When Loss of Self-Control Is Really an Impulse Control Disorder

Causes and Effects of Impulsive Behavior Disorders

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

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 behavior 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 Behavior Disorders Include:

    • Oppositional Defiant Disorder: 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 DisorderSeen 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, uses 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.


    Despite their vast differences, impulsive control disorders tend to work in similar ways. In the beginning, the person will feel a building tension. Then, there’s an increase in suspense before the act is committed.

    The individual will almost always experience excitement while doing the impulsive act, whatever it may be. Afterward, however, he or she is far more likely to experience regret and guilt. Those who suffer from an impulsive behavior disorder will usually feel as though they have no control.

Impulse Control Disorders vs. Other Illnesses

Some studies show similarities between impulsive behavior 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 behavior 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), aggressive reactions to themselves or others, these can be signs and symptoms of varied drug addictions.

There may be multiple behavioral 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 Behavior 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, which handles planning and controlling, are the two 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 compromised, risky and impulsive behaviors can arise and go out of control.

Hormonal Imbalances

Hormones may affect impulsive behavior 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 health care professionals have divided impulse control disorders into a subgroup of existing problems. ICDs are often categorized within anxiety problems and obsessive-compulsive disorders. Studies suggest that chemicals in the brain, such as serotonin and dopamine, play a major role in impulsive behavior 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 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, offer 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 Behavior Disorder?

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Mike Loverde

As a Certified Intervention Professional (CIP), member of NAATP, NAADAC, and accredited by the Pennsylvania Certification Board, Mike Loverde knows first-hand what it’s like to live life with addiction. By overcoming it, he had a calling to work with others who struggle with drug and alcohol addictions—the people who use and the families who feel helpless watching them decay.

With thousands of interventions across the United States done and many more to come, Loverde continues to own the intervention space, since 2005, by working with medical doctors, psychiatrists, psychologists and others who need expert assistance for their patients who need intervention. To further his impact on behavioral health and maximize intervention effectiveness, Loverde is near completion of a Masters in Addiction Studies (MHS) accreditation, as well as a Licensed Independent Substance Abuse Counselor (LISAC), and is committed to attaining the designation of a Licensed Professional Counselor (LPC).

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