Intermittent Explosive Disorder: Explosive Anger And Other Symptoms

Medically reviewed by Dr. Andrea Cziffer Paul , MD
Updated April 14th, 2025 by BetterHelp Editorial Team

Losing your temper occasionally may be normal if these incidents are rare and well-justified. However, when anger is severe and frequent, it could be a sign of a mental health condition like intermittent explosive disorder (IED). People with IED experience sudden periods of rage and aggressive impulses that are either disproportionate to the incident at hand or seemingly come out of nowhere. IED can significantly affect one’s professional and social life, and personal relationships may be adversely impacted. Understanding the symptoms of IED and the treatment options available may help you or a loved one seek support. 

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Anger can affect your life in many ways

Intermittent explosive disorder: More than anger

Intermittent explosive disorder is a mental health condition that features frequent uncontrollable outbursts of anger or aggression that are out of proportion to the situation that incites them. These angry outbursts can consist of physical aggression, verbal aggression, or temper tantrums. They are spontaneous and appear quickly after someone with IED is provoked, generally lasting no longer than 30 minutes. Between outbursts, people with IED may behave appropriately, although they may have a low tolerance for frustration.

How is anger different from IED?

Anger is a common emotion that everyone feels from time to time, and it is less intense than the outbursts experienced with IED. People who do not have IED may only get angry occasionally, while those with IED will experience frequent, recurring anger outbursts that they may find difficult to control.

Anger as an emotion can sometimes be justified. People who get angry generally experience this feeling as a reaction to being wronged or mistreated. However, people with IED have outbursts that are disproportionate to the situation. For some, these outbursts may occur for no reason at all. 

Disruptive, impulse control, and conduct disorders

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), intermittent explosive disorder belongs to a group of conditions known as disruptive, impulse control, and conduct disorders. These conditions generally first show symptoms in childhood and can persist into adulthood. A significant difference between these conditions and other mental health disorders is that, with these disorders, the person focuses their emotions outward so that they directly affect others. With conditions like anxiety and depression, emotions may be more frequently turned inward.

Symptoms of intermittent explosive disorder

With IED, bouts of explosive anger occur suddenly, often with little or no warning. These episodes generally last less than 30 minutes and may occur every few weeks or months. Between episodes, the person may be impulsive, angry, or aggressive. In addition, some people with this condition may notice signs that they are going to have an episode, like irritability and rage, or physical symptoms like shaking, tingling, muscle tension, chest tightness, or a rapid heart rate.

During outbursts, someone with IED may get into physical fights, damage property, push, shove, or slap others, or yell and get into heated arguments. They may have temper tantrums, threaten harm to animals or people, or go on long, angry rants. Some people may feel relief after the outbursts, though they may regret their actions or be apologetic about what they said or did.

Subtypes of IED

Some researchers have identified subtypes of IED that can affect symptoms. These subtypes are defined as hurt people only, destroy property and hurt people, destroy property only, destroy property and threatened people, and threaten people only. This study determined that 73% of people with IED had the subtypes where they hurt people only or destroy property and hurt people and that those with these subtypes were more likely to externalize any comorbid mental disorders as well.

Causes, risk factors, and complications

IED can have multiple contributing factors, and prevention of behaviors may be difficult without professional help. 

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Causes of intermittent explosive disorder

IED can begin after age six or during adolescence and continue into adulthood, though the condition is more common in young adults than older adults. The cause of IED is unknown, but some researchers believe that symptoms may develop due to a combination of genetics, environment, and brain chemistry. 

Risk factors for intermittent explosive disorder

Risk factors for developing intermittent explosive disorder include a history of abuse or trauma as a child and a history of other mental health conditions, particularly borderline personality disorder (BPD), antisocial personality disorder (ASPD), attention-deficit hyperactivity disorder (ADHD), and substance use.

Complications of intermittent explosive disorder

Symptoms of intermittent explosive disorder affect people’s lives in many ways. Because anger episodes are so explosive and out of proportion, they can lead to relationship problems that can cause trouble at work, home, or school. The outbursts associated with this disorder can lead to divorce, job loss, school suspension, and family stress.

Mood disorders, like depression and anxiety, and issues with drug or alcohol use can occur alongside IED, as can physical health problems, like high blood pressure, heart disease, ulcers, diabetes, and stroke. 

When to reach out to mental health and medical professionals

If you experience frequent uncontrollable outbursts of anger or if your anger is affecting your daily life or your personal or professional relationships, talk to your doctor for guidance or consider reaching out to a mental health professional.

How to get help if you are in a relationship with someone who has IED and is abusive 

If you are in a relationship with someone who has IED who is not getting treatment or if you are scared that they may hurt you, take steps to protect yourself. The National Domestic Violence Hotline offers 24/7 support via phone call, text, or chat, as well as resources about creating a safety plan to help you remove yourself and any children or pets from the situation.

Treatment for intermittent explosive disorder

Treating intermittent explosive disorder usually involves psychotherapy and medication.

Mental health treatment

Cognitive-behavioral therapy (CBT) is commonly used to treat IED. In this type of psychotherapy, a therapist can help you identify events or situations that may set off an outburst and learn new ways of thinking. For example, a therapist can help you learn to realize when you have unrealistic expectations and work toward changing them into more positive or realistic viewpoints. CBT can also help you learn problem-solving skills to overcome challenges that might incite a reaction and communication techniques to learn how to listen actively and respond thoughtfully instead of in anger.  

Medical professionals and medication

Some people with IED may be recommended medication to manage their symptoms, particularly if they have also been diagnosed with mental health disorders like anxiety or depression. If you’re interested in learning more about this option, talk to your doctor. Antidepressants may be used to help treat these conditions, as well as mood stabilizers in cases of bipolar disorder. However, everyone is different. 

The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

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Anger can affect your life in many ways

Alternative support options 

If you’re interested in talking to mental health professionals about your symptoms or if your anger has started to affect your relationships or professional life, you may be hesitant to talk to a therapist in your area due to shame. In these cases, you might try online therapy. With an online therapy platform like BetterHelp, you can meet with a qualified, licensed professional from home or anywhere you have a reliable internet connection. Often, those who sign up are matched with a provider in as little as 48 hours, and you can change therapists at any time for no charge until you find one you are comfortable talking to. 

Research has found that online therapy is effective and can have multiple benefits. For example, one review of 17 studies found that, in some cases, online CBT may be more effective than in-person treatment. Plus, this review found that study participants were equally satisfied with online treatment and that it was more cost-effective than in-person therapy. 

Takeaway

People with IED have sudden explosive outbursts that may be out of proportion to the situation or may not have an identifiable cause. Symptoms of this condition can be challenging to control and affect the person’s personal and professional life, putting a strain on relationships and having significant consequences. If you’re experiencing symptoms of IED or if your anger is affecting your daily life, reach out to a mental health professional online or in your area for support. 

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