Living with Intermittent Explosive Disorder (IED): Sudden Temper Tantrums, Anger Outbursts, and Uncontrolled Aggressive Behavior

Man having Intermittent Explosive Disorder (IED)- anger outburst episode


Wondering what drives sudden, uncontrollable anger outbursts? Intermittent Explosive Disorder (IED) provides the answer. IED is an impulse-control disorder where resisting aggressive impulses becomes nearly impossible, leading to frequent, intense outbursts. Imagine temper tantrums, threats, tirades, and even physical attacks on others or their possessions – all happening in a flash! These episodes cause serious bodily injury and property damage. In fact, IED affects as many as 7.3 % of adults.

What’s truly fascinating is how the aggressiveness during an IED episode is way out of proportion to the actual trigger or stressor. Experiencing these “spells” or “attacks” often involves a build-up of intense tension or arousal that suddenly erupts into aggression. This is followed by a strange mix of relief and sincere regret. As the dust settles, feelings of remorse, guilt, and embarrassment usually kick in, leaving a sense of puzzlement and a need to apologize.

How is Normal Anger Outbursts Or Sudden Anger Different from Intermittent Explosive Disorder (IED)?

Normal anger is a natural emotional response to perceived threats, frustrations, or injustices. It happens rarely in certain situations, is typically mild to moderate in intensity, and resolves relatively quickly. It may last from a few minutes to a couple of hours. When managed effectively, normal anger does not significantly impair daily functioning or relationships. It is usually proportionate to the situation and does not interfere with long-term well-being.

In Intermittent Explosive Disorder (IED), fewer but more severe anger episodes are experienced – if three episodes occur within a 12-month period, resulting in significant property damage or physical assaults causing injury, then it is a diagnosis of IED.           

What are the Main Causes of Severe Anger Outburst in Intermittent Explosive Disorder (IED)?

The exact cause of IED is not fully understood, but several factors are believed to contribute to its development:

  1. Biological Factors: Abnormalities in brain chemistry, particularly involving neurotransmitters like serotonin, play a role. Genetic predispositions also contribute as studies suggest 44% to 72% of impulsive aggressive behavior is genetic.
  2. Environmental Factors: Exposure to violent or abusive environments during childhood increases the risk of developing IED. Trauma and stressful life events also are significant contributors.
  3. Psychological Factors: Certain personality traits, such as impulsivity and a tendency toward anger increases the chances to be susceptible to IED. 
  4. Co-occurring mental health disorders: Other mental conditions also exacerbate this disorder as 80% IED patients also struggle with anxiety disorders, intellectual disabilities, autism, and bipolar disorder.

What are the Signs and Key Symptoms of Intermittent Explosive Disorder (IED)?

Impulsive attacks and anger outbursts typically occur with little or no warning. These episodes may happen frequently or be spaced out over weeks or months, with less severe verbal or physical outbursts occurring in between. Here are some key symptoms:

  1. Recurrent outbursts: Outbursts involve verbal aggression (yelling, screaming, or threatening) or physical aggression (hitting, slapping, or damaging property). They occur suddenly and without significant provocation.
  2. Generalized anger: Persistent irritability or anger between episodes.
  3. Distress and disturbed life: The disorder causes significant distress or impairment in social, occupational, or other important areas of functioning.
  4. Brief yet frequent episodes: The aggressive episodes typically last less than 30 minutes but they are infrequent, and more severe physical outbursts. 
  5. Impulsivity: The aggressive episodes are impulsive and not premeditated. They are a reaction to a perceived threat or frustration.
  6. Feeling of regret later: The anger outbursts are followed by feelings of remorse, regret, or embarrassment.
  7. Suicide thoughts or self harming behaviors : Self-harming behaviors or thoughts of  suicidal particularly during or following explosive episodes. Up to 25% of IED patients attempt suicide, and self-harm without suicidal intent.  About one-third report engaging in behaviors like cutting with razor blades or burning with cigarettes.
  8. Harming people, animals, or objects: Outbursts involve damage or destruction of property, or physical assault against animals or people.

How to Treat Anger Outbursts at Home – Treatment for Intermittent Explosive Disorder (IED)

Effective management of IED typically involves a combination of therapeutic approaches:

Education and Awareness to Enhance Understanding and Coping Mechanism

  • Education plays a pivotal role in deepening comprehension of the disorder, facilitating a deeper understanding of its symptoms, triggers, and impacts on daily life.
  • Awareness initiatives help combat stigma associated with IED, promoting empathy and acceptance within communities.
  • Awareness efforts also benefit caregivers and support networks, equipping them with knowledge to provide effective support.

Building Community and Resilience Through Support Groups

  • Support groups serve as invaluable platforms for individuals affected by Intermittent Explosive Disorder (IED) to connect with others facing similar challenges.
  • Participants benefit from sharing experiences, gaining insights, and receiving emotional support in a non-judgmental environment.
  • These groups foster a sense of belonging and solidarity, empowering members to navigate the complexities of the disorder with greater resilience and understanding.

Promoting Holistic Mental Health and Making Lifestyle Changes

  • Implementing lifestyle changes, including regular exercise, a balanced diet, and adequate sleep, enhances overall mental well-being.
  • These changes contribute to stress reduction, potentially diminishing the frequency and severity of anger outburst episodes associated with the disorder.

Cultivating Emotional Management with Mindfulness Practices

  • Mindfulness practices such as meditation and yoga provide valuable tools to cultivate emotional awareness and regulation.
  • Regular mindfulness practice contributes to overall emotional stability.
  • These practices encourage a focus on the present moment, which helps in recognizing emotional responses as they arise, thereby reducing the likelihood of explosive episodes associated with Intermittent Explosive Disorder.      

Recognizing Triggers and Developing Healthier Responses Using CBT

  • Anger Management Training teaches skills to control and reduce anger.
  • Stress Reduction Strategies help in managing stress that can trigger explosive episodes.
  • Cognitive Restructuring involves challenging and changing negative thought patterns that contribute to anger and aggression.

Managing Symptoms with Medication

  • Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), which help regulate mood and reduce impulsivity.
  • Mood Stabilizers assist in maintaining emotional equilibrium.
  • Anti-Anxiety Medications help alleviate anxiety that may exacerbate anger outbursts.

Intermittent Explosive Disorder is not just about uncontrollable anger; it’s about the deep emotional turmoil that lies beneath. Learning to manage anger through therapy, mindfulness, and positive lifestyle changes turn what once seemed like an insurmountable obstacle into a stepping stone towards resilience and self-discovery.

About Hope and Belief 

Hope and Belief is an online resource for exploring the incredible potential of mind power and the transformative power of thoughts while nurturing mental health. We are dedicated to empowering individuals with valuable insights, techniques, and resources to harness the power of their minds for personal growth and well-being. Our goal is to disseminate the profound impact of positive thinking, visualisation, affirmations, and mindfulness practices as we delve into the fascinating realm of mind-body connection. Whether you’re seeking guidance for overcoming challenges, managing stress, or cultivating a resilient mindset, Hope and Belief offers a wealth of articles, tips, and exercises to support your mental and emotional journey. Start your journey by unlocking the remarkable capabilities of mind power, understanding the power of thoughts, and fostering a life filled with hope, belief, and profound mental health.

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