Intermittent explosive disorder is characterized by sudden, impulsive, and aggressive outbursts or angry verbal expressions that are grossly out of proportion to the situation. These explosive episodes can involve road rage, domestic abuse, throwing or breaking objects, and temper tantrums.
These aggressive outbursts can cause significant distress, negatively impact relationships, work, and school, and may have legal and financial consequences. Intermittent explosive disorder is a chronic condition that can last for years, although the severity of outbursts may decrease with age.
Treatment for intermittent explosive disorder typically involves a combination of medications and psychotherapy to help individuals control their aggressive impulses.
Explosive eruptions occur suddenly, lasting less than 30 minutes, with little or no warning. They may occur frequently or be separated by weeks or months of nonaggression. Verbal outbursts may occur between episodes of physical aggression. Individuals with intermittent explosive disorder may be irritable, impulsive, aggressive, or chronically angry most of the time.
Aggressive episodes may be accompanied by symptoms such as rage, irritability, increased energy, racing thoughts, tingling, tremors, palpitations, and chest tightness.
These outbursts are out of proportion to the situation and can include temper tantrums, tirades, heated arguments, shouting, slapping, shoving, physical fights, property damage, and threatening or assaulting people or animals. After the episode, individuals may experience feelings of relief, tiredness, remorse, regret, or embarrassment.
The exact cause of intermittent explosive disorder is unknown, but it’s likely caused by a combination of environmental and biological factors. Factors such as growing up in families with explosive behavior and experiencing physical abuse at an early age may contribute to the development of the disorder.
Genetics and differences in how the brain functions may also play a role in the development of intermittent explosive disorder.
Intermittent explosive disorder can lead to various complications, including impaired interpersonal relationships due to frequent verbal fights or physical abuse. It may also result in problems at work, home, or school, mood disorders, substance use problems, physical health issues, and self-harm or suicide attempts.
Preventing intermittent explosive disorder may involve seeking treatment from a professional, including psychotherapy and medications. Other prevention strategies include practicing relaxation techniques, cognitive restructuring, problem-solving, improving communication, changing the environment, and avoiding mood-altering substances.
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To determine a diagnosis of intermittent explosive disorder and rule out other physical conditions or mental health disorders, your doctor will likely perform a physical exam and may include lab tests to rule out physical problems or substance use that could be contributing to your symptoms.
Your doctor or mental health professional will also conduct a psychological evaluation, where they will talk to you about your symptoms, thoughts, feelings, and behavior patterns.
The criteria in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) are often used to diagnose intermittent explosive disorder.
Treatment for intermittent explosive disorder typically includes a combination of talk therapy (psychotherapy) and medication.
Individual or group therapy sessions can be helpful in building skills to manage anger and control inappropriate responses. Cognitive behavioral therapy is a commonly used type of therapy for intermittent explosive disorder, focusing on identifying triggers and managing anger through relaxation training, cognitive restructuring, and communication and problem-solving skills.
Medications such as selective serotonin reuptake inhibitors (SSRIs), anticonvulsant mood stabilizers, or other drugs may be used to treat intermittent explosive disorder.
Part of your treatment may involve unlearning problem behavior, developing a plan to manage anger, improving self-care, and avoiding mood-altering substances.
If you’re in a relationship with someone who has intermittent explosive disorder and they won’t seek help, it’s important to take steps to protect yourself and your children. Create an escape plan and know where to seek help in case of emergency.
If you’re concerned about repeated emotional outbursts, make an appointment with a mental health professional who specializes in treating emotional disorders. Prepare for your appointment by listing your symptoms, personal information, medications, and questions for the doctor.
During the appointment, the doctor is likely to ask about the frequency and triggers of your outbursts, any history of injury or verbal abuse, and the impact of the outbursts on your family or work life.