Intermittent Explosive Disorder

What is intermittent explosive disorder?

Intermittent explosive disorder (IED) is an impulse control disorder. People who have this disorder have sudden, unpredictable reactions that are violent and aggressive. Their reaction is out of proportion to what happened. They may regret the outburst afterwards. They are not violent or aggressive most of the time.

How does it occur?

As with other impulse control disorders the cause of IED is not known. The neurotransmitter serotonin (a brain chemical) may play a role in this disorder. Things that increase the risk for the disorder include having parents who:

• abused and neglected the child
• abused drugs or alcohol
• were impulsive, destructive, reckless, or violent
• were not consistent in their discipline

Violent, destructive behaviors often start in childhood. IED occurs more often in men. Women may have it as part of premenstrual syndrome (PMS).

What are the symptoms?

IED may be linked to violent behavior such as physical assault, murder, or violent suicide. People who have intermittent explosive disorder:

• are repeatedly and suddenly violent
• cannot stop or control impulsive, aggressive actions
• destroy property
• react way out of proportion to things that happen

How is it diagnosed?

Your healthcare provider or a mental health specialist will ask about your symptoms and any drug or alcohol use. You may have lab tests to rule out medical problems such as chemical imbalances. To be diagnosed with IED, the person must have the symptoms listed above and be unable to control an impulse that might be harmful to self or others.

The provider or mental health therapist will also make sure that behaviors are not caused by another mental disorder such as bipolar disorder, depression, or attention-deficit/hyperactivity disorder, or by substance abuse or a medical condition such as a head injury or Alzheimer's disease.

How is it treated?

Treatment for IED usually involves both psychotherapy and medicine.

Cognitive-behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future that are not realistic. This therapy helps you recognize unhealthy ways of thinking. You will learn new thought and behavior patterns that lead to healthier living.

You may be prescribed medicines such as antidepressants, mood stabilizers, or antipsychotic medicines.

What can I do to help myself?

Maintaining a healthy lifestyle is important. To help control intermittent explosive disorder:

• Exercise at least 20 minutes every day. For example, take a brisk walk.
• Learn which activities make you feel better and do them often.
• Talk to your family and friends.
• Eat a healthy diet.
• Avoid caffeine, alcohol, and nicotine.
• Get 7 to 9 hours of sleep per night.
• Avoid using drugs.
• Learn relaxation techniques or yoga.

When should I seek help?

If you have symptoms of violent behavior, seek help from your healthcare provider or a mental health professional. Don't wait to get help until you are arrested by the police and the court orders treatment. If you or someone you care about has intermittent explosive disorder, get help from a mental health professional early.

For more information, contact:

The National Alliance for the Mentally Ill (NAMI)
800-950-NAMI
Web site: http://www.nami.org

Mental Health America (formerly The National Mental Health Association or NMHA)
800-969-6642
Web site: http://www.NMHA.org