exhibit signs of pyromania, which include family therapy and community intervention. Selective serotonin reuptake inhibitors (SSRIs) are also used to treat this condition.

Bipolar Disorder

Bipolar Disorders are characterized by two extremes of moods.. elation and depression. The clinical picture of depressed mood is the same as seen in Major Depression, so the distinguishing factor is the Manic features.

Elation encompasses a wide range of moods, from normal joy to pathological mania. Mania is characterized by extreme elation, hyperactivity, agitation, accelerated speech and disordered thinking. Mania also has features of extreme irritability, paranoia and rage.

Manic Symptoms:

Persistent elevated, expansive or irritable mood
Distress
Impaired normal functioning
Inflated self-esteem or grandiosity
Decreased need for sleep
Pressurized speech
Racing thoughts, flight of ideas
Distractibility
Increased activity
Impaired judgment
Lability of mood
Delusions and hallucinations
Self-destructive behaviors
Bizarre behaviors
Depressive Symptoms:

Insomnia or hypersomnia
Chronic fatigue
Low energy level
Feelings of inadequacy
Decreased effectiveness
Decreased concentration
Decreased attention span
Social withdrawal
Loss of interest in everyday activity
Decreased libido
Pessimistic
Tearfulness
Self-destructive behavior

Borderline Personality Disorder

A pervasive pattern of instability of interpersonal relationships, self-image and affect, as well as marked impulsivity.

People with borderline personality disorder are unstable in several areas, including interpersonal relationships, behavior, mood, and self-image. Abrupt and extreme mood changes, stormy interpersonal relationships, and unstable and fluctuating self-image.

Unpredictable and self-destructive actions characterize the person with borderline personality disorder. These individuals generally have great difficulty with their own sense of identity. They often experience the world in extremes, viewing others as either "all good" or "all bad." A person with borderline personality may form an intense personal attachment with someone only to quickly dissolve it over a perceived slight.

Fears of abandonment may lead to an excessive dependency on others. Self-mutilation or recurrent suicidal gestures may be used to get attention or manipulate others. Impulsive actions, chronic feelings of boredom or emptiness, and bouts of intense inappropriate anger are other traits of this disorder, which is more common among females.

Onset is early adulthood.

Some of the typical signs are:

frantic efforts to avoid real or imagined abandonment
a pattern of unstable and intense interpersonal relationships characterized by alternating extremes of idealization and devaluation
identity disturbance.
unstable self-image
impulsive, irresponsible behaviors
recurrent suicidal behavior, gestures or threats
self-mutilating behaviors
affective instability (episodes of intense dysphoria, irritability, anxiety)
chronic feelings of emptiness
inappropriate intense anger
difficulty controlling anger
transient stress-related paranoid ideation
severe dissociative symptoms

Kleptomania (Impulse-Control Disorder)

This disorder is characterized by episodes of stealing. Usually with a build-up of tension before the act and a sense of relief after the act. Most of the time the stolen objects are petty things that they can afford to buy.

Recurrent stealing episodes (failure to resist impulse)
Increased tension before episode
Pleasure, relief or gratification at the time of episode
Motive is not anger or vengeance
Kleptomania appears to be much more common in females, but little is understood about the etiology. There is also some association with other disorders such as depression and anxiety.

Kleptomania involves the failure to resist impulses to steal things that are not needed for either personal use or for their monetary value. There is typically anxiety prior to the act of theft and relief or gratification afterward. If the theft is related to vengeance or psychosis, kleptomania should not be diagnosed. (Kleptomania is quite rare, where common shoplifting is not).

Treatment typically involves behavior modification. Other treatment approaches involve seeing the theft as an unconscious process and analyzing it as such may assist in gaining insight and eventually extinguishing the behavior.

Prognosis is fair, but can increase with a positive therapeutic relationship and a strong motivation to change the behavior. Kleptomania often goes untreated and results in legal difficulties.

Dissociative Identity Disorder (Multiple Personality Disorder)

presence of 2 or more distinct personality states of identities. Each identity with it's unique cognitive patterns, of perceiving, thinking and functioning styles
each personality has it's own memories, hand writing, voice, medical problems and even different brain waves.
history of severe childhood trauma and abuse

Sexual Addiction

Sexual Offenders engage in illegal sexual behaviors which involve victimization; often demonstrating addictive elements and patterns in their sexual acting out.

Sexual Addicts engage in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others.

Offending Sexual Behaviors Include:

Exhibitionism
Voyeurism
Child Pornography
*****
Stalking
Sexual Harassment
Professional Misconduct

Addictive Sexual Behavior Include:

Compulsive Masturbation
Multiple Affairs
Consistent use of Pornography
Unsafe Sex
Sexual Anorexia
Multiple or Anonymous Partners
Phone, Cybersex
Sexual Massage, Escorts, Prostitutes
Prostitution

Consequences Include:

Social
Relationship
Emotional
Legal
Physical
Financial

Cycle of Sexual Addiction
Sexual behaviors that are compulsive and continue despite serious consequences are usually a sign of sexual addiction.

Like other addicts, sex addicts engage in distorted thinking; rationalizing, defending and justifying their behavior while blaming others for resulting problems. They deny having a problem and make excuses for their behavior.

Sex addicts usually participate compulsively in more than one type of sexual behavior... ie: compulsive masturbation, viewing pornography and patronizing prostitutes. Although some sex addicts are hypersexual, most are not. For the addict who has affairs, the thrill of the chase and conquest rather than the sexual experience itself may be the source of excitement. Like other addictions, the sex addicts report progression of their disease; ie: taking increasingly greater risks or trying new sexual behaviors to maintain the same euphoric effect. Sex addicts tend to sexualize other people and situations, finding sexual connotations in the most ordinary incident or remark.

Patterns and examples of sexual addiction

Fantasy sex: neglecting commitments because of fantasy life, masturbation
Seductive role sex: extramarital affairs (heterosexual or homosexual), flirting and seductive behavior
Anonymous sex: engaging in sex with anonymous partners, having one night stands
Paying for sex: paying prostitutes for sex, paying for sexually explicit phone calls
Trading sex: receiving money or drugs for sex
Voyeuristic sex: patronizing adult bookstores and strip shows, looking through windows of houses, having a collection of pornography at home or at work
Exhibitionist sex: exposing oneself in public places or from the home or car, wearing clothes designed to expose
Intrusive sex: touching others without permission, using position of power (eg, professional, religious) to sexually exploit another person, rape
Pain exchange: causing or receiving pain to enhance sexual pleasure
Object sex: masturbating with objects, cross dressing to add to sexual pleasure, using fetishes as part of sexual rituals, having sex with animals
Sex with children: forcing sexual activity on a child, watching child pornography
The main elements of addiction, whether chemical or behavioral are:

Compulsivity- meaning loss of control over the behavior - i.e. continuing to engage in a particular behavior after repeated attempts to stop.
Continuation despite adverse consequences, such as loss of job, money, marriage, or health - or arrests or public humiliation.
Preoccupation or obsession with obtaining and using the substance or participating in the behavior to the detriment of other essential life activities or goals
Addictions are defined not by how much of the drug or behavior is used, but rather the effects on the person's life. An addiction can be suspected when the behavior has made the person's life unmanageable. Some clues regarding sex addiction are:

The problem behavior is not an isolated occurrence; there is a pattern of this behavior over a significant time span.
Despite a previous significant adverse consequence, the behavior is repeated. Sexual decisions do not appear to be made on a rational basis.
Increasingly greater risks are taken over time. For example sexual encounters may initially take place only out of town, but later closer to home.
The person denies to him/herself and others that there is a problem when it is evident to others, utilizing minimization, rationalization and justification to continue to engage in their behaviors while trying explain the problem away.
Secretive, illicit or dangerous sexual behaviors have a higher intensity in arousal (high) which encourages irrational choices. Some sexual behaviors that may represent an addictive disorder are:

Multiple extramarital affairs
Using a position of power to gain sexual access to multiple partners.
Use of prostitutes, escorts and sexual massage
Indecent telephone calls
Excessive expenditure of time and money on pornography/cyber and phone-sex
Multiple anonymous sexual encounters
Touching others without permission
Sex addicts, like most other addicts, have family histories of alcoholism, drug dependency, abuse or other significant family dysfunction. Often they are sexualized or exposed to sexual experience at an early age. This tends to distort their adult relationships encouraging isolation and superficiality in relationships..

Treatment for Sexual Addiction involves the same approach as for other addictions. Treatment is focused on bringing the addicts out of their distortions and denial, forcing them to realistically confront themselves and the damage their behaviors have caused. Family members must be involved in the process, learning the full reality of the Sex Addicts disorder.

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