What Is Intermittent Explosive Disorder?

Intermittent explosive disorder (IED) is a mental health disorder marked by episodes of extreme, unwarranted anger. The disorder affects as many as 7.3 percent of adults, or 11.5-16 million Americans, in their lifetimes.

People with intermittent explosive disorder may attack others or destroy their possessions. Typically beginning during adolescence, the disorder is often associated with the onset of depression, anxiety and substance abuse disorders. According to a study funded by the National Institute of Mental Health (NIMH), nearly 82 percent of those with IED also had another mental health disorder, yet only 28.8 percent received treatment for their anger. The study authors suggest that treating anger at the first symptoms might prevent some of these co-occurring mental health disorders from developing.

According to the psychiatric diagnostic manual, an individual may be diagnosed with IED if they have had three episodes of impulsive aggressiveness "grossly out of proportion to any precipitating psychosocial stressor." The person must have "all of a sudden lost control and broke or smashed something worth more than a few dollars, hit or tried to hurt someone, or threatened to hit or hurt someone."

Individuals who had three of these types of episodes within one year were found to have much more severe IED, particularly if they attacked both people and property.  Intermittent explosive disorder affects nearly 4 percent of adults each year (or5.9-8.5 million Americans). Over the course of a lifetime, this translates into 43 attacks and substantial functional impairment.

One of the reasons IED is associated with depression, anxiety, and alcohol and drug abuse disorders is that individuals likely face more stressful life experiences, such as financial difficulties and divorce.

Identifying IED early in life, perhaps in school programs, and treating the mental health disorder right away might prevent some of the associated risks. Although most study participants with IED had seen a professional for emotional problems at some point in their lives, only 11.7 percent had been treated for their anger in the 12 months prior to the study.

IED affects more Americans than previously thought, but researchers believe the current figures are still conservative. For example, outbursts of anger in people with bipolar disorder, which often overlaps with IED, were excluded.


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