Intermittent Explosive Disorder Test: Symptoms & Treatment

Do you often wonder, why am I angry? Do you experience sudden outbursts of anger or aggression? You may be experiencing signs and symptoms of intermittent explosive disorder.

Intermittent explosive disorder (IED) is a mental health condition characterized by aggressive outbursts of anger. These sudden episodes can result in physical or verbal violence. This disorder can impact both children and adults.

In children, these outbursts can sometimes be described by others as temper tantrums. In adults, they can look like verbal arguments, physical fights, or property damage. These episodes can significantly impact a person’s relationships, work, and overall quality of life.

In this article, we will discuss the symptoms, causes, diagnosis, and treatment options for intermittent explosive disorder and provide resources for further support. We will also discuss if there is an actual intermittent explosive disorder test and explore how a mental health professional can accurately diagnose you.

What Is Intermittent Explosive Disorder (IED Disorder)?

According to the American Psychiatric Association^[1], intermittent explosive disorder is a mental health condition that falls under disruptive, impulse control, and conduct disorders. People with conduct disorders have difficulty with self-control, such as regulating aggressive behaviors and stopping impulses.

IED typically appears for the first time in childhood or adolescence, but symptoms can continue into adulthood. It is most common in people under the age of 40. Research suggests it predisposes individuals to depression, anxiety, and substance abuse disorders^[2].

IED is characterized by sudden and repeated episodes of explosive outbursts of anger or aggression disproportionate to the event that triggered them. Anger outbursts can result in physical or verbal aggression. They often lead to impaired interpersonal relationships, difficulty maintaining employment, and negatively impact a person’s quality of life. These outbursts may result in serious legal and financial consequences.

People with IED have a low threshold for tolerating frustration or adversity and become easily and disproportionately angered by seemingly innocent events. They are usually in a normal or good mood outside of these outbursts.

If you experience any of these symptoms yourself or observe them in a loved one, seeking help from a mental health professional as soon as possible is essential. Research has shown that early intervention can help reduce the negative impacts^[3] the disorder might have on a person’s life.

Intermittent Explosive Disorder Symptoms

The main symptoms of intermittent explosive disorder are impulsive outbursts of intense anger and aggression that are grossly out of proportion to the triggering event. Anger outbursts can occur without warning and usually include violent behavior. The person will typically experience physical and emotional symptoms as well. Symptoms may include:

• Fury, anger, rage
• Irritability
• Increased energy (adrenaline rush)
• Fast, uncontrollable thoughts
• Shaking
• Heart palpitations
• Tightness in the chest
• Tingling or numbness
• High levels of tension
• Verbal arguments
• Temper tantrums
• Physically assaulting people or animals
• Throwing, kicking, or breaking objects and slamming doors, which can result in property damage
• Domestic violence
• Road rage

Anger episodes, and the physical and emotional symptoms experienced during them, can range from mild to severe. They can result in physical health problems for the person who exhibits these behaviors and pose a risk to others. After an explosive outburst, the person might feel a sense of relief, which is usually followed by shame, remorse, and humiliation.

Research shows that certain factors put people at increased risk^[4] of developing intermittent explosive disorder. Risk factors include:

• Being male
• People between the ages of 13 and 23
• Being unemployed
• Being divorced or separated 
• Having a lower education level
• Having prior traumatic experiences

Also, people with other psychiatric disorders are at increased risk of developing IED. The conditions associated with increased risk of IED are those characterized by symptoms of problematic or impulsive behaviors, such as attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). ADHD and anger are common co-occurring disorders.

What Causes Intermittent Explosive Disorder?

Researchers are still exploring the exact causes of intermittent explosive disorder. It is most likely a combination of genetic, biological, and environmental factors contributing to this disorder. The precise combination of factors resulting in IED may vary from person to person.

• Genetic factors: Studies have shown^[5] there may be a link between specific genes and aggressive, violent, and impulsive behaviors. This genetic component means the disorder may be passed down from parents to children.
  • Biological factors: Research indicates that brain structure and function may be altered in people with IED. Brain magnetic resonance imaging (MRI) studies suggest that the disorder causes hyperactivity in the amygdala^[6], which is the part of the brain involved in emotional regulation. Additionally, research shows that the level of serotonin^[7] may be lower than normal in people with IED.

Environmental factors: Experiencing multiple traumatic events in childhood^[8] has been linked to the development of intermittent explosive disorder. Childhood is a time when a person is particularly vulnerable to negative input because the brain is still learning and growing. Children who experience traumatic events sometimes don’t learn the appropriate coping mechanisms to deal with difficult emotions such as anger, frustration, or rage.

How Is It Treated?

IED is usually treated using a combination of therapies. The most common initial treatment is psychotherapy, also known as talk therapy, which helps the person learn how to change their thoughts and behaviors. For some people, medications are necessary. Therapists usually teach relaxation techniques that can help control explosive outbursts.

Therapy

Talk therapy is the most common intermittent explosive disorder treatment. Therapy can be in a group or one-on-one. There are both in-person and online therapy programs that make accessing this type of care very easy.

Usually, a mental health professional will use a particular type of therapy known as cognitive behavioral therapy (CBT) to treat this disorder. CBT is a structured, goal-oriented therapy that helps people learn how to change their thoughts about anger and aggression. IED treatment has four pain pillars: cognitive restructuring, relaxation training, coping skills training, and relapse prevention. This format provides people with IED the necessary coping skills to manage potentially triggering situations in day-to-day life and prevents relapses.

Studies have shown that in people with IED, CBT effectively reduced aggression, anger, hostile thinking, and depressive symptoms^[9] and improved their anger control.

Medications

Medications may help control symptoms in people with IED. They are usually used in combination with talk therapy and relaxation methods. Medications are thought to work by increasing the threshold at which certain stimuli trigger an angry outburst.

The most commonly prescribed medication for IED is fluoxetine, which is a selective serotonin reuptake inhibitor. Fluoxetine works by increasing the levels of serotonin in the brain. If your symptoms do not respond to fluoxetine, there are other medications to try. This includes phenytoin, oxcarbazepine or carbamazepine, lithium, lamotrigine, topiramate, and valproate.

Relaxation Methods

Specific techniques aimed at improving relaxation can help control IED symptoms. Mental health professionals usually teach relaxation techniques such as deep breathing and progressive muscle relaxation to help minimize responses to triggering situations.

Other relaxation methods such as yoga, meditation, massage, and aromatherapy may also be beneficial.

Conclusion

Intermittent explosive disorder is a chronic disorder characterized by sudden aggressive outbursts of anger. These angry outbursts typically occur with little or no warning. IED usually causes significant distress and impacts a person’s work and relationships. There is no specific test for IED. Diagnosis is made through an examination with a mental health professional. Treatment is usually a combination of talk therapy, medications, and relaxation techniques to assist with anger management.

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