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Impulse Control Disorder: Unveiling the Struggle and Seeking Balance

Impulse control disorders can dramatically impact the lives of those who suffer from them and their loved ones. These disorders can lead to a wide variety of unexpected consequences and can worsen many co-occurring mental health and substance use disorders. Luckily, there are treatment options available for every form of impulse control disorder that can significantly improve the quality of the patient’s life.

What Is Impulse Control Disorder (ICD)?

Impulse control disorder (ICD) is a class of mental health disorders that are all characterized by some form of impulsivity. This impulsivity is defined as a failure or inability to resist temptations, urges, or impulses. The different types of ICDs are defined by a specific impulse that the sufferer has difficulty resisting. An example might be an inability to not speak one’s thoughts, no matter how inappropriate they might be for the situation. The impulse control disorder class is something of a catchall category and includes many behaviors commonly referred to as “addictions.” For example, sex addiction, internet addiction, and shopping addiction are all classified as impulse control disorders.

Symptoms of Impulse Control Disorder

The symptoms of impulse control disorders will vary depending on which type of ICD the patient suffers from. However, there are some symptoms commonly seen with most or all ICDs, including:
  • Repetitive or compulsive engagement in behaviors despite experiencing negative consequences from engaging in them.
  • Decreased control over problematic behavior or behaviors.
  • An urge to engage in the problematic behavior that may feel impossible to control.
  • Feelings of irritability, anxiety, or depression when the individual feels an urge but does not engage in a behavior.
  • Feelings of pleasure and/or relief when the individual engages in the behavior or shortly after.
Some other symptoms of impulse control disorders may be more related to the consequences of the ICD rather than a direct symptom of the disease itself. Examples of such symptoms include:
  • Fear of abandonment.
  • Fear of being unable to control oneself.
  • Avoiding situations where impulse control might be problematic.
  • Obsessive thought patterns.
  • Compulsive thought patterns.
  • Feelings of low self-worth.
  • Emotional detachment.
  • Poor social skills.
  • Difficulty forging and maintaining meaningful relationships.

Types of Impulse Control Disorders

There are many impulse control disorders, and new disorders are regularly added to the category. Each disorder is primarily distinguished by what impulse it is that the sufferer has trouble resisting.
  • Kleptomania: An urge to steal or shoplift for the pure sake of gratification.
    • Some estimates claim that 5% of all shoplifting in the United States, as well as over 100,000 annual shoplifting arrests, are the result of kleptomania.
  • Pyromania: An urge to deliberately start, grow, and watch fires.
    • Pyromania is responsible for millions of dollars in damages every year and is most associated with young males.
  • Intermittent explosive disorder: Repeatedly experience severe, aggressive episodes that are significantly out of proportion to the cause.
    • Intermittent explosive disorder is one of the most common and serious impulse control disorders.
  • Compulsive shopping/shopping addiction: Urge to shop even for items that are unnecessary and cannot be afforded.
    • An estimated 80% to 90% of sufferers are female, and the onset is usually late teens to early 20s.
  • Internet addiction: Excessive internet use to the point where it damages the sufferer’s life.
    • Excessive internet activity can include chatting, web page browsing, online gambling, online shopping, or online pornography.
  • Sexual compulsion or sex addiction: Frequently engaging in sexual acts or thoughts, often without regard for the consequences.
    • Risky or otherwise inappropriate partner selection is commonly seen. More commonly seen among males than females.
  • Oppositional defiant disorder: A pattern of angry, negative, defiant, disobedient, and hostile behaviors.
    • ODD is one of the most commonly diagnosed and serious mental health conditions seen in children.
  • Conduct disorder: A lengthy pattern of antisocial behaviors, including theft, lies, physical violence, property destruction, and rule breaking.
    • Conduct disorder is only diagnosed in those under the age of 18. Those over 18 who would be diagnosed with conduct disorder would typically be diagnosed with antisocial personality disorder, which cannot be diagnosed in those under 18 as a result of psychiatric rules.

Diagnosing Impulse Control Disorder

Only a mental health professional can properly diagnose an impulse control disorder. If you or someone you love has experienced the symptoms above, you may want to consult a psychologist. Mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to assess and provide diagnoses for their patients. The DSM-5 includes a number of mental health disorders under the class of impulse control disorder. Each of these disorders has a unique set of criteria that must appear before that condition can be diagnosed.

Treatment Options for Impulse Control Disorder

Impulse control disorders are not as well-understood as many other mental health conditions, and the treatment options are somewhat more limited as a result. Additionally, many impulse control disorders, such as internet addiction and shopping addiction, have only begun to appear in recent years. There is no cure for impulse control disorder. However, there are treatment options that can dramatically improve the quality of ICD sufferers’ lives. The most effective treatment options for impulse control disorder combine medications that help with symptoms and therapies that help patients understand themselves and change their behavior.

Medications for Impulse Control Disorder

There are no medications approved solely for the treatment of impulse control disorder. However, many medications target specific symptoms of the disease or the secondary symptoms that these primary symptoms cause. Examples of medications used for the treatment of impulse control disorder include:
  • Selective serotonin reuptake inhibitors (SSRIs): Treat mood and anxiety symptoms.
  • Mood stabilizers: Prevent/minimize abrupt or dramatic changes in mood.
  • Antipsychotics: Manage aggression, irritability, and impulsivity.
  • Stimulants: Treat attention-deficit/hyperactivity disorder (ADHD), which often co-occurs with and worsens ICDs.
  • Naltrexone: Reduces certain impulsive behaviors.
  • Topiramate: Reduces impulsivity and aggression.
  • Beta blockers: Manage physical symptoms of emotional states.

Therapy for Impulse Control Disorder

Therapy is considered a more effective method of treating impulse control disorder than medication. This is because ICD is not curable, meaning patients must develop skills to help them manage symptoms of the condition. Examples of some of the most common and effective therapies for impulse control disorder include:
  • One-on-one therapy: Provides patients with insight into their condition and helps them modify behaviors.
  • Group therapy: Helps patients learn how to interact with others and provides a sense of community and support.
  • Cognitive behavioral therapy (CBT): Helps patients identify and change negative thought and behavioral patterns.
  • Dialectical behavior therapy (DBT): Helps patients manage intense emotions, improve relationships, and develop healthy coping mechanisms.
  • Acceptance and commitment therapy (ACT): Helps patients develop better psychological flexibility and improve behaviors.

Managing Impulse Control Disorder for a Healthier Life

By its very nature, impulse control disorder can be very difficult for sufferers to control. However, there are techniques that can help people with ICD resist impulses. Psychiatric mental health nurse practitioner (PMHNP) Valerie Puffenberger provides the following strategies to help manage impulse control disorder:
  • Cognitive behavioral therapy: CBT can help individuals identify and challenge irrational thoughts and beliefs that contribute to impulsive behaviors.
  • Mindfulness and meditation: Practicing mindfulness can help increase self-awareness and improve impulse management.
  • Developing a support network: Building a support network of understanding family and friends will help keep you accountable and motivated.

Erasing the Stigma

There is substantial stigma around impulse control disorders, especially when the impulses involve stigmatized behavior such as sex or theft. “Some folks think impulsive behavior is just about having strong willpower or self-control. There's a misconception that being impulsive is more of a choice than a symptom of an actual underlying disorder,” says Puffenberger. If you have ICD, there is nothing to be ashamed of. Impulse control disorder is a disease that requires long-term management, and just like there is no shame in having diabetes, there is no shame in having ICD. “Impulse control disorders are pretty complex. They’re not just about making choices or flexing willpower. There are deeper things going on in the brain and mind. It's crucial to treat folks dealing with ICD with understanding and empathy. These are real mental health matters that need the right kind of support and treatment,” says Puffenberger.

Find Support for ICD

If you or a loved one suffers from impulse control disorder, it may seem as though your life has become unmanageable. Luckily, support and treatment options for impulse control disorder are out there and can make a world of difference. At Legacy Healing Center, we use a three-pronged approach to treat impulse control disorders. It includes the right psychotropic medications, evidence-based psychotherapy, and peer support. You don’t have to let impulse control disorder control you any longer. Call 888-534-2295 today to speak with a staff member about your treatment options.

Impulse Control Disorder FAQs

How is impulse control disorder diagnosed according to DSM-5?

The DSM-5 has specific criteria for each type of impulse control disorder. For example, to be diagnosed with kleptomania, a patient will “typically attempt to resist the impulse to steal, and they are aware that the act is wrong and senseless. The individual frequently fears being apprehended and often feels depressed or guilty about the thefts.”

What are the treatment options for impulse control disorder?

There are a wide variety of treatment options for impulse control disorder. The most effective combine medications to alleviate or eliminate symptoms with therapies to help modify behaviors and minimize the impact of the disease.

What is the ICD-10 code for impulse control disorder?

The ICD-10 code for impulse control disorder, unspecified is F63.9.
About the Author
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Jeffrey Juergens

Jeff Juergens is a leading author in the addiction and recovery field, dedicating the last seven years of his life to helping those struggling with substance use issues find the help that they need. Jeff's work has been used in rehabs across the country as tools to help patients achieve sobriety.

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Dr. Edwin Gomez, M.D.

Edwin Gomez, M.D. joined the Legacy Healing Centers Medical Team in 2021. In addition to working at Legacy Healing Centers, Dr. Gomez operates a private practice and research here in the South Florida Area and the Florida Keys. Prior to joining Legacy Healing Center, he served as Medical Dire...