Many people mistakenly believe that only a select few people are ever affected by mental health issues. Many different types of psychosocial stress can contribute to or even directly cause psychiatric disorders in individuals. Some of these are widely disseminated and recognized, while others are less so. The intermittent explosive disorder is one such condition.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, classifies approximately 200 different mental disorders. Anxiety and depression are the most widely mentioned mood disorders. One of the conditions that are rarely discussed is intermittent explosive disorder.
Having a mental illness can take a toll on your mental and emotional health, as well as that of your loved ones. It’s possible that you feel worse because you don’t know anything about the condition. Learn more about the intermittent explosive disorder and how you can learn to control your aggressive thoughts and actions by reading this piece.
Epilepsy with Irregular and Sudden Attacks
Repeated, unpredictable outbursts of aggression and violence characterise intermittent explosive disorder (IED). Flying into an unjustified rage is another name for this phenomenon. The DSM-5 classifies this condition alongside “Disruptive, Impulse, and Conduct Disorders.” (Diagnostic and Statistical Manual of Mental Disorders).
An individual with an explosive disorder often acts irrationally and overreacts. Their aggressive tendencies and outbursts can harm their relationships and their standing in society, and even get them in trouble with the law.
The intermittent explosive disorder is more of a defect in impulse control, and the deliberate, fast-onset outbursts typically don’t last more than half an hour. Most people feel relieved after an outburst of anger, but they also experience feelings of guilt, regret, and embarrassment. Intermittent Explosive Disorder is considered a chronic disorder and problematic behaviour by the American Psychiatric Association. Aggressive behaviour seen in those with IEDs has been linked to the actual harm done to animals and human beings.
Impulsivity, hostility, and frequent outbursts are hallmarks of this disorder. To feel better, patients with IEDs need to “explode” with anger even in the absence of any obvious triggers. Patients frequently cited a loss of cognitive and emotional autonomy as a primary symptom. Patients with IEDs are more likely to make threats or initiate physical attacks. However, a diagnosis of IED cannot be made until at least three separate incidents of impulsive aggressive behaviour have occurred.
Intermittent Explosive Disorder: Pathophysiology
Low serotonin levels in the brain have been linked to rash behaviour and a propensity toward violence. A low level of the serotonin metabolite 5-hydroxy indole acetic acid (5-HIAA) in the cerebrospinal fluid may be an indicator of this.
Brain lesions in the amygdala and prefrontal cortex, which regulate emotional responses and impulse control, have been linked to this condition. The impairment in brain function and blood sugar regulation can hurt judgment and planning abilities.
Intermittent Explosive Disorder Symptoms
There is no buildup to the aggressive episode, and it lasts for a full half an hour. The aggressive outbursts or lulls in behaviour can last for days, weeks, or months. Between bouts of bodily impulsive hostility, most patients have fewer verbal outbursts. Aggressive outbursts often come with physical manifestations like:
- Irritability
- Rage
- Rapid-fire thinking
- Tremors
- A tingling feeling
- Palpitations
- Pain in the chest
- Shouting
Verbal and physical outbursts that are out of proportion to the situation and careless of potential repercussions include:
- Outbursts of rage
- Being contentious
- Violence against the body
- destruction of property
- Aggression in speech
- Assault
How is the Diagnosis of Intermittent Explosive Disorder Made?
Gathering the patient’s medical history and context is the first step in making a diagnosis. To accomplish this, a thorough mental and physical examination, as well as a psychiatric assessment, are performed to eliminate other potential causes of mental illness.
The doctor will first try to rule out substance abuse and/or physical problems that can cause impulsive and aggressive behaviour before making a diagnosis of the intermittent explosive disorder. In the psychological evaluation, the patient discusses their experiences in terms of symptoms, emotions, and behavioural patterns. Intense aggressive behaviours, as defined by the following criteria, must be present for a diagnosis of IED to be made.
Aggression towards other people, animals, or property, either verbal (including arguments) or physical, for three months. Even if the outbursts of behaviour don’t cause any physical harm, they can still have monetary and legal repercussions. After 12 months, there have been three separate incidents of destruction of property or physical assault against animals or other people.
The level of aggression displayed during the outbursts should be extremely out of proportion to the circumstances and should not have been prepared in advance. Furthermore, the aforementioned outbursts should not be attributable to substance use disorders or other mental health conditions.
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However, the hostility is restricted to the manic or depressive phases. With intermittent explosive disorder, periods of aggression are interspersed with times of calm or happiness.
According to the DSM-5, the intermittent explosive disorder is not a matter of character flaw but rather of brain dysfunction. Many people think this erratic conduct is merely a matter of changing one’s perspective. Individuals with impulse control disorders, like IED, pose a risk to themselves and others. It may lead to difficulties in social interactions, in the workplace, and other areas of mental health. The episode’s level of aggression is extremely out of proportion to the psychosocial stressors that triggered it. The DSM criteria for IED are used in conjunction with the psychiatric assessment to establish a diagnosis.
The criteria for diagnosis of intermittent explosive disorder were well-defined in the DSM-IV-TR. A proper evaluation necessitates:
- Several incidents of violent behaviour were carried out on the spur of the moment and caused significant harm to other people.
- The degree of aggression is completely out of proportion to the circumstances and unprovoked.
- No other mental disorders or medical problems can be blamed for the violent outbursts.
Intermittent Explosive Disorder: Possible Triggers and Contributing Factors
In some cases, the symptoms of intermittent explosive disorder first appear in adolescence. Although the exact cause of this explosive disorder is unknown, both genetics and the surrounding environment play significant roles.
Effects of Heredity
There may be a genetic component to the intermittent explosive disorder, just as there is with other mental conditions and illnesses. This is a condition that can be passed down through families. It has been established that the offspring of parents with a history of IED are more likely to develop impulse aggression themselves.
The Role of the Environment
Some individuals who suffer from intermittent explosive disorder were raised in homes where violent outbursts and angry words were regular occurrences. These children are more likely to continue to display these characteristics as adults because they experienced similar traumas as children.
Natural Variables
Brain function, chemical makeup, and structural differences distinguish those with the sporadic explosive disorder from the general population. These variations led researchers to conclude that the abnormalities in the region of the brain that processes external stimuli, motor function, and elicits anger responses explain why patients with intermittent explosive disorder behave and process information in the way that they do. Some people may develop the intermittent explosive disorder after experiencing emotional difficulties. To name a few examples:
Substance Abuse and Alcoholism as Problems
As the severity of impulsive aggression rises, so does the frequency and quantity of substance use among those with Intermittent Explosive Disorder, with the risk being multiplied by a factor of five.
Self Harm
Evidence of self-harm is common among people diagnosed with the intermittent explosive disorder, which is characterised by recurrent acts of impulsive aggression. Some stem from the shame and fear that follows an outburst.
Damaged Connections with Others
Those who suffer from the intermittent explosive disorder are more likely to experience episodes of physical aggression, leading to the impression that they are perpetually hostile. They engage in destructive behaviours such as verbal and physical abuse, which can have lasting effects on families and relationships.
Multiple Stress Disorder
Aggression towards others and extreme outbursts are strongly linked to post-traumatic stress disorder. Patients with the intermittent explosive disorder exhibit impulsive aggressive behavior, which can be used as a warning sign for those who may attempt suicide.
Negative effects on health and daily functioning are possible for those with the intermittent explosive disorder. Marriages and other close relationships are especially vulnerable to this issue. Judgment in the classroom and on the job may also suffer as a result.
The intermittent explosive disorder is a risk factor for the development of other severe psychiatric illnesses as well as drug and alcohol abuse. Other medical conditions, such as chronic pain, high blood pressure, stroke, and diabetes, also put them in danger. The most vulnerable populations are:
- Gender: Male
- The effects of early exposure to violence on children
- Home environments characterised by hostility and erratic behaviour Multiple traumatic event survivors
- Those who have suffered psychological shock
- People with a substance abuse history
- Ailment or disease
How to Curb the Urge to Explode
In most cases, patients with intermittent explosive disorder need the assistance of a mental health professional to take preventative measures against their symptoms. Gaining mastery over one’s symptoms may be medically feasible when combined with therapy, medication, and coping strategies. Here are some steps you can take to lessen the likelihood that your child will develop IED:
Stick to the Plan
Treatment for the intermittent explosive disorder can be a joyous experience if the patient diligently attends therapy sessions and uses coping mechanisms as prescribed by their mental health professional. The doctor may advise continuing medication to lessen the frequency of bouts of rage.
Learning How to Unwind and Recuperate
Calming practises like yoga and meditation can be useful for managing explosive anger. Stress, which can be a trigger for IED, is also mitigated through these physical activities. When you’re not under pressure, you let things happen. The answer to finding inner calm and releasing pent-up rage may lie in the practices of yoga and meditation. Being in tune with your inner self can help when you feel like you’ve lost command of your feelings.
Changing One’s Way of Thinking
Improve your optimistic thought processes as much as possible. If you’re having trouble seeing the sunny side of things, cognitive behavioural therapy can help. A trained therapist will work with you to replace negative thinking with constructive alternatives. One’s reaction to any event can be enhanced by altering one’s perspective on the circumstance in light of more reasonable expectations and more rational thoughts.
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Do your best to hear what the other individual is saying. Instead of reacting aggressively, try to grasp what the other person is saying. Instead of responding with the first thing that comes to mind, attempt to come up with something more positive and reasonable. The act of listening to itself can be calming to the individual being listened to. Putting in the effort to listen can buy you some much-needed mental space to consider the circumstance objectively.
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Immediately Leave That Place
If you can, remove yourself from or avoid settings that may bring on an angry outburst. Getting some physical distance from the aggravating circumstance can help you gain perspective. Get out and do some things, like errands or walking, to help you relax. Take some time to reflect on the situation and calm down.
Stay Away From Substances That Can Alter Your Moods, Such as Alcohol and Drugs
You should avoid anything that can affect your mood, as this could set off your explosive disorder. The use of these drugs can amplify negative emotions. It’s best to avoid them, particularly in situations where a conflict could arise.
Intermittent Explosive Disorder and Its Treatment
If treated promptly and appropriately, the intermittent explosive disorder can be healed. Medication and CBT, including relaxation therapy, cognitive restructuring, and coping skills instruction, are the most effective treatments.
Typical Psychiatric Medication Treatments
The most widely prescribed medication for treating the intermittent explosive disorder is fluoxetine. If you’re looking for alternatives to fluoxetine, you can try phenytoin, carbamazepine, or oxcarbazepine. Mood disorders like depression and anxiety can also be treated with drugs from these categories.
Collective Healing
In addition to the benefits of cognitive behavioural therapy (CBT), group therapy can be useful and effective in reducing anger episodes by teaching participants how to interact with others and how to observe the behaviour of others.
Explosive Disorder Patients’ Outlook
Depression and anxiety are common among people with the intermittent explosive disorder. It can also lead to issues in one’s own life and one’s relationships. If you or a loved one is experiencing symptoms of this condition, it is crucial to seek medical attention from mental health care professionals. This condition is highly controllable with the help of medication and cognitive behavioural therapy. The intermittent explosive disorder can last anywhere from 12 years to a lifetime, but it can be treated.
When people with IEDs finally let out all their pent-up anger, they often report a sense of relief and calm. After the initial wave of relief subsides, regret sets in. The proper people and treatment plans, along with education, anger management, and medications, can help ease the disruptive effects of IEDs.
