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Impulse Control Disorders and Treatment

What Is Impulse Control Disorder?

Impulse control disorders include a number of psychiatric conditions that may cause social, legal, occupational and financial impairments. These disorders usually have the following characteristics1:

  • A “hungry” urge  just before giving in to behavior that is problematic.
  • A pleasurable feeling during the act of such behavior.
  • Decreased self-control over such behavior.
  • Repeated participation in such behavior, even in the face of negative consequences.

While there are some people who indulge in their impulses due to drug use, immaturity or plain orneriness – there are others who may simply have deficient impulse control functioning. Individuals who struggle with impulse control may desperately want to control their urges, but they can’t just simply do so when they want. In the course of seeking help for such a situation, some of these individuals may be diagnosed with an impulse control disorder.


How Impulse Control Affects Your Life

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Woman with cravingsGood impulse control can help you make wise decisions and keep you safe. Instead of running into traffic, screaming at your boss or buying an item you can’t afford – you’ll rely on sound reasoning and keep your actions in check.

Impulse control can also have important implications in society. Some impulses are simply socially unacceptable, and people who break those rules on a regular basis are often shunned or arrested.

Some individuals simultaneously struggle with both an impulse control disorder and a substance use disorder – a condition referred to as a dual diagnosis. If you’d like to speak with someone to learn about dual diagnosis treatment for impulse control disorders and substance abuse, call 1-888-744-0789 today.

The Basic Facts About Impulse Control Disorder

People with impulse control disorders aren’t wild people who do whatever they want to do all the time. Instead, people with impulse control disorders tend to focus on one specific type of behavior, and this is the one behavior that person can’t seem to keep in check.

Almost any behavior could be part of an impulse control disorder, but common impulse control disorders may include:

  • Skin picking.
  • Hair pulling (“trichotillomania”).
  • Gambling.
  • Shopping.
  • Setting fires (“pyromania”).
  • Stealing (“kleptomania”).
  • Sexual behavior.

If you have an impulse control disorder, you may already know that the actions you perform aren’t good for you and they might get you in trouble. You may even want to stop doing these things. And yet, you find it extremely difficult to stop on your own. It’s a compulsive behavior over which you have little or no control.

Causes of Impulse Control Disorder

It’s hard to know exactly why some people develop impulse control disorders and others do not. A few factors have been recognized, however, in possibly contributing to the development of impulsive control disorders:

  • Coexisting mental health problems.
  • Genetics.
  • Medications.

Coexisting Mental Health Problems

For some people, impulse control disorder exists alongside a larger mental health issue, such as depression or obsessive-compulsive disorder. This sort of dual mental health problem can be quite common.

One study published in the journal Comprehensive Psychiatry, for example, found that 27.4% of people with bipolar disorder also had an impulse control disorder at the same time.2

While more research needs to be done on the topic, it could be that both mental health problems arise from the same chemical imbalances or structural problems in the brain.

Genetics

For some individuals, genetics may also play a role in making one more prone to developing impulse control disorder – meaning that a parent with the disorder might be able to pass the problem down to his or her children.

Family and twin studies, for example, have suggested a possible genetic component to developing trichotillomania (hair pulling).3

Medications

Interestingly, some people who have Parkinson’s disease can develop impulse control disorders as a result of certain medications they take. These medications are designed to correct dopamine imbalances in the brain, according to the Parkinson’s Disease Foundation – but they can also indirectly work on the portions of the brain that control behavior.4,5

Parkinson’s patients who might never have broken the rules a day in their lives might suddenly become compulsive gamblers, for example – or they might engage in inappropriate sexual activity in public places. This sudden change in behavior can be incredibly damaging to an individual’s relationships with friends, family and caregivers.


Treatment for Impulse Control Disorder

If you have an impulse-control disorder, you may already know that it can be very difficult to successfully manage the disorder on one’s own. It’s important to remember that this disorder is a medical condition that can be treated, and that there are professional treatment options that can provide significant help and allow you to live a life that’s free of compulsions.

Treatment for impulse control disorder may involve any combination of the following:

  • Habit reversal.
  • Medication management.
  • Impulse control treatment facilities.

Habit Reversal

Some individuals benefit from a type of therapy known as “habit reversal.”

According to OCD Action, habit reversal was developed in the 1970s to treat stammering, tics and skin picking.6 The idea here is to help the person identify the action when it is occurring – and then learn to replace that action with something else that is less harmful.

Man with eyes closedTreatment options that focus on complete abstinence of any action at all may do no good, as the pressure to act – to do something – to relieve mounting pressure may still exist.

Habit reversal is different, as it provides you with something you can do when you feel compelled to engage in your destructive impulse. If you pull your hair, you might be asked to clench your fists instead. If you pick at your skin, you might learn to close your eyes until the feeling passes. Your therapist might also teach you breathing exercises you can use to help relax your body, soothe tense muscles and control your urges.

In addition, you might be asked to keep a journal in which you write down when you felt the urge to act. As you look through this journal with your therapist, you might discover that specific people or places make you feel tense and more likely to perform your compulsion. When you spot that pattern, you can figure out how to avoid it.

Medication Management

Medications can play an important role in both treating and preventing the development of an impulse control disorder.

  1. Some people need to start a new medication to successfully control impulse control disorder.
  2. Some people need to change their current medication to stop feeding their impulse control disorder.

1. Starting a New Medication 

If you have impulse control disorder and are not currently taking any medications, you may need to begin a new medication to successfully help manage your impulse control disorder. A number of different medications commonly used to treat impulse control disorders include7:

  • Antidepressants. While these drugs have been commonly used for treating various impulse disorders, there are mixed findings on the drug’s actual effectiveness in treating impulse control disorders.
  • Mood stabilizers/anti-epileptics. More studies are needed to better determine the effectiveness of these medications in treating impulse control disorders.
  • Opioid antagonists. Opioid antagonists such as naltrexone have showed the strongest promise for successfully treating impulse control disorders.
  • Atypical neuroleptics. Atypical neuroleptics such as olanzapine have not shown to provide much benefit to those with an impulse control disorder.
  • Glutamatergic agents. N-acetyl cysteine (NAC) is a glutamatergic agent that has shown potential benefit in treating impulse control disorder.

2. Changing Your Current Medications

If your condition arose due to Parkinson’s disease medications, for example, you’ll need to work with your doctor to find alternative medications that won’t cause this sort of serious disruption in your life.

The best thing you can do is to discuss your health conditions and medications with your doctor so you can optimize your health and minimize impulse control problems from medications.

Dual Diagnosis Impulse Control Treatment Facilities

Dual diagnosis treatment programs can address the simultaneous issues of substance abuse and an impulse control disorder. These facilities may offer an effective combination of both medication and therapy. While quality of dually diagnosed substance use disorder and impulse control treatment will be similar across facility types, some offer more comfort amenities than others.

  1. Standard facilities often offer both residential and non-residential treatment structures. While there aren’t the same range of comfort amenities as are offered by luxury or executive facilities, standard programs usually offer the most affordable pricing for those on limited budgets.
  2. Luxury facilities provide residential treatment in the context of many high-end, resort-like amenities designed to make your recovery process as pleasant as possible.
  3. Executive facilities also offer residential treatment with high-end amenities – although they also cater to busy professionals by providing the resources and program structure that lets them maintain an active involvement in the work place throughout recovery.

You Can Overcome Impulse Control

Feeling free
Impulse control disorders can be disruptive, distressing and dangerous. But thankfully, they can be successfully treated.

With the right sort of therapy, and with the dedication to stick to treatment – you can keep those impulses from controlling your life. You’ll learn to relax when tension mounts, and you’ll have the strength to control those destructive thoughts.

How to Talk With Your Doctor

For many people, the hardest part of the process involves talking about the issue with a doctor. Discussing an issue like this can be difficult, and maybe even a little embarrassing. After all, who wants to admit that they can’t stop tearing at their hair or setting fires?

However, it helps to remember that you are dealing with a medical condition rather than a form of personal weakness. You have a right to get treatment for this condition – and with treatment, you can get better.

The following tips might help you hold this important conversation:

  • Bring a friend. If a family member or close friend has seen the effects of your behavior firsthand, ask that person to come along to your appointment. This person might even be able to break the ice for you.
  • Write it down. If you find talking about the problem too hard, write down your important points. Keep a list of when you feel compelled to act, and hand that list over at the beginning of your appointment.
  • Bring this article. Use this article as a jump-off point to help you talk to your doctor.
  • Find a support group. There are many online support groups for people with compulsions. Sometimes, reading through stories of people who have survived the disorder can inspire you to make your own changes, and speak up.

Personal Testimonies

Recovery success stories from other people can provide substantial motivation and hope when you feel stuck in the thick of your own impulse control problems. Read on to hear about a few individuals who benefitted from seeking help for their impulse control problems.

Anna’s Compulsion+

On the outside, Anna looked like a regular teen. She pulled down high grades at school, she had a close relationship with her mom and she had a part-time job. As she grew older, however, and the pressures of home, school and work began to grow, Anna found it harder and harder to cope with the stress. One night, as she was sitting in front of the computer, feeling anxious, she started swirling a lock of hair around her finger. Soon, that swirling turned into pulling. When Anna pulled out the hair, she felt better. The tension seemed to melt away, at least temporarily. As time went on, Anna found herself more and more tempted to pull her hair out. Soon, she had bald patches all along the sides of her head. When her mom noticed this damage, Anna and her mom went to the doctor together to get Anna help. Now, three years later, Anna doesn’t pull her hair at all. She still attends support groups monthly as a means to cope with stress in a healthy way.

Jon’s Gambling Situation+

Three years ago, Jon was preparing to get married. He was excited about this big change, but planning the wedding became really stressful. There were so many details to cover, and so many people to invite, and Jon just had trouble keeping up with it all. One day, just to pass the time, he stopped by the local bar and sat down at a video poker game. He won a little money, and he noticed that winning tended to relieve the stress he was feeling. Soon, he found himself tempted to gamble each time he was stressed, and he wasn’t always lucky enough to win. When Jon’s fiancée discovered that he’d spent their entire honeymoon account on gambling, he was forced to admit that he had a problem. He went through therapy, and joined a 12-step support group. Now, when Jon feels tempted to gamble, he goes to a meeting instead. It’s become an effective way he can keep his impulses under control.

Tracy’s Compulsion to Steal+

Ever since she was a teenager, Tracy has been compelled to steal. She doesn’t always take things that she wants. In fact, sometimes she puts things that she steals back on the shelves the next day. But she finds that getting away with a theft is a bit of a thrill that she can’t quite pass up. She feels tense before she steals, and when she walks out of the door, all of that tension just disappears and she feels great, until she gets home and feels guilty. Months ago, a security guard caught Tracy in the act, and let her off with a warning. She knows she has to stop, but she’s not sure how she should start. When the tension builds up, what will she do instead? She’s preparing to talk to her doctor, in order to start down the road to recovery.


Find the Help You Need

Dual diagnosis treatment centers can help people recover from substance abuse and simultaneous behavioral health conditions such as impulse control disorders. If you’re concerned that you may be struggling with both an impulse control disorder and a problem with drugs and/or alcohol, call to speak with one of our recovery advisors at 1-888-744-0789. We would be happy to help answer any questions you have and help you sort through what treatment options would be best for you.

Sources

  1. Grant, J. E., Odlaug, B. L., Kim, S. W. (2007). Impulse control disorders: clinical characteristics and pharmacological management. Psychiatric Times, 24(10), 64-9.
  2. Karakus, G., Tamam, L. (2011). Impulse control disorder comorbidity among patients with bipolar I disorder. Compr Psychiatry, 52(4), 378-85.
  3. Chattopadhyay, K. (2012). The genetic factors influencing the development of trichotillomania. J Genet, 91(2), 263.
  4. Marsh, L., Callahan, P. (2005). Gambling, sex, and…Parkinson’s disease? Parkinson’s Disease Foundation.
  5. Stenberg, G. (2016). Impulse control disorders – the continuum hypothesis. J Parkinsons Dis, 6(1), 67-75.
  6. Information resources. OCD Action.
  7. Schreiber, L., Odlaug, B. L., Grant, J. E. (2011). Impulse control disorders: updated review of clinical characteristics and pharmacological management. Front Psychiatry, 2: 1.