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Impulses are a natural part of life. Part of what separates humans from other species is our ability to control our urges. Impulse control is how we demonstrate psychological maturity and excel in society. However, the simple concept of “think before you act” isn’t quite so easy for everyone.
What are Impulse Control Disorders?
“Conduct Disorder is seen in children and adolescents who exhibit aggressive, deceitful, and destructive behaviors, with no regard for breaking rules and little to no guilt or remorse after the fact.” – Mike Loverde
A person is afflicted with an impulse control disorder (ICD) when he or she absolutely cannot resist the urge to do something. This goes well beyond the occasional need to give in to temptation and order extra-large fries at a fast-food establishment.
The actions displayed by a person with an impulse control disorder are usually harmful to oneself or toward other people. Impulsive control disorders span a broad category and were once known to range from drug addictions to paraphilic sexual fantasies.
However, updates to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recategorized some of what were once considered ICDs, such as compulsive gambling and sexual addiction, into another classification. It is common to see other addictive behaviors in a person with an ICD as an inability to maintain control over one’s impulses.
Common Impulsive Control Disorders Include:
- Oppositional Defiant Disorder: This can be present in children who have ongoing defiant and hostile behaviors toward authority figures, even after negative consequences are experienced. Often present with ADHD or ADD.
- Conduct Disorder: Seen in children and adolescents who exhibit aggressive, deceitful, destructive behaviors, with no regard for breaking rules and little to no guilt or remorse after the fact.
- Antisocial Personality: A disregard for others, using people as the means to an end. Often begins with Conduct Disorder in childhood.
- Intermittent Explosive Disorder: Uncontrolled and violent episodes.
- Pyromania: This disorder centers on an obsession with fire.
- Kleptomania: A kleptomaniac will engage in compulsive theft.
- Compulsive Shopping: An individual will often buy things that are not needed.
Impulse Control Disorders vs. Other Illnesses
Some studies show similarities between impulsive control disorders and similar mental conditions. The primary difference is the fundamental issue the individual faces.
Those with attention-deficit/hyperactivity disorder (ADHD) experience a significantly reduced attention span. Quelling impulses isn’t the primary challenge. They struggle to maintain focus, keep their minds from jumping to new topics, and complete tasks.
People with impulsive control disorders, on the other hand, struggle the most with denying their compulsion.
What can be very disconcerting to parents of children, teenagers, and adults challenged by compulsivity is assessing whether the behaviors can be attributed to childhood insecurity, unhealthy outlets of stress, or a serious personality disorder.
Whether impulsiveness is exhibited through food issues, trichotillomania (pulling of the hair), or aggressive reactions to themselves or others, these can be signs and symptoms of varied drug addictions.
There may be multiple control disorders co-occurring. Seeking help from a licensed behavioral health expert sooner rather than later is crucial to uncovering the root problem(s) and finding answers.
The Causes of Impulsive Control Disorders
Medical professionals and scientists have yet to discover a definitive root cause of impulse disorders, although there are factors suspected to influence an individual’s condition. These can be physical, biological, psychological, emotional, cultural, societal, or in combination.
Brain Structure
Studies suggest that particular structures in the brain affect impulse disorders. The limbic system is a section of the brain devoted to emotions and memory function. The frontal lobe handles planning and control. These two are the most likely suspects. But the pre-frontal cortex is also of importance as it fuels sound decision-making. When it is out of balance or compromise, risky and impulsive behaviors can arise and go out of control.
Hormonal Imbalances
Hormones may affect impulsive control disorders, too. Researchers believe that compounds such as testosterone are especially at fault. These hormones are associated with violence and aggression. They are also less present in women. This correlates with data showing that women are more prone to less violent types of control problems. For example, men are more likely to be pyromaniacs, and women more commonly suffer from kleptomania.
Differing Opinions within the Mental Health Community
Many healthcare professionals have divided impulse control disorders into a subgroup of existing problems. ICDs are often categorized as anxiety problems and obsessive-compulsive disorders. Studies suggest that chemicals in the brain, such as serotonin and dopamine, play a major role in impulsive control disorders.
Many ICD patients show responsiveness to medications typically used for depression and anxiety. Selective serotonin reuptake inhibitors, or SSRIs, are a branch of antidepressants that are particularly useful.
Impulse Control Disorders and Drug Addiction
Dealing with an impulse control disorder is extremely difficult. Many sufferers are dealing with other mental health issues, such as depression or anxiety, as a direct result of their lack of control. Others will turn to alcohol or drugs as a coping method.
Unfortunately, a history of uncontrollable impulses means that ICD sufferers present a much higher risk of forming a dependency or addiction. Thankfully, there are many proven treatment options. Medications, as stated, have provided some patients with significant improvement in their symptoms.
Treating Impulse Control Disorders
Behavioral therapy also shows significant promise for ICD patients – even in those who also suffer from alcohol use disorder or drug addiction.
Cognitive Behavioral Therapy (CBT) is effective in helping those with ICD retrain their brain to reduce the urge to act out in unhealthy ways. By combining cognitive and behavioral therapy modalities, patients learn:
- Positive self-perception, how others see them, and how the world affects their mental health.
- To understand how they allow others’ actions to influence their own lives.
- How facing their own interactions affects behaviors and responses in others.
Continuous CBT, coupled with mindfulness and other practices that can serve as healthy coping mechanisms, offers relief when stress can trigger an episode of impulsivity.
Many patients experience positive turnarounds when they enter dedicated treatment facilities, principally because these places are equipped to treat the underlying causes of impulse control disorders, other mental health conditions, and drug or alcohol dependency.
Unsure If You or a Loved One Has an Impulsive Control Disorder?
An intervention is not about how to control the substance user; it is about how to let go of believing you can.
“The most formidable challenge we professionals face is families not accepting our suggested solutions. Rather, they only hear us challenging theirs. Interventions are as much about families letting go of old ideas as they are about being open to new ones. Before a family can do something about the problem, they must stop allowing the problem to persist. These same thoughts and principles apply to your loved one in need of help.”
Mike Loverde, MHS, CIP
