An impulse control disorder is a term that describes a person’s inability to avoid or stop doing things that might be harmful to themselves or to other people. It’s not uncommon for people who live with this type of disorder to feel anxiety or building tension before committing the action or finding relief in the behavior – like mounting pressure, or an itch that needs to be scratched. Despite knowing how dangerous the action or behavior is, and sometimes even in spite of negative consequences, once the person has acted upon the behavior, he or she feels relieved, perhaps even happy.
Officially, there are five officially recognized types of impulse control disorders. They are the following:
Intermittent Explosive Disorder
Kleptomania
Pyromania
Pathological Gambling
Trichotillomania
These impulse control disorder examples each have their own symptoms, but similar traits are shared between the five. All of these disorders are characterized by a person’s powerlessness to control his or her actions or behavior. The results are negative, and sometimes catastrophic, affecting not only the individual’s life, but the lives of those around them.
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The 5 Impulse Control Disorders
Intermittent explosive disorder
Overview. Typically, intermittent explosive disorder is characterized by sudden and repeated aggressive or violent behavior. The person might lash out impulsively, screaming, yelling, or throwing things. These types of outbursts often occur during situations that don’t call for such physical or verbal violence – they can happen in traffic (i.e. road rage), at home (i.e. domestic abuse), or in the workplace (i.e. workplace violence and harassment). The behavior of adults who suffer from intermittent explosive disorder have been compared to that of a young child’s temper tantrum, a seemingly uncontrollable and impassioned show of negative emotion.
Intermittent explosive disorder, like the other four that fall under the impulse control disorder umbrella, can have a very distressing and negative impact on one’s life, including the breakdown of relationship at home, the loss of a job, or poor academic evaluation and performance. It can also lead a person to experience legal consequences.
Symptoms. Without warning, explosive reactions can occur swiftly and suddenly, lasting approximately half an hour or less. Some people experience these eruptions frequently, while others can go months without an episode. Typically, though, people with this disorder regularly feel angry or irritable often, or may feel impulsive in other ways too.
Some of the symptoms include racing thoughts, irritability, rage, heightened emotions, heart palpitations, chest tightening, tingling, and tremors. The person experiencing an episode may find him or herself in a heated argument or going off on a tangent. He or she may raise his or her voice in conversation, even going as far as to push, slap or hit the other person; he or she may even cause damage to physical objects nearby or property. In more serious cases, the person may assault others or abuse animals.
Immediately after the action or behavior, the person may feel a sense of relief or euphoria, followed by exhaustion. Later, however the person is likely to experience regret, shame, or remorse.
Causes. It’s been reported that intermittent explosive disorder can begin after the age of six years old, or may manifest in adolescence. The disorder appears more frequently in young adults and less in older adults. While the disorder can appear in anyone, it’s more commonly reported in those who may have grown up in violent and physically abusive households. There may also be a genetic and neurological component; the disorder can be passed down through the generations. Those with a history of physical abuse and other mental health disorders are at a higher risk of developing intermittent explosive disorder.
Kleptomania
Overview. Kleptomania is characterized by the urge to steal. Those with this disorder find themselves stealing things they don’t actually need, or items that have little value. While kleptomania is considered one of the rarer impulse control disorders, it stems from a person having difficulty with emotional self-control. A person with kleptomania often feels hesitant to seek treatment or help because they’re so ashamed of their behavior, but psychotherapy is imperative if one wants to overcome the disorder.
If left untreated, kleptomania can lead to disrupted relationships, loss of employment, and legal problems. Keep in mind that kleptomania is not the same as shoplifting – shoplifters usually steal for personal gain, out of rebellion, or are responding to a dare or pressure. Kleptomania is a disorder – someone with kleptomania steals because he or she has a mounting and irrepressible urge to do it.
Kleptomania episodes usually come without warning; a person with this disorder typically doesn’t plan on stealing. A person with kleptomania may steal from public places, but might also steal personal property belonging to friends or family. The items stolen aren’t often high in value, and may even be returned in secret.
Other conditions associated with kleptomania include anxiety, bipolar disorder, depression, personality disorders, alcohol and substance abuse, eating disorders, and other impulse-control disorders (including shopping and gambling).
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Symptoms. Some kleptomania symptoms include an uncontrollable desire to steal items that are unnecessary or have little value. If you have kleptomania, you may feel anxious or aroused by the thought of stealing; once you complete the behavior, you may then feel a tremendous rush of excitement, pleasure or relief. Shortly after the act, however, you may feel remorse, shame, self-loathing or guilt, but these feelings don’t last – the urge and temptation soon return, leading to a vicious and shameful cycle.
On the most serious and severe end of the disorder, a person with kleptomania may experience suicidal thoughts. He or she may even attempt suicide.
Causes. It has never been documented what exactly causes kleptomania, but like other impulse disorders, experts believe that it may be due to changes in the brain. It could be that people with kleptomania have low levels of serotonin (which is known to be common in those who present impulsive or spontaneous behavior). It could be that a person with kleptomania also suffers from some kind of addictive disorder, and the act of stealing causes a rush of joyful feelings. It might also be that the person has an imbalance in his or her brain’s opioid system, which regulates urges.
Kleptomania is considered uncommon, and for many, may never be diagnosed. Those with kleptomania often are too embarrassed to seek treatment, or are arrested and jailed for their behavior. Kleptomania usually begins in young adulthood but can start in the later years of life, usually affecting women. Those with a family history of mental illness (including bipolar disorder, obsessive compulsive disorder, anxiety, depression, substance abuse or a personality disorder) are at a higher risk of developing kleptomania.
Pyromania
Overview. Pyromania is typically characterized by the impulsive and obsessive need to set fire. It is not necessarily in an effort to cause death or destruction – it is an impulse control disorder that is marked by an unmanageable need to set fire. Pyromania is not the same as arson, which is a deliberate setting of fire for personal gain, revenge or desire to hurt people or destroy property. Pyromania serves no other purpose than to simply satisfy an urgent need to set fire.
Typically, a person with pyromania will exhibit an obsession with fire and lighting things on fire. He or she may visit the fire department often, or may even assist in putting out fires.
Pyromania is more common in males than females, and can affect both adolescents and adults. It is more typical in those who have learning disabilities, as well as those who are uncomfortable or ill equipped to handle social situations. Young adults with pyromania may exhibit other negative behaviors (including aggression or criminal activity).
Symptoms. Pyromania symptoms are considered unique in that no other impulse control disorder includes the desire to set fire. The main symptom of this particular disorder is the relief one feels they will only find after they’ve set something aflame; a person with pyromania might feel an intense, burning desire to light something on fire accompanied with heightened emotions. This has been likened to how a person with a substance abuse disorder might feel (an urgent, pressing need to use). Once the fire is set, the person with pyromania may feel a sense of relief or a rush of pleasure.
A person with pyromania may keep a shocking collection of lighters or items that would be used to create fire. His or her clothing or other personal items may reveal burn holes. He or she may experiment with paper, or inflammable material, in an effort to watch things burn on a smaller scale.
Causes. The cause of pyromania is unknown. However, it has been associated with other disorders, including substance abuse, addictions or personality disorders. Pyromania has presented itself in people who have lacked social support or adult attention and caregiving. It has also been considered that childhood neglect, or the experience of physical or sexual abuse, has also made way for the disorder. However, experts note that it’s very important not to assume that those who have experienced such life events are doomed to pyromania. While those with pyromania sometimes display acts of defiance, and may even have criminal records, the act of setting fire is not to hurt to maim others – it is simply to find relief from the urge to light and watch fire.
Pathological gambling
Overview. Pathological gambling (also known as compulsive gambling or gambling disorder) is characterized by the obsessive or urgent need to gamble, regardless of its effect on one’s life. The act of gambling can be described as taking a risk on losing something of value in the hope of gaining something of greater value.
Gambling stimulates a person in the way alcohol, drugs or other addictive behaviors can, leading to gambling disorder. A person with this disorder may soon find that despite devastating losses, he or she is skipping work to gamble, may hide the activity from friends and family, accumulate debt, and deplete his or her savings (or the savings of a spouse or other loved one). In even more serious cases, a person with a gambling disorder may even consider theft in an effort to support and continue the addiction.
Symptoms. The symptoms of pathological gambling include an obsessive preoccupation with gambling and the need to gamble using increasing amounts of money. A person with this disorder may try to stop to no avail; he or she may feel anxious, restless, frustrated or angry when trying to stop. A person with gambling disorder may also feel as though the only way they can get out of their mess is to gamble more, and will lie to friends and family about their activity. They may be willing to risk personal and professional relationships in order to gamble, an activity which they feel is the only way to escape the shameful, guilty and helpless feelings that accompany the disorder.
While casual gamblers are able to set a limit (“I’ll stop when I lose $100,” or “I’ve worn $100 – I’m done for the night!”) those with pathological gambling disorder only want to keep playing, either to keep winning or to gain back losses. It’s a destructive cycle that cannot be stopped without treatment.
Causes. Like other impulse control disorders, the exact cause of pathological gambling hasn’t been determined. However, those who suffer from other mental health disorders (including bipolar disorder, personality disorder or depression) are at higher risk of developing gambling disorder. It’s also more common in younger people or those in middle-age. Those with influential family members or friends who have the disorder may also be at a higher risk.
It’s also been reported that medications on the market used to treat restless leg syndrome or Parkinson’s (medications called dopamine agonists) have an atypical side effect that may cause compulsive behavior like gambling.
Trichotillomania
Overview. Also known as hair-pulling disorder, trichotillomania is a disorder characterized by the irresistible need to pull one’s hair from the scalp, eyebrows, or other parts of the body. Although hair-pulling disorder is usually manageable, there are those who pull hair from the scalp who end up with bald spots. These people often resort to desperate methods of disguising them.
Usually, this disorder presents itself more in females than in males. It often begins between the ages of 9 and 13, triggered by stressful experiences or events like abuse, death, violence or conflict. Without treatment, the condition will come and go throughout one’s life, and may worsen over time.
The physical damage caused by this disorder includes scarring, infection and irritation to the skin and scalp. Those who eat the hair they’ve pulled out may experience trichobezoar (an oversized matted hairball) in the digestive tract, which can lead to intestinal obstruction, weight loss or death.
Symptoms. Some of the symptoms of this disorder include pulling hair from the scalp, or pulling out eyelashes or eyebrows. The need to pull hair may be preceded by tension or anxiety, and may be followed by a sense of pleasure or relief. Some people with trichotillomania may even play with, bite, chew or eat hair that has been pulled out. When severe, the hair loss is noticeable. Some people with the disorder may also pick at their skin or bite their nails. The activity is usually performed in private.
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Causes. The cause of this disorder remains unknown, but those with a family history of the disorder are at a higher risk. People with trich (as it is also known) may also have other disorders, including anxiety, depression, or obsessive compulsive disorder. It is also connected to emotions, both positive and negative – people with the disorder may deal with negative emotions by pulling out hair, and seek positive emotions by pulling out hair.
If you or someone you know is living with an impulse control disorder and needs treatment and guidance, visit us at www.hopetherapyandwellness.com.
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