Intermittent explosive disorder

DEFINITION

Intermittent explosive disorder involves repeated episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may be signs of intermittent explosive disorder.

People with intermittent explosive disorder may attack others and their possessions, causing bodily injury and property damage. They may also injure themselves during an outburst. Later, people with intermittent explosive disorder may feel remorse, regret or embarrassment.

If you have intermittent explosive disorder, treatment may involve medications and psychotherapy to help you control your aggressive impulses.

CAUSES

The exact cause of intermittent explosive disorder is unknown, but the disorder is probably caused by a number of environmental and biological factors.

• Environment. Most people with this disorder grew up in families where explosive behavior and verbal and physical abuse were common. Being exposed to this type of violence at an early age makes it more likely these children will exhibit these same traits as they mature.
• Genetics. There may be a genetic component, causing the disorder to be passed down from parents to children.
• Brain chemistry. There may be differences in the way serotonin, an important chemical messenger in the brain, works in people with intermittent explosive disorder.

People with other mental illnesses — such as mood, anxiety or personality disorders — or certain medical conditions — such as Parkinson’s disease or traumatic brain injury — may display aggressive behaviors. However, they would not be diagnosed as having intermittent explosive disorder because the cause is from another condition.

SYMPTOMS

Explosive eruptions, usually lasting less than 30 minutes, often result in verbal assaults, injuries and the deliberate destruction of property. These episodes may occur in clusters or be separated by weeks or months of nonaggression. In between explosive outbursts, the person may be irritable, impulsive, aggressive or angry.

Aggressive episodes may be preceded or accompanied by:

• Irritability
• Increased energy
• Rage
• Racing thoughts
• Tingling
• Tremors
• Palpitations
• Chest tightness
• Feeling of pressure in the head
• Depression, fatigue or relief may occur after the episode.