Impulsivity is the tendency to act with a lack of inhibition and without considering the consequences of that action. People with Borderline Personality Disorder (BPD) characteristically act impulsively in ways that can be self-damaging.
The BPD symptom of impulsivity can manifest itself in many ways, but the following are some of the more common impulsive behaviors:
- Substance abuse
- Overspending or compulsive shopping
- Binge eating
- Risky sexual behavior
- Screaming at or threatening to harm others
- Reckless driving
People diagnosed with Borderline Personality Disorder often engage in such impulsive behaviors as a way to cope with or release their emotions. People with BPD may not make these behaviors obvious to others, and often engage in them secretly.
However, just because someone is acting impulsively, it doesn’t always mean they have BPD. It’s symptomatic of Borderline Personality Disorder when the compulsive behaviors become frequent or dangerous.
These impulsive behaviors frequently mask the underlying Borderline Personality Disorder because they can often be easier to identify and diagnose than BPD. It may be that a person with BPD first gets diagnosed with one of their compulsive disorders, even though that impulsive behavior may be the coping mechanism rather than the underlying condition.
Engaging in these impulsive behaviors can lead to trouble in relationships, finances, and employment, beyond those that someone with Borderline Personality Disorder normally experiences. Without proper treatment for this BPD symptom, it can become unmanageable and potentially dangerous.
DBT Therapy for BPD Symptoms and Impulsivity
Psychotherapy is a common treatment for people with Borderline Personality Disorder (BPD). One of the most effective ways to treat BPD symptoms, including impulsivity, is through Dialectical Behavior Therapy (DBT).
DBT focuses on building skills that will help reduce impulsive behaviors through social skill training, mood awareness, and meditative exercises. Mindfulness, one of the four DBT skills taught during DBT treatment, can help people with BPD become more aware of their actions so that they can take time to better consider the consequences. Mindfulness can help people with Borderline Personality Disorder make healthier decisions and have more appropriate reactions to emotions and situations.
Dialectical Behavior Therapy is provided through both individual and group therapy sessions, as well as homework assignments and phone coaching.
Medications for BPD Symptoms and Impulsivity
Medications may also help with impulsivity, but are most effective when used in conjunction with psychotherapy. Medication is not considered a first-line treatment choice, but may be useful in treating some symptoms of Borderline Personality Disorder and/or the mood disorders that have been diagnosed in conjunction with BPD, such as depression.
According to brain research organization The Dana Foundation, selective serotonin reuptake inhibitors (SSRIs), often prescribed as antidepressants, can be effective in treating the impulsive and aggressive behaviors typical in people with Borderline Personality Disorder. SSRIs can be effective even in people who don’t display any symptoms of depression.
Similar medications, such as venlafaxine (Effexor) and nefazodone (Serzone), may also be useful in treating impulsivity. These drugs can help correct an underlying problem in the serotonin system.