“Keep Calm & Don't Explode” or “Walking Time Bomb”

“Keep Calm & Don't Explode” or “Walking Time Bomb”

According to DSM V, Intermittent Explosive Disorder or IED is a recurrent behavioral outbursts that represents a failure to control aggressive impulses. In simple terms, a person with IED can’t control his anger and will impulsively explode into rage with little or no apparent provocation. It was earlier referred to as the Passive-Aggressive Personality type of impulse control.

The onset of recurrent, problematic, impulsive, aggressive behavior is commonly seen in childhood and adolescence, and hardly manifests after the age of 40. IED tends to co-exist with ADHD, other mood disorders, anxiety disorders and substance use disorders, although the onset of other disorders is typically later.  

Risk factors to develop IED are usually for children who have experienced physical and emotional trauma, as are those with first-degree relatives who have the disorder. It is more prevalent is younger individuals (younger than 35-40 years), compared to older individuals (above 50 years).

Needless to say, intermittent explosive disorder can have a devastating effect on people's life; maintaining relationships and employment can be highly impossible when you're never sure when you'll have another outburst. Again, intermittent explosive disorder doesn't mean you have a hasty temper; it's a real disorder with real consequences. The following signs and symptoms will help you recognise the problem and make sure to seek professional help;

  • You Feel Like You Can't Control Your Anger
  • You've Had Multiple Outbursts
  • You've Had Multiple Outbursts
  • You've Had Multiple Outbursts
  • You Have Actual Road Rage
  • Your Thoughts Race During An Episode
  • Your Outbursts Aren't Caused By Another Disorder

If left untreated, the effects of IED can cause severe and extreme distress in various aspects of your life. Some of the long-term effects are- Academic impairment, School suspension, Dropping out of school, Poor social skills, Injuries, Incarceration, Substance abuse and addiction, Alcohol abuse, Domestic violence, Child abuse, Self-harm and Suicidal ideations.

The treatment for IED could involve medication or therapy, including behavioural modification and a combination of both offers the best prognosis. Group counselling and anger management sessions can also be helpful. Relaxation techniques have been found to be useful in neutralizing anger. There are no medications specifically for IED, but studies suggest that a variety of medications have been used to help people with IED, including antidepressants and anti-anxiety medications, as well as anticonvulsants and other mood regulators.

Cognitive behavioural therapy (CBT) is commonly used to help people with IED learn which situations trigger their rage episodes. Through CBT they can learn to recognize and manage their anger in a healthy, non-disruptive way. A therapist will work with the patient and family (and, when appropriate, teachers) to manage and prevent explosive episodes.

If you recognise the signs of IED, then learning to prevent further episodes is necessary. The following techniques can be learnt to help deal with IED, along with professional treatment.

  • Stick with your treatment
  • Practice relaxation techniques
  • Develop new ways of thinking (cognitive restructuring)
  • Use problem-solving
  • Learn ways to improve your communication
  • Change your environment
  • Avoid mood-altering substances. 


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