What is intermittent explosive disorder?

Although anger and rage are universal basic emotions, there are people who get angry and lose their roles more easily. Could this constitute a diagnosis of mental disorder?

Intermittent explosive disorder (IED) is characterized by recurrent episodes of aggression that are produced by the inability to control one’s impulses. The DSM-5 (psychiatric manual of the American Psychiatric Association)  quantifies the criteria for diagnosing it in two ways:

  • When for at least three months there are around two verbal aggressions per week (tantrums, disputes or fights) or physical attacks against property, animals or other individuals (without causing destruction or injury).
  • When in the last 12 months there have been at least three outbursts in behavior that cause damage or destruction of property or physical aggression with injury to animals or other individuals.

On the other hand, another series of criteria are taken into account, such as:

  • The magnitude of aggressiveness is considered disproportionate to the stimulus that triggered it.
  • Outbursts are not premeditated or have a tangible goal, so they are the result of impulsiveness.
  • Outbursts produce discomfort in the person and alter their work / school performance or interpersonal relationships and have financial or legal consequences.

Who manifests it?

It is more common in males . It can originate from the age of six, although it is more common during adolescence, when it has its maximum expression. It is a chronic disorder , although the severity of aggressive episodes decreases with age.

The percentage of the population that manifests it varies greatly between different countries and according to the diagnostic criteria used, ranging from 1.4% in Iran to 7.3% in the USA.

What are the causes?

  • Childhood maltreatment, sexual abuse or neglect.
  • Social context where violence is normalized or positive characteristics are attributed to it (eg courage, strength, masculinity …), as well as contexts with a lack of regulation or emotional education.
  • History of other mental health disorders. People diagnosed with antisocial personality disorder, borderline personality disorder, attention deficit hyperactivity disorder (ADHD), etc. they are more at risk of suffering from it.

How to understand anger?

It is essential to understand that after anger there is always sadness , they are two sides of the same coin. It has to do with the feeling of frustration , something has been different from the expectations that were had. The problem with people with Intermittent Explosive Disorder is that they do not have emotional tools and abilities to channel that suffering or frustration, so they express it uncontrollably with the worst consequences.

It is important to remember that the force generated by emotions is neutral. Depending on what we do with it, it will be destructive or creative . For this it is crucial:

  • Accept the wild and irrational nature of emotions.
  • Learn to own the situation through reasoning and understanding.

Guidelines for managing anger

To start working on anger, it is important to stop hiding the feelings that are hidden behind it and express what you feel as soon as it appears. If we modify its manifestation, we can also better understand its origin.

  • Don’t keep your anger. Express small disagreements as they arise.
  • Be assertive , speak to your interlocutor expressing your feelings or needs, taking into account theirs, without judging or offending and assuming your own responsibilities (do not blame others).
  • In a difficult situation, ask first how the other sees it and then explain how you see it.
  • Lower your tone and your verbal rhythm.
  • Do not respond immediately , postpone your response.
  • Find out what things usually help you get arguments to make you understand and not lose your nerves.
  • Identify and analyze the situations that normally alter you: day, time, situation, place, people present, what I do, how what I do affects me … It will help you find patterns.
  • Channel your anger in a healthy way , for example, with relaxation or breathing techniques, physical activity, taking a walk in nature …

What you should know…

  • Intermittent explosive disorder (IED) is characterized by recurrent episodes of aggression that are produced by the inability to control one’s impulses.
  • It is more common in males. It can originate from the age of six, although it is more common during adolescence, when it has its maximum expression.
  • The problem with people with IED is that they do not have tools and emotional skills to channel that suffering or frustration, so they express it uncontrollably with the worst consequences.

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