A diagnosis of intermittent explosive disorder, or IED, can sound scary.
If you’re the parent of a child or teenager who’s been diagnosed with IED, you may be wondering exactly what the diagnosis means for your child’s future – and for their present, for that matter.
Take a look at some of the things that you need to know about Intermittent Explosive Disorder.
IED: Getting a Diagnosis
Intermittent explosive disorder falls in the family of impulse-control disorders.
People who have IED have difficulty resisting aggressive tendencies, and they may have tirades or temper tantrums that are out of proportion to any provocation they might have experienced in the situation. This can result in verbal aggression, property damage, or even serious assaults.
Intermittent explosive disorder often begins to present in late childhood or adolescence, and it’s more commonly diagnosed in young men than young women.
IED can often co-occur with disorders like ADHD, conduct disorder, oppositional defiant disorder, bipolar disorder, and depressive disorder. IED can also mirror the symptoms of some other types of disorders.
IED is diagnosed with a psychological evaluation, using the criteria in the DSM 5.
In most cases, doctors will first recommend a physical evaluation to rule out substance abuse or other physical causes for the symptoms.
Often, the most obvious symptoms of IED are behavioral symptoms.
People who have IED may display both physical and verbal aggression and may have episodes that involve angry outbursts, damaging property, and physically attacking people, animals, or objects. People with IED may also be prone to road rage.
However, there are other symptoms that accompany IED as well. For example, people who have IED may have physical symptoms, like headaches or feelings of pressure in the head, chest tightness or heart palpitations, muscle tension, and tingling or tremors in the limbs.
They may also have cognitive and psychosocial symptoms. Some people with IED describe racing thoughts and feeling a loss of control over their thoughts.
They may have a low tolerance for frustration. They might have periods of feeling uncontrollable rage or irritability, and other periods of feeling emotionally detached.
IED: Causes and Risk Factors
There’s no one thing that causes intermittent explosive disorder, and in most cases, it’s believed to be caused by a combination of physical, environmental, and genetic factors.
While there’s no specific gene that’s been identified as causing IED, many experts believe that at least some IED-related traits are passed down genetically in families.
However, one’s environment is also thought to play an important role in developing IED. Children who have been abused or who grow up in homes where they’re subjected to strict punishments – especially harsh physical punishments – are more likely to develop IED.
Furthermore, research has shown that people with IED may have abnormalities in the areas of the brain that control inhibition and arousal. The mechanisms in the brain meant to handle serotonin may also work abnormally in people with intermittent explosive disorder.
There are certain risk factors that may lead to a greater likelihood of someone developing IED.
The most common risk factors for IED include:
- Being male,
- Experiencing physical or emotional trauma,
- Exposure to violence at an early age,
- Substance abuse, and
- Some medical conditions.
IED: Effects and Consequences
IED can have serious long-term effects on a person’s life and quality of life, so early diagnosis and treatment are important.
When people with IED get the treatment that they need in order to manage the symptoms of the disorder, they’re better able to avoid the long-term negative effects of IED.
Some of the most common effects of IED include experimentation with drugs or alcohol that can lead to addiction, difficulties getting along with others at home, work, or school, low self-esteem, and suicidal thoughts or behaviors.
These effects can lead to even more negative consequences like:
- Dysfunctional family, friend, or romantic relationships,
- Domestic or child abuse,
- Legal problems including incarceration, and
Medical conditions like ulcers, high blood pressure, heart disease, and stroke, and chronic pain may also be exacerbated by IED.
While there’s no one single treatment that works for everyone, intermittent explosive disorder is typically treated with a combination of medication and psychotherapy. Medications commonly used in the treatment of intermittent explosive disorder include antidepressants like SSRIs and anticonvulsant mood stabilizers.
In therapy, mental health professionals help people with IED learn to identify situations or behaviors that may be likely to trigger an aggressive response. By identifying triggers, people with IED can learn to remove themselves from situations before reacting or to employ coping mechanisms that prevent them from acting out in inappropriate ways.
People with IED also learn to manage their anger and exert self-control when they feel tempted to respond in violent or aggressive ways. Communication and problem-solving skills, relaxation training, and learning to mentally re-frame situations and think about them in a different way can all contribute to helping a person with IED control their aggressive impulses and avoid some of the worst effects of the disorder.
Intermittent explosive disorder is a disorder that can cause serious damage to both the person with IED and the people around them. But with treatment, people with IED can absolutely learn to prevent outbursts and limit or eliminate the damage that the disorder can cause to themselves or others.
It’s important for people who think that they might be suffering from IED, or parents of children who may suffer from IED, to seek treatment and to stick with treatment once they find a provider that they’re comfortable with and a treatment plan that works.
Without proper treatment, people who have IED will often have extreme difficulty preventing episodes of aggression or violence.
But with treatment, people with IED can lead healthy, happy lives and can form and maintain healthy relationships with others.
Dr. Nalin is a Licensed Clinical Psychologist, and Founder and Executive Director of Paradigm Treatment Centers, who has been a respected leader in the field of adolescent mental health for more than 20 years. He received his undergraduate degree from the University of Southern California, his Master’s degree from Loyola Marymount University, his Doctoral degree from Pacific University’s APA approved Clinical Psychology program, and completed his training at the University of California, San Diego’s APA approved psychology internship program.
Dr. Nalin has provided training and mentoring to students entering the field of psychology at institutions of learning including Pepperdine University’s Graduate School of Education and Psychology, UCSD, Pacific University, and Santa Monica College. He was also instrumental in the development of the treatment component of Los Angeles County’s first Juvenile Drug Court, which now serves as a national model.
Dr. Nalin has appeared as an expert on shows ranging from CBS News and Larry King, to CNN, The Today Show and MTV. He was also featured in an Anti-Drug Campaign for the Office of National Drug Control Policy (ONDCP).
Dr. Nalin is a Diplomate of the National Institute of Sports Professionals and a Certified Sports Psychologist as well as a Certified Chemical Dependency Intervention Specialist. He lectures and conducts workshops nationally on the issues of teen mental health, substance abuse prevention, and innovative adolescence treatment.
In 2017 Dr. Nalin was awarded The Sigmund Freud Foundation and Sigmund Freud University’s Distinguished Achievement Award in recognition of his work with youth in the field of mental health over the course of his career.