In psychology, an impulse control disorder refers to compulsive and uncontrollable behavior that sufferers engage in under stress. The respective, impulsively performed action leads to a brief relaxation of tension.
What characterizes an impulse control disorder?
Possible behaviors that offer early clues include lying, stealing, aggressive and auto-aggressive behavior, and a tendency toward risky or obsessive sexual behaviors. Wounds, bald patches and chewed fingernails can also be signs of possible compulsive behavior.
According to abbreviationfinder, a characteristic of impulse control disorders is that people are unable to resist their impulses. The decision to carry out a certain action is not made and carried out consciously. In addition, the various impulses do not pursue any goal. A typical impulse control disorder is, for example, pathological stealing, which is also known as kleptomania.
People who steal compulsively do not pursue motives such as enrichment, envy or harming another person. They steal instinctively and have no interest in the stolen items, often even hiding or destroying them. Other impulse control disorders include compulsive shopping, overeating, gambling, addiction to masturbation, and the compulsion to injure one’s body by scratching or pulling one’s hair and nails.
Basically, an impulsive action can be divided into five different action sections. After the first impulse, the desire to carry it out grows, which is associated with high tension. This is reduced by performing the compulsive action and leads to brief relaxation. The last stage, which does not always take place, is characterized by feelings of guilt.
The causes of impulse control disorders have not yet been conclusively researched. In all probability, however, the disorders are triggered by a complex interplay of genetic and physical foundations, upbringing, environment and experience. In addition, researchers suspect that the hormone level of those affected is relevant to the problem and has a significant influence on the type of disorder.
Men have higher testosterone levels than women and are more prone to aggressive disorders, such as compulsive burning. Women, on the other hand, engage in less aggressive compulsions, although they are often self-destructive. Trichotillomania, i.e. the compulsion to pull out hair, is a compulsive act that is often performed by women. In addition, the question of how impulse control disorders are connected with other mental disorders is investigated. The connection with substance dependencies and serious mental illnesses such as borderline personality disorder, for example, is particularly important.
Symptoms, Ailments & Signs
The symptoms of an impulse control disorder are not always specific, as there are many different forms of the disorder. In addition, those affected are usually not aware of their own behavior. In children, typical behavioral patterns such as spontaneity or seemingly pointless actions can easily be mistaken for mental disorders.
In the USA in particular, there is a tendency towards the rapid administration of psychotropic drugs when there is a suspicion of mental illness in childhood. In any case, a possible mental disorder should always be considered in connection with the age and the environment of the person concerned. Possible behaviors that offer early clues include lying, stealing, aggressive and auto-aggressive behavior, and a tendency toward risky or obsessive sexual behaviors.
Wounds, bald patches and chewed fingernails can also be signs of possible compulsive behavior. Those affected also often suffer from obsessive thoughts, pursue irrational ideas and have difficulty concentrating. Because impulse control disorders occur whenever people are overwhelmed by the situation they are in, psychological state is an important factor.
People who suffer from lack of impulse control are often depressed, suspicious, feel alone and suffer from low self-esteem.
Diagnosis & course of disease
The diagnosis of an impulse control disorder must always be made by a specialist. This is not always easy to diagnose, since some disorders, such as compulsive eating or shopping, are socially accepted to a certain extent on the one hand and also overlap with addictions on the other. Compulsive burning is not necessarily comparable to gambling addiction and eating disorders can also be understood as a conscious attempt to gain body control or as an unconscious act of compensation.
Complications from this clinical picture vary greatly, since the impulse control disorder can be a symptom of several diseases. The compulsion to buy, for example, often means a great financial burden. Some sufferers make larger expenses even when they cannot actually afford them, or they spend money that was earmarked for other purposes. This can lead to significant interpersonal tensions with those around you.
The same applies to some extent to gambling addiction. Gambling addicts also often neglect their family and circle of friends. Professional complications can also arise – for example, when you are absent, poor performance or games (e.g. on the computer or mobile phone) during working hours.
People with trichotillomania pull their own hair. This can result in bald spots that are not very aesthetic. If the eyebrows are completely removed, sweat may trickle from the forehead into the eyes. The eyelashes also serve to protect the eyes; if the trichotillomaniac pulls them out, their protective effect is also missing. In addition, the human body is not able to digest hair. This can create a hairball in the intestine. Such a so-called bezoar can lead to intestinal obstruction.
Kleptomaniacs may face the legal ramifications of their pathological stealing. This also applies to pyromaniacs if they set fire to someone else’s property or violate regulations. In some cases, pyromaniacs will suffer injuries when setting an object on fire. All impulse control disorders can be associated with other mental illnesses, such as depression.
When should you go to the doctor?
People with unusual behavior or sudden changes in behavior should always be examined and treated by a doctor. If there are spontaneous, uncontrolled outbursts of anger, violence or verbal attacks, a doctor or therapist is needed. If an affected person’s mood repeatedly shifts from harmless to aggressive or upset within seconds or minutes, a doctor should be consulted.
The clinical picture of an impulse control disorder includes the lack of insight into a discrepancy. For this reason, special sensitivity is required when dealing with the person concerned. A special bond of trust is important for people with increased impulsivity or with problems with emotion control to see a doctor.
If the behavior of the person concerned is experienced as abnormal, a doctor should be asked for advice. People who are colloquially perceived as choleric, raving mad or inflamed with rage can learn to change their behavior through therapeutic care. Uncontrolled behavior is perceived as frightening by people in the area and should be discussed with the person concerned and a doctor.
Relatives are well advised to get information from a specialist doctor so that they can show the right behavior when dealing with the person concerned. If the impulse control disorder increases in intensity or if it poses a risk to others, a medical officer can be called in.
Treatment & Therapy
In principle, those affected can be treated with drugs under the supervision of a psychiatrist or choose a non-drug therapy approach such as talk therapy, behavioral therapy or psychoanalysis. It is important to clearly define the goals of therapy. On the one hand, there is the possibility of completely suppressing unwanted behavior and, on the other hand, the goal of modifying the compulsive action and reducing it to a harmless level.
A preliminary consideration for determining the goal of therapy is, for example, the question of the extent to which the person affected is physically harming themselves. In addition, the social and legal context of the action must be considered. For example, compulsive stealing is evaluated differently than compulsive buying. The therapist must also assess whether the patient is able to reduce the harmful behavior to a level that is not harmful. And of course it should not be forgotten whether the person concerned is willing to cooperate. In the case of children in particular, patients are often unaware of the seriousness of the situation.
Outlook & Forecast
The prognosis is linked to the present cause or underlying disease of the person concerned. In many cases, behavioral therapy or other psychological support can improve the symptoms. If the patient is aware of the disease and cooperates, the patient receives a good prognosis. With an optimal treatment plan, incremental changes are achieved until you are free of symptoms.
With a low intensity of the impulse control disorder, a significant alleviation of the symptoms can be achieved after just a few months. A behavioral regulation takes place, which is built on the basis of intensive training. The more severe the disorder, the longer the treatment usually takes. The difficulty lies in keeping the patient motivated until the end of the treatment. Initiated therapies can be discontinued, which makes it difficult to obtain a good prognosis.
If the impulse control disorder is based on a mental disorder, the prognosis worsens. In the case of reduced intelligence or a serious mental illness, the person concerned is dependent on daily care. In severe cases, medical care is needed. In many cases, healing is not achieved in these patients. Long-term therapy is required so that step-by-step optimization can be implemented. Once prescribed drugs are discontinued, a relapse is to be expected.
Mental illnesses, such as impulse control disorders, are unavoidable and affect people of all ages, genders and social backgrounds. However, as with all mental illnesses, a stable environment that encourages personal development minimizes and encourages the chance of becoming ill. Social contacts, avoiding drugs and other addictive substances and a fulfilling everyday life provide a good basis for a life without illness.
A successfully treated impulse control disorder requires lifelong follow-up care. Otherwise, the risk of recurrences of this mental disorder is increased. In psychological therapy, those affected have usually learned strategies for dealing with stressful situations without displaying impulsive behavior.
In the context of aftercare, it is relevant to further internalize these learned mechanisms and to always apply them. As soon as patients notice that they are becoming impulsive again, they contact their former psychiatrist immediately. Aftercare also includes taking measures to prevent new phases of the disease.
Life situations associated with stress also increase the risk that those affected will develop an impulse control disorder again. Then it is necessary that one’s own actions are critically questioned and that a psychological counseling center or the former psychologist is consulted as quickly as possible. All activities that promote mental stability are also helpful, from yoga to sports and meditation.
Self-help groups also offer many affected people important support after professional treatment. Here, patients receive support from like-minded people and may be made aware of relapsing behavior before they even admit it to themselves. Either way, follow-up care for impulse control disorder is a lifelong process.
You can do that yourself
The actions people with impulse control disorder can take vary widely, depending on the type of disorder. It should be noted that a holistic therapy of the disorder distinguishes, for example, between self-damaging (compulsive hair-plucking) and criminal behavior or behavior that harms others (compulsive setting fires).
It should be noted that in the vast majority of cases, impulse control disorders will not be managed alone. The decisive factor is that those affected are willing to undergo therapy and follow the steps consistently. Only afterwards and concomitantly can one speak of self-help measures. These essentially consist of finding alternative actions that relieve the tension that has built up. This substitute action should be easy to carry out anywhere to provide maximum protection against relapses. For example, in impulse control disorders involving the hands, sufferers can sit on them to prevent impulse-controlled behavior. Such measures may need to be worked out with a therapist.
In the case of an impulse control disorder, it is usually not the goal to eliminate the disorder, as this is currently hardly possible. Instead, valves must be created which the person concerned can use and which ideally also have other uses. Along with the fact that the aim is to free oneself from the urge to pursue one’s disorder, it is up to those affected to find suitable options in their everyday life within the framework of exploratory therapy, which are then incorporated into the further course of therapy.