Impulse Control Disorders

Definition

Impulse control disorders (ICDs) are based on having extreme urges and failing to resist acting on them.

ICDs can involve:

• Gambling
• Stealing—kleptomania
• Pulling one’s hair, eyebrows, or eyelashes—trichotillomania
• Outbursts of physical or verbal rage—intermittent explosive disorder
• Setting fires—pyromania
• Sexual thoughts and acts
• Uncontrolled use of the Internet, which may serve as an outlet for other ICDs

ICDs have a harmful impact on daily life. They cause problems with school, work, and other people in your life. They often involve problems with money and the law.

Causes

The cause of ICDs is unknown. Chemical changes in the frontal lobe may be linked with ICDs. The frontal lobe of the brain controls impulses.

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Risk Factors

Most people with ICDs have other mental health problems such as bipolar disorder or obsessive-compulsive disorder.

Your chances may also be higher for:

• Substance misuse—you or within your family
• Having other people in your family that have the same problems
• Having Tourette syndrome
• Having problems with how your family works such as fighting or abuse
• Using certain medicines that treat Parkinson disease
• Having late stage Parkinson disease

Symptoms

ICDs can start at any age. But, many start when you're a child or a teen. Symptoms are based on the ICD you have.

ICDs may cause:

• Injuries from fights or burns from starting fires
• Lying or stealing
• Compulsive or repetitive behaviors
• Irritability, impatience, or anger
• Problems with your family, partner, or spouse
• Repeated problems with other people in your life, school, or work
• Problems with money or the law, which may involve being arrested

People with ICDs tend to feel:

• Growing tension before the act
• Pleasure or eurphoria during the act
• Relief after the act—there may or may not be feelings of guilt or distress

Diagnosis

You will be asked about your symptoms and health history. A psychological exam will be done. Some people may have burns or other injuries that can be seen. This makes diagnosing an ICD easier. For others, it can be made based on your pattern of behavior that doesn’t have a better explanation.

Treatment

ICDs are treated with:

Medicines

One or more medicines may be needed. It may take some time to find the right ones. They are used to balance the chemicals in your brain. The most common are antidepressants, but others can be used.

Counseling

Therapy may be done alone or in a group. It will help you to cope with problems that contribute to ICD. It also helps you change how you react to urges.

• Cognitive behavioral therapy (CBT)—A form of talk therapy focusing on how to handle stressful situations. CBT helps you change how you think so you take control of your feelings.
• Family therapy—Helps other people in your family with support and coping skills.

Prevention

There is no way to prevent ICDs since the cause is unknown.