Intermittent Explosive Disorder (IED) is a mental health disorder characterized by extreme, angry, violent outbursts. These outbursts are impulsive, relatively short, lasting around 30 minutes or less, and occur off and on, usually separated by a few weeks or months. Examples of angry outbursts include road rage, domestic violence, starting fights, property destruction, and temper tantrums.
Intermittent Explosive Disorder is a serious condition that can result in lasting harm to the individual and those around them. It can lead to issues in school, work, and relationships, and may involve the law as the person grows older.
Treatment for IED usually involves a mix of medication and therapy.
What Is Intermittent Explosive Disorder?
Intermittent Explosive Disorder is usually diagnosed in late childhood to early adolescence. It can last many years, although the intensity of episodes usually decreases over time.
Importantly, the episodes of intermittent explosive disorder are not premeditated and are out of proportion. For example, responding with violence to someone trying to mug you is understandable. Responding violently to someone cutting you in line is not a proportionate reaction.
Symptoms of intermittent explosive disorder include:
- Sudden episodes of intense anger or rage
- Physical aggression (e.g., hitting, shoving, or destroying property)
- Verbal outbursts (e.g., screaming, insults, threats)
- Overreactions to minor provocations
- Road rage or temper tantrums
- Irritability or agitation before an outburst
- Feelings of relief or release after the outburst
- Guilt or remorse following aggressive episodes
- Frequent arguments or fights with others
- Difficulty controlling impulses or anger
These episodes are out of proportion to the situation and not premeditated.
With time, people can learn to identify an incoming episode. They will likely experience many warning signs of an episode, such as a racing heart, tight chest, rage, irritability, an excess of energy, and tingling or shaking.
With treatment, people with intermittent explosive disorder can learn to identify the signs of an approaching rage episode and take steps to remove themselves from the situation and calm down.
What Causes Intermittent Explosive Disorder
The exact cause of intermittent explosive disorder is not known. However, it is thought to have a few factors:
- Genetics: There is likely a genetic factor passed down hereditarily. One theory is a genetic predisposition to getting more easily stressed.
- Biology: Differences in brain structure and neurochemicals may also play a part in the anger and aggressive outbursts associated with intermittent explosive disorder.
- Environment: It is thought that growing up in a household where emotional and aggressive outbursts were common can lead to a child developing intermittent explosive disorder themselves. It is, in part, learned through modeled behavior. It is also likely a trauma response, as those who have experienced traumatic childhood experiences are more likely to struggle with intermittent explosive disorder.
Children with Antisocial Personality Disorder, Borderline Personality Disorder, substance abuse disorders, or ADHD are also more likely to show signs of intermittent explosive disorder.
How to Treat Intermittent Explosive Disorder
Intermittent explosive disorder can have serious effects. People with IED are more likely to experience divorce, trouble with the law, mood disorders, and self-harm. Physical abuse and fights are also possible when IED remains untreated.
Fortunately, there are treatment methods for Intermittent Explosive Disorder. The most common form of treatment is Cognitive Behavioral Therapy.
Cognitive Behavioral Therapy for Intermittent Explosive Disorder
Cognitive Behavioral Therapy (CBT) is structured and goal-oriented. A therapist will help you identify negative, untrue thought patterns that are influencing your belief system and behaviors. From there, you can start to dismantle unhelpful habits and patterns while growing towards your goals in a value-oriented way.
Intermittent explosive disorder can steal the choice from many people. They may feel out of control when they react to their angry urges and regret it later. CBT gives the power and control back to the individual.
There are a few ways it does that, including:
- Cognitive Restructuring
This involves identifying and challenging irrational or overly negative thoughts that lead to anger and aggression. For example, “They’re trying to make me fail on purpose,” is a thought that might be behind an anger outburst at your coworkers. This thought is irrational, however, because there’s no proof behind it. It is a cognitive distortion called "mind reading”. You can’t know what someone else is thinking, and CBT teaches that you shouldn’t act based on what you think someone else might be thinking. By learning to spot these thoughts and replace them with more balanced and realistic ones, people can reduce the intensity of their emotional reactions and respond more calmly in triggering situations.
- Relaxation Training
This includes techniques like deep breathing, progressive muscle relaxation, and mindfulness. These skills are crucial in preventing a rage outburst. CBT will also teach self-awareness skills critical in identifying when a rage outburst is about to happen. Then, you can learn to use these relaxation tools to calm your body, regulate your nervous system, and make it out of the situation without an IED episode.
- Teaching Coping Skills
Finally, personalized, healthy coping skills are an important part of any therapy process. This focuses on developing healthy ways to handle frustration, stress, and conflicts with others. Despite what it seems like, the angry outburst usually doesn’t come from nowhere. It is a slow build of tension and pressure by hundreds of little triggers. Your coffee was too hot, traffic was bad, you got one too many red lights, your coworker’s “hello” sounded too fake, and now you’re yelling in your weekly meeting. By practicing positive communication, problem-solving, and emotional regulation, for example, individuals learn alternatives to aggressive behavior and gain better control over their responses.
If you or someone you love is struggling with intermittent explosive disorder, Lifebulb therapy can help. We have therapists with experience in IED and who accept most major insurances. Don’t wait until you or someone you love gets hurt. Seek treatment now.
