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Impulse Control Disorders

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If you are unable to control your impulses, even if the behavior produces undesirable results then you may have impulse control disorder. An impulse is an urge you have to do something, whether eat a snack or buy a new shirt. Most adults are able to think rationally about an impulse and decide whether or not to act on that impulse, but some people lack that control and end up giving into their wants and desires, even if it causes negative consequences.

What is Impulse Control Disorders?

Impulse control disorders consist of a group of mental health disorders. When you have an impulse control disorder you are unable to resist the urge to give into your impulses, even when you know it will likely lead to harm.

Common Impulse Control Disorders:

  • Compulsive Buying Disorder
  • Pathological Gambling
  • Hypersexuality
  • Compulsive Eating
  • Kleptomania
  • Pyromania
  • Trichotillomania (Compulsive Hair Pulling)
  • Onychophagia (Compulsive Nail Biting)
  • Intermittent Explosive Disorder (Compulsive Violent Outbursts)

Acting on impulses does not necessarily mean you have an impulse control disorder. The key factor in distinguishing between healthy impulsiveness and an impulse control disorder is that, with the latter, you experience negative consequences as a result of acting on your impulse. You are aware of the negative consequences associated with the impulses, but you are unable to resist the urge to act on your impulses.

If you have an impulse control disorder you may gain great pleasure when acting on the impulse. In some cases, the action may even result in sexual arousal. If you do not act on the impulse, then you can become very anxious. After the impulsive act is complete, you feel regret, shame and/or remorse.

Impulse Control Disorders TreatmentWith impulse control disorders, the focus is completing the impulsive action. The necessity of the actual action is not relevant. For example, if you are a kleptomaniac, you will feel the uncontrollable urge to go to the grocery store and steal food for your family, even if you have the money to purchase the food, you first inclination will be to steal the food. You need to act on the impulse – not because the theft is necessary to obtain food because you just cannot resist the urge. More than likely you perform these impulses in solitude. For example, if you have a compulsive eating disorder, you will eat by yourself – not binge eat with company.

There is disagreement in the psychological community as to how impulse control disorders should be classified. Some professionals classify them as “addictions,” some classify these disorders as subsets of obsessive compulsive disorder and yet others classify impulse control disorders as a separate category all together.

Instances of impulse control disorder can be seen throughout popular culture.  Public figures such as Jacqueline Kennedy had an impulsive buying disorder and Winona Ryder was arrested for shoplifting due to her kleptomania disorder. 

Common Impulse Control Disorder Symptoms

The symptoms of an impulse control disorder vary depending on the specific problem. In all cases, you will be unable to control your actions despite knowing that these behaviors will likely produce negative consequences. In some cases, it can be difficult to distinguish between healthy, controllable impulsive behaviors and this disorder because the consequences vary so greatly. For example, a very wealthy person may not be significantly affected financially by a compulsive buying disorder, but a low-income individual may suffer serious financial difficulties from the disorder.

Distinguishing Features of Any Impulse Control Disorder

  • You perform the impulsive act alone.
  • You engage in the impulsive activity fully knowing that it will produce consequences, such as harm to self or others.
  • Before the act, you feel tense and/ aroused.
  • You become incredibly excited during the act.
  • After the act, you are filled with guilt and/or shame.
  • You feel out of control in regards to your actions.

What Causes Impulse Control Disorders?

Impulse control disorders are likely caused from a combination of biological, social and psychological factors. Researchers believe that this disorder is caused by a neurotransmitter imbalance in your brain. Studies also support the theory that hormone imbalances can lead to risky behaviors commonly associated with impulse control disorders such as violent and/or aggressive tendencies.

How Are Impulse Control Disorders Treated?

  • Impulse control disorders hare typically treated with a combination of psychotherapy, behavioral modification therapy and pharmacology.
  • With cognitive therapy, you are encouraged to identify your behavioral patterns and the negative consequences associated with those behaviors.
  • Behavioral modification therapy teaches you how to avoid the situation and use self-restraint techniques to expose the situation.
  • Exposure therapy helps you gradually build up a tolerance to the situation while exercising self- control. For example, if you have a pathological gambling disorder, you may first be shown pictures of a Blackjack table and then given a deck of cards to hold. Over time you will work your way to standing inside the casino without gambling.
  • The FDA has not approved specific medications in the treatment of impulse control disorders; however, some medications have proven effective such as SSRI antidepressants. SSRI medications are mu-receptor antagonists. These antagonists have gained FDA approval for treating impulse control-related alcohol and opiate addictions. Alternative therapies such as meditation, hypnotism, and herbal remedies have also proven beneficial in treating impulse control disorders.

References:

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed.). Washington, DC.

Grant, J. E., Levine, L., Kim, D. & Potenza, M. N. (2005). Impulse control disorders in adult psychiatric inpatients. American Journal of Psychiatry.