Impulse Control Disorder and Addiction
Impulse control disorder does not refer to one specific illness. Instead, it represents a class of different psychiatric disorders that cause people to become impulsive in their decision-making and behaviors. According to Innovations in Clinical Neuroscience, impulsive behavior breaks down into different stages, including the impulse itself, growing tension, the feeling of pleasure and relief from fulfilling the urge, and subsequent guilt, especially if the action was a negative one or if the person was avoiding the action.
There are many different and common conditions that fall into the impulse control disorder classification. These include:
- Attention deficit hyperactivity disorder: This condition, often referred to as ADHD, is a well-known disorder that primarily impacts children; however, the condition also impacts some adults. ADHD makes it difficult for the person to focus and may prompt hyperactivity. In some individuals, attention deficit hyperactivity disorder makes them feel compelled to act first without thinking about the consequences of their actions.
- Antisocial personality disorder: Antisocial personality disorder is a serious psychiatric condition where people consistently ignore the feelings of other people. They may impulsively act in their best interest without regard to consequences and may face challenges with the legal system, becoming criminalized due to their impulsive actions.
- Substance-related disorders: This group of disorders applies to a broad category of substance-related issues. Regardless of the substance of abuse, the impulse to continue to use the substance, despite its legality or impact on the individual’s life, is the shared characteristic.
- Borderline personality disorder: This is considered a serious mental illness that significantly impacts mood, behavior, and relationships with other people. Most people diagnosed with borderline personality disorder start showing symptoms in early adolescence.
- Kleptomania: This impulse control disorder is where individuals feel compelled to take items that to not belong to them. These may be items from friends, family, or strangers, or from public places such as retail stores. Stealing these items opens up individuals for liability and legal prosecution if they are caught. The items do not need be valuable to be taken. Rather, it is the act of stealing itself that provides satisfaction.
- Pyromania: Pyromania is a well-known impulse control disorder where individuals feel and act upon the impulse to deliberately start fires. Although often parodied in the media, pyromania is a serious condition where setting fires provides a form of instant gratification or stress relief.
- Sexual compulsion: Individuals suffering from this condition have a hard time controlling sexual thoughts or sexual behavior. There are a variety of names for this condition, including hypersexuality and nymphomania. This condition can have a strong impact on a person’s health, as it may facilitate having more sexual partners than what is considered normal. An increased number of sexual partners is related to an increased risk of unwanted pregnancy or acquiring a sexually transmitted disease. Sexual compulsion may also impact the ability to have healthy and committed relationships.
- Compulsive buying disorder: This condition involves the urge to continue shopping or purchasing items. This includes items that individual may not even need or have money to pay for. Despite this, the individual feels the need to purchase items anyway. In some cases, this can cause distress due to financial concerns caused from spending so much money. In other instances, individuals do not have room to store all of the items they purchase and may also suffer from a hoarding disorder.
There are a variety of other impulsive control disorders that are not included on this list. Other impulse control disorders include hair pulling and skin picking, as well as gambling. Each disorder may require a different set of treatment options to achieve long-term recovery.
Many of these disorders are fairly prevalent. According to a study published in the American Journal of Psychiatry, 31 percent of inpatient adult psychiatric patients are impacted by these disorders. There also appears to be a link associated between Parkinson’s disease and being diagnosed with an impulse control disorder. According to Neurology Clinical Practice, one in seven patients with Parkinson’s disease who receives dopaminergic therapies as part of treatment is diagnosed with compulsive tendencies.
Some of these impulse control disorders are more prevalent than they even may seem. Although attention deficit hyperactivity disorder, or ADHD, may receive a lot of media attention through celebrities who suffer from the condition and commercial advertising, other impulse control disorders may actually be more common.
Impulse Control Disorder Issues
For those suffering from an impulse control disorder, there are a wide range of issues that may stem from the condition. These largely depend on the type of impulse control disorder the individual suffers from. They range from trouble maintaining healthy relationships to possible incarceration.
For instance, those with compulsive buying disorder are extremely susceptible to debt and hoarding disorder. Those facing sexual compulsion often face issues establishing healthy romantic relationships and may be more susceptible to STDs, as they are more likely to have an increased number of sexual partners. Those with kleptomania or antisocial personality disorder are much more likely to face jail time than those suffering from other types of impulse control disorders. Their impulses may cause them to commit crimes, either by stealing or some other criminal activity that puts them at risk.
Signs and Symptoms
While the signs and symptoms of someone with an impulse control disorder will largely depend on the specific disorder itself, there are some shared characteristics that can be used to identify impulsive control disorders in a broader sense. These include:
- Instability or angry outbursts: When someone is dealing with an impulse control disorder, they may be more likely to be irritable or have an unstable mood. This stems from the guilt and frustration associated with managing their impulses.
- Inability to maintain control over emotions: Moodiness or a general lack of emotional stability may suggest an impulse control disorder.
- Inability to maintain control over behavior: In many cases, people with impulse control disorders act on impulses that may not be logical or even safe.
- Risky behaviors: Many impulse control disorders cause a person to engage in unsafe, illegal, or otherwise dangerous activities. These can often be the telltale signs that someone is suffering from one of these disorders.
- Feelings of guilt: Part of the natural cycle associated with impulsivity is guilt. If someone consistently is feeling guilty, they may have impulsivity issues.
- Lying: As a way to cover up their behavior, those with an impulsive control disorder may lie. In the case of a condition like antisocial personality disorder, this may stem from a larger plan the individual creates. However, in most cases, lying is a way that people manage their conditions to keep them hidden from other people.
- Injuries: Unexplained acute injuries may be the result of an impulse control disorder. Pyromania, for instance, may cause burns to show up on the body.
- Obsessive actions: In many cases, individuals obsess about what they are impulsive about. This may translate into repetitive or obsessive actions.
- Lack of concentration: Although a lack of concentration may be a hallmark of ADHD, it can also be a symptom of other impulse control disorders.
- Depression: It can be frustrating and upsetting to manage an impulse control disorder alone. Those managing these conditions may face an increased likelihood of depression.
Because of the large number of the different psychiatric conditions that fall into the impulse control disorder classification, there are many different root causes to the conditions. In some cases, the root cause may not still be thoroughly understood. Some of the conditions begin manifesting in youth or adolescence, while others are exacerbated by extreme stress.
Many impulse control disorders provide a sense of relief to a person once the action is fulfilled. For instance, those suffering from a compulsive buying disorder will feel relieved once they buy something. However, that feeling of initial relief may turn into guilt after a short period of time, especially if they do not need the item, cannot afford it, or have nowhere to store it.
This aspect of an impulse control disorder providing relief can perpetuate the disorder. If someone has been taught that certain activities provide relief, they may associate those activities with stress relief. This means that any time the individual faces stress, they may turn to this activity.
Not all impulse control disorders are caused by developed associations with stress relief, however. People are born with some of these conditions. Scientists support that these conditions are likely caused by chemical imbalances in the body or brain.
Those suffering from an impulse control disorder are more susceptible to co-occurring issues that range from mental health issues to substance abuse issues. This can make it more difficult to treat any one condition individually, as they are interrelated. A comprehensive treatment plan should be developed by a specialist that best addresses each of these issues in a holistic manner.
According to the Journal of Psychopathology, bipolar disorder may be more common in those who suffer from impulse control disorders. In addition, various mental health issues, such as depression and anxiety, may be more common in those who struggle with impulse control disorders.
Substance abuse is common in those who suffer from impulse control disorders. Often, people abuse drugs or alcohol in an effort to manage the symptoms of their impulse control disorder. While substances may dampen some of the symptoms temporarily, substance abuse only exacerbates the issue in the long-term. Those who suffer from both impulse control disorders and substance abuse or addiction issues need professional help in a comprehensive treatment program that is equipped to handle cases of dual diagnoses.
Talking to a Loved One
It can be difficult to discuss treatment options with a loved with an impulse control disorder and addiction issues. Depending on how the disorders are impacting the person, the individual may or may not be aware that the conditions are present. The person may be aware that one issue is present, but not see the other issue as a contributing factor.
When approaching a loved one, it’s important to start from a place of empathy and understanding. Remember that addiction and mental health disorders are not matters of willpower; they are medical diseases that require medical treatment.
A large part of getting help is being ready. Many people with impulse control disorders are not aware of the treatment options available to them or that they are not alone in their struggles. Simply knowing that there are others who struggle with the same issues can help people to take the first step toward getting help. In addition, it can help to stress to your loved one that co-occurring disorders are incredibly common, but comprehensive treatment can address both issues simultaneously, allowing for full recovery on all fronts.
Fortunately, there are many highly effective treatment options available to those who suffer from an impulse control disorder. Depending on the type of disorder, how long the person has managed the condition, and its severity, the chosen therapy will differ.
For many impulse control disorders, pharmaceutical medication is recommended. There are targeted approaches available to address many of the symptoms associated with the conditions. For instance, ADHD medication may help those suffering from the condition to focus on the tasks they need to perform. In some instances, medications may be used to treat co-occurring addiction issues, particularly during the detox phase. It’s important to have an integrated treatment team supervising the entire treatment process to ensure overall management of all medications and therapies.
There are a variety of cognitive therapies available as well. Some therapy-based treatment options involve the use of behavioral modification techniques. A psychologist teaches a client to cope with stress and to find other ways to relieve tension rather than turning to substances of abuse. In other cases, licensed therapists collaborate with their clients to identify specific root causes of the addiction and to develop unique strategies to overcome these issues based on the individual circumstances.
For less serious cases of impulse control disorder or addiction, where either condition is not significantly impacting the person’s life in a way that jeopardizes their safety, family, or health, outpatient therapy may be enough to provide substantial relief. However, for most cases of co-occurring disorders, treatment is more complex, and inpatient care is recommended. Inpatient treatment allows a person to fully focus on recovery, without the daily distractions of everyday life.
Impulse control disorders and addiction impact millions of people across the United States and internationally. While some people may try to self-manage these conditions, they are usually unsuccessful. Professional help that includes therapy and pharmaceutical medication can make the difference, enabling people to effectively manage all co-occurring disorders and step forward toward a life of health and balance.