Impulse Control Disorders
People who have impulse control disorders cannot avoid doing things that might bring harm to themselves or others. Typically, people with this problem feel some type of increasing anxiety before committing the action, like pressure building up. Then, after the action, they feel relief or even happiness, despite the possibly dangerous consequences.
The officially recognized impulse control disorders discussed in this section are pathological gambling, kleptomania, pyromania, trichotillomania, and intermittent explosive disorder. In addition, compulsive sexuality has been included because of its similarities. More recently, some researchers have also suggested that other problems such as Internet addiction and computer game addiction be considered impulse control disorders because they share similar traits. In general, all of these problems are characterized by an inability to control one’s actions, and results that have an extremely negative impact on the person’s life, as well as the lives of others.
Pathological gambling is repeated betting behavior that greatly interferes with a person’s finances, job, family life, or other relationships. For many people with this problem, their family relationships are frequently disrupted and may even end because of the person’s behaviors. People with this problem sometimes lose jobs because of missed days at work and are sometimes forced to sell personal items, like cars and houses, to pay off gambling debts. Many pathological gamblers are constantly looking for a “system” to make back the money they’ve lost, but this often leads to losing even more money. As with some of the other impulse control disorders, many pathological gamblers often hide their actions from their friends and family; however, in desperate financial times they may turn to those same people and ask to borrow money to continue their gambling.
A person with kleptomania (literally, stealing madness) steals things that are of no financial or personal value. Many thefts by kleptomaniacs are unplanned, and the items stolen are sometimes put away without ever being used. Stolen items may even be given away, thrown away, or returned. Many people struggling with kleptomania steal when they get anxious or frustrated. However, it’s also possible that the person has strong random urges to steal that only seem to go away after performing the act. Immediately following the theft, the person might feel better or even pleasantly excited. Later, however, people with kleptomania often feel guilty about what they’ve done or recognize that their actions are harmful to themselves and others.
Pyromania (literally, fire madness) is the repeated act of deliberately setting fires, usually at random locations, after which the person feels relieved or excited. The motive for setting these fires isn’t always to harm someone, but harm is often the result. By definition, in pyromania the motive for setting a fire isn’t personal gain, such as collecting insurance money. People struggling with pyromania are usually very interested in all aspects of fire. They’re interested in how fires start, what fires do, and how fires are stopped. Many of them are even interested in the fire department and scan the fire department’s radio for calls so they can go to the scene and watch as the fire is extinguished.
People with trichotillomania (literally, hair-pulling madness) experience a release of tension or a feeling of satisfaction when they pull out their hair. Many people with trichotillomania pull out the hair from their head, eyelashes, eyebrows, legs, arms, face, and pubic region. Many of them pull out enough strands of hair that the hair loss becomes noticeable. This causes much discomfort, especially in social situations where it can be observed. As a result, people with this problem often go to great lengths to hide their loss of hair, either by wearing hats, wigs, or long-sleeve shirts, or by covering the bald area with makeup. People with trichotillomania may not even be aware that they are pulling out their hair. Many of them say that they feel bored or nervous before pulling out their hair, but after pulling it out, they feel guilty, sad, or angry. Some of the same people also report that they pull out their hair when they’re watching television, reading, talking on the telephone, or driving.
Intermittent Explosive Disorder
A person with intermittent explosive disorder will suddenly and unexpectedly lash out at other people in a very hostile way. By definition, the result of these aggressive behaviors is injury to other people or damage to their property. The actions of people with intermittent explosive disorder are much more extreme and aggressive than what the situation requires. People who have intermittent explosive disorder feel very angry, energized, and nervous when they lash out, and then feel depleted of strength, relieved, embarrassed, and maybe even depressed when the event is over.
People struggling with compulsive sexuality often engage in high-risk sexual behaviors, such as having sex with multiple partners or people they don’t know, having sex in potentially dangerous situations, or having sex in situations that puts them at risk for sexually transmitted diseases. A person struggling with this problem will often spend a great deal of time thinking about sex and planning for sex, and spend a great deal of money having sex or collecting pornography. For many people with this problem, the sexual act loses its pleasurable qualities and becomes disconnected from feelings of love or companionship. Instead, it’s more like a chore that never brings satisfaction; the sexual urge merely has to be satisfied. People with this problem often feel compelled to keep their impulsive behavior secret, which leads to difficult relationships with spouses, partners, and friends.