If you are in a relationship with someone with IED and are being abused, please see our domestic abuse page for more information about domestic violence.
What is Intermittent Explosive Disorder?
Intermittent Explosive Disorder (also known as IED) is an impulse control disorder characterized by extreme expressions of anger - often to the point of violence - that are disproportionate to the situation at hand. People who have IED may experience job loss, divorce, car crashes, jail time, or school suspensions as a result of their anger.
Road rage, domestic violence, angry outbursts that involve breaking objects can be a symptom of IED.
Those who have Intermittent Explosive Disorder may attack other people, causing injury and property damage. After the outburst, however, people who have Intermittent Explosive Disorder may feel regret, remorse, or embarrassment.
The violent behavior associated with IED isn't always directed at other people or things. Certain people with IED are at a much greater risk for self-harm and suicide. At greater risk for self-injury are those with IED who have problems with substance abuse and/or depression.
Risk Factors for Intermittent Explosive Disorder:
There are a number of factors that increase the risk for development of Intermittent Explosive Disorder. These risks include:
- Age: Intermittent Explosive Disorder is most common in teens and people in their twenties.
- History of Substance Abuse: those who abuse drugs or alcohol have an increased risk for development of Intermittent Explosive Disorder.
- Mental Illness: People with other mental illnesses are at greater risk for developing Intermittent Explosive Disorder.
- Gender: Men are far more likely to have Intermittent Explosive Disorder than women.
- Child Abuse: people who have been abused as children are at higher risk for development of Intermittent Explosive Disorder.
Symptoms of Intermittent Explosive Disorder:
These explosive outbursts experienced by people with Intermittent Explosive Disorder tend to last between 10 and 20 minutes, and often result in the deliberate destruction of property and injuries. These outbursts may happen in clusters, or separated by months without any aggression.
These explosive outbursts may be accompanied with (or preceded by) the following:
- Irritability
- Increased energy
- Rage
- Tingling
- Tremors
- Heart palpitations
- Chest tightness
- Headache and/or pressure in the head.
Causes for Intermittent Explosive Disorder:
The precise cause for Intermittent Explosive Disorder is unknown, but the disorder is likely caused by a number of interrelated biological and environmental factors.
Many people with Intermittent Explosive Disorder grew up in families where child abuse, explosive outbursts, verbal and physical abuse were common. Seeing this sort of violence at a young age makes it more likely for children in these households to demonstrate the same traits as they become adults.
Intermittent Explosive Disorder may also have a genetic link, passed down from parents to children.
Diagnosis of Intermittent Explosive Disorder:
The DSM-IV criteria for Intermittent Explosive Disorder includes the occurrence of different episodes of failure to resist aggressive impulses that leads to destruction of property or violent assault that is completely disproportionate to the provocation or stressor.
All other mental disorders (antisocial personality disorder, borderline personality disorder, ADHD) must be ruled out before a diagnosis of Intermittent Explosive Disorder can be made.
All other physical conditions (traumatic brain injury, Alzheimer's disease, alcohol or drug intoxication) must be ruled out before a diagnosis of Intermittent Explosive Disorder can be made.
Diagnosis of Intermittent Explosive Disorder is made during a psychiatric interview after the exclusion of any other reasons for the disproportionate outbursts.
The DSM-IV diagnosis requires this for a proper diagnosis of Intermittent Explosive Disorder:
1) Several episodes of impulsive behavior that lead to serious damage to either persons or property, wherein
2) The degree of aggressiveness is grossly disproportionate to the circumstances and/or provocation
3) The episode of violence can't be better accounted for by another mental or physical illness.
Treatment of Intermittent Explosive Disorder:
There's no golden standard of treatment for those who have IED. Treatment for IED generally includes a combination of medications and therapy.
Medications: many types of drugs are available to help to control IED. These medications to treat intermittent explosive disorder include:
- Mood regulators
- Antidepressants
- Anticonvulsants
- Anti-anxiety agents
Therapy: individual or group therapy may also help those who suffer with Intermittent Explosive Disorder.
Coping with Intermittent Explosive Disorder:
If you have IED:
Learn to control your anger - coping with anger is a learned behavior, so using techniques from cognitive behavioral therapy or anger management classes can help recognize what makes you angry and how to control it.
If your loved one has IED:
Sadly, a lot of people who have IED refuse treatment. If your partner or other loved one won't get help or treatment for IED, you must take steps to protect yourself and your family.
Remember: no one deserves to be abused. The abuse isn't your fault.
Make an escape plan:
If a situation at home is escalating, and you feel an episode of rage coming on, try to remove you and your children from the situation. Consider making an emergency plan before an emergency arises.
- Locate a domestic abuse hotline or woman's shelter for advice when your abuser isn't home.
- Lock up firearms - refuse to give the abuser the key or lock combination.
- Pack an emergency bag - clothes, keys, personal papers, medications and money. Hide the bag or give it to a close neighbor.
- Know where to go if you feel threatened - even if it's the middle of the night.
Find Help:
- Call 911 for all emergencies.
- National Domestic Violence Hotline: 800-799-SAFE (800-799-7233) - hotline available for crisis intervention and referrals to area resources (like women's shelters).
- Your doctor - the doctor and nurse who treat your injuries can help you find local resources to keep you safe
- Woman's shelter or crisis center - often provide 24-hour support, emergency shelter and advice about legal matters.
- Counseling/Mental Health Center - many areas have counseling and support group for people in abusive relationships.
- Court system - the court system can help you to get a restraining order legally mandating that the abuser must stay away from you.
