BPD What Is Impulsivity? By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial process Updated on February 07, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Westend61 / Getty Images Table of Contents View All Table of Contents Characteristics Identifying Causes Examples Treatment Coping Impulsivity, or impulsive behavior, is broadly defined as actions without foresight that are poorly conceived, prematurely expressed, unnecessarily risky, and inappropriate to the situation. Impulsivity is associated with undesirable, rather than desirable, outcomes. Impulsivity is a characteristic of a number of mental health conditions, including borderline personality disorder (BPD), bipolar disorder, and attention deficit hyperactivity disorder (ADHD). People who experience impulsivity may make hasty decisions, get into arguments, and engage in risky behaviors. In addition to undermining relationships and a person's overall sense of well-being, impulsive behaviors can also lead to financial and legal harm if left unchecked. Fortunately, there are treatments that can help bring impulsivity under control, including psychotherapy, mindfulness training, and pharmaceutical drugs. Characteristics of Impulsivity According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), impulsive behaviors are a hallmark of BPD and other conditions. How it presents may vary depending on a person's specific diagnosis and the severity of their condition. People who are impulsive are commonly described as: Hot-headedRashUnpredictableUnstable This instability often causes people to struggle with feelings of inadequacy that manifest with unstable emotions, unstable behaviors, and unstable relationships. In BPD, for example, people may be quick to lash out at anything considered a slight and will often fail to recognize how those emotions are unreasonable or excessive. In psychological terms, impulsive behaviors are inherently inappropriate either in terms of scale or potential risk. In some cases, people are less likely to take into account potential consequences and will often turn to self-harm behaviors (like binge eating or excessive drinking) as a means to cope. However, impulsive behaviors are not, in and of themselves, a diagnosis. It is only when the behavior is pervasive, detrimental, and interferes with a person's ability to function normally that mental health diagnoses such as BPD or bipolar disorder may be considered. Impulsivity should not be confused with a compulsion, in which a person recognizes the behavior is abnormal but cannot stop it. With impulsivity, the person will act out without inherently recognizing that the behavior is abnormal. Identifying Impulsivity Impulsivity is not a separate condition, but it is often a symptom of a mental health condition. No single test can confirm whether impulsive behavior is the result of BPD, bipolar disorder, or some other condition. A doctor will perform a psychological exam to determine whether the symptoms are consistent with the criteria outlined in the DSM-5. During a psychological evaluation, a doctor will ask questions about the symptoms a person is experiencing, including questions about the severity, nature, and duration of the symptoms. In some cases, they may ask other people who have contact with the individual, such as family members, for information about symptoms and behavior. In addition to a psychological assessment, a doctor may also conduct a physical exam and order blood work. This can help rule out medical conditions that might be contributing to or causing the symptoms. Risk Factors for Impulsivity There are a number of different factors that are associated with an increased risk for impulsive behavior. Some of these include: Age: Younger people are more prone to engaging in impulsive behaviors than older people.Sex: Boys and men tend to be affected by impulsivity more frequently.Family history: A family history of mental illness or impulsive behavior can lead to an increased risk.Trauma: Exposure to trauma, violence, abuse, and neglect may increase a person's risk for impulsivity.Substance use: Using drugs and alcohol can contribute to impulsive behavior. Diagnostic Criteria for BPD Causes of Impulsivity The exact causes of impulsivity are not fully understood, but it is believed that both environmental factors and genetic factors may play a role. Psychological Factors Impulsivity may sometimes stem from traumatic experiences, particularly those that occur in early childhood. A child's upbringing, including their caregiver's parenting styles, can also impact the development of self-regulation skills. Kids who do not learn to regulate their behavior effectively may experience greater impulsivity as a result. Environmental factors can also make more people with mental health conditions such as BPD and bipolar disorder effectively manage symptoms of impulsivity. Genetic Factors In some conditions, impulsivity might be influenced by genetic factors. Genetic mutations that impact the production of serotonin and dopamine, the neurotransmitters associated with mood and cognition, can contribute to increased impulsivity. Some research has also shown that genetic errors may increase heritable impulsivity. Other conditions linked to impulsivity, including bipolar disorder and ADHD, are believed to share underlying genetic factors. These genetic influences likely impact the shared symptoms such as impulsivity. It is this combination of environmental, genetic, and physiological factors that likely creates the perfect storm for the development of many mental health conditions that are associated with impulsivity. Conditions Linked to Impulsivity Impulsive behaviors can occur in a number of different mental health conditions: Physical causes of impulsivity, including acquired brain injury or a neurodegenerative disease like Alzheimer's disease or Huntington's disease. Bipolar mania, often in tandem with grandiosity and a flight of ideas (During an acute manic episode, a person will often act impulsivity with little thought of the consequence. Spending sprees and hypersexual behaviors are two common examples of impulsivity related to bipolar disorder). Attention-deficit hyperactivity disorder (ADHD), known as hyperactive-impulsive ADHD, spurred by the child's inability to keep still or control inappropriate behavior (It is this lack of control, combined with a constantly shifting focus of interest, that spurs impulsivity.) Substance use disorders, although the impulsiveness is typically exhibited under the influence of drugs, when craving drugs, or when actively seeking drugs. Antisocial personality disorder (ASPD), closely aligned with BPD but differs in that there is a pervasive and persistent disregard for morals, social norms, and the rights and feelings of others Impulse control disorders: These include conditions such as intermittent explosive disorder, kleptomania, pyromania, and trichotillomania, which can result in risky behaviors that may harm the self or others. How impulsivity presents varies depending on the condition. With borderline personality disorder, a person will have extreme emotions that they find hard to control. With antisocial personality disorder, there will be a marked lack of emotions. Examples of Impulsivity Impulsivity may be experessed in a variety of ways depending on the underlying cause. Every individual and situation is different. Some common examples of impulsivity include: Abruptly changing or canceling plansAn inability to remain stillBinge eating or drinkingClearing out belongings to "start anew"Constantly "turning over a new leaf"Destroying propertyEscalating confrontationsFrequent emotional outburstsInability to receive criticism without affrontJoining and quitting a lot of groupsJumping to conclusionsMeaningless or risky sexOver-apologizingOversharing of emotionsOverspendingPhysical violenceQuitting a job suddenlySelf-harmSelf-mutilationThreatening to harm one's self or others Treatment for Impulsivity While impulsive behaviors can be severe and pervasive, they can often be successfully managed with treatment. Many treatments for mental health conditions have components that specifically target impulsivity. Psychotherapy Dialectical behavior therapy (DBT) focuses on building skills that reduce your impulsive behaviors and increase your ability to think and reflect before acting. By using coping mechanisms to handle intense emotions, a person with BPD is better equipped to face situations without confrontation. Mindfulness, a skill taught in DBT, encourages you to stay in the moment, which can help you to remain more aware of your actions so you take the time to consider consequences. Practicing this technique can help you to take the time needed to reflect on your options, empowering you to make more rational decisions about how to respond to events around you. Mindfulness meditation is a modality often used to support the training. Medication Medications like selective serotonin reuptake inhibitors (SSRIs) sometimes combined with a low dose of an antipsychotic may also help. This is especially true if your behavior is extreme and poses a risk to your safety or those around you. There are a number of drugs that specifically treat impulsivity, including: Atypical antipsychotics: Abilify (aripiprazole) is seen to reduce interpersonal problems and impulsivity. Mood stabilizers: Lamictal (lamotrigine) may help reduce impulsivity and anger, while Topamax (topiramate) may ameliorate impulsivity, anger, and anxiety. Medications are most effective when used in conjunction with psychotherapy with a therapist who specializes in treating impulsive behavior. Medications Used to Treat BPD Coping With Instability In addition to complying with your treatment plan and seeing a therapist, there are steps you can take to better cope with impulsivity. Often, the first step is to identify the impulsive behaviors that you’d like to change. Next, you can try one of these strategies when you notice an urge to engage in one of those behaviors: Conduct a chain analysis, which allows you to identify the impulsive behavior, what happened prior to the behavior, evaluate your thoughts and feelings, and consider the consequences. Join a support group. If you lack resources like supportive friends and a family, joining a support group can be helpful in managing your impulsive behaviors. It will also allow you to talk to others about what has (and hasn't) worked for them as far as coping with impulsive behaviors. Replace impulsive behaviors with healthy ones. While impulsivity may cause a short-term positive effect (for example, taking away anxiety or fear), there are healthy ways to cope, including going for a walk, journaling, talking to a trusting friend, or meeting with a support group. Practice deep breathing. Deep breathing is one way to help manage stress, which can help you regulate your mood and reduce impulsive behavior. Focusing on your breathing can also help distract you as you move past the urge to act impulsively. If you or a loved one are struggling with impulsivity, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.: 2013. Bakhshani NM. Impulsivity: a predisposition toward risky behaviors. Int J High Risk Behav Addict. 2014;3(2):e20428. doi:10.5812/ijhrba.20428 Kulkarni J. Complex PTSD: A better description for borderline personality disorder?. Australas Psychiatry. 2017;25(4):333-335. doi:10.1007/s00213-008-1173-0 Bornovalova MA, Hicks BM, Iacono WG, Mcgue M. Longitudinal twin study of borderline personality disorder traits and substance use in adolescence: Developmental change, reciprocal effects, and genetic and environmental influences. Personality Disorders: Theory, Research, and Treatment. 2013;4(1):23-32. doi:10.1037/a0027178 Pettersson E, Lichtenstein P, Larsson H, et al. Genetic influences on eight psychiatric disorders based on family data of 4 408 646 full and half-siblings, and genetic data of 333 748 cases and controls [published correction appears in Psychol Med. 2019 Jan;49(2):351]. Psychol Med. 2019;49(7):1166-1173. doi:10.1017/S0033291718002039 Zimmerman M, Morgan TA. The relationship between borderline personality disorder and bipolar disorder. Dialogues Clin Neurosci. 2013;15(2):155-69. Miller DJ, Derefinko KJ, Lynam DR, Milich R, Fillmore MT. Impulsivity and attention deficit-hyperactivity disorder: Subtype classification using the UPPS Impulsive Behavior Scale. J Psychopathol Behav Assess. 2010;32(3):323-332. doi:10.1007/s10862-009-9155-z Perry JL, Carroll ME. The role of impulsive behavior in drug abuse. Psychopharmacology (Berl). 2008;200(1):1-26. doi:10.1007/s00213-008-1173-0 May JM, Richardi TM, Barth KS. Dialectical behavior therapy as treatment for borderline personality disorder. Ment Health Clin. 2016;6(2):62-67. doi:10.9740/mhc.2016.03.62 Ripoll LH. Psychopharmacologic treatment of borderline personality disorder. Dialogues Clin Neurosci. 2013;15(2):213-24. By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for BPD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.