Impulse control disorders involve the inability to resist certain urges. These strong, sudden impulses can lead to serious consequences such as physical injury, arrest and imprisonment. People with impulse control disorders continue to engage in the harmful behavior despite the negative consequences.  

Substance abuse is an example of a common impulse control disorder. However, this guide focuses on impulse control disorders, not elsewhere classified in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or impulse disorders that, unlike substance abuse, do not have their own distinct diagnosis in the DSM-IV. These less common disorders include intermittent explosive disorder (aggression and violence), kleptomania (stealing), pyromania (fire-setting), gambling addiction and trichotillomania, a type of self-injury that involves plucking out hair from the head and body.

Each impulse control disorder has varying symptoms. Many include features of “tension and release,” where increasing levels of anxiety are experienced prior to the act, and feelings of pleasure, gratification or relief are experienced after the act.

Many impulse control disorders begin early in life – from childhood to the early 20s. Intermittent explosive disorder, pyromania and gambling addiction tend to occur more often in men,  whereas kleptomania and trichotillomania are more common in women.

A mental health evaluation is the first step in diagnosing these impulse control disorders. Some behaviors involving impulse control may be due to another mental health disorder (e.g., personality disorders, mood disorders) or certain medical conditions (e.g., head trauma, Alzheimer’s disease, epilepsy). There are specific criteria identified by the APA that must be met for a patient to be diagnosed with an impulse control disorder.

The cause of impulse control disorders is not clear. Treatment may consist of mental health therapy, medication, or a combination of both. Many types of impulse control disorders are chronic and require long-term treatment.