ADHD impulsivity: why it happens and how to manage it

You should read this if you have a brain that always says, "I just gotta!"

People with ADHD are often more impulsive than neurotypicals due to their dopamine-seeking behavior and lack of premeditation — or thoughtful planning.[1] The simple definition of impulsivity is speaking, behaving, or making choices without taking the time to consider the consequences of the actions.

What is ADHD Impulsivity?

In children and adults with ADHD, or Attention-Deficit/Hyperactivity Disorder, impulsivity shows up in a variety of behaviors. Of course, it can be more intense in some individuals than others, especially if they have the hyperactive-impulsive subtype, as opposed to the inattentive subtype (formerly known as “ADD”).

Examples of impulsivity

Here are some common examples of impulsive behaviors:

  • Struggling to stay on an important task after being suddenly struck with a brilliant idea.
  • Lack of self-control at checkout counters and buying all of the things.
  • Blurting out inappropriate, ill-timed, or even hurtful things in conversation.
  • Making big – sometimes life-changing – decisions without thinking them through.

If you’ve found yourself in any of these situations, it’s likely that you later asked yourself, “what the heck was I thinking?” The thing is - you probably weren’t thinking — you were just acting without evaluating the possible outcome.

The neuroscience of ADHD impulsivity

a brain with two labeled parts: the prefrontal cortex and the thalamus
Photo by Inflow

The people around impulsive ADHDers might think we’re simply being rude or chaotic — but it’s not a lack of caring or a moral failing that leads to impulsivity. Like many ADHD symptoms, impulsivity is caused by a difference in our brains! 

Prefrontal Cortex (PFC)

The Prefrontal Cortex (PFC) is the “driver” of our minds — it regulates emotions, decision-making, and motivation.

Abnormal PFC function has long been associated with ADHD symptoms[2], but with impulsivity, there’s another brain region involved: the “crossing guard” thalamus.

Thalamus

The thalamus has an important job: to signal the PFC to “go” or “stop” certain behaviors via dopaminergic pathways. For ADHD brains, that communication is slowed, leading to increased impulsivity, among other symptoms.

Science translation: The signals that tell non-impulsive neurotypicals to “stop, evaluate, and make careful decisions” doesn’t stop ADHD brains quickly enough.

How to tell if you act impulsively with ADHD

dictionary entry for "impulsive". adjective. definition: acting or done without forethought; acting as an impulse
Photo by Inflow

1. You tend to interrupt people when they’re speaking

Knock knock.

Who’s there?

Interrupting cow!

Interrupting cow wh–

MOO!

It’s me. I’m the interrupting cow. 

2. You really have trouble waiting your turn

I can’t tell you the number of game nights I’ve ruined because I can’t handle waiting while someone decides which word to play in Scrabble. Just let me do it!

This also applies to adults and teens who grow impatient while driving and have a tendency towards road rage.

3. You are prone to emotional outbursts

Emotional outbursts include everything from anger to sadness, and everything in between. But - serious question:

How can I possibly be expected to take a deep breath and count to 10 when I’ve already gone full She-Hulk?

4. You make quick decisions that you regret later on

Impulsive choices might include things like:

  • Overindulging with foods and drinks (“compulsive eating”, some call it)
  • Risky sexual behaviors
  • Substance overuse and abuse
  • Overspending

Take it from me - the hangover, nausea, walk of shame, and overdraft fees are not worth it.

ADHD impulsivity: coping strategies and treatments

stones stacked on one another on the beach
Photo by Pixabay

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy, or CBT, is a form of talk therapy that can help patients explore the relationship between their thoughts and behaviors, and work toward restructuring those cognitive patterns and connections.

A therapist may be able to help you adjust your beliefs around your impulses - from negative or destructive ones (“I can’t control myself!”) to a more positive and empowering perspective (“Controlling my impulses is hard, but I can do hard things!”)

Mindfulness practices

Some people with ADHD struggle to focus on the present moment they’re in.  Practicing mindfulness — through meditation or breathing exercises — can help us to slow down and pay attention to our thoughts and related behaviors.

When we practice becoming aware of our impulses, we’re more likely to consider them — and their consequences — and make more mindful decisions on how to move forward. 

Medication

Many adults with ADHD report improved impulse control with the use of medication (both stimulant and non-stimulant) as a part of their treatment regimen.

Talk to your doctor about whether medication is an appropriate treatment for you.  

Too long; didn’t read

Impulsivity is one of the most common symptoms ADHD — especially those with the hyperactive-impulsive presentation of the condition. Adults with ADHD are commonly impulsive with their decision-making, financial responsibility, and emotions. If you’re struggling with poor impulse control, please know that you are not alone, and that there are plenty of ways to cope, such as Cognitive Behavioral Therapy (CBT), mindfulness, and medications.

While there’s no single quick fix that will magically turn us into careful, calculated decision-makers overnight - with practice and proper support, we can build new skills to help us improve.

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