ADHD impulsivity means acting, speaking or deciding before you have thought it through, such as interrupting, intruding on others or having trouble waiting your turn. [nimh-adhd-impulsivity] Several things help, and one of the best studied is the if-then plan, which improved children’s ability to hold back an unwanted response in two small experiments. [gawrilow-gollwitzer-2008-response-inhibition] This guide covers what impulsivity looks like, what the research on if-then plans found and where it stops, and what else helps with impulse control. Our overview of ADHD covers the condition itself.
What is ADHD impulsivity?
ADHD impulsivity is one of the three areas the National Institute of Mental Health lists for ADHD, alongside inattention and hyperactivity, and it shows up as interrupting, intruding on others or having trouble waiting your turn. [nimh-adhd-impulsivity] For some people inattention is the strongest feature, while others have the most difficulty with hyperactivity and impulsivity. [nimh-adhd-impulsivity]
Everyone acts on impulse sometimes. In ADHD the behaviours are frequent, occur across several settings such as school, home and work, and interfere with daily life. [nimh-adhd-impulsivity] In daily life that can mean talking over someone, buying something the moment you see it, saying yes before you have checked your calendar or sending a message while angry.
Why do people with ADHD act on impulse?
Researchers describe it as a problem with action control, meaning stopping an unwanted response and waiting for a reward, and the underlying causes of ADHD are still being studied. The experiments below start from that description: ADHD is associated with failures to inhibit inappropriate responses, and children with ADHD are known to have particular trouble delaying gratification. [gawrilow-gollwitzer-2008-response-inhibition] [gawrilow-2011-delay-of-gratification]
The National Institute of Mental Health says researchers are investigating genes, hormones and other molecules, brain structure and activity, and prenatal and early life exposures. [nimh-adhd-impulsivity] So there is a description of what goes wrong, and no single settled explanation of why.
What are if-then plans, and do they help?
An if-then plan links a specific situation to a specific response: if this happens, then I will do that. Psychologists call them implementation intentions. They help in general, and they helped in small experiments with children with ADHD, though those studies had limits. A review of 94 independent tests found a medium-to-large effect on reaching goals, an effect size of 0.65. [gollwitzer-sheeran-2006-implementation-intentions] That review was not about ADHD.
Two sets of experiments tested them in children with ADHD:
- Holding back a response. In the first study, children with ADHD who added an if-then plan to the goal of suppressing a response improved on a Go/NoGo task, which asks you to respond to some signals and hold back from others, to the same level as children without ADHD. In the second, combining if-then plans with stimulant medication gave the highest suppression performance. [gawrilow-gollwitzer-2008-response-inhibition]
- Waiting for a reward. Forty-five inpatient children with ADHD, with an average age of 10.7, did better at delaying gratification after forming if-then plans. The result was repeated in 47 outpatient children with ADHD, average age 10.3, and in 40 children without ADHD, average age 11.3. [gawrilow-2011-delay-of-gratification]
Read those with their limits in view. The participants were children, the tasks were lab tasks, and the samples were small. They show that a simple plan can help a child with ADHD hold back a response in a controlled setting. They do not show how well plans work for adults in everyday life, where the cues are messier and the stakes are different.
How do you write an if-then plan for impulsivity?
Pick one situation where you reliably act before you think, name the cue you will notice, and choose one small response you can actually do when the urge is strong. By design, an if-then plan names a specific cue and a specific response, so a vague plan such as “I will think first” is not the format that was tested.
| The situation | An if-then plan in that format |
|---|---|
| Urge to interrupt | If someone is mid-sentence and I want to jump in, then I will note my point and wait for a pause |
| Buying on impulse online | If I want something that is not on my list, then I will add it to a note and wait a day |
| Replying while angry | If a message makes me angry, then I will wait ten minutes before I reply |
| A new idea mid-task | If a new idea pops up while I am working, then I will add it to a later list and carry on |
These are our illustrations of the format and not wording used in the studies. Start with one situation and keep the response small.
Five minutes to write one if-then plan
Pick one situation where you reliably act before you think. Write one plan in the form: if the cue I will notice happens, then I will do one small thing. Read it aloud once.
3:00
Keep the response small enough to do when the urge is strong. If you cannot choose a situation, think about which one has cost you the most in the past month.
Done. Put the plan where you will see it, such as a note on your phone.
What else helps with ADHD impulsivity?
Standard ADHD treatments include medication and psychosocial interventions such as cognitive behavioural therapy. [nimh-adhd-impulsivity] If-then plans are a small technique that can sit beside those and do not replace them. In the second experiment above, the children who combined plans with stimulant medication did best. [gawrilow-gollwitzer-2008-response-inhibition]
- Medication. Our guides to stimulant and non-stimulant medication and ADHD medication explained cover how the choices differ. Decisions about medication belong with a doctor.
- Therapy. Our guide to CBT for ADHD covers the skills-based therapy that targets planning and organising.
- Sleep. The National Institute of Mental Health says NIH-supported research highlights sleep as a target for early ADHD interventions. [nimh-adhd-impulsivity] Our guide to ADHD and sleep covers what the research shows.
- Structure. Our guide to executive dysfunction covers the planning and follow-through side of ADHD.
When to seek help
Speak to a doctor if impulsive behaviour is costing you money, work, relationships or safety, or if you think you may have ADHD and have never been assessed. The National Institute of Mental Health notes that teens and adults with ADHD are more likely to engage in risky behaviours, such as substance use and unsafe sexual activity, and are at increased risk of poor job performance and financial problems. [nimh-adhd-impulsivity] ADHD is diagnosed by a clinician. Our guide to ADHD in adults covers what an assessment looks at.
No screener on this site measures ADHD, and we would rather say so than point you at one that measures something else. The self-assessment hub lists the seven we do have.
If you feel unable to keep yourself safe, contact your local emergency services or a crisis helpline.
How MyFreud can help
Whether a plan is changing your weeks is hard to judge from memory. Daily mood tracking in MyFreud shows the pattern across weeks, so you can compare the weeks you used a plan with the weeks you did not. It does not diagnose ADHD, and it does not replace a doctor or a therapist.
Download MyFreud and start today: App Store or Google Play.