What Is Intermittent Explosive Disorder: Symptoms & Treatments

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Intermittent explosive disorder (IED) is a deeply challenging condition where patients require the utmost empathy and understanding. This disorder manifests in sudden, intense bursts of anger or aggression, often disproportionate to the triggering event. 

People experiencing IED may feel trapped within a whirlwind of emotions, causing distress to themselves and their loved ones. Recognizing the emotional turmoil they endure, it is essential to have a supportive and compassionate environment, providing them with the help and guidance they need for greater peace and emotional stability.

However, to execute this, you must first understand what IED is, its symptoms, its causes, and the best treatment options. So, let’s explore everything you need to know about intermittent explosive disorder.

What is intermittent explosive disorder?

Starting with what is IED? Intermittent explosive disorder (IED) is a mental health condition characterized by recurrent outbursts of impulsive and aggressive behavior. People with IED struggle to control their temper, often reacting disproportionately to minor triggers. 

These explosive episodes may involve verbal or physical aggression, property damage, or even harm to others. The disorder can cause significant distress and impairment in daily life, affecting personal relationships and work or school performance. 

Treatments for intermittent explosive disorder typically involves psychotherapy, anger management techniques, and sometimes medication to help manage symptoms and improve emotional regulation. Early intervention is crucial to enhance coping strategies and reduce the impact of these aggressive episodes.

11 common symptoms of intermittent explosive disorder

Intermittent explosive disorder (IED) outbursts are recurrent. They can be verbal and physical, causing distress to the people and those around them.

IED disorder can significantly impact personal relationships, work, and overall quality of life. Here are some common intermittent explosive disorder symptoms for easy IED diagnosis.

1. Frequent explosive outbursts

One of the primary IED symptoms is the recurrent occurrence of explosive outbursts. These sudden and intense episodes can lead to aggressive behavior, physical assaults, shouting, and verbal abuse. 

Seemingly minor stressors can trigger the outbursts, and people may have difficulty controlling their reactions during these moments.

2. Intense anger and irritability

People with IED often experience intense feelings of anger and irritability, which may persist even between explosive episodes. They may have a short temper, become easily frustrated, and perceive minor annoyances as major provocations.

3. Verbal or physical aggression

IED can manifest in both verbal and physical aggression. During an outburst, the person may engage in destructive behavior, such as smashing objects or punching walls. They might also direct their aggression toward others, leading to physical altercations and confrontations.

4. Increased heart rate and trembling

Physical symptoms can accompany the emotional turmoil during an IED outburst. The person may experience an elevated heart rate, trembling, sweating, and tense muscles. These physiological responses are common during moments of intense anger.

According to Christiana Njoku, a licensed professional counselor:

A racing heart is a dangerous sign that need not be ignored; be in control of your anger.

5. Intense rage episodes

The anger experienced by people with IED goes beyond what is considered normal emotional reactions. They may describe their feelings during an outburst as a sense of rage that is uncontrollable and overwhelming.

6. Guilt and regret

Following an explosive episode, people with IED often experience feelings of guilt, shame, and regret. They may feel remorseful for their actions and have difficulty understanding why they reacted so extremely.

7. Impulsivity

IED is often associated with impulsive behavior. The person may act without considering the consequences, leading to harmful actions during an outburst. This impulsivity can also extend to other areas of their life, such as reckless decision-making and substance abuse.

8. Relationship problems

The frequent outbursts of anger and aggression can strain personal relationships, leading to conflicts with family members, friends, and colleagues. The person may have difficulty maintaining stable relationships due to their unpredictable and explosive behavior.

As a relationship coach, Christiana Njoku noted that:

In a relationship where one partner has intermittent explosive disorder, there is a tendency that such a relationship may not last.

9. Legal and financial consequences

The aggressive behavior associated with IED can result in legal problems, such as assault charges and lawsuits. The financial burden of damages and legal fees can also exacerbate stress and anger.

10. Emotional distress

People with IED often experience emotional distress and internal turmoil. They may feel overwhelmed by their anger and struggle to cope with the aftermath of an outburst.

11. Social isolation

As a result of relationship difficulties and fear of judgment, people with IED may withdraw from social interactions. They may isolate themselves to avoid triggering situations or to protect others from their aggressive behavior.

What causes intermittent explosive disorder?

While the exact causes of IED is not fully understood, research suggests a combination of biological, environmental, and psychological factors that contribute to their development.

1. Biological factors

There is evidence that genetics plays a role in IED. People with a family history of the disorder are at a higher risk of developing it. Additionally, abnormalities in brain structure and function, particularly in impulse control and emotional regulation areas, may contribute to the disorder.

2. Neurotransmitter imbalance

Imbalances in certain neurotransmitters, such as serotonin and dopamine, have been associated with aggressive behavior and may influence the severity and frequency of explosive episodes.

3. Childhood trauma

Early life experiences such as physical abuse, emotional abuse, neglect, or witnessing violence can increase the likelihood of developing IED later in life. These traumatic experiences may disrupt normal emotional development and coping mechanisms.

4. Stress and environmental triggers

Environmental stressors, such as financial difficulties, relationship problems, or job-related stress, can act as triggers for explosive outbursts in people already predisposed to IED.

7 ways intermittent explosive disorder is diagnosed

Diagnosing intermittent explosive disorder (IED) involves a comprehensive evaluation by a qualified mental health professional, typically a psychiatrist or psychologist. 

There is no specific medical intermittent explosive disorder test, so the diagnosis is based on a thorough assessment of the person’s symptoms, history, and behavior. Here are a few ways through which IED is diagnosed:

1. Clinical interview

The diagnostic process begins with a detailed clinical interview. The medical professional may ask the person about their symptoms, the frequency and intensity of their explosive outbursts, and any triggers or patterns associated with the episodes. 

Gathering information about family history, medical history, and any past trauma or significant life events is also essential.

2. DSM-5 criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the criteria for diagnosing IED. The clinician will compare the person’s symptoms to the specific criteria listed in the DSM-5 to determine if they meet the necessary criteria for the disorder.

3. Symptom duration

Explosive outbursts must occur regularly over a period of at least three months to meet the criteria for IED. The frequency of the outbursts is an essential factor in diagnosing the disorder.

4. Rule out other conditions

It is crucial to rule out other mental health disorders or medical conditions that could be causing or contributing to aggressive behavior. For example, bipolar disorder, substance abuse, or neurological conditions can present similar symptoms and must be considered during the diagnostic process.

5. Behavior analysis

The mental health professional may use behavior analysis and tracking tools to gain insight into the triggers, antecedents, and consequences of the person’s explosive episodes. Understanding the outbursts’ patterns and circumstances can aid in diagnosis and treatment planning.

6. Psychiatric assessment

A comprehensive psychiatric evaluation may be conducted to assess for any co-occurring mental health conditions that could be influencing the expression of IED.

7. Input from others

In some cases, the clinician may seek input from family members, friends, or colleagues who have witnessed the person’s outbursts. Their perspectives can provide valuable information about the severity and impact of the behavior on the person’s life and relationships.

5 best treatment options for intermittent explosive disorder

Treating intermittent explosive disorder (IED) typically involves a combination of therapeutic interventions and, in some cases, medication. 

The treatments aim to help people manage their anger and aggressive impulses, improve emotional regulation, and enhance their overall functioning and well-being. Here are some ways how to treat intermittent explosive disorder:

1. Cognitive-Behavioral Therapy (CBT)

CBT is quite an effective therapeutic approach for IED. It aids individuals to identify and challenge negative thoughts and beliefs contributing to their explosive outbursts. Through CBT, people learn healthier coping strategies, anger management techniques, and problem-solving skills to respond to triggers and stressors more adaptively.

Learn more about Cognitive behavioral therapy in this video:

2. Anger management training

Anger management programs are designed to help people recognize the signs of building anger and develop strategies to control and express it constructively. These programs often involve relaxation techniques, assertiveness training, and communication skills to help people cope with frustrating situations more effectively.

As Christiana Njoku suggests:

With anger management training, you will stay in control of what triggers anger in you.

3. Medication

In a few cases, medication can be prescribed to manage the symptoms of IED. Antidepressants, mood stabilizers, and anti-anxiety medications have been used to reduce the intensity and frequency of explosive episodes. However, medication is typically considered in conjunction with therapy rather than as a standalone treatment.

4. Stress reduction techniques

Learning stress reduction techniques such as mindfulness, meditation, or yoga can be beneficial in helping people become more aware of their emotional states and manage stress before it escalates into an outburst.

5. Supportive interventions

Support from family, friends, or support groups can play a key role in the treatment of intermittent explosive disorder. Having a strong support network can provide understanding, encouragement, and a non-judgmental environment for people to discuss their struggles and progress.

Commonly asked questions

Find answers to key questions about IED disorder, including its occurrence in children, distinctions from bipolar disorder, calming strategies, self-care tips, and its prevalence.

• Can children have intermittent explosive disorder?

Yes, children can have intermittent explosive disorder (IED). It is a behavioral disorder characterized by sudden outbursts of aggression and anger that are disproportionate to the triggering event. Early intervention and professional support are crucial for managing IED in children.

• Is intermittent explosive disorder the same as bipolar disorder?

No, intermittent explosive disorder is not the same as bipolar disorder. Bipolar disorder involves cycles of extreme mood swings between depression and mania, whereas IED centers on recurrent aggressive outbursts without prolonged mood fluctuations.

• How can you calm someone with an IED?

When dealing with someone experiencing an intermittent explosive disorder outburst, staying calm and avoiding confrontation is essential. Give them space, validate their feelings, and encourage them to seek professional help. Safety should be a priority, and engaging in de-escalation techniques or mediation can be helpful.

• How do I take care of myself if I have intermittent explosive disorder?

If you have intermittent explosive disorder, self-care is vital—practice stress-reduction techniques, such as mindfulness and deep breathing. A balanced diet, regular workouts, and sufficient sleep can help manage the condition. Seeking therapy or counseling to learn coping strategies is highly recommended.

• Is intermittent explosive disorder a rare condition?

No, intermittent explosive disorder is not considered rare. It is a relatively common behavioral disorder affecting both children and adults. However, it often goes unreported and undiagnosed, making it essential for individuals experiencing its symptoms to seek professional evaluation and support.

Living with intermittent explosive disorder

Intermittent explosive disorder is a serious mental health condition characterized by recurrent explosive outbursts of anger and aggression. The symptoms of IED can significantly impair daily functioning, relationships, and overall well-being. 

If you are living with intermittent explosive disorder or know someone experiencing these symptoms, seeking professional help from a mental health expert is crucial for diagnosing, treating, and managing the disorder. Early intervention can lead to improved coping strategies and a better quality of life for individuals with IED.