Look Out For Impulsivity in Mental Illness

It is hard to put yourself and your struggle out in the world. For me, when I write a post that is personal, it is in the hope that my current reality will reach and help someone. It is also cathartic. So, in that vein, this post is about the struggle of impulsivity on our family.

Impulsivity is associated with a number of diagnoses, such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and anxiety, all of which my son has. It is like a perfect storm of impulsivity in his little body. Impulsivity is characterized as acting on a whim, with little to no forethought, or consideration of the consequences. Now imagine that you have what I like to term as an overdeveloped emotional quotient. I envision this as being heavily influenced by the constant ebb and flow of other people’s emotions and your own. For example, your friend is having a day where they really need space, some down time and don’t really want to hang out or talk. You can’t understand this temporary change of normal interaction you have with your friend. This leads you to be upset, to question whether or not this friend likes you anymore, to dissect their interaction with everyone else and casting yourself in a bad light. Since this is happening in your head, you can’t focus on your work, or your other friends, and you become angry and unable to exhibit expected or required reactions to anything else. Your entire emotional health has been upended by a perceived emotion of this friend. So, you have been influenced by your friend’s emotions and your emotions have become explosive as a result. Think of it as not only being sad by someone else’s misfortune, but devastated and you feel out of control and unable to think through the consequences of your choices. Now imagine you are a prepubescent child with this added struggle. Do you see the recipe for constant upheaval? I do, but recently I realized that this overdeveloped emotional quotient can enhance the impulsivity towards the negative.

Often, the inability to control impulses is characterized by lying in our house. The unknown consequence of truth-telling when you know it confesses wrong doing is debilitating and therefore you lie hoping no one catches it. This lying then becomes the idea that your family can’t possible love or like you because you can’t get it right. Every time you mess up even the smallest bit, your mind tells you that you are a terrible and unlovable person. This is when impulsivity may lead to harmful actions. But you don’t recognize that harmful acts mean you are physically injured.You act without thought that running into the street can lead to pain, you act without thinking that hitting yourself can be damaging, you can believe that not being around is better than being terrible. But you don’t realize that not being here is permanent. We must recognize that these thoughts and actions may be indicative of depression also. Depression is not only an immense sadness, it is sometimes the inability to process emotions and thoughts which leads to dangerous impulses. Many medications used to treat symptoms exhibited by those with ASD, ADHD, and anxiety may cause depression. You now have a diagnosis that increases lack of impulse control and are given medications that may lead to depression. Recently we had the misfortune of learning how destructive this intersection of impulsivity and depression can be. My son was incredibly upset by emotions of others at school, then struggled to make good decisions and choices, which then led to him impulsively exhibiting self harmful actions. Our response has been swift in hopes of helping him understand that even when you don’t want to harm yourself, taking actions that could lead to harm can easily turn into being harmed. That being harmed is permanent, that our lives aren’t movies or television where the hurt and damage isn’t real. He is constantly battling the emotional part of his brain trying to take over and he barely knows what that means.

I continue to learn that we have a long way to go to understand what mental illness can look like in children. There is a great need to research how we can help our children when mental illness is present with other illnesses of the brain. But, I still have to go figure out, with the professionals, how to treat this adolescent depression and keep my son safe. I fumble with the words to reassure him that emotions are a fact but our reaction to them is ever evolving and in our control. I try to help him understand that he can review his day and recognize where he might be influenced by negativity in someone else. This is a hard thing when awareness of others and self is still an emerging skill. But, he has always been a hard worker, so I am encouraged that he will put his tenacity to work here.

This Mental Health Awareness month, I hope that you are educated on how impulsivity and mental illness can coexist, that you can love and support someone who struggles with this, that you can see someone you love in here and seek help. I hope that we continue the conversation, the education, and the support so that no one is left to languish in the convergence of impulsivity and mental illness.