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Impulse Control Disorders and Treatment

What Is Impulse Control Disorder?

Impulse control disorders include several psychiatric conditions that may cause social, legal, occupational, and financial impairments. Impulse control disorders follow a cycle. First, there’s the buildup of tension in anticipation of a behavior. Often this is accompanied by a positive feeling during the act or a feeling of release after the act.

Occasionally, this euphoria is followed by feelings of shame and regret. When a person suffers from an impulse control disorder, they have less and less control over their behavior and will continue with negative patterns even if they experience negative consequences as a result.

Good 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  socially unacceptable, and people who break those rules on a regular basis are often shunned or arrested.

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There are a number of different types of impulse control disorders, ranging from skin picking to hail pulling and risky sexual behavior. Gambling, obsessive shopping, and stealing are also examples of impulse control disorders.

Impulse control disorders manifest in different ways for different people. However, there are some similarities, no matter the type of impulse control condition. These include the following:1

  • An urge just before giving in to the problematic behavior.
  • A feeling of pleasure during the behavior.
  • Decreased self-control over the ability to control the behavior.
  • Repeated participation, even when there are negative consequences.

Some people might indulge their impulses because of drug use or immaturity, but others have a deficient impulse control. These people want to control themselves but can’t. In these instances, they’re often diagnosed with impulse control disorder.


Causes

Woman with cravings

Science still isn’t clear on what causes impulse control disorder to develop. There are few factors that seem to be consistent in all people who have this condition—coexisting mental health problems, genetics, and medication use.

Dual mental health conditions, such as obsessive-compulsive disorder or bipolar disorder, can sometimes accompany impulse control disorder. Dual mental health problems can be quite common. More research is needed, but it’s possible that there’s a correlation between chemical imbalances and structural problems in the brain.2

Genetics might play a factor in the development of this condition. If a parent has it, then it’s likely that it may be passed down to the child. Some research suggests that in families who have twins there’s a greater chance of developing a hair pulling impulse control disorder.3

Medications that are designed to correct dopamine imbalances in the brain might also affect portions of the brain that control behavior. For people who have Parkinson’s disease, this might put them at risk for developing impulse control disorders.4,5


Treatment

For those who suffer from this condition, it’s very difficult to manage it on your own. Remember that this disorder is a medical condition that can be treate; there are plenty of professional treatment options that can help you live a life free of compulsions. Treatment will look different for each person but might include habit reversal therapy, medication management, or in-patient treatment at a facility.


Habit Reversal

Habit reversal is a technique that was developed in the 1970s. It helps treat tics, stammering, and skin picking.6

The idea is that a person can identify when the action occurs and then learn to replace that compulsion with something less harmful. Habit reversal is useful since it provides a person with an alternative when the compulsion presents itself. Breathing exercises are often a part of habit reversal therapy to help sooth tight muscles and control urges. Journaling has also been shown to be useful so a person can begin to understand triggering sensations and environments.


Medication Management

Medication can help successfully control this disorder, either by introducing a new medication or changing a current medication. For those who have impulse control disorder as a result of Parkinson’s medication, carefully discussing treatment options with your doctor is essential to help minimize this condition.

New medications can help treat impulse control disorder. These include some of the following:7

  • More research is needed to determine how effective these medications are for treating this condition.
  • Glutamatergic agents. N-acetyl cysteine (NAC) is a glutamatergic agent that has shown potential benefit for those suffering from impulse control disorder.
  • Opioid antagonists. Opioid antagonists such as naltrexone have showed the strongest promise for successfully treating impulse control disorders.

Dual Diagnosis Impulse Control Treatment Facilities

It’s possible that you have been diagnosed with impulse control disorder while struggling  with substance abuse. A treatment program designed to address both conditions can be a way to overcome these challenges and begin living your best life. There are three different types of treatment centers available.

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 they are treatable. With the right therapy and a commitment to treatment, you can keep impulses at bay. For many, the hardest part of the process is talking with your doctor. After all, who wants to admit they can’t control themselves? It’s important to remember that you’re suffering from a medical condition that from a personal weakness. You have the right to get treatment, and you owe it to yourself to find a way to live your best life.

When you’re ready to discuss this condition with your doctor, it might be helpful to write down important points ahead of time. That way, you’ll remember everything you want to discuss. Bringing a friend can be helpful too, if that person has witnessed your behavior first-hand.

Support groups, either in person or online, often provide the framework for building a solid foundation of understanding and acceptance. Combining a support group with the right type of treatment can get you on the road to wellness.


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. OCD Action. (n.d.). Information Resources.
  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.