What Triggers ADHD Impulsive Reactions, and How Can We Deal With it?

One of the main symptoms of ADHD, as noted in the DSM-5, is impulsivity. The neurological causes include a less active and/or developed pre-frontal cortex, which is where self control lives. Lower dopamine also contributes, as the immediacy of any reward, including attention, is more sought after than with neurotypical brains.

We can look at ADHD impulsivity as the vehicle for the quick, unplanned, and often regrettable action. But what is the gasoline? What is feeding that reaction? 

Just like a vehicle without fuel can’t move, impulsivity needs a trigger to move forward.

There can be a variety of fuels and triggers. Let's take a look at a few common ones.

Many ADHDers participate in people pleasing behavior. After years of negative messages and feeling that the next screw-up is just around the corner, ADHDers (kids and adults) want to make sure that they aren’t hated. They want to prove that they can do a good job, and that they are worthy of praise! So they enter people pleasing mode, committing to tasks and responsibilities without first thinking about whether they have the time or the ability to do the job. This sets up a situation that can end up in one of three ways: the ADHDer completes the task perfectly, and on time, without any of their other work being impacted; the ADHDer will have to work like mad to get this new commitment squared away, which means putting other tasks on the back burner; or this task will not be done well, or on time.

The combination of the strong pull of people pleasing behavior, combined with impulsivity, puts the ADHDer right in the crosshairs of a potential disaster. It also takes away agency from the ADHDer - they feel like they have no control. They HAVE to say yes.

Another trigger is fear. This can be fear of getting into trouble, of making someone angry, of losing someone. The fight or flight instinct one experiences when afraid is stronger in ADHDers than neurotypicals. This causes larger reactions, often resulting in emotional dysregulation. Add the impulsivity to this emotional stew, and things can be said or done that, with some forethought, would never have seen the light of day.

And then there are impulse purchases. Everyone has, at some point, bought something without giving it much thought, only to realize later that it was too expensive, unnecessary, or just wasn’t right. But with ADHD, this happens more often than with neurotypicals, due to the impulsive nature of ADHD. What’s the trigger? It can be dopamine seeking. It can be a distraction from a bad day. The triggers are many, and the impulsivity puts it into action.

So, what can we do about this?

Some often quoted strategies are to take a breath, to count to five, to take a drink of water. Those strategies can work, but given the flood of emotions and brain chemicals that are triggered, it can be very difficult to put the brakes on!

What can work is knowing your triggers. Identifying what fuels your reactions can give you the extra wherewithal to pause, even briefly. The more specific you can be, the better. So, rather than “I overpromise at work,” we can shoot for “I overpromise when my colleagues ask me to do something because I want them to like me.”

Structural and environmental changes can help too. For example, setting up a rule that you do not commit to anything without looking at your calendar gives you that extra space to consider saying no. When your fear reaction is heightened, look for how it feels in your body, and structure a break when you have that physical feeling. For impulse spending, take your credit card information off of your phone and computer to make it more difficult to make purchases.

It can also be helpful to practice how you will handle your trigger situations. Role playing “I really can’t commit to anything without looking at my calendar” or “I feel myself getting hot, I’m going to go wash my face” not only makes it more comfortable to say it, it also gives you the rehearsal that a weak non-verbal working memory doesn’t provide.

The impulsivity of ADHD can be difficult to deal with - it can feel like you are constantly in need of apologizing! Identifying your triggers, the fuel behind the impulsive actions, as well as setting up structures and environmental changes to force you to pause, can really make a difference.