MD, DC & VA · Telehealth Available
Regain Control with Professional Impulse Control Disorder Treatment
You have tried to stop. The behavior keeps happening anyway.
Explosive anger that destroys relationships. Compulsive stealing that makes no sense even to you. Gambling you cannot walk away from. Hair pulling or skin picking you cannot resist no matter how hard you try.
These are not personality flaws. They are recognized psychiatric conditions with clinical names and treatment approaches that work. At Ardent Behavioral Health, we evaluate and treat the full spectrum of impulse control disorders — including ADHD, anxiety, and depression that almost always come alongside them. We serve adults across Maryland, Virginia, and Washington DC through telehealth and in-office appointments.
Why Choose Ardent for Impulse Control Disorder Treatment
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Impulse control disorders treated as primary focus
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CBT, DBT & Habit Reversal Training (HRT)
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Major insurance accepted
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Telehealth available statewide
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Co-occurring conditions treated in-house
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No referral needed
Understanding Impulse Control Disorders
What Are Impulse Control Disorders?
An Impulse Control Disorder Treatment means the urge wins—even when you do not want it to. Even when you already feel something is about to happen next. Even after it has already cost you something important.
These conditions are classified in the DSM-5 as a distinct diagnostic category—separate from OCD and ADHD, though all three frequently overlap. Most cases begin in adolescence or early adulthood and get worse over time without proper treatment.
What makes them especially hard to catch is that the behavior looks like a choice to everyone around you. It does not feel like one. Many patients spend years being told it is a stress problem, a personality issue, or a matter of self-discipline — before finally getting a diagnosis that actually fits.
If that describes your experience, you are in the right place.
DSM-5
classified distinct diagnostic category
6+
specific impulse control disorders treated at Ardent
CBT
primary evidence-based treatment approach
Days
typical new patient appointment availability
Conditions We Treat at Ardent
Impulse Control Disorders We Evaluate & Treat
You do not need a prior diagnosis to reach out. Our clinicians evaluate and build your treatment plan from there.
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Intermittent Explosive Disorder (IED)
Sudden, disproportionate anger outbursts followed by shame and regret. Diagnosable and treatable — not a personality flaw.
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Kleptomania
A compulsive urge to steal driven by internal tension, not financial gain. Carries real legal consequences. Responds to psychiatric treatment.
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Pathological Gambling Disorder
Unable to stop gambling despite financial and relationship damage. Has neurological drivers — not a willpower issue.
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Trichotillomania (Hair Pulling)
Repetitive hair pulling causing hair loss and distress. Dismissed as a habit, but Habit Reversal Training produces strong results.
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Excoriation Disorder (Skin Picking)
Repetitive picking causing lesions and shame. Most patients never knew it had a clinical name or a treatment path.
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Pyromania
Fire-setting driven by psychological tension, not anger or gain. Rare but serious. Requires a full psychiatric evaluation.
Real-World Impact
How Impulse Control Disorders Affect Daily Life
These disorders are frequently misread — by the people around the patient, and often by the patient themselves. The behavior looks like a choice from the outside. It does not feel like one from the inside.
What patients experience on a daily basis:
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Relationships strained or ended
Explosive anger, erratic behavior, or unexplained compulsions damage the people closest to you.
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Legal consequences
IED-related incidents, kleptomania charges, or gambling-related financial crimes create lasting legal records.
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Financial damage
Uncontrolled gambling that is difficult to recover from without intervention.
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Social isolation
Shame around hair pulling, skin picking, or stealing drives people away from support systems.
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Career consequences
Terminated positions, missed opportunities, disciplinary action.
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Depression and anxiety as secondary effects
Develop from living with unaddressed impulse dysregulation over time.
You do not need to be in crisis. If something has felt off for a while, that is reason enough.
Why Impulse Control Disorders Are Often Misdiagnosed
Many patients arrive at Ardent after years of treatment that helped partially — because no one identified the impulse control pattern underneath everything else.
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IED treated as generalized anxiety or a mood disorder — the explosive anger cycle never addressed as its own clinical target
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Trichotillomania dismissed as a nervous habit or managed with anxiety medication that does not address the compulsive behavior
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Kleptomania treated as a legal or moral problem rather than a psychiatric one
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Gambling disorder managed through financial counseling alone, with no psychiatric support
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Skin picking loosely coded as OCD and treated without the specific behavioral interventions that actually work
If your current or previous treatment has not produced meaningful change, a thorough psychiatric evaluation often reveals exactly what prior treatment missed.
Do You Recognize This Pattern?
The Impulse Control Cycle
Regardless of the specific disorder, impulse control conditions follow the same cycle:
1
Rising tension or urge
A restlessness, tension, or urge builds before the behavior occurs.
2
The act brings temporary relief
The behavior delivers a brief sense of release or relief.
3
Guilt, shame, or regret follows
Sometimes within minutes of the behavior occurring.
4
The behavior repeats
Despite clear and accumulating consequences it continues.
5
Ongoing damage accumulates
Relationships, finances, work, or legal standing take continuing damage.
If this describes what you or someone close to you is experiencing, a psychiatric evaluation is the right next step.
Who Should Seek Treatment?
Treatment is appropriate if any of the following applies:
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An anger pattern that feels beyond your control and has damaged relationships, created legal problems, or affected your career
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A compulsive behavior — stealing, gambling, hair pulling, skin picking — that you have tried to stop and cannot
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A previous diagnosis of IED, kleptomania, trichotillomania, excoriation disorder, or pathological gambling that has not responded adequately to prior treatment
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A sense that your current diagnosis does not fully explain what you are experiencing
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A teenager or young adult in your family showing early signs of explosive anger, compulsive behaviors, or difficulty regulating impulses
You do not need a confirmed diagnosis before reaching out. The evaluation determines the diagnosis and the appropriate treatment direction.
Treatment Approach
How We Treat Impulse Control Disorders
Treatment at Ardent is specific to your diagnosis — not a one-size approach. Here is what we use and why:
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Cognitive Behavioral Therapy (CBT)
Identifies your triggers, builds impulse resistance skills, and restructures the thought patterns keeping the cycle going.
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Dialectical Behavior Therapy (DBT)
Used when intense emotions are driving the behavior. Focuses on emotional regulation and distress tolerance.
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Habit Reversal Training (HRT)
First-line treatment for trichotillomania and excoriation disorder. Ardent is one of the few practices in Maryland offering HRT with a clinician trained specifically in this protocol.
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Medication Management
SSRIs for trichotillomania, kleptomania, and excoriation disorder. Naltrexone for pathological gambling. Mood stabilizers for IED. ADHD medication where co-occurring ADHD is worsening impulse regulation.
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Co-Occurring Condition Treatment
ADHD, anxiety, depression, and OCD are evaluated and treated within the same practice — not referred out.
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Diagnosis-Specific Plans
Every treatment plan is built around your specific diagnosis, history, and co-occurring conditions — never a generic protocol.
How It Works
Start Targeted Treatment — Step by Step
1
Recognize the Signs
The same cycle repeats — urge, behavior, guilt — despite real consequences to your relationships, work, or finances.
2
Book Your Evaluation
Telehealth appointments across Maryland, Virginia, and Washington DC — typically available within days.
3
Get an Accurate Diagnosis
Full history review, including co-occurring ADHD, anxiety, or depression worsening your symptoms.
4
Begin Your Treatment Plan
CBT, DBT, Habit Reversal Training, or medication — chosen specifically for your diagnosis.
5
Treat Everything at Once
ADHD, anxiety, and depression managed within the same practice — no referrals, no gaps.
6
Stay on Track
Regular follow-ups monitor progress, adjust medication if needed, and build lasting impulse control over time.
Know the Difference
IED vs. ADHD — What Is the Difference?
Both involve impulsivity, which is why they are often confused. A person can have both — and often does. They require different treatment approaches and are assessed separately at Ardent.
| ADHD | IED | |
|---|---|---|
| Core problem | Attention, focus, executive function | Explosive anger episodes |
| Pattern | Ongoing, across all areas of life | Specific recurring outbursts |
| Trigger | Overstimulation, distraction | Disproportionate to the situation |
| Treatment | ADHD medication + behavioral therapy | CBT + mood stabilizers where indicated |
| Can they co-occur? | Yes — frequently | Yes — frequently |
Telehealth Care
Telehealth for Impulse Control Disorder Treatment in Maryland
Patients across Rockville, Bethesda, Gaithersburg, Silver Spring, and Germantown complete their full treatment — evaluation, therapy, and medication — entirely through telehealth. No commute. No waiting room. No scheduling around office hours.
What telehealth at Ardent covers:
Why Ardent
Why Patients Choose Ardent
Most psychiatric practices treat impulse control disorders as secondary — something addressed after anxiety or depression is managed. At Ardent, they are a primary focus from day one.
Led by Robin Hewitt, MSN, PMHNP-BC, FNP-C — licensed in Maryland, Virginia, and Washington DC — Ardent brings over 25 years of behavioral health experience to every evaluation.
Impulse control disorders treated as a primary focus — not an afterthought
HRT delivered by a clinician trained in the protocol
Co-occurring conditions treated within the same practice
Telehealth from first evaluation through ongoing care
Culturally competent, gender-sensitive care for every patient
Robin Hewitt
MSN, PMHNP-BC, FNP-C — Dual Board-Certified Psychiatric Mental Health & Family Nurse Practitioner
Robin Hewitt brings over 25 years of healthcare experience, including work in inpatient and outpatient behavioral health settings and with the National Institutes of Health. Licensed in Maryland, Virginia, and Washington DC, she specializes in treating impulse control disorders, ADHD, anxiety, PTSD, and mood disorders using an evidence-based, patient-centered approach. NPI Number: 1013360569.
MSN
PMHNP-BC
FNP-C
NPI: 1013360569
25+ Years Experience
NIH Experience
Insurance & Accessibility
Insurance Plans We Accept
Ardent Behavioral Health is in-network with most major insurers:
Self-pay options are available if your plan is not listed. Ardent handles prior authorization — you do not manage that alone. Reach out to us before your first appointment so we can help confirm your insurance coverage.
Where We Provide Care
Ardent provides impulse control disorder treatment via telehealth across three states:
🏛️ Maryland — Our primary service area, covering patients across the entire state.
🌿 Virginia — Serving patients throughout Northern Virginia and surrounding regions.
🏙️ Washington DC — Available to all DC neighborhoods and surrounding areas.
Not sure if your location is covered? Contact us to confirm.
FAQ
Frequently Asked Questions
Everything you need to know about impulse control disorder treatment at Ardent.
What is the best treatment for impulse control disorder?
CBT for most, Habit Reversal Training for trichotillomania and skin picking, medication where evidence supports it — determined after a proper evaluation.
Is impulse control disorder connected to ADHD?
No. ADHD affects attention broadly; impulse control disorders involve specific compulsive cycles. They frequently co-occur and require different treatments.
Which medications are commonly prescribed for impulse control disorder?
SSRIs for trichotillomania and kleptomania, naltrexone for pathological gambling, mood stabilizers for IED — always diagnosis-specific.
Can impulse control disorder be cured?
Most patients achieve significant reduction in frequency and intensity; some reach full remission. Outcomes depend on the disorder and consistency of treatment.
What doctor treats impulse control disorder?
A psychiatric nurse practitioner or psychiatrist for diagnosis and medication; a CBT or HRT-trained therapist for behavioral treatment. Ardent provides both.
Is kleptomania a mental illness?
Yes — a DSM-5 classified impulse control disorder driven by a compulsive urge cycle, not financial gain. Responds to psychiatric treatment.
How long does treatment take?
Many patients see improvement within 8 to 12 weeks; others need longer, especially with co-occurring conditions.
Does insurance cover impulse control disorder treatment?
Most major plans cover evaluation and outpatient therapy. Ardent can verify your coverage before your first appointment.
Is telehealth available?
Yes — evaluation, therapy, and medication management all available via telehealth across Maryland, Virginia, and Washington DC.
Ready to Get Started?
Book Your Impulse Control Disorder Evaluation Today
If an impulse control disorder is affecting your relationships, your work, your finances, or your legal standing — the right support changes what happens next. Same-week appointments are typically available, most major insurance plans are accepted, and telehealth makes it easy to get started from anywhere in Maryland, Virginia, or Washington DC.