Definition

What is intermittent explosive disorder?

Intermittent explosive disorder involves repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may be signs of intermittent explosive disorder.

These intermittent, explosive outbursts cause you significant distress, negatively impact your relationships, work and school, and they can have legal and financial consequences.

Intermittent explosive disorder is a chronic disorder that can continue for years, although the severity of outbursts may decrease with age. Treatment involves medications and psychotherapy to help you control your aggressive impulses.

How common is intermittent explosive disorder?

The disorder is probably more common than realized and may be an important cause of violent behavior. Some studies have found that intermittent explosive disorder is more common in men. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of intermittent explosive disorder?

Explosive eruptions occur suddenly, with little or no warning, and usually last less than 30 minutes. These episodes may occur frequently or be separated by weeks or months of nonaggression. Less severe verbal outbursts may occur in between episodes of physical aggression. You may be irritable, impulsive, aggressive or chronically angry most of the time.

Aggressive episodes may be preceded or accompanied by:

  • Rage
  • Irritability
  • Increased energy
  • Racing thoughts
  • Tingling
  • Tremors
  • Palpitations
  • Chest tightness

The explosive verbal and behavioral outbursts are out of proportion to the situation, with no thought to consequences, and can include:

  • Temper tantrums
  • Tirades
  • Heated arguments
  • Shouting
  • Slapping, shoving or pushing
  • Physical fights
  • Property damage
  • Threatening or assaulting people or animals

You may feel a sense of relief and tiredness after the episode. Later, you may feel remorse, regret or embarrassment.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes intermittent explosive disorder?

The exact cause of intermittent explosive disorder is unknown, but it’s probably caused by a number of environmental and biological factors. The disorder typically begins in childhood — after the age of 6 years — or during adolescence and is more common in people under the age of 40.

  • Most people with this disorder grew up in families where explosive behavior and verbal and physical abuse were common. Being exposed to this type of violence at an early age makes it more likely these children will exhibit these same traits as they mature.
  • There may be a genetic component, causing the disorder to be passed down from parents to children.
  • Brain chemistry. There may be differences in the way serotonin, an important chemical messenger in the brain, works in people with intermittent explosive disorder.

Risk factors

What increases my risk for intermittent explosive disorder?

There are many risk factors for intermittent explosive disorder, such as:

  • History of physical abuse. People who were abused as children or experienced multiple traumatic events have an increased risk of intermittent explosive disorder.
  • History of other mental health disorders. People who have antisocial personality disorder, borderline personality disorder or other disorders that include disruptive behaviors, such as attention-deficit/hyperactivity disorder (ADHD), have an increased risk of also having intermittent explosive disorder.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is intermittent explosive disorder diagnosed?

To determine a diagnosis of intermittent explosive disorder and eliminate other physical conditions or mental health disorders that may be causing your symptoms, expect your doctor to do a:

  • Physical exam. Your doctor will try to rule out physical problems or substance use that could cause your symptoms. Your exam may include lab tests.
  • Psychological evaluation. Your doctor or mental health provider will talk to you about your symptoms, thoughts, feelings and behavior patterns.
  • DSM-5. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is often used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

How is intermittent explosive disorder treated?

Treatment could involve medication or therapy, including behavioral modification, and a combination of both offers the best prognosis. Group counseling and anger management sessions can also be helpful. Relaxation techniques have been found to be useful in neutralizing anger.

Studies suggest that patients with intermittent explosive disorder respond to treatment with antidepressants, anti-anxiety agents in the benzodiazepine family, anticonvulsants, and mood stabilizers.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage intermittent explosive disorder?

Controlling your anger

Part of your treatment may include:

  • Unlearning problem behavior. Coping well with anger is a learned behavior. Practice the techniques you learn in therapy to help you recognize what pushes your buttons and how to respond in ways that work for you instead of against you.
  • Developing a plan. Work with your doctor to develop a plan of action for when you feel yourself getting angry. For example, if you think you might lose control, try to remove yourself from that situation. Go for a walk or call a trusted friend to try to calm down.
  • Avoiding alcohol and other recreational substance use. These substances can increase aggressiveness and the risk of explosive outbursts.

If your loved one won’t get help

Unfortunately, many people with intermittent explosive disorder don’t seek treatment. If you’re involved in a relationship with someone who has intermittent explosive disorder, take steps to protect yourself and your children. The abuse isn’t your fault. No one deserves to be abused.

Create an escape plan to stay safe from domestic violence

If you see that a situation is getting worse, and suspect your loved one may be on the verge of an explosive episode, try to safely remove yourself and your children from the scene. However, leaving someone with an explosive temper can be dangerous.

Consider taking these steps before an emergency arises:

  • Call a domestic violence hot line or a women’s shelter for advice, either when the abuser isn’t home or from a friend’s house.
  • Keep all firearms locked away or hidden. Don’t give the abuser the key or combination to the lock.
  • Pack an emergency bag that includes items you’ll need when you leave, such as extra clothes, keys, personal papers, medications and money. Hide it or leave the bag with a trusted friend or neighbor.
  • Tell a trusted neighbor or friend about the violence so that he or she can call for help if concerned.
  • Know where you’ll go and how you’ll get there if you feel threatened, even if it means you have to leave in the middle of the night. You may want to practice getting out of your home safely.
  • Come up with a code word or visual signal that means you need the police and share it with friends, family and your children.

Get help to protect yourself from domestic violence

These resources can help:

  • In an emergency, call your local emergency number or your local law enforcement agency.
  • Your doctor or the emergency room. If you’re injured, doctors and nurses can treat and document your injuries and let you know what local resources can help keep you safe.
  • A local women’s shelter or crisis center. Shelters and crisis centers generally provide 24-hour emergency shelter, as well as advice on legal matters and advocacy and support services.
  • A counseling or mental health center. Many communities offer counseling and support groups for people in abusive relationships.
  • A local court. Your local court can help you get a restraining order that legally orders the abuser to stay away from you or face arrest. Local advocates may be available to help guide you through the process. You can also file assault or other charges when appropriate.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 20, 2017 | Last Modified: November 20, 2017

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