A person diagnosed with intermittent explosive disorder exhibits repeated violent outbursts of anger grossly disproportionate to the cause. Symptoms of intermittent explosive disorder can begin to appear in childhood, but may go undiagnosed for years. A pediatrician may misdiagnose a child who has extreme temper tantrums despite the clearly developing pattern of incidents. Adults may go undiagnosed by general practitioners. Some mental health providers are unfamiliar with this relatively rare behavior disorder, as well.
Profile of Intermittent Explosive Disorder
A person with intermittent explosive disorder might go for days or weeks without incident and then unexpectedly "blow up" over some minor occurrence or mishap. Anything can trigger an explosive rage. In the case of a teenager, something as trivial as not being able to locate a favorite video game among his belongings can set off a violent explosion. The teen destroys his room, breaks furniture in the home and smashes costly property. Unable to stop his volatile behavior, the teen attacks anyone who tries to intervene, often causing injury. The episodes can occur anywhere. At school the teen may suddenly become angry and seriously injure a staff person who tries to help, or he may damage school property.
Intermittent explosive disorder in adults often takes the form of spousal abuse, domestic violence, or other violent crime. Road rage and domestic violence are two of the most common displays of adult intermittent explosive disorder, though not everyone accused of these crimes is diagnosed with IED. Adult IED may lead to loss of employment, social rejection, and incarceration.
According to the MayoClinic.com Web site, the article, "Intermittent Explosive Disorder" (Symptoms), states, "Explosive eruptions, usually lasting 10 to 20 minutes, often result in injuries and the deliberate destruction of property. These episodes may occur in clusters or be separated by weeks or months of nonaggression."
To the person suffering from IED episodes the release of anger brings relief. Following the explosive anger, the person may show remorse or embarrassment for the display.
Signals or Warnings that an Intermittent Explosive Episode May Occur:
An explosive episode may be preceded by certain behaviors or may erupt with no obvious warning at all. Once engaged, the person cannot stop the anger until relief is attained, even though he may be causing physical harm. The inability to diffuse the aggression distinguishes Intermittent explosive disorder from routine bouts of anger displayed by someone without IED.
Warnings that may precede an IED episode:
- Feelings of anxiety a few minutes to several hours prior to the episode
- Tension that may or may not be accompanied by headache
- Tingling or crawling sensation
- Trembling
- Irritability or restlessness
- Agitated behavior
- Excessive eating
- Repeating an action over and over again
Diagnosing Intermittent Explosive Disorder
Intermittent Explosive Disorder is typically diagnosed by a mental health provider. A diagnosis of IED is based on an interpretation of family history, genetics, physical exam, and an evaluation & frequency of violent temper episodes. Other similar behavioral conditions – such as oppositional defiant disorder, for example – must be ruled out before an accurate diagnosis can be made.
What causes intermittent explosive disorder? Referring to the article provided by the Mayo Clinic Web site, persons with mental disorders such as depression, anxiety, or mood disorders, and even those with eating disorders may be prone to IED. Substance abuse victims may also be at risk for IED. And, "People with intermittent explosive disorder may have an imbalance in the amount of serotonin and testosterone in their brains."
Children exposed to violence and abuse appear to have a greater chance of developing intermittent explosive disorder as teens and adults. The condition may also be genetic, meaning the disorder is passed from one generation to the next. Other neurological disorders or physical brain injury may cause IED, especially when there is damage to the frontal lobe where impulses are controlled. In fact, intermittent explosive disorder is described as one of the key elements in defining a broad group of behavior disorders called impulse control disorders.
Treatment of Intermittent Explosive Disorder
There is no cure for intermittent explosive disorder, but gaining some control over an otherwise unmanageable condition through therapy and drug treatments is better than doing nothing at all. Anger disorders may require one or a combination of treatments:
- Drug Therapy
- Behavior Therapy
- Anger Management Program
- Psychotherapy
Recognizing there is a problem is the first step to getting help for IED or any other behavioral condition. See a mental health specialist before it’s too late if there is any question concerning serious problems with anger or aggression.
Intermittent explosive disorder is a behavior condition defined by a particular pattern of anger that is profoundly exaggerated compared to the cause. Left untreated, IED can lead to major disciplinary problems for young persons in school. For the adult with IED, the risks may include job loss, social rejection, and the potential for serious conflicts with the law. Repeated acts of aggression may cause damage to property, harm to the individual, and injury to anyone that tries to intervene during an outburst.
Persons diagnosed with IED sometimes get warning signals before an anger outburst. After an episode passes, the person feels relief, but may also feel upset at having displayed such inexcusable behavior. Several methods of treatment can help manage intermittent control disorder. Recognizing there is a problem and seeking professional help are the first steps to responsible care.
Mary King - Mary King is a Suite101 Topic Editor for the Caregiver Support and Home Management sections. She has authored 5 teen-based novels.
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