The Intermittent Explosive Disorder

Introduction

It is a lesser-known psychiatric disorder with unjustified rage episodes. In a person with an intermittent explosive disorder, the behavioral outbursts are commensurate with the situation. It is also characterized as “flying into a rage without reason.”

These distinct episodes of rage can take various forms-aggressive behavior, assault, or physical attacks on others. Rage must be primarily out of proportion to any provocation and are not triggered by a single stimulus or stressor or premeditated.

The person may describe the violent episodes as spells or assaults, accompanied immediately by a feeling of relief or stress in the explosive behavior. Later the person may become disturbed, sorry, unfortunate, or humiliated by the attacking behavior.

Prevalence

An intermittent explosive disorder typically occurs in early adolescence but can be seen in children younger than six. In people under the age of forty, it is most common.

Conservative figures indicate that in 2.7 percent of the general population, IED can be detected. Most patients are young men with a past that often includes repeated car accidents, violations of movement, and likely sexual impulsiveness. These patients can demonstrate extreme alcohol sensitivity.

Cause

The cause of the intermittent explosive disorder is unknown, but some contributing factors have been identified. They include:

• A genetic ingredient (occurs in families)
• Exposure in infancy to verbal and physical violence
• Brain chemistry (different serotonin levels) can contribute to the disorder
  During one or more traumatic children’s activities
• History of psychological disorders including ADHD, antisocial personality disorder, borderline personality disorders
• Almost 82% of people with the intermittent explosive disorder have experienced depression, anxiety, or drug abuse disorder

Symptoms

• Rage
• Irritableness
• A growing sense of stress
• Racing thoughts
• Increased energy intensity
• Tremors
• Palpitations
• Tightness of chest
• Temper tantrums
• Shouting
• Argumentative
• Getting into wars
• Menacing others
• Assaulting persons or livestock
• Damaging properties

What appears to look like adult temper tantrums, the intermittent explosive disorder manifests itself.

Examples of the intermittent explosive disorder are throwing things, fighting for no cause, road rage, and domestic violence. Usually, the outbursts last less than 30 minutes. A person can feel a sense of relief after an outburst, followed by guilt and embarrassment.

Diagnosis

When anyone has an intermittent explosive disorder, it can be difficult to detect since many individuals lose their temper from time to time. But an individual with intermittent explosive disorder’s actions may result in assaults or significant property damage.

If you detect a trend of attacks of anger with devastating consequences or violent responses obviously out of proportion to the situation, you should consider seeking professional assistance.

Although there is no questionnaire for the diagnosis of an intermittent explosive disorder,

if you need a clinical evaluation, answering these questions can help you decide.

• Are you having trouble managing your temper?
• Do you have occasional anger attacks?
• Do you overreact to provocations or situations?
• Did you encounter episodes of indignation during which you hit someone or damaged property?
• Have you got an alcohol or drug problem?
• Is there a history of these types of issues in your family?
• Have you sustained injuries to the head or injury?
• Have you got a history of epilepsy?
• Do you have a history of depression or anxiety disorder, or does someone in your family have one?

If you answer yes to at least two of the first four questions or have replied “yes at least five times, a mental health professional should generally consider seeking an assessment.

Treatment methods

The most successful approach is to incorporate pharmacotherapy and psychotherapy. A combination of cognitive-behavioral therapy (which consists of relaxation training, changing the ways you think [cognitive restructuring], and coping skills training) and medications can better treat the intermittent explosive disorder.

In particular, for intermittent explosive disorders, fluoxetine is the most studied drug. Phenytoin, oxcarbazepine, or carbamazepine are other medications that have been tested for the disorder or have been prescribed if fluoxetine fails.

In general, antidepressants, anticonvulsants, antianxiety, and mood regulators are among the groups of drugs that can be sought. Before the result is reached, various drugs can need to be attempted (e.g., β-adrenergic receptor antagonists, anticonvulsants [carbamazepine (Tegretol), lithium (Eskalith)]).

Serotonergic drugs such as buspirone (BuSpar), trazodone (Desyrel), and selective inhibitors of serotonin reuptake (SSRIs) (e.g., fluoxetine [Prozac]) can be helpful. Through disinhibition, benzodiazepines may exacerbate the disorder.

Other measures include

• psychotherapy,
• limit-setting behavior counseling
• Family therapy.
• If the patient is likely to be hostile towards other group members, group therapy must be used carefully.

Conclusion

A person may be predisposed to depression, fear, and substance abuse by an intermittent explosive disorder. It can also lead to severe problems of personal and connection.

For this reason, if you or a family member has intermittent explosive disorder, it is vital to seek medical attention. Studies have shown that intermittent explosive disruption is thought to be a long-term disease, lasting from 12 to 20 years of life. But the disorder can be successfully managed with cognitive therapy and medication.

Sources consulted:

Intermittent Explosive Disorder: Causes, Signs, Diagnosis & Treatments (clevelandclinic.org)

Intermittent Explosive Disorder (psychcentral.com)

Intermittent Explosive Disorder | Psychology Today

Kaplan and Sadock’s Pocket Handbook of Clinical Psychiatry

Lippincott Williams and WilkinsBenjamin J. Sadock, Virginia A. Sadock

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Learn More About- Intermittent Explosive Disorder(IED) (buddingpsychologists.org)