Intermittent explosive disorder (IED) is when you have sudden, violent reactions that are out of proportion to things that happen. You are not violent or aggressive most of the time.
What is the cause?
The exact cause of this disorder is not known. Possible causes include:
The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
Stress plays a part. You may be at higher risk due to problems such as abuse, financial stresses, or the death of loved ones.
Problems in your family when you were growing up may increase your risk, such as parents who:
Abused and neglected you
Abused drugs or alcohol
Were impulsive, destructive, reckless, or violent
Were not consistent in their discipline
Violent, destructive behaviors often start in childhood. IED occurs more often in men. Women may have it as part of premenstrual syndrome (PMS).
What are the symptoms?
Symptoms may include:
Being repeatedly and suddenly violent
Being unable to stop or control impulsive, aggressive actions
Reacting way out of proportion to things that happen. You may attack or kill another person. People with IED may commit suicide when they are in a rage.
How is it diagnosed?
Your healthcare provider or a mental health specialist will ask about your symptoms and any drug or alcohol use. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms.
How is it treated?
Treatment for IED usually involves both therapy and medicine.
Several kinds of medicines may be helpful. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.
Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.
Behavior therapy helps you recognize that the way you act affects others. This can help you change problem behaviors.
How can I take care of myself?
Time-outs can be useful.
Set a specific amount of time (15 minutes to 1 hour).
Leave the situation (for instance, take a walk or go into another room).
Calm yourself mentally with deep breathing and self-talk.
Do something physical such as walking, jogging, or bicycling.
Return to the situation if the anger does not return. If the anger returns, take another time-out. Do not drink or use drugs during the time-out.
Maintaining a healthy lifestyle is important. To help control intermittent explosive disorder:
Get support. Talk with family and friends. Consider joining a support group in your area.
Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.
Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider’s instructions. Regular exercise can help calm you and make it easier for you to deal with stress.
Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don’t seem to be working.
Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.
Get emergency care if you or a loved one has serious thoughts of suicide, self harm, or harming others.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-08-28 Last reviewed: 2013-11-19
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Intermittent Explosive Disorder: References
Proactive, reactive, and romantic relational aggression in adulthood: Measurement, predictive validity, gender differences, and association with Intermittent Explosive Disorder Dianna Murray-Close, Jamie M. Ostrov, David A. Nelson, Nicki R. Crick, Emil F. Coccaro Journal of Psychiatric Research. Volume 44, Issue 6 , Pages 393-404, April 2010
Efficacy of mood stabilisers in the treatment of impulsive or repetitive aggression: systematic review and meta-analysis
RM Jones, J Arlidge, R Gillham, S Reaguâ€¦ – The British Journal of â€¦, 2011 â€“ RCP
A Review of â€œImpulse Control Disordersâ€ LR Hays – American Journal on Addictions, 2009 – Informa UK Ltd.
Pharmacological Treatments of Impulse Control Disorders. H Myrsethâ€¦ – 2010 – Wiley Online Library
Frontiers: Impulse Control Disorders: Updated Review of Clinical Characteristics and Pharmacological Management
[HTML] from frontiersin.orgJE Grant, LRN Schreiberâ€¦ – Frontiers in Impulsivity, 2011 – frontiersin.org