This week, we look at another behavioral and emotional disorder experienced by adolescents: intermittent explosive disorder. IED is characterized by unpredictable and explosive outbursts of uncontrollable aggression, usually lasting fewer than 30 minutes, that occur frequently, often along with periods of less severe outbursts. The aggression may be physical and/or verbal and targeted at another person, property, an animal, or a combination of the above. The onset of IED typically takes place around age 14. An estimated 16 million Americans may experience IED each year. Between 4 and 6 percent of the U.S. population experience IED in their lifetime.

IED falls under “Disruptive Impulse Control, and Conduct Disorders” in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). For a diagnosis of IED, the individual must be at least 6 years old. Criteria include recurrent impulsive outbursts characterized by either (1) verbal or physical aggression occurring at least two times per week for at least three months that does not lead to destruction of property nor infliction of physical harm, or (2) three or more outbursts involving injury or destruction within 12 months. Additional criteria include aggressive behavior that is greatly disproportionate to the situation; non-premeditated outbursts; outbursts that cause distress or impairment of function and lead to damaging financial, legal, and/or social outcomes; recurrent explosive outbursts that cannot be attributed to another neuropsychiatric disorder, medical condition, or substance abuse.

Common symptoms that may occur with IED:

  • Aggression
  • Anger
  • Anxiety
  • Rage (violent and uncontrollable)
  • Irritability (may be present all the time, not just with an outburst)
  • Frustration
  • Guilt
  • Shame
  • Emotional detachment
  • Racing thoughts
  • Chest tightness
  • Tension
  • Headache
  • Palpitations
  • Increased energy
  • Shortness of breath
  • Stuttering
  • Tingling
  • Tremors

IED often co-occurs with other psychiatric disorders such as ADHD, oppositional defiant disorder, bipolar disorder, and others. Therefore, a comprehensive assessment by a licensed mental health professional is necessary to determine a diagnosis and treatment. Generally, treatment includes a combination of psychotherapy and medication.

The content of this article is for informational purposes only. The content is not intended to substitute for professional mental health advice, diagnosis, or treatment. Always seek the advice of your psychiatrist, psychologist, licensed mental health professional, or other qualified health provider with any questions you may have regarding a mental health condition.