Impulsivity & Disinhibition

Impulsivity & Disinhibition can get the better of us at times. It happens when we want something bad enough or forget to think before we act. This is more common when we’re kids. We want the latest toys or the best tasting food, and cry when we don’t get it. But as we grow older, we learn to suppress our wants. Later on, we even start to consider people, context, and other factors before we act. But this impulsivity can develop into something more harmful. Where we normally think about our decisions, it can be hard for some people because of disinhibition. This means that we immediately react with no plan or regard for the outcomes. This can be a sign of a possible mental disorder. Many people with these disorders are likely to do risky behaviours, pushing them to seek help.

 

What is impulsivity & Disinhibition?

Some of us may know about the Stanford Marshmallow Experiment. For those who don’t, it was an experiment done in 1972 by Prof. Walter Mischel from Stanford University. The experiment involved kids sitting alone in a room with a marshmallow. These kids were told that if they don’t eat the marshmallow until the researcher comes back, they can have two marshmallows. This study was about immediate gratification. Immediate gratification refers to how we are tempted to do something right away for a faster reward. The study showed that kids who did not seek immediate gratification had more successes. They had higher academic scores, healthier bodies, and other life measures. There is functional impulsivity. This is when acting without thinking can be appropriate and even beneficial. Immediate gratification is one of our most basic drives to seek pleasure and avoid pain. So, it’s normal Having good reflexes during fights or being able to resolve problems quickly can be examples of these. There will be times in our lives where we have to act or lose something. An extreme example can be saving someone from a moving car. We may not immediately think of the future outcomes. But what kicks in is our sense of right or wrong. Although impulsivity & Disinhibition is common in children, their ability to a tendency towards immediate gratification can help predict their future. Even as adults, we should know better. When impulsivity gets the best of us so we get into vices, cheat our diets, or hit the snooze button of our alarms. This may not really lead to bad life choices because these behaviours are common. Most of the time, we can stop ourselves from acting on our wants for a long-term goal. But what if we lost the ability to do so completely?

 

When does impulsivity become a problem?

Dysfunctional impulsivity refers to acting with less thought compared to those of the same skill and knowledge. You wouldn’t expect a 25-year-old man to be as impulsive as a 5-year-old child. It was also theorized that there are 3 aspects to impulsivity:

  • Motor – action without thinking, at the spur of the moment
  • Inattentiveness – not focusing on the task
  • Non-planning – acting without thinking carefully

In the DSM-5, impulsivity is related to disinhibition. This is because impulsive people lack the ability to inhibit their need for immediate gratification and act on it. Planning is a needed skill for decision making because our decisions tend to affect others. People could get hurt by our decisions if we act on impulse all the time. It may even harm the person acting on impulse. That is why it is important to stop and consider all factors affecting our decisions.

 

Why are some people impulsive?

Cognitive Factors of Impulsivity & Disinhibition

From a cognitive perspective, people who are impulsive make decisions different from others. They can’t control nor wait for rewards themselves. As a result, they would rather take a quicker reward. Even though it will lead to negative results in the long run or it is of less value. For them, the best rewards are those that are given right away. But it’s the opposite when it comes to punishments. They prefer bigger delayed penalties over smaller later ones. If you were to ask them to think about future outcomes, they would be unable to do so. To them, there’s more uncertainty in the future. Whereas, immediate rewards are more likely to be received. This is similar to how we think “when will this opportunity come again?” It makes sense to think that many things can happen between now and the delayed reward. So, they would rather be rewarded now. An important driving factor is fears. For example, Some people are scared of losing things they care about. As a result, people become defensive to avoid losing them. Another example is when someone is scared of being left behind, they will find ways to cling to people. Even if these actions will harm themselves or other people. For them, it doesn’t matter. Anything would be better than being left behind. Just the anxiety caused by the possibility of being left behind will push them to act without thinking.

 

Social Factors of Impulsivity & Disinhibition

It is an unfortunate reality that we are all born into different situations. The culture of one person can be different from another. When it comes to impulsivity, culture and upbringing play a big role. Poverty can influence impulsive behaviours. This is because they live lacking basic needs, like food, clean water, and shelter. Their health may be at risk if they waited for basic needs. So, their decision-making will lean more towards immediate rewards. People who grew up with parents who had poor impulse control are also more likely to grow up the same way. Abusive, alcoholic, or anti-social parents are still models for kids to learn from. Since most of their early interactions are with their parents, they mostly learn from these behaviours. Because of that, poor impulse control is all they know. If these problems persist into adolescence, it will get harder to change these behaviours. It’s harder to correct bad habits that are learned since childhood. This emphasizes the importance of good parenting behaviours. Your actions not only affect you but also your kids.

 

Biological Factors of Impulsivity & Disinhibition

Most mental disorders have a connection to our own bodies. Mental problems can cause physical problems and vice versa. Studies have shown that there is a part of the brain for inhibiting risky impulses. But these parts of the brain a dysfunctional in those with impulsivity & Disinhibition. This makes it mentally hard for them to think about what happens after the present. It could be the connections in that brain are different from others. But this field needs to be studied further. Chemicals in the brain associated with reward pathways also cause impulsivity. These are related to people who use too many drugs and alcohol because of the direct effect these substances have on the brain. As a result, their brains are conditioned to feel positive, immediate pleasure after use. These vices are used repeatedly because it feels good, despite users knowing the negative effects it has on their lives. Even hormones play a part in impulse control. Some hormones, like testosterone, are linked to aggression and violence. Hormones that are imbalanced can also cause mood swings, adding to impulsive behaviour.

 

Associated mental disorders

Bipolar Disorder

Those with bipolar disorder suffer from episodes of depression and mania. In mania, impulsivity & Disinhibition is part of their major features. They act without thinking, for the pleasure of it. If they don’t act out, they feel a sense of anxiety. People in manic episodes lose focus on their tasks. To them, it seems more important to do what they want to do right here, right now. This often leads them to perform risky behaviours such as drug use, getting into fights, and even doing self-harm. So if you have anyone you know who is going through a manic episode, it is important to stay with them. Much of the time, they cannot think before they act. Thus, it puts them and the people around them at risk.

 

Eating Disorder

People with eating disorders also show impulsive behaviours. Heavily linked to anxiety, people with eating disorders act on their anxieties before anything else. Even when they know that their behaviours are harming their body physically and mentally. As a result, they get the urge to binge or purge food. Usually, this stems from the fear that they may be fat or faulty coping styles. Eventually, binging and purging becomes a habit.

 

Personality Disorder

The most commonly associated personality disorder with impulsivity is borderline personality disorder (BPD). Impulsivity is a large part of BPD. As a result, they take part in risky behaviours. They start fights over small things, use vices, and even self-injury. People with BPD can’t stop their harmful behaviours because they rarely think about it. For them, the world is dangerous and hostile. So they act by those beliefs. They don’t really consider that their behaviour hurts them or others. This is because they lack the emotional empathy needed for insight.

 

Substance Abuse

Substance abuse can span from illegal drugs to alcohol use. As long as they develop a dependence on these vices, and act on these urges, they are may already be abusing substances. Because of the nature of the drugs they take, they achieve immediate pleasure. This starts out as a compulsion first. Then they become obsessed with finding their next dose. Despite knowing that the drugs they’re taking may be harmful, they still actively take them. If they cannot take them, they will do whatever they can to procure it. Even if it means hurting others or breaking the law in the process.

 

Attention Deficit Hyperactivity Disorder

Usually diagnosed at a young age, ADHD is a disorder that people deal with for life. It is as the name implies: they have low attention spans but high activity. Impulsivity & Disinhibition is a big part of this disorder. Although impulsivity is common in kids, their impulsivity stays until their adults. Kids who have a hard time paying attention and sitting still may have ADHD. When they can’t get what they want, they throw tantrums. They get into fights with other kids and blurt out whatever they think. While these may seem common in kids, those with ADHD have it to the point their grades drop. They become unmotivated and sometimes aggressive. Their impulsivity becomes a disorder when it impedes their basic functioning.

 

Impulse-Control Disorders

These disorders are mostly related to compulsive behaviours. One of these disorders is pyromania, where a person likes settings things on fire. Kleptomania is another example, where a person likes stealing things. Even anger management problems like an intermittent explosive disorder where bursts of misplaced aggression occur. Many of these disorders present with poor impulse and compulsive behaviour. People with these disorders can’t help but act on their emotions. If they don’t, there’s an uncomfortable sensation of tension they’ll want to remove even if it hurts themselves or others. Even then, these people tend to feel guilty about their actions. This feeling usually pushes them to seek help.

 

Self-management for impulsivity & Disinhibition

For people who are naturally impulsive, self-management can be a hard task. But if you are willing to work hard and have the right sources of support, you can learn to be more careful with the things you do. The first step is to be aware of why you act this way. Is it because you’re impatient? What about how your parents raised you? How do you see the world? Many of the factors we talked about earlier can all contribute to your behaviour. It may not have been your fault, but it is your responsibility to correct it. Learning to stop and think is usually a good place to start. You may have heard the term “look before you leap”. But this advice can be easier said than done. Your emotions can be overwhelming and you will feel the need to act now. Even if that’s the case, you need to make a habit of thinking about others. Everything we do affects someone else in some way. So it’s important to think about others when making decisions. Another thing to think about is future outcomes. It helps to think of all the facts and where your actions will lead. If you have a hard time with this, it would help to get a second opinion. You can call a friend or an expert before you make big decisions. Although it can tedious, know that it will be worth it.

 

How can a mental health professional help?

Normally, impulsive behaviour wouldn’t need treatment. But when it begins affecting your or someone else’s life, it might be time to seek help. Mental health professionals, like therapists, psychologists, and psychiatrists can give therapy. These professionals can help bring to light the possible factors leading to impulsive behaviour. A common therapy used to impulse control disorders is Cognitive Behavioral Therapy. In this therapy, the client tries to identify what causes your behaviour. Then, the therapist and client figure out proper strategies. It tackles the cognitive factors associated with impulse behaviour in order to correct it. The therapist can also get the help of friends and family. Sources of support are a big part of the therapy process because they can act as a helping hand when things get hard. They can also make sure the client is following their set plans during the course of therapy, and see if they’re getting better. Usually, it’s the people around you who have a big influence on your behaviour. Another important job of the therapist is to check if you have any mental disorder. They can diagnose and treat these disorders. A psychiatrist can prescribe drugs you might need. For people with trouble focusing, they can give Ritalin and other stimulants. It was studied that anti-depressants can help, but more research is needed for this. They can also give drugs if the client might have a mental disorder causing their behaviour.

 

Sources

https://www.goodtherapy.org/learn-about-therapy/issues/impulse-control-disorders
https://www.forbes.com/sites/forbescoachescouncil/2017/10/18/look-before-you-leap-17-ways-to-slow-down-impulsive-decisions/?sh=29d859da4440
https://pubmed.ncbi.nlm.nih.gov/2308076/
https://positivepsychology.com/instant-gratification/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080475/