Intermittent Explosive Disorder is more than just anger, and it is important to seek treatment.
What is IED?
Intermittent Explosive Disorder (IED) is a mental condition that is part of the “Impulse-Control Disorders”. With IED, patients cannot stop their aggressive impulses, and this can lead to destruction of property or assaults on other people. Those with IED may purposely break valuable objects, threaten to act violently, or physically perform the aggressive acts. While anger can be a normal reaction to a stressful situation, in IED, patients express aggression “grossly out of proportion” to the situation. They often describe their behavior as “spells or attacks”. After acting aggressively, the tension is resolved and there is immediate relief; however, patients often later express regret, remorse, or embarrassment. IED is commonly linked to anxiety, depression, and substance abuse, and it generally begins in the teen years, often in young men. Some of the other behaviors that may result from IED include sexual impulsivity and frequent moving violations and accidents. IED is actually a controversial diagnosis, because some professionals feel this disorder is a symptom of other mental health conditions.1
Diagnosis and Symptoms
IED may be relatively common. 16 million people in the US may have had IED at some point in their lives, according to the National Institute of Mental Health. To be diagnosed with IED, patients will need to have had “at least three episodes of explosive anger” in a lifetime. Those with a more severe form of the disorder may have had 3+ episodes in a year. The vast majority of IED patients have substance abuse, anxiety, or depression issues as well, but “less than 29 percent actually receive treatment for these conditions”. Like compulsive gamblers, drug addicts, and alcoholics, IED is a “failure to control…impulses”. There is a need, in these patients, to physically attack a person or object or to have a verbal explosion. They may have lost friends over their aggressive behavior while under the influence of drugs or alcohol. In addition, it is not uncommon for those with IED to have conflicted relationships, to engage in self-harm, or to have a history of lost jobs or legal issues. Chest pain, tingling, palpitations, headaches, and a burst of energy may precede an outburst. Depression, relief, and exhaustion often follow the episode. IED is more likely in young males, those with a history of childhood abuse, or patients may have certain brain chemicals that have predisposed them to IED, such as a “deficiency of serotonin”.2 There may also be a genetic component. If the aggressive behavior is caused by another condition, such as anxiety, personality, or mood disorders, traumatic brain injury, or Parkinson’s disease, patients will not be diagnosed with IED.3
Typical medications prescribed for IED include antidepressants, anticonvulsants, mood stabilizers, and anti-anxiety agents. In psychotherapy, patients learn to “control inappropriate responses” with cognitive restructuring, relaxation, coping skills, and anger management techniques. Family members may need resources to deal with domestic violence, as well.4 Unfortunately, many people who suffer from IED don’t seek help early. Many may wait over 10 years after symptoms first appear. Besides medication, other treatments include cognitive behavioral therapy, addiction counseling (for the patient and family members), group therapy, anger management classes, and even holistic therapies. Complementary and alternative treatments to reduce stress and promote relaxation are helpful. Massage, acupuncture, and yoga are some of the CAM treatment options.5
2, 5 http://www.axisresidentialtreatment.com/anger-management/intermittent-explosive-disorder/
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