Intermittent explosive disorder - Symptoms and causes (2024)

Overview

Intermittent explosive disorder involves repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may be signs of intermittent explosive disorder.

These intermittent, explosive outbursts cause you significant distress, negatively impact your relationships, work and school, and they can have legal and financial consequences.

Intermittent explosive disorder is a chronic disorder that can continue for years, although the severity of outbursts may decrease with age. Treatment involves medications and psychotherapy to help you control your aggressive impulses.

Symptoms

Explosive eruptions occur suddenly, with little or no warning, and usually last less than 30 minutes. These episodes may occur frequently or be separated by weeks or months of nonaggression. Less severe verbal outbursts may occur in between episodes of physical aggression. You may be irritable, impulsive, aggressive or chronically angry most of the time.

Aggressive episodes may be preceded or accompanied by:

• Rage
• Irritability
• Increased energy
• Racing thoughts
• Tingling
• Tremors
• Palpitations
• Chest tightness

The explosive verbal and behavioral outbursts are out of proportion to the situation, with no thought to consequences, and can include:

• Temper tantrums
• Tirades
• Heated arguments
• Shouting
• Slapping, shoving or pushing
• Physical fights
• Property damage
• Threatening or assaulting people or animals

You may feel a sense of relief and tiredness after the episode. Later, you may feel remorse, regret or embarrassment.

When to see a doctor

If you recognize your own behavior in the description of intermittent explosive disorder, talk with your doctor about treatment options or ask for a referral to a mental health professional.

Causes

Intermittent explosive disorder can begin in childhood — after the age of 6 years — or during the teenage years. It's more common in younger adults than in older adults. The exact cause of the disorder is unknown, but it's probably caused by a number of environmental and biological factors.

• Environment. Most people with this disorder grew up in families where explosive behavior and verbal and physical abuse were common. Being exposed to this type of violence at an early age makes it more likely these children will exhibit these same traits as they mature.
• Genetics. There may be a genetic component, causing the disorder to be passed down from parents to children.
• Differences in how the brain works. There may be differences in the structure, function and chemistry of the brain in people with intermittent explosive disorder compared to people who don't have the disorder.

Risk factors

These factors increase your risk of developing intermittent explosive disorder:

• History of physical abuse. People who were abused as children or experienced multiple traumatic events have an increased risk of intermittent explosive disorder.
• History of other mental health disorders. People who have antisocial personality disorder, borderline personality disorder or other disorders that include disruptive behaviors, such as attention-deficit/hyperactivity disorder (ADHD), have an increased risk of also having intermittent explosive disorder.

Complications

People with intermittent explosive disorder have an increased risk of:

• Impaired interpersonal relationships. They're often perceived by others as always being angry. They may have frequent verbal fights or there can be physical abuse. These actions can lead to relationship problems, divorce and family stress.
• Trouble at work, home or school. Other complications of intermittent explosive disorder may include job loss, school suspension, car accidents, financial problems or trouble with the law.
• Problems with mood. Mood disorders such as depression and anxiety often occur with intermittent explosive disorder.
• Problems with alcohol and other substance use. Problems with drugs or alcohol often occur along with intermittent explosive disorder.
• Physical health problems. Medical conditions are more common and can include, for example, high blood pressure, diabetes, heart disease and stroke, ulcers, and chronic pain.
• Self-harm. Intentional injuries or suicide attempts sometimes occur.

Prevention

If you have intermittent explosive disorder, prevention is likely beyond your control unless you get treatment from a professional. Combined with or as part of treatment, these suggestions may help you prevent some incidents from getting out of control:

• Stick with your treatment. Attend your therapy sessions, practice your coping skills, and if your doctor has prescribed medication, be sure to take it. Your doctor may suggest maintenance medication to avoid recurrence of explosive episodes.
• Practice relaxation techniques. Regular use of deep breathing, relaxing imagery or yoga may help you stay calm.
• Develop new ways of thinking (cognitive restructuring). Changing the way you think about a frustrating situation by using rational thoughts, reasonable expectations and logic may improve how you view and react to an event.
• Use problem-solving. Make a plan to find a way to solve a frustrating problem. Even if you can't fix the problem right away, having a plan can refocus your energy.
• Learn ways to improve your communication. Listen to the message the other person is trying to share, and then think about your best response rather than saying the first thing that pops into your head.
• Change your environment. When possible, leave or avoid situations that upset you. Also, scheduling personal time may enable you to better handle an upcoming stressful or frustrating situation.
• Avoid mood-altering substances. Don't use alcohol or recreational or illegal drugs.

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Intermittent explosive disorder