Signs & Symptoms of Intermittent Explosive Disorder

Intermittent explosive disorder (IED) is a type of impulse-control disorder that is typically characterized by unwarranted acts of physical and/or verbal aggression.

Understanding IED

Learn More About Intermittent Explosive Disorder

In order to receive an accurate diagnosis of intermittent explosive disorder, the physical and verbal outbursts that an individual displays must occur at least twice weekly for a minimum of three months, must not premeditated, must impair his or her ability to function appropriately, and typically will result in the physical damage of property or the physical and/or emotional damage of another person.

People with IED have been cited as saying that they experience feelings of aggression that continue to build up inside of them with increasing tension, causing them to act out in a fit of rage. However, once the tension has been released through the act of aggression these individuals often experience feelings of embarrassment and remorse.


Statistics of IED

According to the American Psychiatric Association, intermittent explosive disorder is said to have a one-year prevalence of 2.7% in the United States. Additionally, research has shown that IED is most prominent amongst individuals younger than 35 and much less prevalent in individuals over the age of 50. Furthermore, it is believed that 82% of individuals who have intermittent explosive disorder are also suffering from another type of mental illness. In regards to adolescents in particular, approximately one in 12 are said to suffer from IED.

Causes and Risks

Causes and Risk Factors of Intermittent Explosive Disorder

Experts in the field have concluded that the development of intermittent explosive disorder is a combination of physical, environmental, and genetic factors that contribute to its onset, as described in the following:

Genetic: The various components that are symptomatic of IED are hypothesized as being characteristic of traits that are passed down to children from their parents. As a result, it is believed that people who have a first-degree relative, mainly a biological parent, who struggles with IED are at a greater risk of developing the disorder themselves. However, there has yet to be a specific gene identified as having a prominent impact on its onset.

Physical: The areas of the brain that are responsible for regulating arousal and inhibition are believed to be comprised of abnormalities in individuals who have intermittent explosive disorder. Such abnormalities may also exist in the areas of the brain that control muscular activity through an imbalance of serotonin, which is one of the neurotransmitters responsible for sending chemical messages throughout the brain.

Environmental: Some experts in the field believe that the environment in which a person spends a significant amount of time can play a role in the onset of IED. One hypothesis is that individuals who grow up in homes where they witness a lot of anger and aggression from authority figures are more likely to respond in a similar manner when presented with a negative situation. Another noted hypothesis is that children who are made subject to extremely harsh punishments feel a sense of revenge or redemption when they are able to inflict the same type of emotional or physical pain on another person or object.

Risk Factors:

  • Being male
  • Being exposed to excessive anger, aggression, and violence at an early age
  • Living in a tumultuous environment
  • Exposure to excessively high levels of stress
  • Family history of mental illness
  • Personal history of mental illness
  • Personal history of experiencing trauma
  • Presence of certain medical conditions

Signs and Symptoms

Signs and Symptoms of IED

The ways in which symptoms of IED will present themselves will vary from person to person depending on the individual’s age, the environment in which the individual is surrounded, and the access that the individual has to a healthy support system, among others. The following are symptoms that a child, adolescent, or adult who has intermittent explosive disorder may exhibit:

Behavioral symptoms:

  • Deliberate destruction of property
  • Impulsive physical aggressiveness towards people, animals, and/or objects
  • Impulsive verbal aggressiveness
  • Excessive road rage

Physical symptoms:

  • Muscle tension
  • Tightness of the chest
  • Heart palpitations
  • Chronic headaches
  • Hearing echoes
  • Feeling strong pressure within one’s head (as though his or her mind is “exploding”)
  • Tingling sensations
  • Tremors

Cognitive symptoms:

  • Inability to tolerate any type of frustration, whether it be mild or severe
  • Racing thoughts
  • Inability to focus
  • Experiencing the sensation of not being in control of one’s own mind

Psychosocial symptoms:

  • Rage
  • Shame
  • Guilt
  • Sadness (typically following an explosive outburst)
  • Excessive and uncontrollable irritability
  • Periods of emotional detachment
  • Low self-worth


Effects of Intermittent Explosive Disorder

The long-term effects of untreated IED can have a strongly adverse impact on an individual’s life. Examples of such effects may include:

  • Social isolation
  • Impaired / destroyed interpersonal relationships
  • Academic failure
  • Unemployment
  • Failing health
  • Deteriorated self-esteem
  • Impaired daily functioning
  • Interaction with the legal system
  • Self-injury
  • Suicidal thoughts and behaviors

Co-Occurring Disorders

IED & Co-Occurring Disorders

A diagnosis of intermittent explosive disorder is commonly made in addition to the following mental illnesses when the impulsive and aggressive outbursts are in excess to what are typically symptomatic of the other disorders themselves:

  • Attention-deficit/hyperactivity disorder
  • Oppositional defiant disorder
  • Conduct disorder
  • Autism spectrum disorder

Additional mental illnesses that have been known to co-occur with IED include:

  • Bipolar disorder
  • Anxiety disorders
  • Depressive disorders
  • Posttraumatic stress disorder

Don’t let anything stand in the way of getting your health back. The start of my treatment for intermittent explosive disorder was incredibly difficult to overcome but it does get better!

– Suzie D.