Intermittent Explosive Disorder (IED) Explained

Intermittent Explosive Disorder (IED) is a psychiatric condition characterized by recurrent outbursts of impulsive and aggressive behavior. 

People with IED often struggle to control their anger, leading to episodes of verbal or physical aggression disproportionate to the triggering event. 

IED is classified as a disruptive, impulse-control, and conduct disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It typically emerges during adolescence or early adulthood and may persist throughout a person’s life if left untreated. 

The disorder is characterized by recurrent episodes of aggression disproportionate to the provocation, with symptoms ranging from verbal tirades and property destruction to physical assault.

Individuals with IED often experience significant distress and impairment in various areas of life. Early identification and proper diagnosis of IED are crucial for effective management and treatment. 

Raising awareness and understanding of IED can promote early intervention, destigmatize the disorder, and support those affected. 

This blog aims to explore the various aspects of IED, including its symptoms, causes, impact, and available treatment options, to foster greater understanding and empathy towards individuals living with this challenging disorder.

What Is Intermittent Explosive Disorder?

Intermittent Explosive Disorder (IED) is a psychiatric condition characterized by recurrent impulsive and aggressive outbursts. Individuals with IED struggle to control their anger, leading to sudden and disproportionate verbal or physical aggression. 

Perceived provocations often trigger these outbursts and can occur in various settings. The exact cause of IED is not fully understood, but genetic, neurobiological, and environmental factors likely play a role. 

The disorder can significantly impact relationships, work, and social functioning, causing feelings of shame and isolation. 

How Does Intermittent Explosive Disorder Affect You?

Intermittent Explosive Disorder (IED) can significantly impact individuals, affecting various aspects of their lives. One of the primary ways IED affects individuals is through recurrent explosive outbursts of anger. 

These outbursts can be intense, disproportionate and may result in verbal or physical aggression. These episodes’ sudden and impulsive nature can lead to strained relationships with family members, friends, and colleagues. 

People with IED often experience a sense of guilt, regret, and shame following their outbursts, which can further contribute to difficulties in relationships and self-esteem.

IED can also have adverse effects on a person’s social functioning. Due to the unpredictable nature of their explosive episodes, individuals with IED may avoid social situations or isolate themselves to prevent triggering an outburst. 

This withdrawal from social interactions can lead to loneliness and feeling misunderstood or judged by others.

Furthermore, the emotional toll of living with IED can be significant. Individuals may experience heightened stress, anxiety, and irritability between explosive episodes. 

The constant fear of losing control and anticipating the next outburst can cause emotional distress and impact overall well-being.

In addition to interpersonal and emotional consequences, IED can negatively affect one’s professional life. Difficulties in managing anger can lead to conflicts in the workplace, strained relationships with colleagues, and even loss of employment opportunities.

How Common Is Intermittent Explosive Disorder?

Intermittent Explosive Disorder (IED) is a relatively common mental health condition, although it often goes undiagnosed or unrecognized. According to the Cleveland Clinic, the prevalence of IED in the general population is around 1.4-7%. It can affect people of all ages but typically begins in late childhood or adolescence.

While IED is more common in males than females, it can still occur in both genders. The exact reasons behind the higher prevalence in males are not fully understood, but hormonal and sociocultural factors may play a role. 

Given the prevalence and potential negative consequences of IED, it is crucial to raise awareness and promote early detection and intervention. Timely diagnosis, appropriate treatment, and supportive interventions can significantly improve the quality of life for individuals with IED and those around them.

What Are the Signs and Symptoms of Intermittent Explosive Disorder?

signs and symptoms of IED can vary from person to person

Recurrent, impulsive outbursts of anger and aggression disproportionate to the provoking situation characterize Intermittent Explosive Disorder (IED). These explosive episodes are typically brief and are often followed by feelings of remorse or guilt. 

The signs and symptoms of IED can vary from person to person, but there are some common indicators to look out for.

  • Recurrent verbal or physical outbursts: Individuals with IED experience frequent episodes of intense anger issues, which are often out of proportion to the provoking situation.
  • Inability to control aggressive impulses: During an outburst, individuals with IED may feel a strong urge to engage in aggressive behaviors, such as yelling, throwing objects, or physical violence. They may find it difficult to restrain or control anger.
  • Impulsive and sudden nature of outbursts: The aggressive episodes in IED typically occur suddenly, without much warning. The person may go from calm to explosive within seconds or minutes.
  • Disproportionate response to triggers: The intensity of the outbursts is excessive compared to the provoking event. Even minor frustrations or perceived slights can trigger a severe angry reaction.
  • Feelings of relief or satisfaction after the outburst: Following an explosive episode, individuals with IED may experience a temporary sense of relief, as if a weight has been lifted. However, this relief is short-lived and is often replaced by feelings of guilt, remorse, or shame.
  • Physical and emotional arousal: During an outburst, individuals may experience physical symptoms such as increased heart rate, sweating, trembling, and a surge of energy. They may also feel overwhelmed by emotions such as anger, irritability, and frustration.
  • Significant distress and impairment: The symptoms of IED cause significant distress and impairment in various areas of life, including personal relationships, work, and social functioning.

It’s important to note that these symptoms should not be due to the effects of substances, another medical condition, or better explained by another mental disorder. A proper evaluation by a qualified mental health professional is necessary to diagnose IED and rule out other possible causes of these symptoms.

What Are the Causes of Intermittent Explosive Disorder?

IED is triggered by the same factors that are known as the causes of anger issues

The exact causes of Intermittent Explosive Disorder (IED) are not fully understood but the IED is triggered by the same factors that are known as the causes of anger. There are several factors that may contribute to its development. These include:

  • Biological factors: Certain biological factors, such as abnormalities in the brain’s structure or functioning, may play a role in IED. Studies have suggested that there may be differences in the areas of the brain involved in impulse control and emotional regulation in individuals with IED.
  • Genetic predisposition: There may be a genetic component to IED. Individuals with a family history of IED or other mental health disorders, such as mood disorders or substance use disorders, may be at a higher risk of developing IED.
  • Environmental factors: Environmental factors, including early life experiences, upbringing, and exposure to violence or aggression, can contribute to the development of IED. Individuals who have experienced abuse, neglect, or witnessed aggressive behaviors during childhood may be more susceptible to developing IED later in life.
  • Psychological factors: Certain psychological factors, such as a history of trauma, chronic stress, or difficulties in managing emotions, may increase the risk of developing IED. Additionally, individuals with certain personality traits, such as impulsivity, hostility, or a tendency to externalize anger, may be more prone to IED.
  • Co-occurring mental health conditions: IED often co-occurs with other mental health disorders, such as depression, anxiety disorders, or substance use disorders. These conditions may interact with IED and contribute to its development or exacerbate its symptoms.

It’s important to note that while these factors may contribute to the development of IED, they do not necessarily guarantee their occurrence.

How Is Intermittent Explosive Disorder Diagnosed?

The diagnosis of Intermittent Explosive Disorder (IED) involves a comprehensive evaluation by a mental health professional. The process typically includes thoroughly assessing the individual’s symptoms, medical history, and relevant psychological or environmental factors.

To diagnose IED, the mental health professional will gather information about the frequency, duration, and intensity of the individual’s explosive outbursts. They will also assess the impact of these outbursts on the individual’s functioning and relationships. 

The professional needs to rule out other possible causes of the outbursts, such as substance use, medical conditions, or other mental health disorders.

The mental health professional may use diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to guide the assessment process. 

According to the DSM-5, some criteria for diagnosing IED include recurrent outbursts of aggression that are disproportionate to the provocation, a failure to control aggressive impulses, and significant distress or impairment in social, occupational, or other important areas of functioning.

In addition to clinical interviews, the mental health professional may use validated questionnaires or assessment tools to gather additional information. 

They may also collaborate with other healthcare providers, such as primary care physicians, to rule out any underlying medical conditions contributing to the symptoms.

It’s worth noting that diagnosing IED can be challenging due to the episodic nature of the disorder and the potential for individuals to underreport or minimize their symptoms. 

However, a comprehensive assessment conducted by a qualified professional can help establish an accurate diagnosis and guide appropriate treatment interventions.

How Is Intermittent Explosive Disorder Treated?

doctor giving treatment to intermittent explosive disorder patient.

Intermittent Explosive Disorder (IED) can significantly impact an individual’s life and relationships.

Fortunately, various treatment approaches are available to help manage the symptoms and improve overall well-being. This section will explore the different treatment options commonly used for IED.

  1. Psychotherapy
  2. Medication
  3. Anger management programs
  4. Stress reduction techniques
  5. Supportive relationships and social support

Treating the underlying causes and teaching effective coping strategies can help individuals with IED lead more fulfilling and balanced lives.

1. Psychotherapy

Psychotherapy, or talk therapy, is a common and effective treatment approach for Intermittent Explosive Disorder (IED). Therapists use techniques to help individuals with IED understand and manage their explosive impulses and anger.

Cognitive-behavioral therapy (CBT) often focuses on identifying and changing negative thoughts and behaviors associated with explosive outbursts. 

Therapists may also employ techniques such as anger management training, stress reduction, and conflict resolution skills to promote healthier coping strategies.

2. Medication

In some cases, medication may be prescribed to help manage the symptoms of IED. Antidepressants, mood stabilizers, and anticonvulsant medications have effectively reduced the frequency and severity of explosive episodes. 

These medications can help regulate mood, control impulsive behavior, and address underlying psychiatric conditions that may contribute to IED symptoms. 

It’s essential to consult a psychiatrist or other medical professionals to determine the most suitable medication options and monitor their effectiveness and potential side effects.

3. Anger Management Programs

Participating in structured anger management programs can be beneficial for individuals with IED. These programs provide education, support, and practical skills to help individuals recognize their triggers, manage their anger, and improve overall emotional regulation.

Mastering Anger offers some of the most comprehensive anger management programs that can help you identify your anger trigger and  effectively control anger symptoms. Considering the severity of anger issues, you can enroll in the following classes:

Anger Management courses offered by Mastering Anger are nationally recognized and meet the requirements of courts, probation, legal systems, parole, and employers.

Anger management programs often involve group therapy sessions where individuals can share their experiences, learn from others, and practice new coping techniques and anger management exercises in a supportive environment.

4. Stress Reduction Techniques

Stress can exacerbate symptoms of IED, so incorporating stress reduction techniques into daily life can be helpful. 

These techniques may include relaxation exercises, mindfulness meditation, deep breathing exercises, physical activities, and hobbies or activities promoting relaxation and self-care. 

By managing stress levels, individuals with IED can reduce the likelihood of explosive outbursts and enhance their overall well-being.

5. Supportive Relationships and Social Support

Building and maintaining supportive relationships is crucial for individuals with IED. A strong support system of understanding family members, friends, or support groups can provide emotional support, encouragement, and a safe space to discuss challenges and successes in managing the disorder. 

Social support can also reduce feelings of isolation and improve overall mental health. It’s important to note that treatment for IED is highly individualized, and a combination of different approaches may be necessary.

Working closely with mental health professionals, such as therapists and psychiatrists, can help develop a comprehensive treatment plan tailored to the individual’s specific needs and circumstances. 

With appropriate treatment and support, individuals with IED can learn to manage their symptoms, improve their relationships, and enhance their overall quality of life.

What Are the Risk Factors for Developing Intermittent Explosive Disorder?

Intermittent Explosive Disorder (IED) is a complex condition that various factors can influence. Understanding the risk factors associated with IED is crucial for identifying individuals more prone to developing the disorder. This section will explore the common risk factors contributing to developing IED and shed light on their significance.

  • Biological Factors: Genetic predisposition and abnormalities in brain structure or functioning can increase the risk of developing IED. Individuals with a family history of aggressive behavior or psychiatric disorders may be more susceptible to the disorder.
  • Environmental Factors: Growing up in a violent or abusive environment, witnessing aggressive behaviors, experiencing childhood trauma, or being exposed to chronic stress can significantly contribute to developing IED. These environmental factors can shape an individual’s learned behavior patterns and emotional regulation.
  • Substance Abuse: Substance abuse, particularly alcohol and stimulant use, is associated with an increased risk of IED. The effects of substance abuse on brain chemistry and impulse control can exacerbate explosive behaviors.
  • Co-occurring Mental Health Disorders: IED often coexists with other psychiatric disorders such as mood, anxiety, and personality disorders. These disorders can amplify emotional dysregulation and impulsivity, further contributing to the development of IED.
  • History of Traumatic Brain Injury (TBI): Traumatic brain injuries, especially those affecting the frontal lobes responsible for impulse control and emotional regulation, have been linked to the onset of IED. Physical trauma can disrupt neural pathways and affect behavioral responses.

It is important to note that these risk factors do not guarantee the development of IED, but they may increase the likelihood. Understanding these risk factors can help in early identification, prevention, and tailored interventions for individuals at risk of developing Intermittent Explosive Disorder.

How Do I Take Care of Myself if I Have Intermittent Explosive Disorder?

Living with Intermittent Explosive Disorder (IED) can be challenging, but there are various strategies and self-care techniques that can help individuals manage their symptoms and improve their overall well-being. This section will explore practical tips and approaches for individuals with IED to take care of themselves and promote a healthier lifestyle.

  • Therapy and Counseling: Engaging in therapy, such as cognitive-behavioral therapy (CBT) or anger management therapy, can be highly beneficial for individuals with IED. These therapeutic approaches can help individuals understand and manage their emotions, develop healthier coping mechanisms, and improve communication and conflict-resolution skills.
  • Medication: In some cases, medication may be prescribed to individuals with IED, mainly when symptoms are severe or significantly impacting daily life. Antidepressants, mood stabilizers, or other medications may help regulate mood and reduce the frequency and intensity of explosive episodes.
  • Stress Reduction Techniques: Managing stress is essential for individuals with IED. Practicing relaxation techniques such as deep breathing exercises, meditation, yoga or engaging in hobbies and activities that promote relaxation can help reduce overall stress levels and provide a sense of calmness.
  • Healthy Lifestyle Choices: Adopting a healthy lifestyle can positively impact symptoms of IED. Regular exercise, proper nutrition, sufficient sleep, and avoiding substances like alcohol and drugs can contribute to overall well-being and help regulate mood and emotions.
  • Support System: Building a strong support system of family, friends, or support groups can be invaluable for individuals with IED. Having a network of understanding and supportive individuals who can provide empathy, guidance, and encouragement can help individuals cope with their condition more effectively.
  • Self-Awareness and Monitoring: Developing self-awareness of triggers, warning signs, and early indications of anger can empower individuals to intervene before an explosive episode occurs. Keeping a journal to track triggers, emotions, and patterns can provide insights and aid in developing effective strategies for managing anger.

Remember, self-care is a journey; finding the right strategies may take time. Working closely with healthcare professionals to develop a personalized self-care plan that addresses your needs and supports your well-being while managing Intermittent Explosive Disorder is essential.


Intermittent Explosive Disorder (IED) is a challenging condition that can significantly impact individuals’ lives and relationships. Recurrent episodes of impulsive, aggressive outbursts disproportionate to the triggering event characterize it. 

This blog has explored various aspects of IED, including its definition, signs and symptoms, causes, diagnosis, treatment options, risk factors, and self-care strategies. By shedding light on these critical topics, we aim to provide valuable information and support for individuals affected by IED.

It is essential to recognize that seeking professional help is crucial for accurate diagnosis and effective treatment of IED. 

Mental health professionals, such as psychiatrists, psychologists, or licensed therapists, can provide a comprehensive evaluation and develop an individualized treatment plan tailored to specific needs.

Self-care plays a crucial role in managing IED. Strategies such as stress reduction techniques, adopting a healthy lifestyle, building a support system, and developing self-awareness can contribute to overall well-being and symptom management.

It is vital to approach IED with compassion and understanding for yourself and others. Building empathy and open communication within relationships can create an environment that fosters support and reduces the impact of IED on personal and interpersonal functioning.

We hope to contribute to a more compassionate and informed society regarding Intermittent Explosive Disorder by increasing awareness, promoting understanding, and providing information. 

Together, we can create a supportive environment that facilitates healing, growth, and improved quality of life for individuals with IED.

Carlos Todd PhD LCMHC

Dr. Carlos Todd PhD LCMHC specializes in anger management, family conflict resolution, marital and premarital conflict resolution. His extensive knowledge in the field of anger management may enable you to use his tested methods to deal with your anger issues.


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