When Anger Gets Out of Control: Intermittent Explosive Disorder

When we witness or experience unfairness, and if we find ourselves under threat, one of the ways we typically react is by getting angry. Anger is an emotion that has many shades, from annoyance, mild irritation, and frustration, all the way to being furious and in a blind rage.

Anger is not always a welcome emotion; most people would much rather experience hope, enthusiasm, happiness, or joy. Regardless, anger is one of the varied emotions we can experience.

In some ways, people are wary of anger for several reasons, some of them religious, others social and cultural. Unfortunately, anger is often encountered and expressed in its more destructive guises, as when a person is aggressive or violent. Because of the destructive turn that anger often takes, many people shun anger, dismissing it as a valid, healthy, and natural emotion that can play a positive role in our lives.

The positive role of anger.

One of the ways that anger plays a positive role in our lives is that it’s the adaptive way we respond to a threat. When you or a loved one are in danger, anger helps you to defend yourself. There’s a rush of adrenaline, blood pumping, and muscles ready for action. All of this empowers you to fight or defend yourself against attack. In this way, anger is useful for our survival.

In everyday life, your life and the lives of your loved ones may not be under threat, but the positive role anger plays there is to help you recognize and assert your boundaries. We get angry when our sense of dignity is violated, for example through a joke told at our expense. That anger indicates that something is amiss.

Feelings of anger can help you not only read but respond to social situations such as in the example above, and when expressed appropriately they alert other people not to take advantage of us. When we recognize that something isn’t right, those same feelings of anger can be an impetus toward getting our needs met.

If you know how to channel the energy arising from your feelings of anger, you can direct that anger into more effective performance, increased optimism, and more successful negotiations at work and in life. By inspiring social action, anger can motivate you to redress wrongs and improve the world. Your anger can also move you to improve yourself and empower you when you feel scared, powerless, helpless, or victimized.

One surprising way anger helps us is by pushing us toward greater creativity. Channeled well, a burst of anger can push people to produce varied solutions to a problem, especially when you compare them to a person who’s feeling emotionally neutral. Anger stimulates the fight-or-flight response, and the arousal triggered by this response seems to super-charge the mind, allowing it to make connections in ways that are not available when experiencing other emotions.

When anger is destructive and not constructive.

The above paints a positive picture of anger, but it would be disingenuous to say that anger isn’t problematic in its more destructive forms. The caution that Bible tells regarding anger is precisely because unbridled and destructive expressions of anger are far too easy to fall into for imperfect people.

James addresses anger when he writes, “My dear brothers and sisters, take note of this: Everyone should be quick to listen, slow to speak and slow to become angry, because human anger does not produce the righteousness that God desires.” (James 1: 19-20, NIV)

Of the various unhealthy experiences and expressions of anger, intermittent explosive disorder (IED) is one. IED affects 11-16 million Americans in their lifetimes, including 7.3% of adults. It involves repeated and sudden episodes of impulsive, aggressive, and violent behavior or angry verbal outbursts in which a person reacts in a way that’s vastly disproportionate to the situation. For instance, a person might flip a table over because they spilled some milk.

Intermittent explosive disorder is likely at work in incidents as wide-ranging as road rage, domestic abuse, throwing or breaking objects, or other kinds of temper tantrums. These intermittent, explosive outbursts typically last less than half an hour, and they cause significant distress in your life as they negatively impact your relationships, work, and school, and they can have significant legal and financial repercussions.

IED is a chronic disorder that can affect children aged 6 years and older as well as adults. Adults that are diagnosed with IED are usually younger than 40 years old, and the incidents caused by IED usually decrease with age.

Causes of Intermittent Explosive Disorder.

There are a few environmental and genetic factors that may contribute to a person developing this disorder. Some of these include the following:

• Genetics, and having a family history where close relatives have IED.
• Mental health challenges such as depression, anxiety-related symptoms, substance-abuse disorder, ADHD, antisocial personality disorder, and borderline personality disorder.
• Brain chemistry and function, particularly one’s levels of serotonin.
• Long-lasting trauma or experiencing neglect.
• Experiencing verbal or physical abuse in childhood. Exposure to violence and aggression in childhood could bring about symptoms of intermittent explosive disorder.

Signs of Intermittent Explosive Disorder.

Sometimes anger will simmer beneath the surface and color a person’s actions toward the individual that’s made them angry. You may or may not be able to detect this form of anger. With IED, however, anger is directed outward in obvious ways, and it is disproportionate to the provocation.

Anger will erupt suddenly with little to no warning, and it will usually last less than 30 minutes. The episodes may occur daily, but in some cases, the incidents will be spaced by months or weeks. In between the more severe episodes, there may be less severe outbursts marked by being irritable, impulsive, or aggressive.

IED doesn’t present the same way for everyone, as people with IED experience varying levels of intensity in their symptoms. Some people may show severe physical aggression toward others while feeling less of an urge to be verbally abusive, while it may be the opposite for other people. The signs of IED include the following:

• You get aggressive and violent without a specific reason. This may include pushing, shouting, slapping others, causing damage to personal or private property, or threatening people or animals.
• You get irritable with human contact, and you start heated arguments.
• You go into a sudden rage without much provocation and totally out of proportion to the situation.
• Physical sensations such as a racing heartbeat, tightness in the chest, tingling in your extremities, and tremors.
• You engage in unnecessary tirades, and you use gratuitous abusive language to convey a message.

Impact of Intermittent Explosive Disorder.

People with IED will often engage in destructive behaviors out of impulsiveness, and these behaviors are often accompanied by regret after the fact. IED increases the possibility of having damaged relationships as their loved ones and colleagues may see them as constantly angry and difficult to relate to. As a result, issues such as family stress, divorce, job loss, school suspension, trouble with the law, and financial difficulties after often realities for people with IED.

Additionally, IED may also increase the risk of developing mood disorders such as depression and anxiety, and problems such as alcohol and substance abuse. Not only that, but IED can increase co-occurring physical health problems such as heart disease, stroke, high blood pressure, diabetes, chronic pain, and ulcers. When in a rage, a person with IED may also injure themselves seriously.

Recovery from Intermittent Explosive Disorder.

IED can be destructive in a person’s life. However, there is a good outlook for those struggling with their anger, as there are many ways to bring anger under control and have it fulfill a positive role. One can make lifestyle changes, which can be coupled with therapy and medication where needed.

One important change to make is to one’s mindset. By thinking differently and restructuring how you approach situations, you can learn to slow down and think through situations so that you can respond rationally and without aggression. Other changes you can make include:

Learning relaxation techniques.

When you’re feeling angry, or you’re on the cusp of anger, being able to breathe using techniques such as 4-7-8 will help you calm down. Mindfulness meditation and visualization will also help you reduce the symptoms of anger and respond more calmly.

Honing your communication skills.

Being a better listener helps you process information more effectively, so you don’t respond impulsively or jump to conclusions about what you think the other person means.

Eating and drinking healthy.

A well-balanced diet is good for regulating your mood and helping you stay healthy. You should avoid mood-altering substances such as alcohol and recreational drugs.

Taking care of your body.

In addition to watching what you eat and drink, get regular exercise and sleep well. This will help you regulate your mood better, and exercise helps to elevate your mood. If you’re getting good sleep, you’ll help yourself to do life with a more even keel.

To make great strides toward recovery, it’s important to include psychotherapy as part of your treatment. Your doctor may also suggest certain medications along with the therapy. Regarding psychotherapy, one of the most effective therapies is Cognitive-Behavioral Therapy (CBT) which helps people with IED to control and change their behaviors.

CBT helps one identify the triggers of aggressive reactions, manage and control violent behavior with relaxation techniques and effective tools for coping, and helps them work on developing good communication and problem-solving skills.

If your doctor recommends medication, antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs) and anticonvulsants may help to stabilize your mood. Whatever your doctor prescribes as part of your treatment, it’s important that you follow your treatment plan, attend your therapy sessions without fail, and take your prescribed medication.

IED doesn’t have to keep wreaking havoc in your life. Anger can be brought in line with God’s purposes, and you can begin to work on the relational and other damage that has been wrought by your anger.

Through Christian counseling for anger and IED, you can begin to bring your anger under control and walk in the peace and wholeness the Lord desires for us. You can inquire about counseling for IED or make your appointment to begin your journey with a counselor today.