When Is Impulsivity a Problem?
Medically reviewed by Michael MacIntyre, MDFact checked by Nick Blackmer
Impulsive behavior is not a disorder, but it can be a symptom of a condition like ADHD or bipolar disorder.
Impulsivity is the tendency to act without thinking about the consequences. For some people, impulsivity is simply a character trait—a preference for spontaneity. For others, it can be a symptom of a significant disorder. Some medications and illegal drugs can also lead to impulsive behaviors.
Learn when impulsivity is a problem and what steps to take if you’re concerned.
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Signs of Impulsivity
There are many different definitions of impulsivity. All of them describe it as an antisocial or negative type of behavior. According to one definition, there are four factors involved with impulsivity:
Lack of premeditation: Acting before thinking about the potential consequences
Sensation seeking: Seeking out new and exciting experiences, often with the added element of risk for its own sake
Lack of perseverance: Quitting a challenging activity or job before it’s done
Urgency: Taking negative actions during an emotional outburst
Another way to think about impulsivity is to describe it in terms of how it is expressed. Some researchers describe three different types of impulsiveness:
Motor impulsivity: Acting without thinking, which can include anything from hitting and shouting to simply jumping up and pacing
Cognitive impulsivity: Quick decision-making without thought of consequences
Non-planning: Acting without thought for the future
Compulsive vs. Impulsive
Impulsivity and compulsivity are both behavioral problems that have to do with a lack of control. However, people with compulsivity are unable to stop behaving in inappropriate or harmful ways, while people with impulsivity aren’t able to stop themselves from initiating inappropriate or harmful behavior.
Causes of Impulsivity
The prefrontal cortex is the part of the brain responsible for impulse control. There are several regions within the prefrontal cortex. These interact with neurochemicals such as serotonin to control functions like selective attention, response selection, motivational control, and behavioral inhibition.
Substances that can cause impulsivity include recreational drugs such as cocaine and methamphetamine, but can also include medications such as levodopa (used to treat Parkinson’s disease) and Abilify (aripiprazole).
Risk Factors
Everyone behaves impulsively from time to time, but excessive impulsivity can be a sign of an underlying problem. Certain disorders or environmental influences can put a person at higher risk for impulsive behavior. For example:
Genetic predisposition
Growing up in an environment where adults behave impulsively
Experiencing childhood trauma
Experiencing a brain injury
Having brain differences or a mental health condition
Impulsivity in Children
It is common for children to behave impulsively, even if they don’t have a disorder associated with impulsivity. Some examples of normal impulsive behavior in children include:
Grabbing something they want without asking first
Interrupting conversations between others or interrupting someone who is talking to them
Screaming or tantruming when disappointed or angry
Putting themselves in dangerous situations, like petting a growling dog or walking into a busy street
All children are impulsive sometimes, and it can be difficult to distinguish normal impulsivity from impulsivity pointing to a problem. If you notice excessive impulsivity in your child or impulsive behavior that is inappropriate for the child’s age, talk to their healthcare provider.
When Is Impulsive Behavior an Issue?
There is a fine line between spontaneity and impulsivity. A spontaneous decision to take the day off and go to the beach can be a reasonable choice; an impulsive decision to tell off the boss and quit your job can be disastrous.
The difference between impulsivity and spontaneity is that impulsive behavior is usually negative and often has the potential to be harmful to the individual or the people around them.
While spontaneous people may enjoy doing things on the spur of the moment, impulsive people are more likely to act out or take unreasonable risks. For example, impulsivity is closely associated with:
Pyromania (the impulse to start fires)
Gambling disorders
Kleptomania (the impulse to steal)
Recreational drug use, which can lead to substance use disorders
Impulsive behavior is a problem (or a potential problem) when:
It appears suddenly, as it can be associated with a drug-related issue or with the onset of a physical or mental disorder.
It is associated with an unreasonable level of risk that is likely to harm the person or others.
It has a negative impact on the person’s ability to succeed in ordinary aspects of daily life (for example, they are often fired from or quit jobs, are unable to make friends or keep relationships, etc.).
It causes harm to others. (Impulsive behavior can result in aggression toward others or unreasonable financial or physical harm.)
Conditions Associated With Impulsivity
Impulsivity is usually associated with a physical, psychological, or developmental disorder. It may also be caused by medications or recreational drugs. The most common disorders associated with impulsivity include:
Attention deficit hyperactivity disorder (ADHD), a medical condition that affects your ability to sit still, control your behavior, and organize your thoughts
Bipolar disorder, a mental health condition that causes extreme mood swings
Antisocial personality disorder, a behavior disorder in which a person doesn’t care about other people’s needs or feelings and behaves in hurtful and manipulative ways
Borderline personality disorder, a mental health condition that can cause emotional disturbances and make it difficult to form and keep relationships
Autism, a developmental disorder that can make it difficult to interact socially, plan your actions, or control your emotions and behaviors
Post-traumatic stress disorder (PTSD), a mental health condition that results from a traumatic event and may include recurrent problems with anxiety, attention, emotional regulation, and behavior
Intermittent explosive disorder, a mental health condition that causes extreme emotional outbursts and violence
Parkinson’s disease, a progressive neurological condition that can cause movement problems as well as sudden, uncontrollable urges to act in certain ways
Treating Impulsivity
Impulsivity may be treated with cognitive behavioral therapy, a type of psychotherapy (talk therapy), and medications. The choice of treatment depends, of course, on the cause of the impulsive behavior. In some cases, simply withdrawing or changing a drug or medication can make all the difference.
Treatment may start with a diagnosis of an underlying issue such as ADHD or bipolar disorder. Once the underlying issue is diagnosed, treatment may include appropriate medication. It may also include both behavioral and cognitive therapy.
In other cases, when impulsive behavior is associated with related issues such as uncontrolled gambling, 12-step programs can be very helpful. These are often recommended along with behavioral and cognitive therapy.
Medications for Impulsivity
Certain groups of medications may help treat impulsivity. These include:
Selective noradrenergic reuptake inhibitors (SNRIs)
Opioid antagonists
Glutamatergic agents
Atypical antipsychotics
Stimulant medication
Cognitive and Behavioral Therapy for Impulsivity
Cognitive therapy is traditional talk therapy, which explores inaccurate perceptions or thoughts that drive impulsive behaviors. Behavioral therapy teaches the person to substitute new behaviors for problematic behaviors.
Cognitive behavioral therapy combines elements of both therapeutic techniques to help people think through and manage problematic behaviors. Therapists may also use techniques such as biofeedback (techniques to gain control of involuntary processes) to help people manage issues such as anxiety, which can lead to impulsive behaviors.
Summary
Impulsivity describes behaviors that are associated with a lack of control, such as acting without considering consequences and sensation seeking. Impulsive behavior can be a symptom of a condition like ADHD or bipolar disorder.
Impulsivity is common in children, but excessive impulsivity or impulsivity that is inappropriate for their age should be discussed with a healthcare provider.
The conditions that are associated with impulsivity can be treated with medication, therapy, or a combination of both.
Read the original article on Verywell Health.
