Signs & Symptoms of Intermittent Explosive Disorder

Oasis Behavioral Health Hospital helps individuals in Chandler, AZ diagnose and treat their mental health & addiction disorders.

Understanding Intermittent Explosive Disorder

Learn about intermittent explosive disorder

Intermittent explosive disorder is a mental health condition that is characterized by impulsivity, hostility, and recurrent aggressive outbursts. IED is a type of impulse control disorder in which those who are diagnosed are unable to resist the urge to do something harmful to themselves or others. Additionally, the violent behaviors and angry outbursts associated with this disorder are grossly out of proportion to the situation. Individuals with IED may attack others and their possessions, sometimes causing bodily harm and property damage. Aggressive consequences associated with this disorder can include road rage, domestic violence, or work place violence.

This disorder typically begins in the early teens and is diagnosed after an individual has at least three episodes of impulsive aggressiveness at any time in their life. Those with IED describe their aggressive episodes as spells in which the explosive behavior is preceded by a sense of tension or arousal and then followed by a sense of relief. After the sense of relief wears off the individual usually feels upset, remorseful, or embarrassed about their behavior. While intermittent explosive disorder can be extremely disruptive, with the proper treatment and medication you can learn how to get your anger under control and be able to react more appropriately to specific situations.


Intermittent explosive disorder statistics

According to the National Institute of Mental Health intermittent explosive disorder affects as many as 7.3% of adults, which is 11.5-16 million Americans, in their lifetimes. Of those in the United States diagnosed with IED, 67.8% had engaged in direct interpersonal aggression, 20.9% in threatened interpersonal aggression, and 11.4% in aggression against objects

Causes and Risk Factors

Causes and risk factors for intermittent explosive disorder

It is thought that the cause of intermittent explosive disorder is a combination of biological and environmental factors.

Genetic: There may a genetic component that causes intermittent explosive disorder to be passed down from parents to children.

Physical: Research findings have found that IED may be the result of abnormalities in areas of the brain that regulate behavioral arousal and inhibition. Research has indicated that there may be differences in the way serotonin, a chemical in the brain, works in those who have this disorder. Additionally, research indicates that those with IED have abnormalities on the front portion of the brain. These areas of the brain appear to be involved in information processing and controlling movement, both of which are unbalanced in individuals with this disorder.

Environmental: Some individuals believe that IED is caused by growing up in an environment where harsh punishments were carried out by parents. Additionally, children in this environment may have witnessed their parents or others close to them act out explosively or in violent manners. Observation of this type of behavior as a child makes it more likely that a person will exhibit these same traits as he or she gets older.

Risk factors:

  • Being male
  • Being in your teens or 20s
  • Psychiatric illness
  • Lower socioeconomic status
  • Having parents who abuse drugs or alcohol
  • Having an antisocial caregiver
  • Certain medical conditions
  • Traumatic brain injuries
  • History of physical abuse or neglect

Signs and Symptoms

Signs and symptoms of intermittent explosive disorder

The explosive eruptions of intermittent explosive disorder usually last less than 30 minutes and in many cases result in verbal assaults, injuries, and the deliberate destruction of property. In some instances these episodes occur in clusters separated by periods of nonaggression. When an individual is not in the middle of an explosive outburst, they may be irritable or angry. Some symptoms experienced by individuals with IED may include:

Behavioral symptoms:

  • Breaking things and causing property damage
  • Repeated acts of verbal or physical aggression
  • Being unable to stop or control impulsive, aggressive actions
  • Road rage
  • Constantly getting into fights
  • Increased energy
  • Acts of self-harm
  • Suicide attempts

Physical symptoms:

  • Feeling pressure in the head
  • Fatigue after episode
  • Tingling
  • Tremors
  • Chest tightness
  • Hearing an echo
  • Palpitations

Cognitive symptoms:

  • Racing thoughts

Psychosocial symptoms:

  • Low frustration tolerance
  • Intense anger
  • Irritability
  • Rage
  • Depressed mood
  • Guilt
  • Shame


Effects of intermittent explosive disorder

Without proper treatment adolescents and adults with IED will have a difficult time learning how to control their impulsive behaviors. Over time consequences in an individual’s life may get worse as they continue to engage in this inappropriate and sometimes dangerous behavior. Some of the long-term effects of untreated IED may include:

  • Job loss
  • School suspension or expulsion
  • Divorce or problems with relationships
  • Additional stress on the family
  • Impairment in social areas
  • Auto accidents
  • Hospitalization due to injuries from fights or accidents
  • Financial problems
  • Self-harming behaviors
  • Incarceration or other legal problems
  • Suicidal ideations or attempts

Co-Occurring Disorders

Intermittent explosive disorder and co-occurring disorders

Individuals with impulse control disorders like intermittent explosive disorder often have another mental health disorder. Some of the most common co-occurring disorder include:

  • Anxiety
  • Depression
  • Substance abuse and addiction
  • Bipolar disorder
  • Personality disorders
  • OCD
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