Have you ever experienced sudden episodes of physical aggression or violent, angry outbursts without a clear reason? If so, you may be dealing with intermittent explosive disorder (IED). Understanding intermittent explosive disorder is crucial for finding effective solutions and ways to manage this mental health disorder.
In this article, we will explore everything about IED, from its symptoms and causes to its nature and impact on individuals. More importantly, we will touch upon how you can get intermittent explosive disorder diagnosed and discuss the importance of seeking support from a mental health professional.
What Is Intermittent Explosive Disorder?
Intermittent explosive disorder (IED) is a psychiatric condition. As defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is a recurrent behavioral disorder characterized by repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts.
In short, an individual with intermittent explosive disorder repeatedly has episodes of explosive, disproportionate rage or physical aggression. In some instances, their outbursts can result in physical harm, either to themselves or to others, including property.
Moreover, these sudden outbursts are disproportionate to the situation and can cause significant distress and impairment. More often than not, impulsive violence or aggressive acts can occur without any specific reason.
Intermittent explosive disorder (IED) falls under the category of impulse-control disorders, meaning that those affected struggle to control impulses while trying to resist their aggressive impulses, leading to explosive outbursts of anger and/or violence. These outbursts can be physical or verbal aggression, and often result in significant distress for the individual and those around them.
Who Does IED Affect the Most?
Intermittent explosive disorder (IED) can affect individuals of all ages. However, it is more typically observed in adolescents and younger adults.
Additionally, IED shows a higher prevalence among men, though the condition does not discriminate based on gender. Certain populations — such as veterans and individuals with a history of multiple traumatic events — may be particularly susceptible to impulsive control disorders or IED.
Prevalent studies suggest that IED affects approximately 7.3% of adults during their lifetime, more commonly observed among younger, less educated individuals.
Recognizing the Signs and Symptoms of IED
Behavioral symptoms of intermittent explosive disorder typically begin in late childhood or adolescence and may continue into adulthood. The disorder often co-occurs with other mental health conditions such as anxiety, depression, and substance use disorders.
Intermittent explosive disorder is characterized by recurrent impulsive and aggressive behavior.
The signs and symptoms of IED can vary, but they often include:
- Recurrent explosive outbursts, verbal, physical and impulsive aggression
- Difficulty controlling anger or impulses
- Feelings of tension or irritability before anger outbursts
- Physical symptoms like increased heart rate, sweating, or trembling
- Regret or remorse after anger outbursts
These outbursts often have emotional and physiological signs preceding them, such as irritability, racing thoughts, and increased energy. The consequences of these episodes can be severe, leading to distress and social difficulties.
Potential Causes of Intermittent Explosive Disorder
The exact cause of intermittent explosive disorder is not fully understood, but it is believed to be influenced by a combination of psychosocial stressors, genetic factors, and life experiences. Some research also suggests potential links to abnormalities in certain areas of the brain.
Research suggests several factors may contribute to IED development, including:
- Genetic disposition or family history
- Neurobiological factors and brain abnormalities
- Environmental factors or triggers
Notably, experts have noted a 44% to 72% higher chance of developing intermittent explosive disorder or impulsive aggressive behavior among people whose family has a history of this mental health condition.
Risk Factors of Intermittent Explosive Disorder
Based on the potential causes of IED, several factors may raise a person’s likelihood of developing the disorder. These may include the following:
- Young age and assigned male at birth (AMAB)
- Being unmarried or single
- Lower levels of education
- History of physical or sexual violence, particularly during childhood
- History of IED in the family
Additionally, co-occurring mental conditions and substance abuse may often complicate this disorder.
Diagnosing Intermittent Explosive Disorder
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides diagnostic criteria for intermittent explosive disorder. Mental health professionals — often a psychiatrist or psychologist — typically perform a thorough interview to gain insight into their patient’s behavior.
This includes asking questions about the individual’s:
- Detailed personal medical history
- Family medical history
- Relationship history
- School or work experiences
- General impulse control
Diagnosis of IED involves a comprehensive psychiatric evaluation and assessment of the individual’s history of explosive outbursts. The frequency, intensity, and duration of these episodes, as well as their impact on the individual’s life, are key factors considered in the diagnostic process.
In order to be diagnosed with this mental health condition, you need to demonstrate a failure to control aggressive impulses and aggressive outbursts. This can be in the form of either of the following:
- High frequency/low intensity episodes: Involve verbal or physical aggression towards objects, including temper tantrums or arguments, observed twice weekly for three months
- Low frequency/high intensity episodes: Defined as at least three episodes causing physical assault, property damage or destruction, or animal harm within a period of 12 months
Take note that patients must be at least six years old to receive an official IED diagnosis.
Potential Risks and Complications Linked to IED
Intermittent explosive disorder (IED) can often lead to other problems, mainly due to the aggressive and explosive nature of its symptoms. Moreover, it can also increase your risk of other physical or mental health disorders.
The potential complications and risks associated with impulse control disorder include:
- Impaired interpersonal relationships
- Difficulties at work, school, or home
- Mood disturbances and emotional instability
- Problems with alcohol and substance use
- Physical health issues
- Risk of harm due to physical fights
- Likelihood to perform physical abuse
- Increased risk of self-harm
Intermittent Explosive Disorder vs Anger Issues
It is important to differentiate between normal anger and the anger seen in IED. Here are some distinguishing factors:
- Frequency, intensity, and impulsivity of outbursts
- Disproportionate response to triggering situations
- Psychological and physiological markers
- Impact on functioning and relationships
Treating Intermittent Explosive Disorder
Treatment for intermittent explosive disorder generally involves psychotherapy and medication. A combined treatment approach is often most effective.
Under psychotherapy, cognitive-behavioral therapy (CBT) is a common treatment approach. It primarily helps individuals learn healthier ways of expressing anger, managing stressful situations and developing coping skills.
Medications, particularly selective serotonin reuptake inhibitors (SSRIs), may also be used to help control impulsive behavior. Mood stabilizers may also be prescribed to help stabilize moods and reduce overall aggression.
Living With Intermittent Explosive Disorder
Living with intermittent explosive disorder can be challenging, but with appropriate treatment and support, individuals with this disorder can lead fulfilling lives. Individuals diagnosed with IED generally need to learn ways to self-manage their condition and further improve their quality of life.
Several strategies that can help with self-management and anger control if you have IED are:
- Learning relaxation techniques such as deep breathing, meditation, or mindfulness exercises
- Engaging in regular physical exercise, as it can help reduce stress and promote emotional well-being
- Practicing stress reduction through activities like journaling, hobbies, or spending time in nature
- Seeking support from understanding family, friends, and support groups who can provide encouragement and a listening ear
- Prioritizing self-care by getting enough sleep, eating a balanced diet, and engaging in activities that bring joy and relaxation
- Improving communication skills
Seeking Professional Help for IED
Early recognition and appropriate treatment are crucial for managing IED effectively. If you suspect that you or someone you know may have intermittent explosive disorder, do not hesitate to seek professional help.
Recognizing the need for professional help and seeking timely treatment can significantly improve the quality of life for people with IED. Mental health professionals, such as those at CarePlus New Jersey, can provide an accurate diagnosis, necessary guidance, and any resources you may need to help you manage this disorder effectively.
Remember, you don’t have to face IED alone. If you or someone you know is struggling with intermittent explosive disorder in Northern New Jersey, contact or visit CarePlus New Jersey today to consult a qualified mental health professional and receive compassionate and comprehensive mental health support.
Adolescents with intermittent explosive disorder are at higher risk of self harm or attempting suicide. CarePlus New Jersey offers children up to 21 years of age an immediate crisis line – 877-652-7624.
Adults struggling to resist aggressive impulses or violent behavior can call the 24/7 psychiatric emergency helpline at 201-262-4357.
Always if a life is in danger – Please utilize the National Suicide Prevention Lifeline at 988
Frequently Asked Questions
Does an intermittent explosive disorder affect a person’s health?
Intermittent explosive disorder makes a person aggressive even when they do not want to be aggressive. They can have temper tantrums with little or no warning and are often told they need anger management. Aggressive outbursts can create chest tightness, increase blood pressure, and cause physical injury to ones self and sometimes others.
Psychiatric disorders like intermittent explosive disorder often coincide with substance abuse, mood disorders, and conduct disorders. With this in mind, when left untreated IED may cause physical health concerns in addition to the overall mental health and wellness concerns outlined in this article.
Jen Velten, LPC, ACS, CCTP, DRCC- Director of Trauma Services
Jen Velten graduated John Jay College of Criminal Justice in 2015 with an MA in Forensic Mental Health Counseling and became a Licensed Professional Counselor in 2019. She is licensed in the State of New Jersey with 8 years of experience working with youth and families in the mental health field. She was a school counselor for 3 years as well as a clinician with Care Plus in the Child/Family Division for the past 8 years. Jen has focused her expertise on helping children and adults to overcome complex trauma experiences as well as work with the LGBTQ+ community. Jen is trained in TF-CBT, YMHFA, PFA and most recently became certified in EMDR.