Intermittent Explosive Disorder: When Anger Becomes Destructive

Why do I feel like exploding?

Anger is not easy to manage, whether you’re experiencing it or on the receiving end. But when it becomes exacerbated, with verbal or aggressive reactions, it’s even worse 😥. If you’ve ever noticed someone in your circle reacting with disproportionate anger, they might be dealing with intermittent explosive disorder (IED).

What causes someone to react this way? Unfortunately, there’s no specific cause 😕. A study by Coccaro et al. and McElroy revealed a strong emotional instability, often co-occurring with mood disorders. In other words, IED can stem from a mental health condition that prevents the brain from properly regulating emotions. However, researchers also point to genetic and environmental factors.

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How to know if you have Intermittent Explosive Disorder?

To determine if you have intermittent explosive disorder (IED), you need to refer to the diagnostic criteria established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 📘. Here are the main criteria:

• ▶️ Recurrent and disproportionate anger outbursts: The person experiences frequent episodes of losing control over their aggressive behavior, which is not proportional to the triggering situation 😡.
• ▶️ Verbal or physical aggression: During these episodes, the person may yell, insult, threaten, hit, or break objects...
• ▶️ Negative consequences: These anger episodes have a significant negative impact on interpersonal relationships, work, studies, or other important areas of functioning...
• ▶️ Frequency and intensity: To make a diagnosis, there must be at least three episodes of loss of aggressive control over a 12-month period 📅.
• ▶️ Age of onset: Symptoms must have started before the age of 55. Typically, it begins in adolescence.
• ▶️ Exclusion of other causes: The anger episodes must not be better explained by another mental disorder (personality disorder, depression, bipolar disorder...), nor caused by substance use or a medical condition 🚫.

Do not self-diagnose ⚠️! Only a psychiatrist can diagnose intermittent explosive disorder after a thorough clinical assessment 👩‍⚕️. This list of criteria can help you understand your behavior or that of someone close to you, but it’s essential to consult a professional to confirm if it’s IED.

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How to manage IED?

Having witnessed IED from the outside, I can testify that it’s both impressive and difficult for loved ones to handle 😔. The anger episodes are so sudden and intense that you quickly feel powerless in the face of them… And I know that the person in my family affected by this has always regretted their outbursts, given the impact they had on their relationships and even their mental health 💔.

That’s why they decided to seek help, and the diagnosis was made. They were quickly directed toward cognitive-behavioral therapy (CBT). CBT is often used to help individuals with IED better manage their anger.

That’s what happened for my family member. Through therapy, they were able to identify the thoughts and beliefs that triggered their outbursts 🤯. More importantly, they learned stress management and relaxation techniques to avoid reaching a boiling point. Treatment also helped, as they were prescribed antidepressants to help the brain process information more effectively.

With appropriate care, it’s possible to better manage anger and significantly improve quality of life and relationships with others, even when it seems impossible.

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