Impulse disorders, also referred to as impulse control disorders, are a class of psychiatric conditions characterized by impulsivity, including failure to resist a temptation, impulse, or the inability not to express a thought. They are hallmarked by four main features, which include the following:
- The continuation of repeated problematic behaviors despite the incurrence of adverse consequences
- An increasing lack of control over engaging in problematic behaviors
- Progressing tension or cravings to perform problematic behaviors before acting on them
- Sense of relief or pleasure during the performance of problematic behaviors
Males are thought to be slightly more prone to impulse disorders than females, and these disorders commonly co-exist with other mental health disorders or with problems related to substance abuse. Impulse disorders may be routinely disregarded or misdiagnosed, meaning that people who experience these disorders seldom get the help they need.
Impulse Disorder Types
Impulse disorders are often diagnosed in the late teen years or early adulthood. Different types of impulse control disorders are outlined as follows:
Intermittent Explosive Disorder (IED)
This disorder is characterized by persistent temper tantrums or explosive incidents that are excessive and largely out of proportion to the circumstances in question. Violence, aggression, rage, verbal threats or outbursts, and physical harm to people or things often accompany these episodes. Fortunately, these diatribes typically only persist for about 30 minutes, but they do tend to come on abruptly, with little or no warning.
Anger, agitation, irritability, and impulsivity are also potential symptoms of IED. A person who is experiencing an IED episode will likely encounter racing thoughts, tingling in the extremities, heart palpitations, chest pain, and tremors. They may also be fatigued and relieved immediately after the act and possibly experience guilt or regret about his or her actions later.
The most severe outbursts may occur months apart, with smaller episodes in between. In any case, IED can lead to legal and financial issues, interfere with a person’s interpersonal relationships, cause great distress, and also result in problems related to school or work.
Kleptomania is hallmarked by the impulsive theft of things that are not usually needed. Individuals may steal items and hoard them, give them away, or even later return them to the store from which they took them. The disorder is not about attaining the things stolen, but instead about the compulsion to steal, the excitement involved, and lack of self-control over this preoccupation.
Some experts believe that as much as 24% of people who shoplift have some level of kleptomania. People who suffer from this condition may feel intense guilt or shame after the dissipation of the relief that stealing brings. Unsurprisingly, legal problems are common for people who experience kleptomania.
An individual who repeatedly and intentionally sets fires may suffer from pyromania, which is characterized by an affinity or obsession with fire and fire-setting equipment, along with a strong desire to start fires, and feelings of relief and pleasure while doing so. People with pyromania do not start fires for any reason other than their compulsive need to do so in order to relieve their increasing tension. Fortunately, pyromania is relatively rare and believed to affect only about 1% of the population at some point in life.
Causes of Impulse Disorders
Experts believe that a combination of biological, environmental, psychological, and cultural factors can play a role in the development of impulse disorders.
Two regions of the brain, the limbic system (responsible for many memory functions and emotion) and the frontal lobe (involved with willpower and decision-making abilities), can be affected in a person who has an impulse disorder. Moreover, hormones associated with aggression, such as testosterone, may be elevated in someone suffering from one of these disorders.
In addition, chronic stress, childhood neglect or trauma, and other environmental factors may also contribute to the development of impulse disorder. Some medical conditions, such as brain trauma or an imbalance in brain chemistry related to an underlying mental illness, may also increase the likelihood that a person will suffer from an impulse disorder.
Dangers of Impulse Disorders and Substance Abuse
When an individual abuses drugs or alcohol, the brain’s normal chemistry and circuitry are temporarily interrupted. If this action is performed repeatedly, the brain may eventually become rewired, resulting in substance dependence, which can progress into a loss of control over drug or alcohol use.
Impulse disorders and substance abuse have many commonalities. These disorders are hallmarked by difficulties with self-control regarding destructive behaviors with adverse consequences, and similar regions of the brain may be implicated in both types of conditions.
Substance abuse may serve as a form of self-medication for those with impulse disorders. In turn, substance abuse can contribute to the onset of an impulse disorder or exacerbate one already in progress.
Abusing intoxicating substances before the brain is fully developed, such as in adolescence, may adversely affect parts of the brain related to the formation of willpower, decision-making, pleasure, memory, and mood regulation. These effects can increase the odds of developing substance use issues or mental health conditions, such as impulse disorder, later in life. Regardless of which problem developed first, the combination of impulse disorder and substance abuse can result in increased risk factors and side effects related to both conditions.
For example, substance abuse can increase and intensify episodes of hostility, aggression, and violence. Likewise, the lack of self-control exhibited by a person suffering from an impulse disorder may make him or her more likely to abuse substances. In fact, an estimated 20-50% of people with an impulse control disorder also have problems with substance abuse, according to research published in the journal Frontiers in Psychiatry.
Seeking Treatment for Comorbid Disorders
Those who suffer from an impulse control and/or substance use disorder may not be likely to admit they need professional help. However, getting someone to seek treatment may be accomplished through the organization of an intervention staged by the person’s family and social circle.
Impulse disorders are often characterized by extreme aggression, violence, and episodes of rage. For this reason, it is often beneficial to stage an intervention under the guidance of a professional who is trained to plan and facilitate these type of structured meetings.
In the case of co-occurring disorders, a primary care provider, mental health professionals, and addiction specialists may work together to create an integrated treatment plan. These plans entail a wide variety of therapeutic services, including psychotherapy, counseling, peer support, aftercare planning, and more.
For instance, cognitive-behavioral therapy (CBT) is a widely used form of psychotherapy that helps the individual learn how to modify negative thought patterns and feelings and replace them with more positive ones, which can improve a person’s behavior and overall well-being.
Harmony Treatment and Wellness is a specialized addiction treatment facility that offers programs in both partial-hospitalization and outpatient formats. We use a comprehensive approach to both substance abuse and mental health disorders. We are dedicated to ensuring that every client receives the tools and support they need to achieve a full recovery so they can go on to lead happier, more fulfilling lives.
If you or someone you know is suffering from addiction and a mental health condition such as impulse disorder, please contact us today. We help people break free from the mental and emotional problems that contribute to addiction for life!