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VERIFIED CONTENTAuthor: Krzysztof Bialazite

Disorders of habits and drives are a relatively common phenomenon, but still not fully understood. People affected by them are exposed to a significant deterioration in professional and social functioning. Learn about the types of impulse control disorders and what their treatment is about.

Pathological gambling, kleptomania, addiction to shopping - these are examples of problems included in the group of disorders of habits and drives. Their common ground is incorrect control of the impulses generated in the brain. Lack of control combined with a strong sense of compulsion lead to repetitive pathological behavior.

Disorders of habits and drives - what are they?

Disorders of habits and drives are a group of abnormal behavior with a similar clinical picture. Their common feature is the repeated, strong sense of compulsion to perform a specific activity.

The person affected by this disorder is unable to stop their behavior, despite its negative consequences.

Her behavior is not motivated by rational premises. The effects of impulse control disorders can ruin a patient's life - leading to financial, social and he alth losses. In some cases, they have legal consequences.

How to recognize whether the repetition of a certain activity is a disorder of habits and drives? Disorders belonging to this group are typically characterized by a specific course:

  • Impulse - a strong desire or a sense of inner compulsion to perform a specific activity.
  • Feeling of increasing emotional tension.
  • Losing control over one's own behavior, surrendering to the impulse.
  • A feeling of relaxation, relief, peace and pleasure.

Satisfying the sense of compulsion allows for a short-term reduction of emotional tension. Immediately after it, the patient experiences pleasant emotions. Even so, repetition of activities and loss of control over one's behavior causes considerable suffering. The social and material consequences deteriorate the daily functioning of the patient. Despite feeling guilty, he is unable to regain control of his urges.

The international classification of ICD-10 diseases distinguishes fourmain types of habit and drive disorders:

  • kleptomania (pathological theft),
  • pyromania (deliberate setting on fire),
  • pathological gambling
  • and trichotillomania (habitual hair-pulling).

Apart from them, there is also an additional group of other impulse control disorders. These include the so-called behavioral addictions, consisting in the habitual performance of certain activities.

Behavioral addictions include, among others:

  • workaholism,
  • shopaholism,
  • addiction to the Internet, mobile phone, computer games,
  • and habitual overeating.

What happens in the brain of a person affected by a disorder of habits and drives? Currently, there are several theories that try to explain the underlying causes of these anomalies. It is believed that the tendency to lose impulse control may be related to a malfunction in the brain's reward and punishment centers.

Disturbances in dopamine pathways (one of the so-called "happiness hormones") may cause a tendency to relieve emotional tension through pathological behavior.

The role of genetic and environmental factors (contact with people who relieve stress through addiction or gambling) is also emphasized. The underlying cause of disturbed habits and drives is the inability to solve life problems and deal with difficult emotions.

A person affected by this disorder constantly repeats activities that trigger a short-term feeling of happiness and peace. The repeated pattern becomes permanent, and regaining control over one's own behavior becomes more and more difficult.

Disorders of habits and drives - types

The currently valid ICD-10 International Classification of Diseases distinguishes the following types of disorders of habits and drives:

Kleptomania

Kleptomania is a tendency towards pathological, repeated thefts. Their cause is an unstoppable internal compulsion, caused by increasing emotional tension. Kleptomania differs from ordinary thefts by motivation - the reason for the theft is not the high value of the stolen items or the desire to get rich.

Stolen items are not used later - the thief usually gets rid of them, gives them away or throws them away. After committing the theft, there is a brief feeling of gratification and happiness.

In between their thefts, people with kleptomania experience negative emotions and guilt. Kleptomania is about 2-3 times more common in women than in men. This disorder can lead to serious consequencessocial and legal.

Pyromania

Pyromania means a morbid tendency to set fire to various objects and cause fires. A person affected by pyromania shows excessive interest and even fascination with the subject of fire. Arson attacks are not committed with a specific intention.

As in the case of other disorders of habits and drives, their purpose is to temporarily relieve emotional tension.

There is a feeling of excitement immediately after the arson. Pyromania often occurs in conjunction with other mental disorders such as antisocial personality disorder, intellectual disability, and addiction.

Pathological hazard

Gambling can be recreational, risky or pathological. The problem of pathological gambling occurs in people for whom gambling has become one of the highest priorities in life.

Patients with this disorder neglect other life activities and areas, such as family and professional life, social relationships or material status. Pathological gambling is a form of addiction with all its consequences.

Strong emotions and excitement emerge during the game. Each win causes a strong stimulation of the reward system. Defeats, on the other hand, stimulate subsequent approaches to the game in order to make up for financial losses and reduce emotional tension.

With time, the amount of money you spend on gambling increases and your involvement in games becomes the dominant activity in your life.

Trichotillomania

Trichotillomania is a rare disorder of habits and drives that involve the habit of pulling out one's hair. Trichotillomania leads to visible hair loss. As with other impulse control disorders, there is a feeling of unmanageable compulsion just before the hair is pulled out. In turn, pulling a hair out causes temporary relief and pleasure.

Trichotillomania most often affects the hair on the head, but there are cases of pulling out eyelashes, eyebrows or pubic hair. Hair pulling is the cause of mental suffering, it can cause significant social and professional problems.

In some patients, trichotillomania coexists with other mental disorders. One of them is trichophagia, which is the habit of swallowing hair. The consequence of swallowing hair may be the formation of the so-called trichobezoars, i.e. clumps of hair located in the digestive tract.

Behavioral addictions

Behavioral addictions are a group of addictions related to performing certain activities. This is a relatively new groupaddictions that have recently started to be perceived in terms of disease entities. Behavioral addictions include, among others workaholism, shopaholism, addiction to the Internet, mobile phone or computer games, as well as compulsive overeating.

Behavioral addictions are related to everyday activities, which in most people do not take on a pathological dimension. In a certain group of people, their frequent repetition leads to a loss of control - there is a feeling of compulsion and features similar to addiction to psychoactive substances.

The mechanisms of creating behavioral addictions are constantly being researched. It is known that genetic factors, changes in the functioning of the brain, environmental conditions, and disturbed patterns of coping with difficult emotions may contribute to their development.

Disorders of habits and drives - differentiation

The diagnosis of disorders of habits and drives requires differentiation with other mental disorders that may have a similar picture. Of all the mental problems, disorders of habits and drives most closely resemble obsessive-compulsive disorders (the so-called "obsessive compulsive disorder").

Compulsions are compulsory and repeated activities, such as washing your hands, organizing items, or checking that the door is properly closed.

Disorders of habits and drives resemble OCD in many ways. Common to both disorders is the feeling of a strong, unmanageable compulsion to perform a given activity and using it to relieve the growing emotional tension. The main difference between these disorders is the patient's attitude to their behavior.

In OCD neurosis, a person repeating certain activities feels aversion towards them, notices their pointlessness and wants to stop them. Patients with disturbed habits and drives feel pleasure in the activity performed, and the motivation to repeat it is the accompanying positive emotions (e.g. a feeling of strong excitement when observing a fire by a pyroman).

Disorders of habits and drives - treatment

Treatment of disorders of habits and drives begins with an accurate diagnosis. It is necessary to answer the question whether the disorder is primary or is the result of other mental problems.

If a patient is diagnosed with a comorbid mental illness (e.g. neurotic disorders or depression), it is necessary to initiate appropriate treatment. In the case of most disorders of habits and drives, pharmacological treatment is of supportive importance.

The basis of treatment ispsychotherapy. Its main goal is to make the patient aware of the disease dimension of his behavior.

Once a therapeutic relationship is established, the therapy aims to analyze the causes of the disorder and teach the patient other, non-pathological ways of coping with difficult emotions. A valuable therapeutic method are support groups (including Gamblers Anonymous Community), enabling the exchange of patients' experiences and assistance in recovery.

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