Intermittent Explosive Disorder

Intermittent explosive disorder is defined by episodes of explosive rage or aggression. It can result in injuries to you or others. An episode is usually triggered when you feel provoked. Once provoked, your explosive behavior is an extreme overreaction to the situation. Usually you react within minutes or hours of becoming angered, and then your explosive behavior stops automatically. After the episode, you may feel guilt, embarrassment, or remorse. Examples of explosive episodes include:

  • Vicious name calling.

  • Demeaning verbal slurs.

  • Destruction of property, such as punching holes in walls, breaking furniture, and throwing items.

  • Physical violence, such as punching, slapping, and choking.

The rage occurs in episodes. The episodes may occur in clusters. They may be separated by days, weeks, or months. Each episode usually lasts between 10 and 20 minutes. However, episodes can last for hours. Between episodes the person may show no signs of impulsive or aggressive outbursts.

Many people with this disorder report the following sensations just before or during an episode:

  • Tingling sensations.

  • Tremors.

  • Pounding heart.

  • Chest tightness.

  • Head pressure.

  • Hearing an echo.

These episodes may not always be directed at others. Sometimes these episodes result in self-inflicted injuries and suicide attempts. The greatest risk of self-inflicted injury occurs in those who are also addicted to drugs or have a serious mental disorder, such as depression.

RISK FACTORS

Risk factors of intermittent explosive disorder are listed as follows:

  • Serotonin or testosterone level imbalances in the brain.

  • Minor irregular activity in the brain.

  • Feelings of insecurity or low self esteem or anxiety.

TREATMENT

Treatment for intermittent explosive disorder usually includes a combination of counseling, group support, and medication. Some forms of counselding focus on underlying feelings, motivations, and thoughts. Other forms of counseling examine the patterns of episodes in order to recognize the beginning urges that lead to an explosive episode, identify trigers, and develop strategies to prevent episodes. Anger management support groups can help by providing an opportunity for you to discuss your experiences with others who have had similar experiences and to share management techniques. Medications prescribed for treatment include antidepressants, mood stabilizers, and anticonvulsants. Beta blockers, which are usually prescribed to slow heart rate or control blood pressure, may also help control explosive rages.