Intermittent Explosive Disorder (IED) and Its Impact on Relationships

Medically reviewed by April Justice, LICSW
Updated November 12, 2024by BetterHelp Editorial Team

Anger can produce a plethora of emotions secondary to anger itself. At times, many find that when they’re overwhelmed with anger, it can be challenging to control. While outburst when experiencing anger are common, intense outburst not conducive to a situation could indicate a condition called Intermittent Explosive Disorder (IED). IED can include a variate of reactive symptoms. Of note, IED can include sudden and severe episodes of aggression that have adverse effects on your relationships, work, and general mental health. 

Should you experience concern about your reactions to anger, support is available for those experiencing challenges in these areas. Treatment options like therapy and medication may provide benefit in managing strong emotions like anger. 

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Having difficulties with managing angry outbursts?

Defining Intermittent Explosive Disorder (IED):

While anger reactions in themselves aren’t necessarily problematic, they can produce potentials of developing reactive responses. Intermittent Explosive Disorder (IED) is a mental health condition recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While many may reference IED as “anger issues”, such verbiage can be deemed stigmatizing and derogatory towards those motivated to seek assistance for their anger reactivity. Below explains specifics as to the causes, symptoms, and impacts for those experiencing IED. 

Causes of Intermittent Explosive Disorder (IED): 

Several factors may increase the risk of developing intermittent explosive disorder. Genetics can play a part. In other words, if someone in your family has had anger problems, you might be more likely to have them, too. Brain chemistry is another potential factor; imbalances in certain brain chemicals may cause increased aggression. 

Environmental risk factors may also trigger this condition. For instance, being exposed to violence as a child or experiencing traumatic events may affect how someone manages anger. In addition, stress and substance misuse are known to contribute to aggressive impulses. Recognizing these causes may help in identifying and treating anger disorders more effectively.

While there isn’t a specific cause to IED, several factors may increase the risk of developing it. Genetics can correlate with the development of IED, meaning that if there is family history present of a member experiencing anger challenges, then this could likely influence IED. Furthermore, aspects of brain chemistry serve as a factor such as imbalances in certain brain chemicals like serotonin. Adverse childhood experiences (ACES), such as being exposed to violence as a child, can also correlate to how one manages their anger. 

Warning signs that may require attention

There are variates of warning signs to consider in relation to anger reactions that warrant attention. While these signs may vary from person to person, a general awareness as to some problematic themes can help you further understand your relation to anger, as well as adopting more mindful awareness as to your typical responses. 

Frequent irritability or short temper

Short-temperedness can often correlate to challenges surrounding how you regulate and manage anger. Examples of short-temperedness can include being reactive towards minor problems that arise in life. This behavior can be especially problematic when it produces tension in aspects of your life such as work or home. Short-temperedness can also coincide with anger outburst, which in turn influences perception of minor disagreements being major conflicts. 

Physical aggression or violence

Physical aggression is often a common response when experiencing anger. Turning to physical aggression behaviors like hitting, shoving, or getting into physical fights all indicate a need for professional assistance. Furthermore, such actions increase the potentials of putting both you and others at risk, thus reinforcing further problems as result of reactive aggression. 

Difficulty calming down after becoming angry

It’s natural to experience strain in knowing how to deescalate during an anger-provoking situation. While there is often a natural descent, some find that they encounter an extended anger that generates unfavorable physical and mental health consequences. Unresolved anger themes can contribute to prolonged stress in conjunction with interpersonal strain. This in turn can coincide with unresolved irritability, resentment, as well as ineffective conflict resolution. 

Verbal outbursts or yelling

One of the more common responses to anger are verbal outburst and yelling. At times, these can be more than just an expression of frustration. Unregulated anger can contribute to behaviors of incessant yelling, degrading language, and in severe cases, threats. Such ineffective behavioral responses to anger have the potential to produce strain in relationships, while also contributing to hostile environments. 

Holding grudges or seeking revenge

Often, our reluctance or inabilities to process through the past can contribute to challenges managing anger. This can correlate with dwelling on previous anger-provoking themes, further reinforcing aspects of chronic stress. If one is not mindful of these grudges, behavioral patterns can be influenced by spite leading to the potential of relational or emotional harm. 

Inability to control angry thoughts

The warning signs in association to problematic anger responses vary in intensity and scope. At times, these behaviors can be subtle vs obvious. Adopting more of a mindful awareness to anger triggers is key in ensuring you adopt a healthier response to anger. Lacking mindfulness can correlate to a person focusing on what’s making them angry, correlating with a perpetual state of agitation.

The impact of anger problems on personal relationships

Unresolved anger reactions can have a substantial impact on personal relationships. Anger can cause behavioral responses resulting in frequent arguments, verbal abuse and, in some severe cases, physical abuse. Such actions can erode trust within a relational dynamic, causing partners to feel unsafe around the angry party. 

Anger can also have an adverse effect on one’s mental well-being. Associating with someone who experiences challenges with anger reactions causes stress and anxiety due to the inherent unpredictable nature that anger reactions can generate. This can result in partners and individuals associated with the anger reactions to experience anxiety and depression. 

Familial relationships can be impacted by aspects of anger reactions. Children who are routinely exposed to anger reactions can experience uncertainty as to how to feel, cope with, and regulate their emotions in later years of life. Furthermore, this can translate into their own relational strain as they age, as unresolved anger can contribute to the inability to foster and develop meaningful relationships with others. Professional therapy services like BetterHelp can assist folks adversely affected by anger to learn how to cope with its effects proactively, while also repairing relationship trust that was eroded. 

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The link between anger and bipolar disorder or other mental health disorders

Anger may occur with various mental health conditions and mood disorders. People with bipolar disorder often experience anger during manic or depressive episodes. It's not an isolated symptom, but it can be more intense because of mood swings. 

Other mental health disorders linked to anger include:

  • Borderline personality disorder
  • Oppositional defiant disorder
  • Disruptive mood dysregulation disorder
  • Attention deficit hyperactivity disorder

Knowing how these conditions can influence behavior is key to managing symptoms and finding support. Mood and psychiatric disorders are often linked to anger, which makes treatment more challenging but also more important.

Anger is known to coincide with various mental health conditions and mood disorders. For instance, individuals with bipolar disorder experience anger accompanying manic or depressive episodes. Anger can be further perpetuated during these episodes because of mood swings that people with depression or bipolar disorder experience. 

Some other mental health disorders that are linked to anger include: 

  • Borderline personality disorder
  • Oppositional defiant disorder
  • Disruptive mood dysregulation disorder
  • Attention deficit hyperactivity disorder

Mood and psychiatric disorders are often linked to anger, making pursuits of mental health treatment more challenging for individuals experiencing anger reactions. Building awareness can be crucial to managing responses and developing a support once again. 

What’s the difference between Intermittent Explosive Disorder (IED) and Bipolar Disorder?

While intermittent explosive disorder and bipolar disorder can both involve anger, these mental health conditions vary. Intermittent explosive disorder is characterized by intense and sudden outburst of anger that typically misaligns from the situation and occurs without warning. 

On the other hand, bipolar disorder is a mood condition characterized by periods of extreme “highs” (mania) accompanied by “lows” (depression). Individuals experiencing bipolar disorder may encounter anger reactions during the episodes of mania or mixed affect (mania and depression simultaneously). The distinction between intermittent explosive disorder and bipolar disorder is that anger is typically linked to mood swings in bipolar disorder. Anger is more frequent or unpredictable as seen with IED. 

Individuals with intermittent explosive disorder may demonstrate behaviors that are destructive or volatile in nature including damage to property or, in severe case, harming others. Anger reactions often are perceived as uncontrollable in individuals experiencing IED. In contrast to bipolar disorder, anger and irritability occur as a larger pattern of mood change. 

Anger management techniques for better control

For many walks of life, such as college students and professionals living with stress, coping with anger can produce its challenges. There are several techniques that allow you to develop skills that may help you manage and reduce anger.  

Relaxation Techniques

There are several relaxation techniques that may help calm your mind and body. Visualization, deep breathing, and listening to calming music can be useful techniques to consider to induce a state of calm and regain control of your emotional state. A few of the benefits associated with relaxation techniques include: 

  • Lower blood pressure.
  • Lessened anger and frustration.
  • Boost confidence to handle problems.

Physical Activity

Physical activity may produce benefit as an effective way to release built up tension. Research suggests that those who engaged in regular exercise exhibited lower levels of state anger and higher levels of anger control than those who did not receive exercise. Exercising regularly may also have a positive impact on your mood. Heart health also improves with routine exercise, resulting in more energy throughout the day. 

Cognitive restructuring

Cognitive restructuring, also known as re-framing, allows you to develop techniques to challenge how you think about situations. This technique may be useful in assisting with managing your anger reactions. Keeping our thoughts rational and facts-based allows one to avoid exaggerated thinking patterns. For instance, instead of the thought, “This is terrible”, replacing it with, “It’s frustrating, but I can manage it” produces more balance. Focusing on more balanced thoughts allows for the potential to reduce anger, while also improving how you respond to challenges. 

Time-outs

Creating opportunities for pause can be a great way to regulate anger. Taking a walk or stepping away from an event when you feel anger may allow for opportunity to return to a more calm and composed mind state. This space may also allow you to return to the situation and manage it more productively. Creating space allows you to approach challenges with a more rational mind and improved attitude. 

Diversifying the methods you practice to manage anger can be key. This often allows individuals to discover what anger management techniques works best for them and the particular situations they may find themselves in. 

When to seek a mental health professional for anger disorders

Uncertainty can arise regarding appropriate times to seek mental health support for anger disorder. Identifying the appropriate resources in association with the particular anger challenges you’re facing can help determine appropriate routes of care. Whether it’s routine support via peer-to-peer interaction, life coaching, or more therapeutic support, taking the time to explore options ensures you’re pursuing appropriate levels of care to manage anger reactions. 

Anger management support groups

Joining an anger management support group may be a helpful step in navigating aspects of anger. Anger management support groups provide opportunity to share your experiences of anger with folks experiencing similar challenges. Anger management support groups also provide opportunity to learn coping skills from other peers who may be experiencing similar challenges. These support groups are typically led by a trained mental health professional. 

Other resources

Professional mental health treatment with providers like psychologists or counselors can allow for opportunity to develop a person-centered plan that fits your needs. This treatment plan can allow you to gain awareness as to your anger triggers, coping strategies, while also learning how to regulate your emotions. 

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Having difficulties with managing angry outbursts?

Online therapy for anger problems

Online therapy for anger difficulties can heed a practical approach to managing challenges that arise with anger. Platforms like BetterHelp can provide opportunity to have sessions from home, allowing for more comfort in exploring the nature of anger-related themes. Online therapy also offers flexible appointment times such as evenings or weekends, that can assist you in accommodating aspects of a busy life. 

How effective is online therapy for mental health challenges?

Online therapy has shown promise as an effective treatment for managing anger challenges. A study focusing on a short online cognitive program resulted in reducing anger in 79 adults. 59 of the 79 participants completed the study reported substantial decreases in their anger levels after four weeks. These results show promise regarding online therapy as an effective modality in the management of anger-related themes. 

Takeaway 

Intermittent explosive disorder can influence volatile emotional outburst that don’t align with what a situation may warrant. This can result in adverse impacts to relationships and day-to-day functioning. Building awareness to signs and symptoms of anger like aggression, mood swings, or trouble producing a sense of calm can be integral. Considering anger-management techniques like deep breathing and re-framing may also help manage anger appropriately. Resources such as support groups and online therapy can also provide tools to manage and regulate anger reactions effectively. 

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