Mental Wellness: Understanding Impulse Control Disorders

Impulse control disorders (ICDs) are a type of mental health disorder that is characterized by the inability to control certain impulses. These impulses can be aggressive and antisocial. Typically, individuals who struggle with ICD cannot overcome the impulse to engage in harmful, destructive, or disruptive manners. Understanding impulse control disorders is the first step toward better mental wellness.

There are multiple categories of impulse control disorders as well as different symptoms. ICD usually appears in childhood, but there are rare occasions that it doesn’t manifest until adulthood. The causes of impulse control disorder are just as varied as the symptoms, depending on the person. ICDs can affect mental wellness to various degrees.

No temptation has overtaken you that is not common to man. God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it. – 1 Corinthians 10:13, ESV

Types of impulse control disorders and symptoms

It is thought that impulse control disorders develop due to a combination of factors. These behaviors can occur with other mental health disorders such as anxiety and depression. Biological factors may play a role in the development of ICDs. Commonly, most people who suffer from impulse control disorder have distress or conflict associated with this behavior.

Oppositional Defiant Disorder

An individual who struggles with this disorder will show signs of being uncooperative, defiant, and at times, hostile toward people in authority. These individuals find it hard to comply with any form of authority and often blame others for their attitudes and behaviors.

The most common symptoms of ODD are:

• Frequently in trouble at school
• Has a hard time making/keeping friends
• Frequent anger bursts/temper tantrums
• Irritable, argumentative, angry
• Does not comply with rules or directions from authority

Unkind behavior and harsh words in conversations

Intermittent Explosive Disorder

Those who have this disorder have a hard time reacting appropriately when they become frustrated. This type of ICD is characterized by sudden, intense outbursts that can be violent. There are instances where these outbursts may lead to damaging relationships and the property of others.

Common symptoms of intermittent explosive disorder are:

• Failure to control aggressive outbursts
• Physically assaulting others
• Threatening others
• Starting arguments
• Destruction of others’ property

Pyromania

Individuals who have pyromania are known for their fascination with fire. They have no reason to set a fire other than that they are intrigued by fire or anything related. A person with pyromania typically feels tense until they set a fire, which will lead to a sense of euphoria and relief.

The most common symptoms are:

• Unusual interest in fire
• Excitement before setting the fire, followed by relief
• Intentional setting of multiple fires

Kleptomania

This disorder is characterized by the impulse to steal. The individual will take things that don’t belong to them, regardless of the location. It’s not about the value of the items but rather the release of the pent-up excitement and pleasure of the act of stealing.

Common symptoms of kleptomania are:

• A constant need to steal things that are invaluable and unneeded
• Tense feelings prior to the theft, followed by heightened feelings of relief afterward.

Trichotillomania

This disorder involves the individual having a compulsive tendency to pull out their hair. This doesn’t just affect the hair on the scalp, but also the eyebrows and other areas. It is in the group of body-focused repetitive behaviors.

Common symptoms include:

• A sense of tension before pulling out hair
• A sense of relief after the hair is pulled
• Repeated pulling out of hair on the scalp and other areas
• Biting or chewing pulled-out hair
• Playing with pulled-out hair / rubbing it across the face
• Struggle with distress in various situations related to pulling out hair

Conduct Disorder

Behaviors in this type of disorder are characterized as being persistent and repetitive. They often violate the rights of other people and go against social norms. Conduct disorder is more severe than oppositional defiant disorder. It is also connected to antisocial personality disorder in adults.

The most common symptoms of conduct disorder include:

• Angry outbursts
• Skipping school
• Extreme substance abuse
• Dishonesty
• Mistreating children
• Bullying, fighting, sexual assault
• Consistent rule-breaking
• Running away from home
• Theft, vandalism, arson

Unspecified impulse control disorder

There are times when individuals manifest impulse disorders that do not fit into a specific category. They are still considered to be an ICD and can be treated based on the symptoms and severity.

Common behaviors that are considered unspecified may include:

• Internet use
• Gambling
• Shopping
• Sexual behavior

Causes of impulse control disorders

Identifying the cause of an impulse control disorder can be difficult. This is because each person is different, leading to different causes of the same disorder. Multiple factors play a role in the development of an ICD. Understanding the cause of impulse control disorders can help individuals navigate treatment toward reaching their goal of mental wellness.

Pharmaceutical drugs Certain dopaminergic drugs, such as Mirapex, can contribute to impulse control disorders such as gambling and sexual pursuits. Other drugs, including antipsychotics, antidepressants, and hormone modulators, can also play a role in the development of pathological gambling and hypersexuality.

Abnormal neural activation or connectivity Specific regions of the brain that influence impulse control, which are abnormal, can make it difficult to control impulses in a normal manner.

Neurotransmitters and receptors Abnormal functions of these areas of the mind can impact the person’s ability to control impulsive behavior.

Genetics There is a correlation between genetics and epigenetics and ICD. The presence or lack of certain genes can increase the risk of developing an impulsive control disorder. It is also thought that the effect of environmental factors on gene alteration can have an impact on the development of various impulsive behaviors.

Brain damage Individuals who have developed any type of brain damage have an increased risk of developing some variant of ICD.

Autonomic nervous system Some individuals with ICD may have differences in the activation of the ANS due to issues of dopamine, norepinephrine, and cortisol release. When the autonomic nervous system is dysfunctional, there can be a risk for impulse control disorders.

Psychological aspects There are certain aspects of cognitive and emotional disorders that can increase the probability of a person developing an ICD.

Treatment for ICDs

Treating ICDs is just as challenging as identifying the cause. If the impulse control disorder is related to drugs, it can be more difficult to treat. Treatment for ICD is based on the individual, symptoms, and possible causes. Reaching out to get help with treatment is the first step in obtaining mental wellness that overcomes impulsive behaviors.

• Antidepressants are one of the first choices for treatment, but are subject to the presence of abnormal neurochemical issues related to the ICD.
• Mood stabilizers can improve behaviors but may be limited by the patient’s reaction.
• Opioid antagonists can help with the maintenance of ICD.
• Glutamatergics can create a reduction in the reward side of the ICD.
• Psychostimulants may improve self-control in certain individuals.
• Eugeroics may decrease the risky decision-making associated with gambling.
• Cognitive behavioral therapy can be a great tool to use in understanding ICD behavior and creating strategies to manage ICD without the use of drugs.
• Self-directed neuroplasticity may help some individuals learn to replace the ICD behavior with acceptable alternative behaviors.

Next Steps

Impulse control disorders are difficult to live with and often more challenging to treat. The first step is connecting with a local Christian counselor to identify ICD behaviors. Once the behaviors are noted, the counselor can help establish a treatment plan and possibly connect with a psychiatrist who can help determine the best course of treatment. To begin meeting with a counselor at our location, call today.

Hear my prayer, O LORD; give ear to my pleas for mercy! In your faithfulness answer me, in your righteousness! Enter not into judgment with your servant, for no one living is righteous before you. Psalm 143:1-2, ESV