Impulse Control Disorders

The impulse control centers in our brains weigh the consequences of any urge and prevent us from doing things that might harm ourselves or others. People with impulse control disorder cannot resist the urge to perform a particular action that they know harms themselves or others. The crucial difference between a normal impulse and an impulse control disorder is that an individual with an impulse control disorder consciously commits an action even if it has negative consequences.

Impulse control disorders occur in people who have difficulty dealing with situations or emotions. The impulsive behavior develops in response to stress or tension and builds to excitement. Individuals may not necessarily plan their behaviors, but acting on their urges fulfills their immediate, conscious wishes and gives them release or gratification. After committing the impulsive act, most people feel remorse, self-loathing and out of control.

The most common of impulse control disorders are:

  • Intermittent explosive disorder - expressions of anger, often to the point of uncontrollable rage

  • Domestic violence - intermittent explosive disorder targeting only one spouse or household partner

  • Kleptomania - the obsessive urge to steal objects, either for no reason or for the thrill of doing so

  • Pyromania - deliberately lighting fires for pleasure or stress relief; fires are not set for financial gain, political or vindictive expression, or to cover up a crime

  • Compulsive gambling disorder - the compulsive urge to continue gambling regardless of the consequences

  • Trichotillomania - the obsessive urge to pull out or eat one's own hair, which leads to noticeable hair loss

  • Onychophagia - compulsive nail biting

Other addictions that may be included in this category are compulsive shopping, sexual compulsion and internet addiction.

Causes

Scientists do not know exactly what causes impulse control disorders. Studies suggest that genetics, brain function and chemistry, as well as hormones, may play a role. There may also be environmental causes. Impulse control disorders can occur along with other mental or physical disorders such as anxiety, personality, mood and eating disorders, and traumatic brain injuries. Substance abuse can aggravate impulse control disorders.

Diagnosis

After other mental or medical conditions that can cause similar symptoms are ruled out, a person is usually referred to a mental health provider with expertise in impulse control disorders for assessment.

Treatment

As soon as a physical cause is ruled out, the patient will be referred to a psychiatrist who specializes in impulse control disorders.

Impulse control disorders are usually treated with a combination of psychotherapy, behavioral therapy and medication. In cognitive-behavioral therapy (CBT), sufferers are encouraged to recognize their behavioral patterns and the negative consequences of this behavior. Behavioral change therapy teaches avoidance techniques to use when impulses strike. Exposure therapy helps sufferers gradually build up tolerance for situations that can trigger a reaction while exercising self-control.

Medications can be useful for those who suffer from depression in addition to impulse control.

If you believe you or someone close is suffering from an impulse control disorder, call (402) 717-HOPE.