Intermittent Explosive Disorder
Intermittent explosive disorder (IED) is a condition characterized by frequent episodes of impulsive anger that are disproportionate to the triggering event. These outbursts can lead to physical harm inflicted upon the individual with the IED, other individuals, or animals. Seeking medical treatment for an IED is crucial and should be done promptly.
What is intermittent explosive disorder?
Intermittent explosive disorder (IED) is a mental health condition characterized by recurrent outbursts of anger and impulsive aggression towards others. Individuals with IED struggle to control these sudden and intense episodes, often directing their aggression towards those close to them.
To observers, these outbursts may appear as irrational and unpredictable reactions. They can involve physical attacks, threats of violence, or verbal aggression. Typically lasting around 30 minutes, these episodes are often followed by feelings of remorse, embarrassment, and distress.
In the United States, approximately 16 million people have intermittent explosive disorder. This condition typically manifests at an early age, with an average onset occurring around 12 years old.
What causes intermittent explosive disorder?
Researchers are still investigating the exact cause of IED. However, it is believed that a combination of genetic, biological, and environmental factors contribute to its development.
Genetic factors
There is evidence to suggest that IED tends to run in biological families. Studies indicate that approximately 44% to 72% of the likelihood of developing impulsive and aggressive behavior can be attributed to genetic factors.
Biological factors
Research has shown that individuals with IED exhibit alterations in brain structure and function. For instance, brain imaging studies using magnetic resonance imaging (MRI) have revealed abnormalities in the amygdala, which is a region of the brain involved in emotional processing. Furthermore, studies have indicated that people with IED tend to have lower-than-normal levels of serotonin, which is a neurotransmitter and hormone that plays a role in regulating mood and behavior.
Environmental factors
Experiencing verbal and physical maltreatment during childhood, as well as witnessing violence, can be associated to the development of IED. Additionally, individuals who have undergone one or more traumatic events in childhood are also more likely to develop the disorder.
What are the symptoms of intermittent explosive disorder?
The symptoms of intermittent explosive disorder can vary based on factors such as individual genetic makeup, social skill development, coping strategies, and co-occurring disorders. Here are some examples of the signs and symptoms that individuals with IED may exhibit:
Behavioral symptoms:
- Physical aggression
- Verbal aggression
- Angry outbursts
- Physical attacks towards people and/or objects
- Property damage
- Road rage
Physical symptoms:
- Headaches
- Muscle tension
- Chest tightness
- Palpitations
- Tingling sensations
- Feeling of pressure in the head
- Tremors
Cognitive symptoms:
- Low frustration tolerance
- Feeling a loss of control over one’s thoughts
- Racing thoughts
Psychosocial symptoms:
- Intense feelings of rage
- Uncontrollable irritability
- Brief periods of emotional detachment
How to calm someone with an intermittent explosive disorder?
It is crucial to understand that you are not responsible for de-escalating an angry person, especially when dealing with someone who has intermittent explosive disorder. It is their own responsibility to manage their emotional and behavioral health. However, if you want to assist and support someone you care about during their outbursts, there are specific de-escalation techniques you can employ.
Effective de-escalation requires patience and a calm approach. Try to detach yourself from your personal emotions as much as possible during the episode. Recognizing that the person’s behavior is beyond their control can be helpful.
People with IED often experience intense emotions, utilize immature defense mechanisms such as projection and denial, and struggle with reality testing. This can make it extremely challenging to engage with them in a rational manner. Instead, the goal is to defuse the situation. Here are some specific de-escalation techniques that may be beneficial during IED outbursts:
- Use tactful language that avoids belittling the person.
- Maintain an appropriate distance that respects their personal space while still fostering rapport.
- Avoid delivering ultimatums or engaging in power struggles.
- Validate the person’s anger, acknowledging that they are allowed to express their feelings as long as no harm is caused to themselves or others.
- Suggest face-saving alternatives to their aggression, such as suggesting a cooling-off period.
- Practice active listening skills to demonstrate your positive engagement.
- Offer empathetic statements, expressing understanding.
- Avoid revisiting the details of the incident or assigning blame. Instead, focus on potential solutions to the problem.
- Display deliberately calm body language and use a soothing tone of voice. Refrain from adding to the drama.
- Provide positive reinforcement when the person regains control of their emotions.
Remember, it is important to prioritize your own safety and well-being in any situation involving someone with an IED.
What are the available treatments for intermittent explosive disorder?
Several treatment options are available for intermittent explosive disorder, often involving a combination of approaches:
Therapy
Seeking the assistance of a counselor, psychologist, or therapist, either individually or in a group setting, can be beneficial in managing IED symptoms. Cognitive behavioral therapy (CBT) is a type of therapy that focuses on recognizing and addressing harmful patterns of behavior. It involves the development of coping skills, relaxation techniques, and relapse prevention strategies to effectively manage aggressive impulses.
Oral Treatments
There are no oral treatments specifically for the treatment of intermittent explosive disorder. However, certain oral treatments may be prescribed to help reduce impulsive behavior or aggression. It may take up to three months of consistent oral treatment use to observe the full effects. Additionally, once the person stops taking them symptoms may resurface. Everyone responds to oral treatments, and individual responses can vary.
If you are considering going to therapy for intermittent explosive disorder, visit Mindshift Psychological Services. Check out their website to learn more about their treatment programs. You may also contact them at (714) 584-9700 to schedule an appointment.
