Symptoms, Signs & Effects of Intermittent Explosive Disorder

Learn about IED

Intermittent explosive disorder (IED) is characterized by unprovoked episodes of anger displayed by verbal or physical aggression. IED is usually diagnosed between childhood and late adolescence, and causes an individual to lose control of their emotions or to act out with extreme levels of hostility towards property, people, or animals. These explosive episodes are triggered by a sense of arousal or tension and then bring about feelings of relief. However, once the episode is over, those struggling with IED often feel pangs of guilt or remorse, despite feeling justified in their words or actions. The explosive eruptions associated with IED, usually lasting for less than 30 minutes, may occur in clusters or can be separated by weeks or months of nonaggression. In between these outbursts, an individual may be irritable, impulsive, aggressive, or angry. While this disorder is extremely disruptive, with proper medication and psychotherapy an individual can learn to control aggressive impulses and lead a happier life.

IED statistics

Research has shown that males are diagnosed with intermittent explosive disorder more often than females, with the prevalence among Americans believed to be around 2.7%. Additionally, it is estimated that 82% of those diagnosed with intermittent explosive disorder are also suffering from another mental health disorder.

Causes and risk factors for IED

The exact cause of intermittent explosive disorder is not known, however, it is likely caused by a number of environmental and biological factors. More specifically, research has found that a combination of genetic, physical, and environmental factors can contribute to an eventual diagnosis of intermittent explosive disorder. The following explanations may be a cause of IED:

Genetic: Twin studies have shown a strong genetic component in the diagnosis of intermittent explosive disorder. It is believed that individuals with a first-degree family member who has the disorder have a greater chance of developing IED themselves. 

Physical: Brain chemistry is believed to be strongly tied to the diagnosis of intermittent explosive disorder. There may be differences in the way serotonin, a chemical messenger in the brain, works in those with IED. Additionally, neurobiological research has shown that those with the disorder have abnormalities in the parts of the brain that inhibit motor activity and regulate responses to anger stimuli.

Environmental: Many believe that the environment in which a person is raised can contribute to the development of IED. Children that grow up in families where explosive behavior and verbal and physical abuse were common are at a higher risk for developing IED. By being exposed to this type of violence at an early age, it makes it more likely that they will exhibit theses same traits as they mature.

Risk Factors: 

• Family history of mental illness
• Family history of substance abuse
• Brain trauma
• Personal history of trauma
• Exposure to violence
• Being male (prevalence among men is higher than women)
• Certain medical conditions 

Signs and symptoms of IED

The combination of signs and symptoms of intermittent explosive disorder can appear very different in each individual. The main signs and symptoms of IED may include:

Behavioral symptoms: 

• Assaultive behavior towards others
• Verbal aggression
• Unprovoked outbursts of anger
• Destruction of property
• Road rage
• Self-injury 

Physical symptoms:

•  Muscle tension
• Tightness in the chest
• Heart palpitations
• Tingling sensations
• Headaches
• Hearing echoes
• Tremors

Cognitive symptoms: 

• Feeling out of control
• Racing thoughts
• Lacking the ability to focus 

Psychosocial symptoms: 

• Extreme irritability
• Rage
• Low tolerance for frustration
• Emotional detachment
• Guilt
• Shame

Effects of IED

The effects of intermittent explosive disorder can adversely affect an individual’s life if it is not properly treated. The following effects have been known to occur in those diagnosed with IED:

• Disciplinary problems in school
• Financial difficulties
• Impaired occupational or educational ability
• Loss of employment
• Academic failure
• Failed interpersonal relationships
• Isolation from friends and family
• Marital discord
• Self-injury
• Legal ramifications
• Suicidal thoughts or behaviors

IED and co-occurring disorders

People with intermittent explosive disorder often meet criteria for other disorders. The most common co-occurring mental illnesses diagnosed in those with IED may include:

• Substance use and addiction
• Antisocial personality disorder
• Borderline personality disorder
• Attention deficit/hyperactivity disorder
• Conduct disorder
• Depressive disorders
• Anxiety disorders
• Oppositional defiant disorder