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Humans are impulsive creatures by nature. In some cases, those impulses let the individual take hold of an opportunity that may otherwise pass them by. Impulses can even be life-saving, letting the individual act quickly to get out of a dangerous situation.
On the flipside, impulses can lead to damaged relationships, physical harm, or even legal trouble.
Developing impulse control, or learning to act in a way that’s physically and emotionally healthy and socially acceptable, is like exercising a muscle. Over time, most people learn to manage their impulses and avoid angry outbursts and dangerous or destructive behaviors.
However, for some people, taming impulses is significantly more challenging. Depending on their symptoms and behaviors, they may need to seek professional treatment for an impulse control disorder.
How Does the Diagnostic and Statistical Manual of Mental Disorders Categorize Impulse Control Disorder?
The DSM-5 (the official manual that mental health professionals use to diagnose conditions) categorizes impulse control disorder under disruptive, impulse-control and conduct disorders. While each condition in this category has its own symptoms, they all can cause people to behave aggressively, angrily or in an otherwise socially inappropriate way toward people or property.
The Types of Impulse Control Disorders
Impulse control disorders usually appear during childhood or adolescence; in fact, it’s very rare for symptoms of these disorders to not appear until adulthood. The DSM-5 lists several types of impulse control disorders, each with its own signs and symptoms.
Intermittent Explosive Disorder
Someone with intermittent explosive disorder has difficulty reacting appropriately to frustrating situations. This disorder involves sudden episodes of verbal outbursts or violent, impulsive or aggressive behavior. Outbursts tend to occur with little warning, and they typically last 30 minutes or less.
Before an outburst takes place, the individual may experience increased energy, racing thoughts, tightness in their chest, palpitations and a tingling sensation. Outbursts may include shouting, angry tirades, acts of physical violence, throwing or breaking things or threatening or assaulting people or animals. Right after an outburst, the individual may feel relief. Later on, they may feel embarrassed or regretful.
While a fascination with fire isn’t uncommon, pyromania as described in the DSM-5 is extremely rare, affecting six percent or fewer people in inpatient psychiatric hospitals. It’s characterized by intentionally setting fires on one or more occasions and having an intense attraction to fire and related objects. The individual may experience tension or excitement before setting a fire and feel a release afterward, and they may get intense pleasure from seeing or setting fires.
Pyromania is a term often associated with arson, but there are certain differences. While arson is a criminal act and usually a response to a person or situation, pyromania is driven by psychological factors. To receive this diagnosis, the individual doesn’t set fires:
- For monetary gain
- As a form of protest
- To express anger or get revenge
- To cover up a criminal act
- To commit insurance fraud
- In response to hallucinations or delusions
- Due to impaired judgment from alcohol or drugs
Kleptomania, also called compulsive stealing, is a disorder that drives the individual to take things that don’t belong to them. Oftentimes, the items the individual takes are insignificant and have little value, or they are things the person could easily afford. Before stealing an item, the individual may feel tension or excitement and then relief or pleasure during the theft. Afterward, most people with kleptomania feel remorse, and the items they steal are typically stashed away, thrown out or given away, rather than used and enjoyed.
While it’s a common cause of theft that’s often overlooked, kleptomania is driven by a psychological compulsion, not a desire to obtain financial or material gain. Most criminal thefts are planned and may even be coordinated efforts between two or more people, but theft related to kleptomania is usually spontaneous and a solo act.
A conduct disorder is characterized by persistent and repetitive behaviors that violate the rights of others as well as basic age-appropriate social norms. Some examples of this disorder include acting aggressively through bullying, using a weapon, or physical fights; destroying personal property; lying and stealing; and running away from home or skipping school.
Conduct disorder is only diagnosed in individuals 18 and under. An adult with similar symptoms is diagnosed with an antisocial personality disorder.
Oppositional Defiant Disorder
Someone with oppositional defiant disorder displays anger and irritability, vindictiveness and argumentative or defiant behaviors. They may argue often with authority figures, refuse to comply with rules, and blame others for their misbehavior or mistakes. The individual may also act out of spite or do things to intentionally irritate someone else.
Oppositional defiant disorder shares symptoms with several other disorders such as depression, anxiety, attention-deficit hyperactivity disorder and learning disabilities. It’s only diagnosed when a comprehensive evaluation rules out other possible causes of inappropriate behavior.
Is Addiction an Impulse Control Disorder?
There’s quite a bit of overlap between impulse control disorders and addiction. Oftentimes, these co-occur, and help from experienced mental health professionals is necessary to ensure correct diagnoses and effective treatment.
Currently, the DSM defines an addiction by some key criteria, including:
- Missing school or work due to substance use
- Building up a physiological tolerance to a substance
- Craving the substance
- Inability to quit using the substance despite multiple times trying
Addiction and impulse control disorders share some similarities. With both disorders, the individual continues to participate in a behavior despite bad consequences, they have limited control over their actions as they related to the behavior, they experience an urge or craving before participating in the behavior, and they get pleasure from the behavior. While someone could make the case that impulse control disorders are types of behavioral addictions, the DSM-5 doesn’t recognize non-substance-related addictions (other than compulsive gambling).
Impulse control disorder and addiction are two different conditions, but they frequently co-occur. In fact, a small study found that substance addictions are present in:
- Up to 48 percent of people with intermittent explosive disorder
- About one in three people with pyromania
- Up to half of those with kleptomania
What Causes Impulse Control Disorders?
Impulse control disorders are complex, and they likely result from a mix of factors. The presence of these factors doesn’t automatically mean that an individual has or will develop a disorder, but for someone with a predisposition for mental illness, these factors can have a serious impact on mental health.
As is often the case with mental health disorders, there appears to be a strong genetic element to impulse control disorders. Multiple studies have shown that children and adolescents with impulse control disorders are likely to have a first-degree family member with the same or similar condition.
All children have difficulties with self-regulation and managing impulses. In a healthy environment where appropriate behaviors and constructive coping mechanisms are modeled, most children eventually learn to comply with social norms, though this learning process may last well into adulthood.
However, for children raised in families in which violence; physical, verbal or emotional abuse; or regular and unpredictable angry outbursts are present, there’s a much greater likelihood of developing an impulse control disorder. This often arises as a means of gaining control in a situation in which they otherwise feel powerless.
Studies have shown that differences in how the brain works may lead to impulse control disorder. Research indicates that when the prefrontal cortex, or the part of the brain that controls emotions, planning and memory, becomes imbalanced due to their structure and chemistry, the individual is more likely to have symptoms of impulse control disorder.
Seeking Impulse Disorder Treatment
Impulse control disorders are treatable, and individuals living with them can live healthy, happy lives. Treatment methods depend on the individual, but in most cases, it includes a mix of group therapy, one-on-one talk therapy in the form of cognitive-behavioral therapy, mood stabilizers or antidepressants. Successful treatment also depends on diagnosing and treating co-occurring disorders such as personality disorders, behavioral disorders and substance abuse.
FHE Health is a fully licensed mental health clinic that specializes in treating mental health disorders and co-occurring conditions through personalized, research-backed therapies. If you or someone you know is living with impaired impulse control, reach out to one of our intake specialists by calling (855) 474-2479.