Intermittent Explosive Disorder
Intermittent explosive disorder (IED) is the inability to control extreme outbursts, such as rage, anger and violence. These outbursts are generally disproportionate to the situation, no matter if the triggering event is real or only perceived. Examples include road rage, temper tantrums and often, domestic violence. During instances of intermittent explosive disorder, property may be damaged, injuries may occur and following, the sufferer generally experiences guilt, remorse and embarrassment.
Symptoms of Intermittent Explosive Disorder
Intermittent explosive disorder generally lasts between 10 minutes and 1 hour. Impulses are uncontrollable, recurring and may happen with little to no warning. Some patients report feeling a change in mood or energy just before the outburst, and most patients report feeling a sense of relief once the episode is over. The following are symptoms to be aware of when considering a diagnosis of intermittent explosive disorder:
- Tingling in the hands or feet
- Heart palpitations or tightness in the chest
- Pressure in the head or ringing in the ears
- Tremor, uncontrollable shaking
- Hearing an echo or experiencing blurred vision
- Uncontrollable feelings of strong emotion, usually of a negative nature, such as anger and rage
- Possible property damage or bodily injury associated with the outburst of violence
- Feelings of regret or shame, once the episode has passed
- Perceived or real events that have little to no consequence may trigger violence and rage
Causes of Intermittent Explosive Disorder
Intermittent explosive disorder is frequently accompanied by other mental illnesses, such as bipolar disorder, ADHD or clinical depression. The exact cause of intermittent explosive disorder is not known, but research suggests that environmental factors play the largest role. Patients who grew up in a family home full of anger and violence will often learn this type of behavior and lack the skills to overcome it as an adult. As with other mental illness, genetics and chemical imbalance may also be partially to blame.
Diagnosing Intermittent Explosive Disorder
In order to diagnose intermittent explosive disorder, a trained professional will need to first rule out other signs of mental illness, potential drug abuse or any physical ailments that may be contributing to the condition. Patients will need to have experienced certain criteria to qualify for diagnosis of this disorder. Aggressive behavior that happens recurrently and causes physical or property damage may point to IED, especially when the degree of anger or rage is disproportionate to the event which led to its cause. An evaluation will generally include questions regarding the explosive behavior, family medical history and thorough recounts of any explosive episodes. If intermittent explosive disorder is diagnosed, there are several treatment options available.
Treatments for Intermittent Explosive Disorder
Like many mental illnesses, treatment options vary by individual and situation. People with intermittent explosive disorder have shown improvements both by treatments with prescription medications and by attending different types of therapy. Cognitive therapy, individual psychotherapy or group and family therapy can assist the patient by suggesting new and more positive coping skills, helping to get to the root cause of symptoms and teaching awareness of triggering events and how to prevent violence and extreme outbursts. Traditional medication may accompany therapeutic efforts, and depending upon the individual case, may be recommended as follows:
- Anti-depressants and SSRIs – used when patients experience underlying symptoms, such as clinical depression
- Mood stabilizers or anti-convulsive medication – helps to control impulses that may lead to violent outbursts
- Anxiolytics – help to alleviate tension that may lead to outburst, and increases the tolerance threshold for events that may provoke an episode of rage