Can PTSD Be a Cause of Impulsive or Reactive Behaviors?

You may notice you have a short fuse — small things that otherwise wouldn’t bother you now cause instant irritability. Sometimes you lash out in anger but it’s not always clear why. Other times you might take impulsive risks or engage in activities that could be harmful to your well-being. All of it may feel like a spur-of-the-moment reaction that happened automatically.

• What is PTSD ?

If this sounds familiar, you may be acting in impulsive or reactive ways as a result of trauma — one aspect of your fight survival response. You’re not alone if you sometimes respond impulsively or reactively to the world around you, and it can be a symptom of post-traumatic stress disorder (PTSD).

What Is Impulsive or Reactive Behavior?

As a general category, impulsive and reactive behaviors cover a range of present-day reactions to past reminders of trauma. Some ways you may experience impulsivity or a heightened sense of reactivity could include:

Irritability
Unexpected angry outbursts
Self-destructive behavior (substance use, self-harm, risk taking)
Impulsive urges

Impulsive reactions to “lash out” or urges to engage in behavior that may be harmful to yourself can be associated with your fight survival response (fight-flight-freeze-fawn). The goal of this reaction is to keep you safe during times of danger. With PTSD, however, the reactive behaviors outlive their usefulness and can interfere with your life.

“Self-destructive habits always start as attempts to self-support,” Annie Wright, LMFT, wrote for The Mighty. “What seems harmful now was once an adaptation — a strategic and probably effective adaptation — to challenging circumstances at some point earlier.”

Is Impulsivity a Sign of PTSD?

Impulsivity, irritability or angry reactions are all potential signs your doctor or therapist will evaluate to determine if you have post-traumatic stress disorder (PTSD). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these reactive PTSD symptoms are categorized as “alternations in arousal and reactivity associated with the traumatic event.” Also included in this category of “alternations in arousal” are hypervigilance and exaggerated startle response.

Some other diagnoses that may have impulsive or reactive behaviors as a symptom include:

Acute stress disorder
Complex PTSD (C-PTSD)
Borderline personality disorder
Bipolar disorder
Substance use disorders

What Is It Like to Experience Impulsivity?

When it’s related to PTSD, sometimes impulsivity or being reactive can feel like the anger, irritability or urges are just outside your control. Mighty contributor Emma Laver shared what experiencing these symptoms feels like for her:

I often feel like I have an internal pressure pot simmering within me. Despite my desperate attempts to keep it under control, circumstances are often stacked up against me and eventually it blows. When I say it blows, it blows. It’s almost an out-of-body experience, watching the rage consume all rationale.

Mighty community member John S. explained how PTSD-related anger and irritability show up for him:

I’m not sure if it’s PTSD or anxiety — I get very short or sometimes aggressive with customer service people on the phone when I need to discuss a problem. Partly from the fear/stress of making a phone call and partly from a perceived injustice. This is (hopefully) different from simply being an aggressive, nasty person — I am usually very empathetic and considerate.

Where to Learn More About Reactive Behaviors

To learn more from others with PTSD who get what it’s like to experience impulsivity or reactivity, take a look at the stories below. And if you want to share your experience with others who get it, post a Thought on The Mighty. Here’s how.

Other Symptoms of PTSD

If you live with PTSD, you know the condition is more than just irritability, anger, or impulsive or self-destructive behaviors. Here are some other common symptoms of PTSD:

Post-Traumatic Stress Disorder (PTSD)