Intermittent Explosive Disorder: Symptoms, Causes, & Treatments

Effects of Intermittent Explosive Disorder

Intermittent explosive disorder can significantly affect an individual’s life and the lives of those around them. Their heightened anger can damage their relationships, professional reputation, and legal standing. Furthermore, IED can also negatively impact mental health. People with IED may experience guilt, shame, and embarrassment after an outburst, contributing to low self-esteem and depression.

Effects of intermittent explosive disorder may include:

• Self-injury or self-harm: Individuals with IED may engage in self-harm inadvertently during an outburst or to cope with symptoms.
• Increased risk of anxiety: The unpredictability of the outbursts can also lead to anxiety and fear as individuals worry about when the next episode might occur.
• Increased risk of depression: The guilt associated with their rage may contribute to prolonged low mood and depression.
• Poor relationships: IED outbursts can damage relationships with family, friends, and coworkers. Individuals often do not realize the extent of rage, which can be scary for others.
• Incarceration: In severe cases, those with IED may engage in physical altercations resulting in legal consequences or incarceration.
• Domestic abuse: IED outbursts can result in verbal or physical abuse toward partners or family members, leading to domestic abuse.
• Low self-esteem: Over time, a person struggling with IED symptoms may feel defined by their disorder or that they are a ‘bad’ person. These beliefs can contribute to low self-esteem and confidence.
• Troubles at work: IED outbursts can lead to poor job performance, conflicts with coworkers, and even job loss.
• Substance use disorder: Those who self-medicate with substances to manage IED symptoms may develop a substance use disorder.

How Is Intermittent Explosive Disorder Diagnosed?

The DSM-5 criteria for IED include recurrent, impulsive, and problematic outbursts of verbal or physical aggression disproportionate to the situation. These outbursts must occur at least twice a week for three months or result in significant distress or impairment in social, occupational, or other areas of functioning.

A mental health professional may diagnose intermittent explosive disorder after administering a thorough psychological evaluation. They may also conduct a physical exam and order medical tests to rule out underlying conditions that could contribute to IED symptoms.

Intermittent Explosive Disorder Treatment Options

The most effective treatment for intermittent explosive disorder is a combination of medication and psychotherapy focused on behavior modification. Typically, IED treatment focuses on changing one’s impulses and learning how to control their behavior.

Therapy

Cognitive behavioral therapy (CBT) for anger is the preferred intermittent explosive disorder treatment approach. This therapeutic technique targets thought and emotional patterns that fuel intense anger. Tailored intervention can lead to overall changes, helping to address uncontrollable rage and anger outbursts. However, other therapies can be beneficial as a part of a treatment plan for IED.

Therapy options for intermittent explosive disorder include:

• Rational emotive therapy (REBT): REBT focuses on identifying and changing irrational beliefs and negative thought patterns that may contribute to the outbursts associated with intermittent explosive disorder. REBT aims to help individuals develop adaptive coping strategies and improve their emotional regulation skills.
• Acceptance and commitment therapy (ACT): ACT aims to help individuals adopt psychological flexibility, and clients are encouraged to accept their emotions rather than control or avoid them. This approach can be particularly beneficial for those with IED who struggle with emotional regulation and impulsivity.
• Family therapy: Family therapy is effective for people with strained familial relationships as it can help improve communication and understanding between family members and reduce conflict.
• Couples counseling: Couples counseling may be an option for those who struggle with anger and conflict in their romantic relationships. Therapists can help clients improve communication, increase empathy and understanding, and develop constructive conflict-resolution skills.
• Group therapy: Individuals with IED can benefit from social support and a sense of community. Group therapy provides a safe and supportive environment for individuals to share their experiences, learn from others, and practice new skills.

Medication

There is no one medication for intermittent explosive disorder. However, certain prescriptions can help individuals with IED better manage their explosive anger and reduce the frequency and intensity of outbursts. Antidepressants, mood stabilizers, and antipsychotic medications may benefit those with symptoms of a mood disorder or psychotic features.⁴ Always discuss the risks associated with any prescription with a qualified provider.

Living With Intermittent Explosive Disorder

The best thing you can do to cope with intermittent explosive disorder is to seek treatment. Consider contacting your physician or insurance company for a psychiatrist referral.

Below are tips for coping and living with intermittent explosive disorder:

• Learn relaxation techniques: Relaxation techniques, such as deep breathing, meditation for anger, and yoga, can help manage the intense emotions and stress associated with IED. These techniques can help individuals remain calm in situations that may trigger symptoms.
• Practice cognitive restructuring: Cognitive restructuring involves identifying and challenging negative thought patterns and beliefs that may contribute to rage outbursts. By replacing these negative thoughts with more positive and adaptive ones, individuals can reduce the likelihood of outbursts.
• Focus on improving communication: Improving communication skills can reduce misunderstandings and conflicts that may trigger outbursts. These may involve learning active listening skills, expressing oneself clearly and assertively, and using “I” statements to avoid blaming others.
• Change your environment: Consider finding environments that limit your exposure to triggers or help create a sense of calm. If possible, start by creating a relaxing and supportive environment at home and work.
• Follow your treatment plan: Working closely with a healthcare provider to develop a tailored treatment plan is essential in IED management. Those who stick to their plans achieve the best possible outcomes. You may sometimes feel like you don’t need treatment, but that likely means your plan is working. Stick with it!
• Learn how to manage stress: Managing stress levels and avoiding stressful situations may decrease negative impulses. Regular exercise, adequate sleep, healthy eating, and meditation are beneficial lifestyle choices to help keep you calm and focused.
• Avoid using substances: Drug and alcohol misuse can lower inhibitions, making impulses all the stronger. If you have an impulse-control disorder, including intermittent explosive disorder, you should avoid drug misuse.
• Consider a harm-reduction approach: This entails avoiding situations where you put yourself or others in danger because of your behavior. Harm reduction may require living alone or choosing work that does not directly involve stressful situations.

Final Thoughts

It is important for individuals with IED to work closely with their support team to develop a treatment plan and follow it closely. Remember, your hard work and dedication to improving your life can make a difference–keep at it!