By: Bhaveeshika Charun
What is Intermittent Explosive Disorder?
Intermittent explosive disorder involves repeated, sudden bouts of impulsive, aggressive, violent behaviour or angry verbal outbursts. The reactions are too extreme for the situation. These explosive outbursts, which occur off and on, cause major distress. They can be harmful to relationships and could cause problems at school or work. They can also result in problems with the law. Intermittent explosive disorder is a long-term condition that can go on for years but the severity of outbursts may lessen with age.
Causes:
IED can begin in childhood - after the age of 6 years - or during the teenage years. It’s more common in younger adults than in older adults. It may be caused by the living environment and learned behaviours, genetics, or differences in the brain.
Living environment: Most people with IED grew up in families where explosive behaviour and verbal/physical abuse were normalised. Children who witness these behaviours at an early age may grow up likely having the same traits.
Genetics: Genetics may play a role as there could be a gene related to the tendency to react more easily to stress. This gene may be passed from parent to child.
Differences in how the brain works: There may be differences in the structure, function, and chemistry of the brain in people with intermittent explosive disorder compared to people who do not have that disorder.
Risk Factors:
Being male
Family history of IED or another mental health condition
Possessing certain medical conditions
Personal history of brain trauma
Exposure to trauma/abuse/neglect
Witnessing aggressive or violent behaviours early in life
Complications:
People with intermittent explosive disorder have a higher risk of:
Problems with relationships
Trouble at work, home or school
Problems with mood
Problems with alcohol and drug use
Physical health problems
Self-harm
Developing another mental health condition
Suicidal ideation and attempts
Academic failure
Social withdrawal/isolation
Engaging in criminal activity
Poor peer interactions
Symptoms Behavioural symptoms:
Verbal defiance
Unabashed outbursts of anger
Instigative behaviour towards others
Physical aggression towards others
Causing harm to animals
Damaging property
Self-harming behaviours
Physical symptoms:
Physical injuries due to acting out
Tense muscles
Accelerated heart rate
Headaches
Tremors
Numbness
Tight feeling in one’s chest
Cognitive symptoms:
Poor impulse control
Hearing echoes
Rapid thoughts
Psychosocial symptoms:
Feeling as if one is going to lose control at a moment’s notice
Emotional detachment
Irritability
Feeling of guilt
Agitation
Feeling of shame
Rage
Low frustration tolerance
Treatment:
The American Psychiatric Association says that a person has to have shown a failure to control their aggressive impulses in one of two ways to be diagnosed with
IED:
High-frequency/low-intensity episodes
Low-frequency/ high-intensity episode
IED is treated with a combination of therapy, medication, and lifestyle changes. Therapy:
Cognitive behavioural therapy (CBT) can help you discover why you have episodes and how to prevent them. It can also help you manage anger and find healthier ways to deal with things that bother you. Relaxation training, such as deep breathing and muscle relaxation, is another therapy that can help you develop more control over your impulses.
Medicines: Your doctor might prescribe selective serotonin reuptake inhibitors (SSRIs) or mood stabiliser medicines to help balance your brain chemicals. Antipsychotics, anticonvulsants, and antianxiety medications are also used.
Lifestyle changes: This includes stress management, exercise, healthy sleep, a nutritious diet, and developing a support system.
References:
1. Mayo Clinic. (Jan, 2024) “Intermittent Explosive Disorder” Mayo Clinic https://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/sy
2.Symptoms-causes/syc-20373921 2. Resource Residential Treatment Facility. “IED Symptoms & Effects” Resource Treatment Center https://www.resourcetreatmentcenter.com/behavioral/ied/symptoms-effects/
3. Matt McMillen, Jeffrey Weishaupt. (Jan, 2024) “What is Intermittent Explosive Disorder?” WebMD https://www.webmd.com/mental-health/what-is-intermittent-explosive-disorder
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