Intermittent Explosive Disorder (IED) is a mental health disorder can be characterized by recurrent, sudden episodes of intense anger, aggression, or violent outbursts that are disproportionate to the situation.
Key features
- Sudden explosive anger: yelling, screaming, threats, arguments, or physical aggression.
- Rapid onset: the reaction may seem to come “out of nowhere.”
- Disproportionate response: the intensity of the outburst is much greater than what the trigger would normally warrant.
- Brief episodes: outbursts typically don’t last very long.
- Regret afterward: the person may feel remorse, embarrassment, guilt, or distress after the episode.
- Recurrent pattern: this may not be simply an occasional loss of temper.
What causes IED?
There could be one single cause. Possible contributing factors include:
- Genetic and biological vulnerabilities: consult with a psychiatrist/medical doctor
- Differences in brain systems involved in emotion regulation and impulse control
- Childhood adversity or trauma
- Learned patterns of aggressive behavior
- Difficulties with emotional regulation
- Substance use or other psychiatric conditions
IED vs. ordinary anger
Normal anger:
“I’m very frustrated, but I can control what I do.”
IED:
A relatively minor trigger may produce an extreme, impulsive reaction, sometimes involving aggression or destruction, followed by regret.
Importantly, having a bad temper may not automatically mean someone has IED. Clinicians also need to rule out conditions or circumstances that may cause aggression, such as bipolar disorder, PTSD, personality disorders, substance intoxication/withdrawal, certain neurological conditions, medications, or another medical condition: consult with a psychiatrist/medical doctor.
Treatment
IED is treatable. Treatment may include:
- Please, consult with a psychiatrist/medical doctor
- Cognitive behavioral therapy (CBT): particularly anger-management and impulse-control strategies.
- Emotion-regulation skills: recognizing physiological and cognitive warning signs before escalation.
- Relaxation and mindfulness techniques
- Medication: consult with a psychiatrist/medical doctor.
- Treatment of co-occurring conditions such as substance use, depression, anxiety, or trauma related disorders.
A useful clinical concept is the anger cycle:
Consult with a psychiatrist/medical doctor
Trigger, interpretation, physiological arousal, escalating anger, impulsive behavior, consequences, remorse
The therapeutic goal is to intervene before the escalation reaches the explosive stage.
Shervan K Shahhian
LIBERTY PSYCHOLOGICAL ASSOCIATION 