Why Do People Have Intermittent Explosive Disorder? The Causes

24 Apr Why Do People Have Intermittent Explosive Disorder? The Causes

Intermittent explosive disorder, or IED, represents a mental health condition characterized by sudden, intense outbursts of anger or aggression that are disproportionate to the situation.

People suffering from IED often find themselves flooded irregularly with rage; behaviorally destructive responses to such episodes follow, frequently causing considerable internal, emotional distress.

How serious is Intermittent Explosive Disorder? For many, it can significantly impair daily life, leading to legal issues, strained relationships, or even physical harm.

Is Intermittent Explosive Disorder common? While not as widely discussed as anxiety or depression, IED affects a notable portion of the population, with estimates suggesting up to 7% of adults may experience it at some point.

In this blog, we’ll explore the intermittent explosive disorder symptoms, causes, symptoms, and treatment options, shedding light on this often-misunderstood disorder.

What is Intermittent Explosive Disorder?

Is intermittent explosive disorder a mental illness? Yes, it is a mental disorder that causes sudden outbursts, like violent behavior or angry shouting, in a person who is usually calm.

These episodes are impulsive, uncontrollable, and often lead to verbal assaults, property damage, or physical harm.

An angry person might hurt themselves, hurt others, or damage things. These events happen rarely and are caused by things that usually just make people mad or sad.

However, this person reacts much more strongly than what is normal.

After these events, they might feel relief, but then also regret, shame, and embarrassment.

This problem can be serious, but knowing the signs, causes, and ways to treat it can help people handle their feelings and live better lives.

Prevalence: How Common Is Intermittent Explosive Disorder

How many people have intermittent explosive disorder? IED has an estimated lifetime prevalence of approximately 4% to 7%.

It is earlier diagnosed in adolescents and young adults and mostly appears during the end of the teenage years or early twenties.

Studies show that men have a higher probability than women of being diagnosed with IED.

People who have experienced childhood trauma, such as having severe abuse or neglect, are at much greater risk of having this condition.

Studies show that the heredity, having a family history of mood disorders or personality disorders, may put an individual at risk to develop IED.

IED is frequently underdiagnosed due to stigma, mislabeling as “bad temper,” or confusion with bipolar disorder.

Over 80% of cases coexist with depression, anxiety, or PTSD. Urban populations and trauma survivors face higher risks.

Despite its prevalence, <30% seek treatment, worsening outcomes like relationship breakdowns or legal issues.

Key Characteristics of IED

Intermittent Explulsive Disorder differs fundamentally from normal features of frustration and anger.

Here are some most prominent features:

Frequent Episodes of Impulsive Aggression Example:

A person suffering from IED may have the same incident many times when they just get angry suddenly with too much intensity without any reason.

Mostly such episodes are unpredictable and arise from small issues.

Verbal or Physical Outbursts:

Outbursts can be an expression of shouting, insults, and aggressive gestures.

In extreme cases, it may result in physical violence, property damage, or aggression toward others.

Reactions Beyond Proportion:

IED is often accompanied by an unduly exaggerated emotional response compared to the incident or trigger that initiated it.

Difficulty in Controlling Emotions:

It is tempting for people to explode during a rage episode, resulting in hazardous behavior.

In addition, they do not feel empowered to interrupt their wrath once it begins.

Relief and Remorse:

After such an episode, it often brings momentary relief but overwhelming guilt, shame, or embarrassment.

This emotional cycle may promote avoidance and withdrawal.

Chronic Irritability:

There may be such slight heightened irritability, increased frustration, or low frustration tolerance that persists even between episodes.

This will continue to be a source of stress in relationships and everyday life.

How It Differs From Normal Anger Or Frustration?

Anger is something everyone feels, but IED is different because it happens more often and is harder to control.

Here’s how IED is different from regular anger:

Intensity:

Sessions are characterized by extreme emotional intensity, such as destructive behavior.

Contrary to anger, normal anger can usually be managed without escalating to violence.

Time Span:

IED episodes usually don’t exceed a time limit of less than 30 minutes but the overflow of emotions may continue.

However, regular anger may last longer and tends to be free of impulsive physical or verbal aggression.

Frequency:

These people may suffer two to three episodes in a week or two in one month.

This is different from the occasional angry outbursts without a pattern of recurrence indicating situational frustration.

Impact:

It disrupts interpersonal relationships and the beneficial consequences thereof, such as the career and personal state of mind.

Such an episode never produces long-term ramifications; normal anger temporarily disrupts agreement.

Unlike typical anger, IED is a diagnosable mental health condition often linked to underlying neurological or psychological factors, requiring professional intervention like therapy or medication.

What Is the Difference Between Bipolar Disorder and IED?

Intermittent Explosive Disorder (IED) and Bipolar Disorder are distinct mental health conditions, though both can involve emotional dysregulation.

Here’s how they differ:

Mood Swings

There are dramatic shifts between periods of deep depression and periods of mania or hypomania, which are herein generalizations of moods.

There are no long mood shifts in someone suffering from IED. Instead, it may comprise of sudden attacks of extreme anger without continued mood variations.

Triggers

They can be treated entirely without some minor frustrations perceived as provocations.

Bipolar changes of moods occur without clear external triggers, and emotional changes can last from days to weeks to years and can occur in seconds.

Duration

IED episodes fall within the short-lived category lasting a countable number of minutes, half an hour maximum.

The bipolar episode is intended to take longer than IED-disrupted interference in daily life.

Emotional Regulation

Emotional control is lost with IED mainly during outbursts. Patients often regret the anger once it has diminished.

In Bipolar Disorder, emotional dysregulation perhaps continues during both the manic and the depressive states.

A proper diagnosis would be from a mental health professional to determine if those symptoms are IED, Bipolar Disorder, or other mood disorders.

Treatment:

• IED: Treatment often focuses on impulse control through cognitive-behavioral therapy (CBT), anger management techniques, or medications like SSRIs or mood stabilizers to reduce aggression.
• Bipolar Disorder: Treatment emphasizes mood stabilization with medications like lithium, anticonvulsants, or antipsychotics, alongside psychotherapy to manage mood swings and lifestyle changes.

While both disorders can involve irritability or anger, IED is defined by isolated, impulsive outbursts, whereas Bipolar Disorder involves broader, cyclical mood disturbances.

Accurate diagnosis is critical, as the two conditions may co-occur or be mistaken for each other, and a psychiatrist can help differentiate them through clinical evaluation.

Can You Live a Normal Life with IED?

Yes, many people with Intermittent Explosive Disorder (IED) can live a normal life with the right support and treatment.

Here are some key points to consider:

• Managing IED: Get Professional Help: Therapy and counseling go a long way in developing essential skills related to coping and regulating emotions.
• Medication: Sometimes, doctors will prescribe antidepressants, mood stabilizers, or antipsychotic medications.
• Make Lifestyle Changes: Regular workouts, stress management techniques, and mindfulness practices can greatly help towards achieving an emotional balance.
• Support Systems: Meeting up with family and friends or joining a support group can help give emotional strength and practical support. Through therapy and self-administered care, individuals diagnosed with IED can create healthy relationships to cope with emotional challenges and live meaningful lives.
• Stress Management: Implementing stress-reduction techniques like mindfulness, exercise, and relaxation can significantly help.
• Self-Monitoring: Keeping track of triggers and developing strategies to cope with anger can reduce the frequency and intensity of outbursts.
• Education: Learning about IED can help both individuals and those around them understand the disorder better, fostering supportive environments.

Living with IED might present challenges, but many individuals successfully find ways to cope and lead productive lives.

If you or someone you know is struggling with IED, it’s essential to seek professional help.

Consult Dr. Vivek Pratap Singh, an experienced psychiatrist in Patna, for effective Intermittent Explosive Disorder (IED) treatment, including Cognitive-Behavioral Therapy (CBT).

Schedule in-person or online appointments at Pratap Neuro and Child Psychiatry Clinic

What Are The Signs Of Intermittent Explosive Disorder?

Intermittent Explosive Disorder (IED) is characterized by repeated, sudden episodes of impulsive, aggressive behavior.

Here are some common signs and symptoms:

1: Emotional Symptoms:

• Abrupt and intense waves of feeling angry or enraged
• Becoming irritable and easily frustrated at trivial incidents
• Low frustration tolerance and poor coping with stress
• Feelings of emotional detachment and lack of control over the emotions

2: Physical Symptoms:

• Increased heart rate and rapid breathings
• Muscle tightness or shivers
• Pain or headache in the chest during episodes
• Dizziness or lethargy subsequent to an attack

3: Behavioral Symptoms:

• Aggressive verbal behavior such as yelling, and threats, or insults
• Physical aggression towards another person, animal, or object
• Damage to property in an outburst
• Acts of road rage or violent behavior in public locales

4: Psychological Symptoms:

• Thoughts racing and inability to reason, even for a brief moment
• Relief or gratification right afterward an explosion
• Pangs of conscience, remorse, or humiliation post-incident
• Fear of experiencing another severe outburst and its consequences
• Recognizing early these symptoms is important for preferring diagnosis and treatment.

If these signs resonate with you or someone you know, it’s important to seek help from a mental health professional for an accurate diagnosis and appropriate treatment.

What Causes Intermittent Explosive Disorder?

Intermittent Explosive Disorder (IED) is a complex mental health condition marked by sudden, intense outbursts of anger or aggression that seem out of proportion to the situation.

For those grappling with this disorder, questions like Why do people have Intermittent Explosive Disorder? or Why do I have Intermittent Explosive Disorder? are common.

While the exact cause of IED isn’t fully understood, research points to a combination of biological, psychological, environmental, and genetic factors that contribute to its development.

Below, we explore Intermittent explosive disorder causes to shed light on this often-misunderstood condition.

1: Genetic Factors:

Genetics may partially answer the question, Why do I have Intermittent Explosive Disorder?

A family history of IED or related conditions, such as mood disorders or substance abuse, increases the likelihood of developing IED.

Is intermittent explosive disorder genetic – Studies suggest that inherited traits affecting impulse control or emotional regulation can make some individuals more vulnerable.

However, genetics alone don’t determine IED; they interact with other factors.

2: Brain Chemistry:

The brain plays a significant role in IED.

Abnormalities in brain regions like the prefrontal cortex and amygdala, which regulate impulse control and emotional responses, may lead to heightened aggression.

Imbalances in neurotransmitters, such as serotonin, dopamine, or GABA, can also disrupt emotional regulation, making individuals more prone to explosive outbursts.

Additionally, hormonal imbalances, such as elevated testosterone levels, have been linked to increased aggression in some cases.

3: Environmental Factors:

Early life experiences significantly shape the risk of IED.

Growing up in a chaotic or abusive environment, witnessing violence, or experiencing trauma can heighten the likelihood of developing the disorder.

Chronic stress, neglect, or exposure to aggressive role models during childhood may teach maladaptive ways of handling frustration, leading to explosive behavior later in life.

Socioeconomic stressors, such as poverty or unstable living conditions, can also exacerbate symptoms.

4: Psychological Factors:

Certain personality traits, like impulsivity or low frustration tolerance, are closely tied to IED.

Co-occurring mental health conditions, such as anxiety, depression, or attention-deficit/hyperactivity disorder (ADHD), may amplify emotional dysregulation, making outbursts more likely.

Individuals with difficulty processing emotions or coping with stress are at higher risk, as they may struggle to manage anger constructively.

5: Substance Abuse:

The depressants of inhibition and enhancement of impulsivity would worsen IED symptoms as abused alcohol or drugs operate.

Also decreases efficacy of treatment in managing the emotional conditions.

Seeking professional help, such as therapy or medication, can address the root causes of IED and reduce the frequency and intensity of outbursts.

If you’re wondering about your own experiences, a mental health professional can provide a personalized assessment and tailored treatment plan to help you regain control.

Complications of Intermittent Explosive Disorder

Intermittent Explosive Disorder (IED) can lead to a variety of complications that impact various aspects of life.

Here are some potential complications associated with IED:

Relationship Problems:

Aggressive outbursts can lead to enormous stress in relationships like those of other family members and friends, or even those of romantic partners.

Someone dear to a person might start feeling unsafe or emotionally drained by the experience, leading to that person creating an isolated condition within him or her.

Legal Issues:

Physical aggression can lead to arrests, legal charges, or restraining orders if harm is inflicted on others or property.

Individuals may face charges related to assault or property damage, resulting in a criminal record.

Physical Health Issues:

Chronic anger and stress lead to health complications such as high blood pressure, heart disease, and impaired immunity.

Excess secretion of cortisol or the stress hormone predisposes one towards chronic health conditions.

Mental Health Disorders:

Increased prevalence of anxiety disorders, depression, or substance use disorders is seen in individuals with IED.

Guilt and isolation further aggravate mental health issues.

Thus, these complications make early diagnosis and treatment all the more imperative.

Because of these possible problems, it’s important for people showing signs of IED to get professional help.

Getting help early can manage symptoms better and improve quality of life.

How Is Intermittent Explosive Disorder Diagnosed?

The diagnosis of Intermittent Explosive Disorder (IED) typically involves a comprehensive evaluation by a mental health professional.

Here’s how the diagnosis process usually unfolds:

Clinical Evaluation:

A very thorough psychological interview should help in assessing how frequently it occurs and the possible triggers for the outburst.

The psychologist may ask very important questions regarding the subject’s personal, family, and medical history.

Diagnostic Criteria:

Diagnosis is more based on criteria as included in the DSM-5.

The individual must suffer from recurrent outbursts of aggression that are manifestly grossly out of proportion to psychosocial stressors in his or her life.

Medical History Review:

May involve physical examination and laboratory tests in order to screen out any medical condition or substance use attributing symptoms to it.

That is why a differential diagnosis of IED is so important when developing a treatment plan and differentiating it from mood or personality disorders.

Physical Examination

While IED is primarily a psychological diagnosis, a physical examination can rule out underlying medical conditions that may be contributing to the symptoms, such as neurological issues or hormonal imbalances.

If you or someone you know has symptoms of IED, it’s important to get checked by a mental health expert.

Finding out early and getting help can make it easier to manage the disorder.

Intermittent Explosive Disorder Treatment

For those affected, questions like How to treat Intermittent Explosive Disorder?, Is there a cure for Intermittent Explosive Disorder?, and Is Intermittent Explosive Disorder curable? are often top of mind.

While IED can significantly disrupt daily life, a range of treatment options can help manage symptoms, reduce the frequency and intensity of outbursts, and improve overall well-being.

Below, we explore the most effective approaches to treating IED and address whether a cure is possible.

Psychotherapy:

• CBT is about teaching patients to recognize triggers, challenge negative thought patterns, and learn healthier coping skills.
• Anger management therapy focuses on relaxation skills, impulse control, and emotion regulation.
• Group therapy provides an environment for support, sharing one’s own experience, and learning from others with similar challenges.

Medication:

• Antidepressants (SSRIs): Such as fluoxetine or sertraline, are intended for mood stabilization and reduction in impulsive behaviors.
• Mood stabilizers: Typically given when the patient experiences severe mood episodes in conjunction with aggressive behavior.
• Antipsychotic medications: Indicated when severe aggression poses safety concerns.

Lifestyle Modifications

• Mindfulness Practices: This includes meditation, yoga, or breathing exercises, which may help reduce the emotional build-up.
• Regular Physical Exercise: Exercising reduces stress and contributes to mood stabilization.
• Balanced Diet and Adequate Sleep: Rest and food will help steady emotions.

A combination of psychotherapy, medication, and lifestyle changes offers the best chance for managing IED.

Working closely with a mental health professional, such as a psychologist or psychiatrist like Dr. Vivek Pratap Singh (top psychiatrist in Patna Bihar), is crucial to developing a personalized treatment plan.

How To Help Someone With Intermittent Explosive Disorder? Coping Strategies 

Supporting someone with Intermittent Explosive Disorder (IED) can be challenging, as their sudden, intense outbursts of anger or aggression may feel overwhelming or unpredictable.

Below, we outline practical ways to help someone with IED, along with coping strategies to foster understanding, reduce conflict, and promote emotional stability.

For the Individual with IED:

• Know Your Triggers: Identify and stay away from situations that might induce anger.
• Relaxation: Techniques such as deep breathing, progressive muscle relaxation, or visualization may lessen emotional arousal.
• Use Anger Management Techniques: Focusing on the present will help de-escalate anger.
• Seek Professional Help: Engage in CBT or medication to manage symptoms effectively.
• Communicate Better: Use “I” statements (e.g., “I feel frustrated”) to express emotions calmly.
• Build Support: Share your diagnosis with trusted people; join support groups for encouragement.
• Be Patient: Celebrate small progress, avoid self-blame, and recognize IED as a medical condition.
• Plan for Crises: Have a strategy (e.g., breathing, walking away) for when anger escalates.

For Family Members or Loved Ones:

• Encourage Therapy: Gently suggest therapy (e.g., CBT) or medication; offer to help find professionals.
• Set up Boundaries to Keep Yourself Safe and to Avoid Arguments: Clearly state acceptable behavior (e.g., no yelling) and prioritize safety.
• Join Family Therapy Together: Learn better communication and conflict resolution skills.
• Identify Triggers: Help track patterns (e.g., stress, crowds) and suggest ways to avoid or manage them.
• Learn About IED: Understand symptoms and triggers to approach outbursts with empathy.
• Stay Calm: Use a soft tone, avoid arguing, and give space during outbursts to de-escalate.
• Show Empathy: Validate feelings (“I see you’re upset”) and praise efforts to manage IED.

Conclusion

Intermittent Explosive Disorder is a tough condition. It makes it hard for people to live well in their personal and social lives.

However, with treatment and support, people with this disorder can improve their lives.

They can learn to handle their feelings better. Getting diagnosed early, along with therapy and medicine, can help and stop problems from getting worse.

If you or someone you know has symptoms of IED, please seek help from professionals.

Getting help early can greatly improve emotional stability and quality of life.