Impulsivity: signs, causes and treatment
Impulsivity is the tendency to act without thinking enough about the consequences. We all act on impulse sometimes, but when impulsivity is strong and ongoing, and harms the person or others, it can be a sign of a mental health problem.
Signs of impulsivity
- Quick, unplanned decisions, for example about spending money
- Interrupting others and finding it hard to wait your turn
- Risky behaviour such as reckless driving or substance use
- Outbursts of anger that are out of proportion to the situation
- Regret after acting without thinking
Which conditions involve impulsivity?
Impulsivity can be part of several conditions, including attention deficit hyperactivity disorder (ADHD), borderline personality disorder, bipolar disorder (during manic episodes) and substance use disorders. DSM-5 has a group called "disruptive, impulse-control and conduct disorders", which includes intermittent explosive disorder, kleptomania, pyromania, conduct disorder and oppositional defiant disorder. In DSM-5, hair-pulling disorder (trichotillomania) moved to the obsessive-compulsive related disorders, and gambling disorder moved to the addictive disorders.
Why are teenagers more impulsive?
The front part of the brain, which is involved in planning and impulse control, is not fully developed until around the mid-twenties. That is why some impulsivity is normal in adolescence. But if impulsivity is severe, or causes serious problems at school, at home or in relationships, it is a good idea to talk with a doctor or a mental health professional.
Treating impulsivity in adults and teenagers
- Cognitive behavioural therapy (CBT): recognising the situations that trigger impulses, and learning to pause and think before acting.
- Dialectical behaviour therapy (DBT): skills for regulating emotions and tolerating distress; especially helpful in borderline personality disorder.
- Parent training: for children and teenagers, parent programs help families set clear rules and consistent consequences.
- Treating the underlying condition: if impulsivity comes from ADHD, bipolar disorder or substance use, treating that condition (sometimes with medication) also reduces impulsivity.
- Everyday strategies: enough sleep, avoiding alcohol and drugs, and a "wait ten seconds" rule before important decisions.