Addiction
October 27, 2020
Impulsivity can derail progress in recovery for young men working to rebuild stable lives. When impulsive reactions become an everyday occurrence, the consequences can be serious.
We break down what drives impulsive personality disorder, its symptoms and causes, and options for treatment. Keep reading to learn more.
Impulsive personality disorder is a mental health condition where a person has trouble controlling their actions and emotions. The impulsive behavior happens regularly and can affect everything from school and work to relationships and finances. It’s not limited to happening during substance use or manic episodes. Rather it’s a consistent pattern.
One feature of this disorder is low frustration tolerance. Small problems that might not bother others can cause angry outbursts or sudden decisions.
Impulsive personality disorder is actually a subtype of borderline personality disorder. Researchers have suggested four subtypes of BPD:
The impulsive subtype of BPD is characterized by explosive anger, risky behavior, and conflict when a person feels blocked or criticized. People with this subtype struggle with behavioral inhibition, meaning they act without stopping to think about the consequences. Abandonment fears and unstable image are large pieces of BPD, but impulsive BPD is defined more by outward actions such as fights, reckless spending, unsafe sex, and sudden breakups.
Those with impulsive personality disorder typically make choices for immediate rewards, even if those choices create serious problems later. Researchers describe impulsivity as having a very short pause, or dormancy, between an urge and the action that follows. The most concerning urges are those that can cause harm to oneself or others.
People with impulsive traits are frequently described as hot-headed, rash, unpredictable, and unstable. These tendencies show up across behavior, emotions, thought patterns, relationships, and everyday functioning.
Behavioral symptoms include disruptive actions such as:
Emotional symptoms include rapid mood changes and difficulty controlling anger. This may also involve:
Typical patterns of thought symptoms include:
Relationships can also be affected by impulsive behavior. This can look like:
Finally, impulsivity affects safety and daily functioning, sometimes with serious consequences, such as:
Impulsive personality disorder is thought to develop from a mix of childhood experiences, brain abnormalities, and genetics. These factors often interact with each other, which may explain why the disorder shows up more intensely in some people than others.
Studies show that borderline personality disorder is associated with child abuse and neglect more than almost any other personality disorder, with estimates ranging from 30% to 90% of patients reporting early trauma. This early trauma can affect how children learn to manage emotions and form secure attachments.
Without that foundation, impulse control is harder to develop in adulthood. Experiences such as neglect, inconsistent caregiving, and physical or sexual abuse increase the risk of impulsivity later in life.
Brain imaging studies show evidence that impulsivity is tied to structural and functional differences in different areas of the brain. A review of 23 studies involving nearly 1,000 participants noted the following findings:
Connectivity between brain regions is also interrupted. Weaker connections between control centers and emotion centers may explain why urges are acted on before consequences are considered.
Reviews suggest that inherited factors account for 40-60% of BPD variations. Research shows that impulsive and affective traits are more common in relatives of people with BPD compared to relatives of people with other personality disorders.
Specific genetic mutations can affect how the brain produces serotonin and dopamine, two chemicals responsible for mood and cognition. Changes in these symptoms can contribute to higher impulsivity. Additionally, a genetic predisposition usually interacts with environmental factors, such as trauma, which determines whether impulsive traits turn into a full disorder.
People with borderline personality disorder are much more likely to develop an addiction than the general public. One study found that nearly half of individuals with BPD had at least one substance use disorder in the past year.
Drugs or alcohol are used to cope with boredom, shame, or rapid mood swings. However, substance use also makes impulsivity worse and feeds into unsafe and reckless behaviors.
No medication has been proven to treat borderline personality disorder or its subtypes, including impulsive personality disorder. That said, medications are sometimes prescribed to help manage symptoms such as impulsivity.
Antidepressants like SSRIs are the most commonly used and include the medications citalopram and fluoxetine. One study broke down the commonality of medications prescribed:
Just under half of patients were on more than one medication at the time of the study. Medication may provide some relief, but therapy may be more effective.
Dialectical Behavior Therapy (DBT) is the leading treatment for borderline and impulsive personality disorders. It focuses on skills that help people stop before reacting, tolerate distress, and regulate emotions.
Two DBT skills that may help reduce impulsive behaviors include:
A four-step tool for breaking the cycle of acting without thinking: Stop, Take a Step Back, Observe, Proceed Mindfully. This creates a pause before responding.
A planning exercise where you identify a stressful or triggering situation in advance, create a coping plan, and mentally rehearse responding in a healthy way.
Research shows DBT can lower impulsivity by strengthening the aforementioned skills. In one study, patients who completed DBT had impulsivity levels similar to people without personality disorders.
Impulsive personality disorder can make it feel like life is always one crisis away from falling apart. One decision can change everything, and the aftermath often brings regret. When substance use is added on top of this mental health condition, the cycle can feel even harder to break.
Here at Ethos Recovery, care doesn’t just provide a roof and a set of rules. Staff members work closely with each resident and pay attention to their unique struggles with impulsivity while creating a safe environment. We meet young men where they are in their mental health journey and give them the tools they need to rebuild trust in themselves. Contact us today to learn how we can help.
Borderline Personality Disorder And Childhood Trauma: Witch Relationship? - European Psychiatry
Genetics of Borderline Personality Disorder - University of Missouri-Columbia
Pharmacological Management of Borderline Personality Disorder and Common Comorbidities - CNS Drugs