Intermittent Explosive Disorder: Causes, Diagnosis & Treatment

The importance of mental health has been on the rise, and Intermittent explosive disorder is one such severe mental disorder. It is a health concern causing frequent episodes of aggressive behaviour. Such episodes are usually violent towards the patient and others around them, with proper medical treatment essential here.

Are you or anyone in your family suffering from intermittent explosive disorder? Find out all about it in this article.

The intermittent explosive disorder is a mental health condition characterised by sudden and repeated episodes of impulsive and aggressive behaviour. Here, patients feel sudden outbursts of rage, aggression, or violence. Such reactions are usually extreme and can quickly go out of the patient's control. These might include road rage, breaking of objects, domestic abuse and similar temper tantrums.

Various symptoms of the intermittent explosive disorder can help get an understanding of this disorder. These are usually unpredictable, explosive behaviours that last for about 30 minutes or less. Here are the symptoms of the common aggressive episodes of this disorder.

1. Common Aggressive Physical Symptoms

• Irritable feeling
• Rage
• Tingling
• Chest tightness
• Increased energy
• Rapid changes in thought
• Tremors
• Palpitations

2. Verbal and Behavioural Symptoms

There can also be some verbal and behavioural outbursts based on the situation. Here are the common symptoms that you might notice in this scenario.

• Temper tantrums
• Heated arguments
• Threats and intimidation
• Shouting and yelling
• Physically hurting others (slapping and shoving)
• Tirades
• Road rage
• Physical fights and assaults
• Property damage

3. Outburst Symptoms

While anyone can be aggressive, the episodes of intermittent explosive disorder are unique and distinct. You will know that you have this issue if the episodes and outbursts:

• Are impulsive and unpredictable
• Escalate rapidly from a single provocation or trigger
• Last for about 30 minutes
• Result in mental distress and pressure
• Decline academic and professional performances

Clinical research is still being conducted to identify the exact causes of the intermittent explosive disorder. However, the following factors are found to have contributed to causing it in most cases.

• Genetic Factors: A common belief is that this disorder runs across family history and genetics. There is a high chance of parents suffering from this disorder passing it on to their children.
• Biological Factors: This disorder might occur from brain structure and function changes. For instance, brain magnetic resonance imaging (MRI) studies show that it can affect the amygdala, which has a role in emotional functioning. Thus, people suffering from IED have a lower level of serotonin.
• Environmental Factors: Growing up in an unhealthy environment can also cause this disorder. Those who experience verbal and physical abuse in childhood or witness abuse are more vulnerable to developing this disorder. Having traumatic experiences can also cause this disorder.

If you notice these symptoms in yourself or anyone close to you, do not waste any time visiting your healthcare providers. They might refer you to a mental health professional for more specialised treatment. For diagnosing this condition, they are likely to perform the following procedures.

• Physical Exam: The doctor will try to rule out the possibility of any physical problems. Substance abuse or any overreaction of drugs can also cause similar symptoms. This exam might include lab tests.
• Psychological Evaluation: The doctor will ask some detailed questions regarding your medical records, family medical history, school or work performances, impulse control abilities and relationship problems.
• Criteria in the DSM-5: Many doctors follow the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association as the main criteria. The standards here are used to diagnose this disorder.

Some risk factors can increase the chances of developing intermittent explosive disorder. These are as follows.

• Other Mental Health Issues: People suffering from other severe mental health issues, like borderline personality disorder and attention-deficit/hyperactivity disorder (ADHD), are also at higher risk. Their mind is more vulnerable to getting triggered by difficult situations.
• Brain Health: Some health researchers observed that people with low serotonin levels in the brain are more likely to experience IED. This shows that brain chemistry can be a risk factor for this disorder.

While anyone can develop this disorder, some people are at a higher risk of getting it. For instance, you might suffer from IED if you are the following.

• Male
• Young and unemployed
• Single
• Uneducated
• Suffering from other mental health issues

Intermittent explosive disorder can cause some complications. These are the consequences of experiencing the symptoms of this disorder for a long time. Here are some of the complications that you might experience.

• Problems in a Relationship: This disorder is capable of building relationship issues. Patients of IED are often angry, irritated and withdrawn. Verbal and physical fights will be common in this condition. As a result, their partners and family members might not be able to adjust for a long time, causing divorce, separation and family stress.
• Mood Swings: One of the most significant mental health issues is related to rapid mood swings. This is usually a dangerous condition. With IED, patients experience such mood swings. They might suddenly feel depression and anxiety, with episodes of anger. However, these feelings usually fade in a short time.
• The Trouble With Performance and Work: Patients might struggle with their home, school, or workplace activities. They might not be able to perform at their usual capability or simply lose interest in these. This causes job loss, failure in academic performance, financial crisis, or legal complications.
• Alcohol and/or Substance Addiction: IED might lead the patients to start consuming alcohol and illegal substances and slowly get them addicted to them. This issue can further cause other physical and mental health issues.
• Physical Health issues: While IED might seem like a mental health disorder, it can cause multiple physical conditions. These include diabetes, high blood pressure, heart diseases like heart attacks and strokes, ulcers, and chronic pain.

There can be multiple options when it comes to the treatment of intermittent explosive disorder. However, here are some of the common ones used in most cases.

1. Psychotherapy

In most cases, therapists use cognitive behavioural therapy as effective psychotherapy. It is a structured, goal-oriented talk therapy. Here, the therapists ask you several deep and insightful questions and take notes accordingly. These questions might help them identify the behaviours that usually trigger an aggressive response.

Once the therapists identify the problems, they will suggest coping methods. Some of the standard techniques used here are as follows.

• Relaxation Training: You can try relaxation n techniques like deep breathing, meditation, music therapies, yoga, etc., to calm your nerves and relax your muscles. They will manage your anger essentially.
• Coping Skills Training: This is a technique for role-playing situations likely to cause explosive episodes. You are exposed to this situation, and doctors will ask you to practise healthy behaviour here instead of losing your temper. It can be walking away or calmly thinking of a solution.
• Cognitive Restructuring: This technique requires the therapists to help the patients change faulty assumptions and depressing thoughts about a situation. They are encouraged to think of solutions against frustrating situations and perceived threats.

2. Medication

Certain medicines can improve intermittent explosive disorder by reducing the reactions of triggers and angry outbursts. Therefore, psychotherapy is often combined with medicines to ensure a high-quality treatment. Generally, doctors use the following groups of medicines for such patients.

• Antidepressants
• Anticonvulsants
• Antipsychotics
• Mood regulators
• Antianxiety medications

A selective serotonin reuptake inhibitor, or SSRI, is the most commonly prescribed medicine for this health condition. Fluoxetine is a medicine that can help patients suffering from intermittent explosive disorder and is widely prescribed for this disorder. Other similar medicines include lithium, oxcarbazepine, phenytoin, and carbamazepine.

3. Lifestyle Changes

You can also consider an alternative line of treatment with significant lifestyle changes. These can help you handle the situation. Some of these are as follows.

• Maintain a balanced diet with proper protein and nutrients.
• Get good sleep at night.
• Avoid alcohol and drug consumption.
• Stay physically active with daily exercising.
• Maintain work-life balance and participate in relaxing activities.
• Reduce work stress.

If you suffer from intermittent explosive disorder, you will notice the symptoms discussed above. However, if you notice sudden changes in your behaviour, causing physical harm to people, animals or properties, you must consider visiting your physician.

Moreover, you should also visit the doctor if you experience suicidal thoughts or tendencies of self-harm. Such thoughts are usually sudden and unpredictable and might go away after some time.

Intermittent Explosive Disorder is a severe health concern which might come with other co-occurring conditions. Therefore, it will be beneficial to know about these conditions for people who are suffering from this disorder. These are listed below.

• Depression
• Anxiety issues
• Alcoholism
• Substance abuse and addiction
• Personality disorder
• Bipolar disorder

The intermittent explosive disorder is a severe health condition. It is, therefore, beneficial to try to manage and prevent this condition to avoid its additional complications. Here are some tips to help you prevent this condition.

• Maintain a Proper Treatment: The first step here is to consider a proper treatment for this disorder. Make sure to attend all your therapy sessions, take your medicines and practise all the coping skills. Moreover, if the doctor suggests maintenance medication, take them at the right time. Completing the treatment is essential to manage the symptoms.
• Develop Positive Thinking: Cognitive restructuring can be essential to develop new ways of thinking. Such sessions will help you think logically and rationally. As a result, you will be able to calm your frustrating and irritable thoughts from a disturbing trigger and thereby avoid reacting in a negative manner in certain situations.
• Practise Problem-solving Methods: Once you identify a pattern of your reactions or thoughts, you can think of some problem-solving methods. Here, you need to identify some common triggers and think about how you can divert your mind in such situations. Then, a plan to refocus your energy on something else will help you manage these episodes.
• Indulge in Relaxation Techniques: The episodes of anger and frustration can take a toll on both your mental and physical health. Relaxing techniques can be helpful here. These include meditation, deep breathing, relaxing imagery, yoga, music therapy, etc. These techniques will calm your nerves and help you cope with a situation.
• Change Your Environment: A complex environment is mainly responsible for causing and complicating IED symptoms. Therefore, if you notice that your living environment is unhealthy, with abusive practices, try to change living in it. Moreover, if you notice fights and conflicts in your surroundings, move away from such a situation.
• Take Communication Lessons: People from IED are often misunderstood as they fail to communicate properly. Taking communication lessons can be beneficial here. These will help you comprehend a message coming from someone, think about it and then respond rather than saying the first thing that pops into your head.

Thus, the intermittent explosive disorder is a severe health concern. It causes anger episodes that can be harmful to both the patient and his/her surroundings. Therefore, it is essential to consider following a strict treatment procedure. You can also consider the tips mentioned in this article for managing and preventing its symptoms.