Impulsivity is defined as acting on the spur of the moment, without any forethought or consideration of the consequences or outcomes.1,2 Impulsive behaviors range from small, harmless actions to highly dangerous behaviors and patterns that can be fatal, even if someone is not trying to harm themselves. It is often a facet of ADHD and other mood and personality disorders.
What Is Impulsivity?
Impulsivity can be related to disinhibition, which is defined by the DSM-V as an, “orientation toward immediate gratification, leading to impulsive behavior driven by current thoughts, feelings, and external stimuli, without regard for past learning or consideration of future consequences.” Disinhibition is considered one of the five personality trait dimensions.2
Common Characteristics of Impulsivity
Impulsive symptoms can differentiate between impulsive behaviors—which can present alone or with a co-occurring mental illness—and impulse control disorders, which are continuing or repetitive patterns of impulsive, risky and/or dangerous behaviors that can impact an individual’s and others’ safety.
Some other signs and characteristics of impulsivity and impulse control issues include:4
- Irritability or agitation
- Behaving or being perceived as rash or unpredictable
- Inattentiveness
- Being easily distracted
- Interrupting people’s conversations with poor insight about it
- Depressive emotions (e.g. sad, hopeless, guilty)
- Anxiety
- Self-isolating from those important to them
- Lowered perception of self-worth & self-esteem
- Come-and-go moments of emotional detachment
- Obsessive or compulsive thought patterns (e.g. “I must do this or _ will happen.”)
- Difficulty controlling or stopping impulses
- Difficulty with patience
- Aggressive or violent behavior towards self or others’ and their property/objects/animals
- Engaging in hyper-sexual behaviors
- Illegal behaviors (e.g. stealing, fire-starting)
The characteristics of impulsivity and impulse control issues range from very small signs to major and harmful behaviors. For those who experience these, they may wonder why they are experiencing this- and they are not alone. Impulsive behavior may not have one main thing that can be pointed to and fixed, but is found to have a variety of influences, between genetics, physical, and environmental.
Risk Factors for Impulsivity
Research indicates that individuals with family members who have mental illnesses—such as mood disorders or similar diagnoses—are at increased risk for more impulsive behaviors and impulse control disorders.4 Researchers observed that self-reported personality characteristics that involved impulsivity in adoption and twin studies were at increased significance to be inherited, with rates ranging from 20% to 62%.7
In addition, research has also shown that imbalances in brain structures related to emotions, planning, or memory can increase risk for the development of impulsive symptoms.4 This is considered something to monitor, especially shortly after brain injuries (i.e. strokes, concussion, etc.), as these can increase change in behavior, impulsivity, judgement skills, and attention span.3
Finally, one’s environment can play an important role in the presentation of impulsive behaviors in children and adults. Surroundings where violent situations (witnessed or experienced), aggressiveness, all types of abuse and substance abuse are occurring are settings that can increase an individual’s risk of displaying impulsive symptoms or being diagnosed with an impulse control disorder.4
Common Mental Health Concerns Associated With Impulsivity
For those struggling with symptoms of impulsivity, you are not alone. Those with mental illnesses that present with impulsive symptoms may statistically fall in with 3-6% of the population with Oppositional Defiant Disorder (ODD), 4-6% with Conduct Disorder, 2.7% with Intermittent Explosive Disorder (IED), and 1% with pyromania and kleptomania.6
Some disorders that co-occur with impulsivity symptoms include:6
- Attention deficit hyperactivity disorder
- Intermittent explosive disorder
- Acute and post-traumatic stress disorder
- Mood disorders
- Personality disorders
- Substance abuse and addictive disorders
As one can see, impulsivity connects with many co-occurring disorders and has a number of influences. This makes it difficult to find assessments for diagnoses, services, and to identify what kind of assistance one may need to reduce the impact impulsivity has on their life. There are a number of ways to obtain mental health diagnoses and services.
Treatment of Impulsive Behaviors
Treatment of impulsive behaviors, symptoms, and disorders looks different for each person depending on that person’s goal and treatment plan they have made with their mental health professional. Research indicates that a number of therapies are effective in reducing impulsive behaviors. Additionally, in certain disorders, psychotropic medications can be helpful in reducing these behaviors.4,7
Therapy
Going to therapy can be an uncomfortable and scary experience for people, regardless of their experience level with a therapist or counselor. This being said, if you can find the right fit with a counselor, therapy can be helpful in reducing your impulsive behaviors. It can teach you to become more knowledgeable and self-aware of what influences your behaviors, as well as help you to learn how to control and challenge your impulsive behaviors outside of the session.
Therapy in general, has been found to be effective in a number of areas, but there are a number of therapies that are more common in the treatment of impulsivity and impulsive behaviors or symptoms related to impulse control disorders. These include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), group therapy, and family or couples counseling.7
Types of Therapy
One of the most common therapies is “individual” or “talk” therapy, as some people may call it. This refers to most therapies where you would receive therapy one-on-one with a counselor. CBT, Psychotherapy, Exposure, Gestalt, and a number of others fall under this umbrella whereas group therapy and family/couples counseling do not. Dialectical Behavioral Therapy includes aspects of both types as it is a rigidly structured program.
In therapy surrounding impulsivity, you’ll spend time challenging and becoming more aware of your actions, thoughts and behaviors—CBT, aspects of DBT, and sometimes exposure therapy are common types of therapy that use this approach.
What’s the Timeline for Therapy?
In CBT and many other therapies, the general expectation is about 12 sessions; however, this can change depending on your therapy provider, the cost, and the severity that impulsiveness has had on your life. DBT tends to be more timely—and can be more costly—as it is generally structured with one individual session and one group therapy session a week for a certain amount of time, depending on the program and your severity of behaviors and impulsivity. Some therapy providers may also recommend psychiatry for your level of symptoms or impulsivity.5,7
Intended Outcomes of Therapy for Impulsiveness
The primary intended outcomes of many of these therapies is increased self-awareness and reduced impulsive behavior in a variety of areas. Through becoming more aware and knowledgeable about the connections between your actions, behaviors, and thoughts or “cognitions,” you will hopefully be able to identify when you’re behaving impulsively and/or even dangerously.
By acknowledging these behaviors, you can begin to challenge the thought behind it (i.e. “Why am I immediately jumping into someone’s car I don’t know when they could hurt me?”) This will help you to be less impulsive. This will hopefully lead to safer behaviors and healthier interactions with yourself and others (especially, in some people with ICDs, with authority figures).5,7
Another intended outcome includes insight to behaviors, awareness of your impulsivities’ impact on others, and creating a support system to help reduce these behaviors. Self-awareness is important but those who engage in impulsive behaviors often do not realize the seriousness of their impulsiveness nor the impact on others; this can strain relationships. Ideally, you might be able to say, “I realized that this was dangerous and I appreciate your patience with me. Could you help slow me down or help me with making a decision here?”
Medication
Another treatment option for impulsive behaviors includes psychotropic medications. At this time, there is no FDA-approved medication for impulsivity alone, however there has been some recent research on this topic. Mood stabilizers and atypical antipsychotics have been observed to reduce symptoms of impulsivity and other interpersonal difficulties.5 It’s important to remember that mental health research has repeatedly demonstrated greater benefit with medication and therapy in combination than medicine by itself.5,7
How to Be Less Impulsive
Another relevant way to reduce impulsivity is to make some lifestyle changes. As mentioned above, your environment can influence your levels of impulsivity.3 Research shows there is a connection between impulsivity in drug use and violent behavior.3 It can be helpful to consider ways to change what is influencing some of these behaviors.
Here are other ways to reduce or manage your impulsivity:3,4
- Connect with a therapist who is familiar with impulse control disorders
- Consider joining a support group—online or local—to connect with people who can share your experience
- Explore healthy behaviors that can replace impulsive ones, like journaling, meal planning, setting a budget, or going for a walk
- Practice meditation and/or deep breathing to slow down your thought process and increase emotional regulation
- Practice visualizing and walking through the event beforehand to practice how to stop and consider your options in the moment
- Talk to a friend, family member, or significant other about your impulsivity
- Track your mood each day to increase insight to how you’re feeling
- Create a realistic routine
- Monitor your physical and mental health
- Reduce access to potential sources of harm (i.e. drugs, alcohol)
- Identify things that happen to you before you engage in risky and impulsive behaviors to learn how to stop them in the future
Final Thoughts on Impulsivity
If you’re struggling with impulsive behaviors, it’s important to know you are not alone. There are a number of people who also struggle with impulsivity, whether it’s related to behaviors, symptoms of other disorders, or impulse control disorders. Reaching out to a licensed therapist is a great way to start feeling better and learning appropriate ways to cope.
