Impulse control disorders (ICDs) are a specific kind of mental illness that regularly coincides with substance abuse and addiction. ICDs have also been linked to other problematic behaviors including gambling, pyromania, and kleptomania. However, long-term drug use can lead to the deterioration of critical thinking skills and decreased impulse control. In this article, we’ll explore why these conditions have such strong comorbidity with one another, how one can influence the other, as well as the significance of this relationship.
What Is An Impulse Control Disorder?
While it’s normal for people to be disruptive or defiant at times (especially as children), individuals with an impulsive control disorder have much more severe and longer-lasting episodes to such a degree that it severely impacts their everyday lives.
Impulsive control disorders are often categorized as behavioral addictions. In the DSM-V they are described as disruptive, impulse-control, and conduct disorders. This umbrella term refers to inappropriate, and often extreme, patterns of behavior due to a lack of an inability to control actions, thoughts, or emotions. One of the most notable differences between ICDs and other types of mental illness is that in these instances, their behavior is externalized and is typically directed towards others.
Impulsivity vs. Compulsion vs. Addiction
There is an overlap between impulse disorders, compulsive behavior, and addiction and highlights why drug use is a commonality with impulsivity. Either of the three can result in an individual taking part in behavior they know to be wrong or detrimental, such as drug abuse. The key differences between these disorders are the motivations behind the disruptive behavior as well as the individual’s reaction to their doings.
Impulsivity is defined as unplanned actions or reactions to internal or external stimuli that are carried out without regard for the (often negative) consequences. Compulsions are actions (typically repetitive) done to avoid or resolve internal feelings of discomfort or tension. Compulsive actions do not provide positive feelings and instead, often bring shame or further distress to the individual. In the case of impulsivity, one feels no such remorse and may even feel satisfaction at their aversive behavior. In this regard, impulsivity bears striking resemblance to addictive behaviors.
Addiction is when a person repeatedly engages in detrimental behavior (in most cases, very aware of the negative consequences) believing it to be pleasurable, like a drug high. Both addiction and impulsivity involve a disregard for negative consequences which can contribute to a person taking up drugs or indulging so frequently that they end up becoming hooked on them.
Can One Cause the Other?
Scientists aren’t certain why ICDs occur but the findings strongly suggest that the deterioration of cognitive reasoning that occurs with habitual drug use can indeed lead to alterations in the parts of the brain that deal with motivation. It’s also very easy to see how an impulsive disorder could lead a person to take up substance use. This is a prime example of a dual diagnosis where two co-occurring conditions can cause or worsen the other.
The more prevalent risk, however, lies in the similar vulnerabilities of these individuals. Genetic studies have uncovered that more than 50% of a person’s likelihood of developing either disorder can be genetic. Several genes, in particular, have been identified as contributing factors of both. D2A1 for example, which is frequently present in drug abusers, is double the frequency in someone with an impulsive disorder.
Addiction and impulse control disorders also have similar pathways and can bear similar neurotransmitter make-up. This is notable as dopaminergic systems play a central role in both causing drug-seeking behavior and in creating positive feelings that reinforce such actions.
What This Means For Addiction Treatment
The parallels between impulse control disorders and addiction provide further proof that addiction is a disease. While there is certainly a behavioral component that can make an individual more likely to engage in drug use in the first place, the genetic component shows that it’s not necessarily a lack of willpower or some other fault of the individual. This thinking is the core of our treatment methods here at Amethyst Recovery Center and why we offer judgment-free help and compassion in our dual diagnosis treatment program.