As humans, the ability to control our impulses-or urges-helps distinguish us from other species and marks our psychological maturity. Most of us take our ability to think before we act for granted. But this isn’t easy for people who have problems controlling their impulses.

People with an impulse control disorder can’t resist the urge to do something harmful to themselves or others. Impulse control disorders include addictions to alcohol r drugs, eating disorders, compulsive gambling, paraphilias sexual fantasies and behaviors involving non-human objects, suffering, humiliation or children, compulsive hair pulling, stealing, fire setting and intermittent explosive attacks of rage.

Some of these disorders, such as intermittent explosive disorder, kleptomania, pyromania, compulsive gambling and trichotillomania, are similar in terms of when they begin and how they progress. Usually, a person feels increasing tension or arousal before committing the act that characterizes the disorder. During the act, the person probably will feel pleasure, gratification or relief. Afterward, the person may blame himself or feel regret or guilt.

People with these disorders may or may not plan the acts, but the acts generally fulfill their immediate, conscious wishes. Most people, however, find their disorders highly distressing and feel a loss of control over their lives.

How are they different from similar disorders?

While other disorders may involve difficulty controlling impulses, that is not their primary feature. For example, while people with attention-deficit/hyperactivity disorder (ADHD) or in a manic state of bipolar might have difficulty controlling their impulses, it is not their main problem.

Some health professionals consider impulse control disorders subgroups of other conditions, such as anxiety disorders or obsessive-compulsive disorders. Some medications for treating depression and anxiety also have been successful in treating impulse disorders, particularly antidepressants known as serotonin reuptake inhibitors. This suggests the neurotransmitter serotonin plays a role in these disorders.

What causes impulse control disorders?

Scientists don’t know what causes these disorders. But many things probably play a role, including physical or biological, psychological or emotional and cultural or societal factors. Scientists do suspect that certain brain structures-including the limbic system, linked to emotions and memory functions, and the frontal lobe, the part of the brain’s cortex linked to planning functions and controlling impulses-affect the disorder.

Hormones associated with violence and aggression, such as testosterone, also could play a role in the disorders. For example, researchers have suggested that women might be predisposed to less aggressive types of impulse control disorders such as kleptomania or trichotillomania, and men might be predisposed to more violent and aggressive types such as pyromania and intermittent explosive disorder.

Research also has shown connections between certain types of seizure disorders and violent impulsive behaviors. And studies have revealed that family members of people with impulse control disorders have a higher rate of addiction and mood disorders.