What Is Explosive Anger Disorder?

Explosive anger disorder is another name for intermittent explosive disorder, a mental health condition that the National Institutes of Health (NIH) estimates to affect as many as 7.3% of adults in the United States. Individuals with this condition may display a variety of symptoms that can be difficult to manage and could create challenges for them and their families. In order to understand how to cope with intermittent explosive disorder, it may be helpful to start by learning more about what this condition is and how its symptoms may manifest. 

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What is intermittent explosive disorder (IED)? 

Intermittent explosive disorder (IED) is often characterized by severe outbursts of anger that can be disproportionate to the event that triggered them. These anger outbursts may be directed at other individuals, pets, or objects that are in the near vicinity. Although the risk factors for this disorder can vary, IED may be more common in people assigned male at birth (AMAB). However, some research indicates that the ratio between men and women may be closer to 1:1. 

Individuals with a family history of IED may be at higher risk of developing the disorder. Those with borderline personality disorder, antisocial personality disorder, or other disorders that can cause disruptive behavior, such as attention-deficit/hyperactivity disorder (ADHD), may also be at risk. 

Intermittent explosive disorder (IED) signs and symptoms

IED can involve a variety of behavioral, physical, and psychological symptoms. These symptoms may include: 

Individuals experiencing IED may also have poor impulse control and feel as though they are unable to stop themselves from engaging in specific angry behaviors. IED can also cause feelings of shame and guilt, which may be more common after outbursts of anger or physical fights. 

What are the diagnostic criteria for intermittent explosive disorder? 

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the diagnostic criteria for IED include the following:

• Recurrent outbursts involving an inability to control aggression as manifested by one of the two following conditions:

1. 1. Verbal aggression or physical aggression toward other individuals, property, or animals. This aggression must occur twice per week on average for a period of 3 months. If the aggression is physical, it doesn’t result in destruction of property, damage, or physical injury to other individuals or animals. 
   2. Three behavioral outbursts that involve property damage or physical injury within a 12-month period. These may be against one’s own property or the property of others, animals, or other individuals. 

• The level of aggressiveness expressed during outbursts is out of proportion to any precipitating psychosocial stressors or the situation that provoked them.
• Aggressive outbursts are not better explained by another mental health disorder or medical condition.
• Aggressive outbursts are not premeditated or committed with a specific objective.
• Aggressive outbursts cause distress or impairment in interpersonal or occupational functioning, or they are associated with legal or financial consequences.
• The individual is at least 6 years old.

What are the potential consequences of intermittent explosive disorder? 

Individuals living with IED may experience a variety of negative consequences, especially if the condition is left untreated. For example, IED symptoms can cause a person to lash out at loved ones, which could put significant strain on interpersonal relationships. If a person with IED engages in violent behavior, they may face legal ramifications. In addition, outbursts that take place at school or work could result in expulsion or termination. 

Can individuals with intermittent explosive disorder develop other mental health disorders?

Research suggests that developing intermittent explosive disorder does not exclude someone from experiencing comorbid disorders. In a 2019 study, researchers analyzed data involving thousands of participants to determine what conditions those with IED may experience concurrently. These conditions may include depression, bipolar disorder, anxiety, substance misuse disorder, and post-traumatic stress disorder. 

Does anger always indicate someone is experiencing intermittent explosive disorder? 

While anger may be one of the more common symptoms of IED, becoming angry does not necessarily mean a person is experiencing this disorder. Anger is a normal emotion that people may experience in a variety of situations, and in most cases, it subsides after a short period of time. However, if someone finds they cannot control their anger or they take their anger out on others, that may indicate they are experiencing a mental health condition.  

How to cope with intermittent explosive disorder and anger

While it is typically important to talk to a mental health or medical professional if you believe that you are experiencing IED, there may be some other ways to cope with this disorder. Coping techniques may include improving communication skills, learning anger management techniques, exercising, and using relaxation techniques. 

Improving communication skills

Individuals with IED may experience difficulty communicating their thoughts and emotions, which can exacerbate their emotional outbursts. One way to improve these communication skills could be through techniques like active listening and “I” statements. Active listening typically involves dedicating one’s full attention to a conversation and acknowledging the other person’s perspective, while “I” statements can help to frame feelings from a personal view and avoid misunderstandings. 

Anger management techniques

Anger management often focuses on processing and expressing anger in a healthy way, which may benefit individuals with IED. According to the American Psychological Association (APA), this may be done through three primary approaches: expressing, suppressing, and calming. 

• Expressing: This step involves learning how to communicate your needs and talk about emotions in a productive manner. While this may differ from person to person, it can involve speaking without yelling and remaining respectful. 
• Suppressing: While it may not sound healthy, temporary anger suppression may be beneficial. This can involve redirecting anger away from those around you or converting it into more positive feelings. 
• Calming: The final approach involves calming oneself down internally. This can involve addressing outward behaviors directed at others and the inward responses directed at ourselves. For many individuals, this can mean trying to lower their heart rate, taking deep breaths, and giving themselves a moment for overwhelming anger to subside. 

Exercise

According to Harvard Health, exercise can be an effective way to reduce stress and relax. Aerobic exercise, such as running, swimming, or biking, can lower levels of cortisol. Often referred to as a stress hormone, cortisol plays a key role in the way that individuals respond to stressful situations. Exercise can have a variety of other benefits as well, such as blood pressure and blood sugar regulation, lower risk of chronic disease, and overall lower risk of early death.

Relaxation techniques

Relaxation techniques may allow a person with IED to refocus their attention during outbursts and calm down. Others may help lower stress levels in general, which may reduce anger overall. While relaxation techniques can vary in effectiveness, some examples include:

While these techniques may be beneficial, seeking treatment may be even more helpful—especially if an individual with IED poses a threat to themselves or others or is engaging in physical abuse. 

Are there medical treatments for intermittent explosive disorder?

Individuals experiencing IED may benefit from various treatment approaches, including some that involve medication and therapy. Medications like antidepressants, mood stabilizers, and beta blockers have been used to treat IED. These may be used in conjunction with certain types of talk therapy, such as cognitive behavioral therapy. Never start, stop, or change the way you take any medications without consulting your doctor first. 

Are you experiencing intermittent explosive disorder?

Address your anger with a professional

What mental health treatment can help intermittent explosive disorder?

Research suggests that cognitive behavioral therapy (CBT) can be an effective treatment for intermittent explosive disorder. In one study, researchers compared the results of individuals engaging in CBT with those of a control group. They found that CBT reduced anger, aggression, depressive symptoms, and hostile thinking. These results were seen both immediately after treatment and after a three-month follow-up. 

While CBT and other types of therapy may benefit individuals with IED, in-person therapy isn’t always available or convenient. Some people may live in a remote region or somewhere without a sufficient number of mental health professionals. Others may find that it is difficult to discuss sensitive topics, such as angry outbursts or incidents of aggression, in a traditional office setting. In such cases, people may prefer online therapy, which allows for communication via texting, calling, or video chats. Research shows that online therapy can be as effective as in person therapy, with a 2022 study finding no significant differences between the outcomes of therapy delivered online and in person. 

Takeaway

Explosive anger disorder, more commonly referred to as intermittent explosive disorder (IED), is typically characterized by anger, emotional outbursts, and aggression. In addition to behavioral symptoms, this disorder can involve physical symptoms, such as headaches, chest pain, and muscle tension. IED can also occur alongside other mental health conditions, including depression, anxiety, and post-traumatic stress disorder. 

In some cases, intermittent explosive disorder affects individuals' ability to function in relationships, work, and school. If those with IED are experiencing these effects or pose a threat to themselves or others, it is important to seek help. This can start by having intermittent explosive disorder diagnosed by a mental health professional, who may provide treatment through cognitive behavioral therapy. 

If you’re experiencing symptoms of explosive anger disorder, know that you don’t have to face it alone. Take the first step toward getting support with anger and reach out to BetterHelp.