Intermittent Explosive Disorder: Explosive Anger And Other Symptoms
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.
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.
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.
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.
Frequently asked questions
What is explosive anger a symptom of?
Explosive anger might be most common among individuals living with explosive anger disorder, which is an impulse control disorder. However, explosive anger may also be common among some people living with bipolar disorder, borderline personality disorder, conduct disorder, or substance use disorders (formerly called substance abuse). Only a licensed mental health professional can provide an intermittent explosive disorder diagnosis. Untreated intermittent explosive disorder may lead to impulsive aggression, such as verbal and physical abuse, which can lead to physical injury and have serious legal repercussions. Intermittent explosive disorder treatment may consist of talk therapy and medication.
Do people with IED have empathy?
People living with IED can have empathy, but they may have difficulty controlling their anger. They may have verbal or physical outbursts that make them seem to lack empathy, but this disorder doesn’t mean they can’t experience empathy and other human emotions.
Is explosive anger part of bipolar?
Explosive anger may occur in some people living with bipolar disorder. However, there are various types of bipolar disorder, and they can affect people in different ways. Some people living with bipolar disorder may experience mania and irritability, while other people may experience depressive and manic episodes.
What causes sudden bursts of anger?
Sudden bursts of anger can have a variety of causes. Some people may be living with a mental health condition that causes difficulty with emotion regulation, which may lead to aggressive or violent behavior. Other people may react in anger as a result of trauma or unresolved conflict. In some cases, people may experience anger after being treated unfairly.
Why do I suddenly explode with anger?
You might have a tendency to explode with anger for a number of reasons. Some mental disorders, such as an impulse control disorder, can lead to problems with anger. For example, intermittent explosive disorder makes it difficult for some people to control their impulses. Other people might be experiencing excessive stress that leads them to explode at times. Regardless of the cause, there are treatments available for explosive anger and other behavioral symptoms.
What mental illness has violent outbursts?
Intermittent explosive disorder is typically characterized by aggressive outbursts, some of which can be physically violent. However, IED is not the only disorder that can cause outbursts. Borderline personality disorder, bipolar disorder, and oppositional defiant disorder can also lead to violent outbursts.
How do you fix explosive anger?
Explosive anger can be treated, often through therapy and/or medication. Those experiencing impulsive aggressive behavior as a result of intermittent explosive disorder (IED) might benefit from cognitive behavioral therapy (CBT), possibly in conjunction with a selective serotonin reuptake inhibitor (SSRI). People living with other mental disorders might also benefit from CBT and/or medication. Those who don’t have a disorder might find it beneficial to practice relaxation techniques, such as visualization, mindfulness, and deep breathing exercises, in addition to attending a support group or individual therapy.
Is IED a form of bipolar?
IED is a separate mental disorder from bipolar disorder. Both can cause problems with anger and impaired personal relationships, but there are several types of bipolar disorder. Some people living with bipolar disorder may experience more depression than mania and irritability. These disorders may be caused by a combination of genetic factors and environmental factors.
What is dissociative rage?
Dissociative rage is not an official mental disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is used in clinical psychiatry. However, some people may use the term to describe a type of rage that happens when a person loses touch with reality and their own thoughts and feelings.
What is the hardest mental illness to live with?
It can be challenging to determine exactly which mental illness is most difficult to live with. However, those that cause delusions, hallucinations, or a loss of touch with reality can cause significant challenges in everyday life.
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