Dealing With Intermittent Explosive Disorder

Perhaps you’ve been there. A discussion or mild disagreement with your spouse or significant other (or child or friend or whatever) suddenly gets out of control. The other person loses it and flies into an uncontrollable rage that no amount of rational talk can calm down. Perhaps they become verbally abusive, or in worst case, physically abusive. It can be a frightening experience, made all the more so by its suddenness. There is no warning; the person typically goes from calm to hysterical in a matter of moments. It is called Intermittent Explosive Disorder (IED), expressions of anger that are disproportionate to the situation at hand.

Now getting angry is a natural state, we all do it from time to time. It is the logical result of our feeling that a situation is not working out as we feel it should. Anger can be constructively channeled and needs to be expressed. To not do so can result is physical problems. Anger repression can be the cause for high blood pressure, rigidity, or ulcers.

By the same token, people who are angry all the time also endanger their own health.

We tend to get angry when somebody hurts our feelings or self-esteem, or if we are unable to achieve desired goals, or if a promise or commitment has been broken.

Uncontrolled anger is another problem altogether. We all may struggle with it from time to time, but some people have serious problems keeping their anger in check, choosing to express it through violent and aggressive means.

Signs of Intermittent Explosive Disorder or rage include, but are not limited to:

- Sudden loss of control over trivial issues

- Continuous accumulation of malice, hatred, or envy for someone

- Sudden violent impulses

- Inability to face reality

- Over domination of others

- Extreme agitation followed by period of melancholy

- Persistent mental duress

- Yelling, name calling, ridiculing, and sarcasm

Usually, those with anger management issues are dealing with mental problems as opposed to physical. A bad relationship, or poor self-image, or a history of abuse, stress, or frustration has a way of framing their life where the only prism they can see through is one of anger and rage.

IED is currently categorized as an impulse control disorder, belonging in the same class of Axis 1 disorders as kleptomania, pyromania, pathological gambling, and others. The aggression inherent to IED is often unpremeditated, and defined by a disproportionate reaction to any provocation.

IED is often viewed as the “first cousin” to Bipolar disorder, with outbursts usually lasting less than an hour, usually accompanied by a sense of relief, in some cases pleasure, and some measure of remorse after the fact.

A recent study by the National Institute for Mental Health indicated that IED may be more common than initially thought, affecting up to 16 million Americans in their lifetimes. Unfortunately, the same study also concluded that less than 30% seek treatment for what is a treatable condition. Evidence also suggests that IED might predispose toward depression, anxiety, alcohol and drug abuse disorders by increasing stressful life experiences, such as financial difficulties and divorce.

Typically, individuals with IED will not take responsibility for their loss of control, instead blaming the victim, other circumstances in their life, or some third party who may have told them something or said something that "caused" their uncontrolled anger. Their actions are always justified and never their fault or responsibility. This lack of control is an integral part of the problem, and the inability to accept any responsibility for the aggression helps to alleviate guilt. It also prevents the individual from making any changes.

The most prescribed treatment for IED is known as Cognitive Behavioral Therapy (CBT), which is designed to help the patient uncover and alter distortions of thought or perceptions which may be causing or prolonging psychological distress. The therapist approaches the problem with the assumption that a) the patient is capable of becoming aware of his or her own thoughts and changing them, or b) that sometimes the thoughts elicited by stimuli distort or fail to reflect reality accurately.

If you are in a marriage where one partner suffers from IED (as I was for twenty years; my wife’s uncontrolled rage was the defining issue in our separation), you should seek marriage counseling related to IED. You and your spouse can hopefully learn how to mitigate the impact that IED has had and can continue to have on you and your children. Objective feedback and support from a professional source can go a long way towards treating and healing the impact of IED on your relationship.

So if you are dealing with IED in your marriage or relationship, don’t just assume that the other partner is whatever expletive you last chose to describe them. They may be dealing with a very real disorder known as Intermittent Explosive Disorder, and it is treatable. To borrow a tired cliché’, realizing you have a problem is half the battle. Once this concept is grasped, there is every reason to believe that both of you can have your life back, a life you both deserve.

Now go and take care of each other…..and good luck…..

Billy is the Director of Content for Leadsbyfone LLC, a lead generation company servicing the water damage restoration industry.  He is based in Atlanta, GA