Impulse-Control Disorders

The defining behavior of Impulse-Control Disorders is the inability to stop an impulse. This behavior might be harmful to oneself or others. The impulse causes anxiety, tension, or arousal. Once an impulse is acted on, it gives relief or pleasure. However, regret or guilt may follow. There are several types of impulse-control disorders. They are described below.

CAUSES

There are no known causes for the different forms of Impulse-Control Disorders. Research has shown certain influences such as the following:

  • Problems with certain naturally occurring chemicals in the brain may play a role in impulse stealing and excessive gambling disorders.

  • Most people who cannot control their aggressive behavior, tend to have grown up in families where explosive behavior and verbal and physical abuse were common.

  • In 2006, researchers reported finding mutations in a specific gene that may give rise to the disorder of people pulling out one's hair repeatedly, without control. These gene mutations are thought to play a role in only a few cases.

SYMPTOMS

Symptoms depend on the specific type of disorder. (See below).

DIAGNOSIS

Specific problems must be present for a diagnosis. These differ depending on the specific condition. For example:

Intermittent Explosive Disorder:

  • The person fails to stop aggressive impulses time and time again. These impulses result in damage of property or harm to another person.

  • The level of aggression during an incident is out of balance with the event that took place.

  • The aggression is not a result of another mental disorder.

  • The aggression is not due to the effects of a drug or a medical condition.

Kleptomania:

  • Acting out the impulse to steal objects without the motive of monetary gain.

  • Not able to stop the urge to steal objects.

  • Increased tension that leads up to the theft.

  • Pleasure and/or relief during the act of stealing.

Pyromania:

  • Set fires on purpose on more than one occasion.

  • Having feelings of tension or emotional pleasure before setting the fires.

  • Being obsessed with anything regarding fire:

  • The tools associated with fire.

  • The uses of fire.

  • The aftermath of fire setting.

  • Having relief, pleasure, or happiness from setting, witnessing, or being involved in a fire or its aftermath.

  • The patient does not have other motives for setting fires, such as:

  • Financial motives.

  • Anger or revenge.

  • A desire to cover up another crime.

  • Delusions or hallucinations.

  • Ideological convictions (such as terrorist or anarchist political beliefs).

  • Impaired judgment resulting from substance abuse, traumatic brain damage, dementia, or mental retardation.

  • The fire setting cannot be better accounted for by anti-social personality disorder, a conduct disorder, or a manic episode.

Compulsive Gambling:

At least five of the following signs and symptoms must be present to make a diagnosis:

  • Routine gambling that becomes harmful to the person.

  • Being preoccupied with gambling. Examples would include reliving past gambling ventures or planning ways to get gambling money.

  • Needing to gamble with increasing amounts of money to become excited.

  • Trying to cut back on gambling without success.

  • Getting restless or irritable when trying to cut down on gambling.

  • Gambling to escape problems or to relieve feelings of sadness or helplessness.

  • Chasing losses or trying to gamble back lost money.

  • Lying to people to hide the extent of gambling.

  • Committing illegal acts for the sake of gambling.

  • Risking or losing an important relationship, job, or educational opportunity because of gambling.

  • Turning to others for money when the financial situation becomes hopeless.

Trichotillomania:

  • Pulling out your hair over and over again. This results in noticeable hair loss.

  • Increasing sense of tension before pulling or when you try to resist pulling.

  • Pleasure or relief when pulling.

  • Your hair loss is not related to another medical or skin condition.

  • Hair pulling causes you significant distress.

TREATMENT

Treatment can be challenging. A major part of treatment is admitting that a problem exists. People who are under pressure from loved ones or an employer may resist treatment. It is important to know that treatment can help regain a sense of happiness and control. Treatment may be able to help heal damaged relationships or finances.

Treatment involves three main approaches. These are:

  • Cognitive behavior therapy (CBT) - focuses on recognizing unhealthy, absurd and negative beliefs. Then, one must replace them with healthy, positive ones. Another form of CBT is group therapy. In group therapy, one can tap into the advice, feedback and support from other people facing similar issues.

  • Medications - may help mood and emotional issues. Two medicines that are used to treat mood disorders are antidepressants and mood stabilizers. In addition, medications found useful in treating drug abuse may help with treatment.

  • Self-help groups.

HOME CARE INSTRUCTIONS

  • Changes at home or work may be required. This will help reduce tensions that can lead to unwanted behavior.

  • Your caregiver can help you understand what changes would be helpful. This depends upon your specific condition.

  • If medication is prescribed, take as directed.

SEEK MEDICAL CARE IF:

You feel that you are experiencing side effects from prescription medications.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.