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PTSD and Impulsive Behaviors


Updated June 30, 2014

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There is a strong connection between PTSD and impulsive behaviors. What are impulsive behaviors? Well, impulsive behaviors are any type of behavior that occurs quickly without control, planning, or consideration of the consequences. Impulsive behaviors tend to be connected with immediate positive consequences (for example, relief from emotional pain). However, in the long-term, there may be a number of negative consequences, such as greater distress or regret.

There are a number of different behaviors that could be considered impulsive. Behaviors that may be considered impulsive include eating disorder-related behaviors (for example, binging or purging), alcohol and/or drug use, deliberate self-harm, and suicide. These are all behaviors that people usually say happen quickly and are done to obtain fast relief from emotional pain. All of these behaviors commonly co-occur with PTSD.

PTSD and Eating Disorder Behavior

If you struggle with an eating disorder, you may have also experienced some kind of traumatic experience in your life. Eating disorders are common among people who report a history of trauma. Childhood sexual abuse, in particular, has been found to be a risk factor for developing an eating disorder.

In addition, people with PTSD are three times as likely as someone without PTSD to develop bulimia nervosa (an eating disorder characterized by a cycle of uncontrolled bingeing behaviors followed by purging, restricting behaviors, or excessive exercise), and people with bulimia nervosa are more likely to have PTSD than people with anorexia nervosa (an eating disorder where a person refuses to maintain a healthy body weight).

Bulimia nervosa behaviors may be a way of managing uncomfortable and distressing emotions associated with having experienced a traumatic event or PTSD. People with PTSD often experience very strong, unpleasant emotions (such as guilt, shame, sadness, and fear), and if they do not have healthy ways of managing those emotions, they may develop or rely on more unhealthy behaviors that could provide comfort in the moment, such as binging.

PTSD and Substance Abuse

People with PTSD are consistently found to be more likely to have problems with alcohol and/or drug use than people without PTSD. For example, one study found that approximately 31% of people with PTSD have also experienced problems with drug use in their lifetime, and around 40% of people with PTSD have had problems with alcohol use in their lifetime.

There are a number of reasons why PTSD may be connected with substance use. A common theory is that the substances are being used to "self-medicate" the intense and unpleasant symptoms of PTSD. For example, the more severe a person's hyperarousal symptoms are, the more likely they may use alcohol as a way of dampening or reducing those symptoms.

PTSD and Deliberate Self-Harm

Deliberate self-harm (also called self-injury) is defined as the deliberate and direct destruction or alteration of body tissue without a desire to end your life, but resulting in injury severe enough for tissue damage to occur. Basically, deliberate self-harm means doing something to cause immediate physical harm to yourself but not for the purpose of ending your life. Typical self-harm behaviors include cutting and burning.

Many people who self-harm have also experienced a traumatic event at some point in their life. People who have a history of sexual abuse and/or physical abuse in particular have been found to be more likely to engage in self-harm. People with PTSD also are more likely to hurt themselves in this way.

People may use self-harm as a way of attempting to express and manage uncomfortable and upsetting emotional experiences, such as anxiety, sadness, shame, and/or anger. Self-harm may also provide a temporary escape from or be a way of avoiding emotional pain. These emotional experiences commonly stem from experiencing PTSD symptoms, such as intrusive thoughts or memories about a past traumatic event.

Self-harm may also be a way of expressing pain. People struggling with the emotional numbing symptoms of PTSD (where there are difficulties in having certain emotions, especially positive emotions), may use self-harm as a way to feel something or create feelings.

PTSD and Suicide

People who have experienced physical or sexual assault are at greater risk for suicide. In addition, if a person has PTSD, they are are also at greater risk for suicide. The symptoms of PTSD can make a person feel constantly afraid and isolated. In addition, depression is common among people with PTSD. A person may feel as though there is no hope or escape from their symptoms, leading them to contemplate suicide.

Getting Help for Impulsive Behaviors

There are a number of different coping skills that may be helpful in managing impulsive behaviors. Some of these include distraction, replacing impulsive behaviors with a healthy behavior that serves the same function, identifying the long-term negative consequences of a behavior, and changing the consequences of a behavior. There are also a number of different ways of coping with suicidal thoughts.

In addition, getting treatment for your PTSD may also help to reduce urges to engage in impulsive behaviors. You can find out more information about treatment providers in your area who might offer some of these treatments through UCompare HealthCare from About.com.


Brewerton, T.D. (2007). Eating disorders, trauma, and comorbidity: Focus on PTSD. Eating Disorders: The Journal of Treatment & Prevention, 15, 285-304.

Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192-205.

Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060.

Tarrer, N., & Gregg, L. (2004). Suicide risk in civilian PTSD patients: Predictors of suicidal ideation, planning, and attempts. Social Psychiatry and Psychiatric Epidemiology, 39, 655-661.

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