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All About Intermittent Explosive Disorder (IED): Serious Mental Health Disorder Found In Adolescents

Intermittent explosive disorder or IED is a persistent, highly prevalent and seriously impairing mental health disorder in adolescents that is both undiagnosed and understudied. The mean age for the onset of IED is 12 years.

According to definitions in the DSM-5, IED is characterised by repeated and sudden episodes of aggressive and destructive behaviours that may involve physical or verbal injury to objects, self or others, destroying properties, threatening others or other antisocial behaviours.

A study has shown that around 63.3 per cent or two-thirds of adolescents reported lifetime anger attacks that involve the aforementioned behaviours, and out of them, around 7.8 per cent met the criteria for diagnosis of IED. [1]

Causes Of Intermittent Explosive Disorder

The exact cause for the development of intermittent explosive disorder is unknown, however, experts point out many environmental and biological factors for the occurrence of the condition. They may include:

  • Childhood physical or emotional trauma. [2]
  • Reduction in serotonin secretion or its functions.
  • Growing up in families in which physical and verbal abuse is common.
  • Having aggressive or violent nature in parents can be passed from parents to children.
  • Traumatic brain injury.
  • Other similar pre-existing mental health conditions like impulse control disorders or attention-deficit/hyperactivity disorder (ADHD). [3]
  • In some cases, substance abuse or alcoholism.
  • Gray matter dysfunction or deficit in the brain. [4]

Symptoms Of Intermittent Explosive Disorder

Some of the symptoms of the intermittent explosive disorder may include: [5]

  • Extreme violence and anger.
  • Antisocial behaviours that do not involve any feelings of remorse, regret or guilt.
  • Failure to resist a temptation or impulse to perform acts that are harmful to self or others.
  • Sense of pleasure, relief or gratification after performing a harmful act.
  • Committing harmful behaviours without an obvious motive.
  • Not taking responsibility for their behaviours or loss of control and instead of blaming circumstances, the victim or some third party.
  • Having guilt ideas due to not accepting their acts, leading to thoughts of self-harm.
  • Increased palpitations.
  • Continuos racing thoughts in the mind.
  • Chest tightness.
  • Sudden irritation.
  • Verbal aggression such as saying abusive words.
  • Property destruction.
  • Physical fights or shouting.
  • May include assaulting animals.

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Risk Factors Of Intermittent Explosive Disorder

Intermittent explosive disorder can be present in adolescents even without a history of the condition in the family. Though genetics may contribute to the condition, it could not only be the sole reason. Environmental factors, especially a history of childhood abuse or family behaviours can affect a child in many ways and may increase the risk of IED in them.

Complications Of Intermittent Explosive Disorder

Untreated or unmanaged intermittent explosive disorder can lead to complications like:

  • Mood disorders that may lead to anxiety and depression.
  • Panic attacks due to anger attacks.
  • Relationship problems that may lead to loneliness and stress.
  • Suicidal thoughts or self-harm behaviours.
  • Substance abuse or excessive drinking habits.
  • Physical problems like high blood pressure, ulcers, diabetes or chronic pain.

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Diagnosis Of Intermittent Explosive Disorder

Intermitted explosive disorder is mental health or psychiatric disorder, it is diagnosed on the scale of DSM-5 or Diagnostic and Statistical Manual of Mental Disorders. Patients with IED are thoroughly examined by a medical expert based on the aforementioned symptoms., and accordingly, diagnosed for the condition. [6]

The diagnosis could be tough and confusing as some of the symptoms may be similar to other mental health conditions like disruptive mood regulation disorder and conduct disorder.

Treatments Of Intermittent Explosive Disorder

There are two primary ways for the treatment of intermittent explosive disorder: psychosocial treatment and medicines.

  1. The psychosocial treatment method involves various parent and child programs that may help improve interactions between you and your kids. These programs may help parents to better monitor their child's behaviours, teach them social skills and respond to them in a positive way. They also help children feel more positive about their family and themselves, strengthen their social skills and engage in good behaviours. [7]
  2. Medicines may include antidepressant and anti-anxiety pills or medications to improve the brain chemicals and promote good quality of life.

Management Of Intermittent Explosive Disorder

  • Follow the treatment methods or make sure that your child follows their therapy session and take medicines on time.
  • Make ways to reduce stress at home and create an environment full of positivity and happiness.
  • Learn ways to communicate better with others.
  • Understand your triggers and make ways to handle them in any condition.
  • Stay away from alcohol consumption or the use of illegal drugs.

List Of Suicide Helpline Numbers

  • iCall: 9152987821 | Mon-Sat, 8:00 AM -10:00 PM | Languages: English, Hindi
  • COOJ Mental Health Foundation (COOJ): 0832-2252525 | 01:00 PM - 07:00 PM | Monday to Friday
  • Fortis Stress Helpline: +918376804102
  • Parivarthan: +91 7676 602 602 | 10:00 AM to 10:00 PM | Monday to Friday
  • Connecting Trust: +91 992 200 1122 | +91-992 200 4305 | 12:00 PM to 08:00 PM | All days of the week
  • Roshni Trust: 040-66202000, 040-66202001 | 11:00 AM - 09:00 PM | Monday to Sunday
  • Sahai: 080-25497777 | 10 AM- 8 PM Monday To Saturday | sahaihelpline@gmail.com Sumaitri: 011-23389090 | feelingsuicidal@sumaitri.net | 2 PM- 10 PM Monday To Friday; 10 AM - 10 PM Saturday And Sunday
  • Sanjeevani: 011-24311918, 24318883 | Timings: 10:00 AM - 5.30 PM (Monday to Friday)
  • Sneha: 044-24640050 (24 HOURS) | 044-24640060 8 AM - 10 PM |help@snehaindia.org
  • Lifeline: lifelinekolkata@gmail.com - 033-24637401 | 033-24637432 | 10 AM - 6 PM

To Conclude

Intermittent explosive disorder in early childhood is often neglected by parents, which in turn, progress with age and even persists till lifelong. Early diagnosis and treatment of the condition can help a child get the necessary professional help and improve their quality of life with age.

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Is IED a mental illness?

Yes, Intermittent explosive disorder or IED is a mental health condition characterised by aggressive and antisocial behaviours in adolescents. The episodes can be persistent, recurrent and sudden.

Is Intermittent Explosive Disorder Bipolar?

As per the criteria on the scale on DSM-5, the diagnosis of both intermittent explosive disorder and bipolar can be different. However, they may be commonly associated with each other as IED can lead to other mood disorders like bipolar or can be caused due to the same condition.

How do I live with someone with IED?

Living with someone with Intermittent Explosive Disorder can be difficult as they are restless, have a high temper, engage in heated arguments and could be violent. Instead of leaving behind such people, it is good to understand and listen to them and provide them with professional help.