The U.S. National Institute of Mental Health (NIMH) reports that impulse-control disorders occur in approximately 9 percent of U.S. adults in any year, with almost 25 percent occurrence over the lifetimes or American adults. Each disorder type has a similar course of symptoms. Each type is distinguished from the others by distinct impulsive behaviors. Although some of the symptoms may seem similar to other mental illnesses, such as bipolar disorder and antisocial personality disorder, impulse-control disorder symptoms are marked by the experience of remorse.
Increase in Tension or Stress
Most diagnoses of impulse-control disorders start with symptoms of an uncontrollable increase in stress, tension and/or arousal before any harmful behavior begins. These unpleasant feelings can feel "out of the blue" and not precipitated by anything in a person's environment. Alternatively, the person may feel triggered by some other experience, externally (i.e., in the surroundings) or internally (i.e., thoughts in the mind).
Impulsive Behaviors
Once this tension or stress reaches a fever pitch, a person feels unable to resist acting on urges to do something--impulsive behaviors that end up harming himself and/or other persons. These behaviors are not planned. For example, a person may explode into fits of rage (intermittent explosive disorder) and become aggressive, assault someone else or damage property. Another example, kleptomania, involves impulsively stealing of objects without reason or cause. Pyromania describes impulsive and recurrent fire setting and a obsession with the consequences and community emergency services response to fire setting. Compulsive or pathological gambling (addiction to gambling activities) and trichotillomania (compulsive, uncontrollable urges to pull out one's hair) are two other categories of impulse control disorder. The sixth category is "not otherwise specified," or "NOS," in which the increase in tension results in eating disorders, skin-picking, pedophilia, substance abuse or fetishism. The American Psychiatric Association lists these six distinct categories of symptoms and diagnosis.
Decreased Tension, Then Guilt and Remorse
Once the person's impulsive behavior is completed, she will experience a sense of relief, pleasure or gratification. These feelings replace the stress that was present before the behavior began. People with impulse control disorder symptoms often feel as though their lives are out of control and they have limited ability to respond in healthy and safe ways to stress and anxiety. Because she feels relieved but can recognize how grossly out of proportion the impulsive behavior was to her environment or source of stress, she will feel overwhelming guilt and remorse.
References
- Diagnostic and Statistical Manual of Mental Disorders, 4th ed.; American Psychiatric Association; 2000
- U.S. National Institute of Mental Health: Study of Co-morbid Occurrence of Impulse Control Disorders
- Psych Central: What are Impulse Control Disorders?
