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7 signs of Intermittent Explosive Disorder

When Christopher was 16 years old, he got into a verbal argument with his older brother in their grandmother’s kitchen, resulting in his chasing his sibling with a skillet in one hand and knife in another. When he was 22, he drove his car into the garage door after a breakup with a casual girlfriend. At 39, his family confronted him about all the money and items he thought they weren’t aware that he’d been stealing from them, causing him to fly into a rage and threatening their lives.


“I’ve been in and out of trouble since I was a kid, but everyone including me just kind of thought I was a hothead, or you know, just a bad person,” says Christopher, now 48. He estimates that he finally sought psychiatric help a year and a half after his family turned their backs on him.


“Something in me just thought, ‘There’s no way this is normal,’” muses Christopher. “I guess when I realized I’d behaved so badly over, really, my entire life… so bad to the point my family decided they wanted nothing to do with me anymore, I went for help.”


Jenna, 10, is described by her mother Karen as having a “Jekyll and Hyde kind of a personality.


“She can be an incredibly sweet, loving, affectionate girl. I’ve seen it,” says Karen. “But I’ve also seen this very frightening, horrific side to her that I don’t recognize. It’s like she turns into someone else.” Jenna, who splits her time between her parents’ homes, has exhibited violent behavior with Karen when something doesn’t go her way, or if she doesn’t get what she wants. Karen has had to call authorities for assistance more than once.


But Jenna’s father, Rick, nor the school Jenna attends have ever witnessed or reported such extreme behavior. They agree she sometimes becomes upset or angry, but with no more force or intensity than other kids in the classroom or around the neighborhood.


Christopher and Jenna, both under the care of mental health professionals, have been diagnosed with intermittent explosive disorder.


While angry behavior could be attributed to various types of anger disorders, intermittent explosive disorder is explicit and defined. Intermittent explosive disorder, a chronic disorder known to begin in childhood, and which can continue to adulthood, is characterized by sudden and repeated episodes of violent, aggressive behavior and/or hostile verbal outbursts. These reactions – which can involve hurting others or throwing objects -- are typically not in proportion to the situation. The symptoms of the disorder may decrease over time and with age, but likely will not go away unless treated with medication and professional therapy.


How do you know if you or a loved one has intermittent explosive disorder? What causes anger issues? Is there such a thing as an anger disorder test?


Furthermore, can anything be done?


Here, seven telltale signs that you may have intermittent explosive disorder.


1. Low tolerance for frustration. If the ability to handle and overcome stressful events and thoughts is considered frustration tolerance, having a low threshold of frustration tolerance means you may not react well at all to those stressful events. You feel as though your needs haven’t been met, and therefore need to release a burst of anger to find relief from the frustration.


Low tolerance for frustration is common in adults and children, and may even present the same way.


If you find yourself very irritable, and also have ADHD, there are ways to cope with your feelings.


“When Jenna’s playing a video game and she loses a round, she can get really angry,” says Karen. “She’s thrown her tablet across the room and actually broken it, which gets her even more riled up. Then it’s at least 20 minutes of screaming, crying, and losing it, which is usually followed by some deep, remorseful sobbing.”


Christopher understands this behavior, and says he’s embarrassed to admit he’s not much different from a 10-year-old in some cases. “I get it,” he says. “Hey, I’ve even lost it in a therapy session – my therapist asked me a question that I guess triggered something in me. I completely ignored the fact he was there to help me and just saw him as an enemy.


“I’ve been taught in recent years that that kind of immediate reaction is my body trying to avoid any kind of discomfort, which to a person without IED would probably be like, ‘Well, that sounds counterintuitive,’” adds Christopher with a small laugh. “But when you have a low tolerance for things that frustrate you, it happens. You react.”


Experts suggest learning mindfulness exercises to increase frustration tolerance. Consider deep breathing exercises, or waiting for five minutes before reacting. You may also try forcing yourself to think about a different perspective and challenging yourself to think about whether you’re reacting rationally or irrationally. You may be relieved and empowered to know that how you react to your frustration is actually within your control.


2. Intense anger. Intermittent explosive disorder might be a diagnosis in your future if you exhibit signs of intense anger.


Before we go further, it’s important to first understand anger. The truth is, everyone experiences anger, and at varying levels and degrees. You can feel minimally annoyed at having to wait in a grocery store lane for longer than a few minutes, or you can have a full-on verbal match with your spouse. Anger can be caused by person problems like relationships woes, by disappointment, by scary events, or by bad memories. Anger can be made worse by hormonal changes, or by early trauma that are yet to be resolved.


When it gets dangerous is when anger rises to an extreme, especially when the reaction is triggered by something relatively trivial.


Child anger symptoms can include having temper tantrums, hitting siblings, peers or parents, or having complete meltdowns in private or public spaces. Adults with anger issues may throw objects, hit other people, or cause damage to property. For kids and adults, anger is a problem if or when you feel you can’t control your anger, your thoughts are constantly negative, you threaten violence to yourself or others, or feel compelled to do dangerous, harmful things to release your anger.


“My anger just comes out of the blue,” shares Christopher. “When it hits, it’s like I can’t feel anything else – it just takes over my entire body and it’s all I can think about.


“My anger could be triggered by anything – someone could look at me wrong and I’m literally foaming at the mouth I’m so ticked.


“And that intense feeling of being that mad – it’s just the beginning.”


3. Mood changes before an outburst. The term “mood swing” is so often used in everyday language that it’s easy to minimize the severity of a true mood swing. The fact is, just because someone is happy one minute and then tears up easily at a car commercial or dog video doesn’t mean he or she qualifies as a person experiencing a mood swing. He or she may just happen to feel different emotions stronger than others.


However, some people do experience true mood swings, and they’re particularly common for those with anxiety or anger disorders. Some experts have said that mood swings are either a symptom of certain disorders, or could be a symptom of the symptoms, meaning that some symptoms of a disorder can be causing the person so much stress that mood swings end up happening.


Karen says that when Jenna was a toddler, she would frequently throw her toys out of her crib while screaming at the top of her longs. Karen’s friends, who’d had babies before her, told her it was normal. “Kids get grumpy when they’re tired,” she says she was told. “Even my mom told me, ‘That anger means something else. She’s tired or she’s hurting or she’s lonely. She doesn’t know how else to explain herself so you’ll hear her.’”


Turns out there’s a lot of truth in that. Feeling overwhelmed with other emotions you feel ill equipped to handle – like disappointment, stress or frustration – may lead you into an explosive episode. Without the tools and skills to be able to talk yourself out of what you might consider an intimidating, scary, or potentially displeasing situation, the only way you feel you can find comfort is to get angry.


“I try to recognize every negative thing I feel before it gets to anger,” says Christopher. “It sounds like a lot of work, and it is in the beginning, but it eventually becomes part of your subconscious.


“I know now that my outbursts usually happen after I’ve felt – but pushed aside – other bad feelings. I didn’t want to think about them, or probably more accurately, didn’t know how, so I got mad.”


4. Blinding rage. If intense anger is one of the earlier symptoms, blinding, uncontrollable rage is one of the later, more serious kind. This physical manifestation of angry feelings might cause you to do extreme, regrettable things, like hurting strangers, loved ones, or yourself. You may find yourself breaking objects or destroying property, all in an attempt to rid yourself of the tense feelings of anger that have welled up inside you.


While Christopher says he’s never committed anything criminal, he does recognize when his rage gets the best of him.


“My anger just comes out of the blue,” he shares. “(Before treatment), my wife and I might be having dinner and she’d say something and I’d just explode. I’d start yelling at the top of my lungs. I’ve even called her names. She just would try to stay calm and wait for the episode to end, and I’d feel so bad after.” Before therapy, Chris continues, he says it was if he was incapable of being just slightly irritated. It was as though he needed to fly into a full-blown rage just so he could rid himself of the intense feelings.


If some of these symptoms apply to you, you could have one of the five types of impulse control disorders.


5. Feeling out of control before and/or during an episode. Much like mood changes before an episode, a person with IED may recognize feeling completely out of control of his or her situation and emotions before erupting into physical or verbal violence.


Those who experience and exhibit aggressive anger are typically aware of their emotions, but just don’t fully comprehend why they’re so angry. And as mentioned earlier in this article, being unskilled or unable to handle those deeper core emotions is likely the reason for the explosive outburst. When a person with intermittent explosive disorder feels overwhelmed – or out of control – more often than not, it will lead to violent behavior.


“It’s not just emotions,” recognizes Christopher. “Anything can feel overwhelming to me – money issues, my relationship, traffic. Anything.


“When I feel like more time and energy are being required of me than I feel capable of giving, there I go – I blow up.”


Karen says young Jenna has shown the same behavior. If she’s studying for a test or getting ready for a big soccer game, and she feels frightened and ill-prepared, she becomes belligerent and loud, knocking things over or calling her mother horrible names.


If your child suffers with extreme aggression, learn some tips on how to better manage it.


“We’ve both learned to make sure to space out her responsibilities so that she doesn’t feel suffocated, or like she’s lost control of her own universe,” Karen says. She adds that when she sought assistance on how to control her aggressive child’s behavior, “our therapist suggested reminding Jenna that she has control of her reactions to her emotions – and that seems to do the trick often. She feels like at least, she’s in charge of that.”


6. Guilt. Another telltale sign that you may IED is the rush of guilt and remorse you might feel following an episode, regardless of how minute or major. It’s true that some experts blame anger disorders on heredity and neurological defects, but they’re also often due to deep-rooted childhood trauma – experiences of neglect, rejection, abandonment or abuse. These feelings are so often buried and supressed that people have a difficult time recognizing the connection between those experiences and the anger they’re experiencing now. Their violent behavior doesn’t make them bad people – it just makes them human doing bad things, because they don’t know a healthier way to cope. And because good people don’t like doing bad things, guilt after an episode becomes inevitable.


“The guilt is sometimes more unbearable than anything else,” says Christopher. “It makes you think, ‘Wow, you’re an (expletive). How could you do those things?’”


Karen says Jenna “breaks down” after an attack. “It’s almost like she collapses out of her body,” explains Karen. “She can be this vile little person, and when things de-escalate, she’s almost more shocked than I am that she did or said those things. Her remorse overwhelms her.”


7. Depression. After the rage, the racing heart, the violence and the screams comes the guilt. After the guilt comes the deep, unshakeable sadness.


Experts have reported that major depressive disorder – marked by unwavering sadness, loss of interest in everyday life and people, or suicidal ideation -- is actually a common co-occurring psychiatric disorder to IED, but it doesn’t appear in every case. What does appear for those with intermittent explosive disorder, however, is the sorrow after an attack. People who feel depressed after an episode say they have a hard time functioning or completing regular tasks, have no interest in things they usually enjoy, feel fatigued, or are unable to sleep.


“It’s like a giant wave,” says Chris. “For me it’s like this: I get irritated, I blow up, I get out of control, I lose my mind on someone I love or appreciate, and then I feel guilty. And then the guilt just doesn’t seem to lift and I get depressed. Like, ‘am I ever going to get out of this? Is this really who I am?’


“This disorder confuses you. You want to get out of it and sometimes it feels like you can’t.


“But you can. It’s not a life sentence if you get the right kind of help and the willingness to accept that help.”


If you or someone you know may have intermittent explosive disorder and you need guidance, please visitwww.hopetherapyandwellness.com

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