Impulsive and Disruptive Behavior Treatment in Bellevue, WA
Some people have a “short-fuse” while others can control the urge to punch someone in the face. What’s the difference? How can some naturally control their basic urges, impulsiveness and aggression, while some simply seem to “see red”? The explanation may be in the function and development of various parts of the brain.
What are Impulsive and Disruptive Behaviors?
For the context of this article, impulsive and disruptive behaviors are not the occasional interjected joke or the instance where you talk over someone. The behaviors here are typically so severe they cause some form of day-to-day distress, inhibiting social function, relationships, work, and school. Many people with these issues find themselves in trouble with the law as a result of their inability to control impulsive and aggressive actions.
What Causes Impulsiveness?
Impulsive and disruptive behaviors can be a result of various brain functions, most notably the limbic system and the prefrontal cortices. The limbic system (as well as the amygdala) is the site of our most “primal” instinct: flight-or-flight. When activated, autonomic nervous system actions kick in, and aggressive “protective” (impulsive) actions may occur. The limbic system is kept in check and moderated by the prefrontal cortices (the orbital and ventral medial specifically). These two centers of the brain are responsible for higher reasoning functions and the suppression of aggressive/disruptive tendencies.
The serotonin system has an effect on controlling aggression and impulsive actions as well. Low levels of serotonin (specifically cerebrospinal fluid levels of serotonin creator 5-HIAA) have been found in both criminal offenders and soldiers exposed to sustained violence (think PTSD) according to the Psychiatric Times’ article, Neurobiology of Impulsive-Aggressive Personality-Disordered Patents. Serotonin can signal the release of various hormones which themselves signal other parts of the brain (hypothalamus) in mediating aggressive, sometimes disruptive, responses. An increase of serotonin receptor sites was also reported in those prone to impulsive-aggressiveness, perhaps meaning that despite normal levels of serotonin, there still was an inadequate amount of serotonin for the number of receptors needing to be filled.
What Does this Mean for Treatment?
By understanding the underlying cause of impulsive/disruptive behavior and aggression rather than attempting to control (the largely uncontrollable) external situations and stimuli that generate aggressive and impulsive responses, we can treat impulsive behavior from within.
One of the most promising treatment options available for impulsive and disruptive behavior come in the form of off-label SSRI’s, also known as selective serotonin reuptake inhibitors (a common medication for depression). In essence, SSRI’s leave more unused serotonin in the brain to be used later, increasing the overall amount of available serotonin in the brain. And as we’ve just learned, serotonin plays a key role in moderating impulsive/aggressive/disruptive responses. Drugs that limit the limbic system’s sensitivity have also been shown effective (known as mood stabilizers) as have conventional
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