Many people act on impulse from time to time. However, there are some people who are impulsive to a significant degree, and meet the criteria for an impulsive disorder. According to the The Diagnostic and Statistical Manual of Mental Disorders (DSM), individuals who have impulse control disorders are unable to resist or control the urge, temptation or drive to do something that causes harm to themselves or to someone else. The act is not something the person planned in advance.
Before engaging in the behavior, individuals with these disorders may experience a growing sense of tension or arousal. When they act on the impulse, it gives them a sense of pleasure, relief or gratification. In some cases they may feel guilt or regret afterwards.
There are several psychiatric disorders that often include difficulties with impulse control as part of the clinical picture. Such disorders also involve many other maladaptive thoughts and behaviors in order to qualify for a diagnosis. These include substance-related disorders, borderline personality disorder, intermittent explosive disorder, conduct disorder and bipolar disorder (during a manic episode). However, the DSM also lists several disorders under the specific category, “Impulse-Control Disorders not Elsewhere Classified”. These disorders have many similarities, yet also significant differences and include kleptomania (stealing), pyromania (fire setting) and pathological gambling.
The cause of most impulse-control disorders is not really known. However, research that suggests that lack of impulse behavior may have something to do with various neurotransmitters, particularly serotonin, but also dopamine and norepinephrine. Genetics may also play a role in development and also pre-disposition. There are no actual “cures” for any of the impulse-control disorders. In general, a combination of medication and psychotherapy, particularly cognitive behavioral therapy (CBT), is usually the recommended treatment for these disorders. Medications may involve the SSRIs, which target serotonin, other types of antidepressants, anti-anxiety medications, anti-convulsants, and mood stabilizers.
Considering the potentially serious, if not deadly (e.g. with intermittent-explosive disorder and pyromania) consequences of these disorders, getting the appropriate treatment is important. Unfortunately, many individuals with these disorders don’t seek treatment, either due to the shame or because they don’t really want treatment.