Intermittent explosive disorder (IED) is a mental health condition that causes repeated, sudden outbursts of anger or aggression that are far out of proportion to the situation. The outbursts are impulsive, often last less than 30 minutes and are usually followed by guilt or embarrassment. IED is an impulse control disorder, and it is treatable with therapy, medication or both.
Key Takeaways
- IED involves recurring impulsive outbursts of verbal or physical aggression.
- As many as 7.3% of U.S. adults may have IED at some point in their lives.
- Symptoms usually start in the early teens and can continue into adulthood.
- Trauma, genetics, ADHD and substance use are linked to higher risk.
- Cognitive behavioral therapy is the main treatment, often with medication like fluoxetine.
- The ICD-10-CM code for intermittent explosive disorder is F63.81.
What Is Intermittent Explosive Disorder?
IED is more than having a short temper. It is a pattern of explosive anger that keeps happening, feels out of your control and causes real harm to your life.
During an episode, a person may yell, threaten, slam or throw things, damage property or get into physical fights. Afterward, many feel relief, then exhaustion. Later, regret or shame often sets in.
IED is more common than most people think. A national study led by Harvard researchers found that as many as 7.3% of adults may have IED during their lifetime. That’s about 11.5 to 16 million Americans. Only about 29% had ever gotten treatment for their anger.
Symptoms of Intermittent Explosive Disorder
According to the Mayo Clinic, outbursts usually start with little warning and last under 30 minutes. They may happen often or be separated by weeks or months.
Before an Outburst
- Rage or intense irritability
- Racing thoughts or a sense of building tension
- Tingling, shaking or a pounding heartbeat
- Tightness in the chest
During an Outburst
- Shouting, temper tantrums or heated arguments
- Threatening or pushing people
- Breaking objects or damaging property
- Physical fights or road rage
After an Outburst
- Relief, followed by tiredness
- Guilt, remorse or embarrassment
- Damaged relationships or trouble at work
How IED Is Diagnosed
A mental health professional diagnoses IED through an evaluation. The diagnostic criteria, summarized by Cleveland Clinic, include one of two patterns.
| Pattern | What it looks like |
|---|---|
| Frequent outbursts | Verbal or physical aggression about twice a week for 3 months, without injury or property damage |
| Severe outbursts | Three episodes in 12 months that cause injury or damage property |
The anger must be far out of proportion to the trigger. It must be impulsive rather than planned. It also can’t be better explained by another condition, a medical problem or substance use. The person must be at least 6 years old.
IED ICD-10 Code
In the ICD-10-CM system used for U.S. medical billing, intermittent explosive disorder is coded F63.81. It falls under impulse disorders.
What Causes IED?
The exact cause isn’t known. Researchers believe several factors work together:
- Environment: growing up around explosive anger or violence.
- Trauma: physical abuse, bullying or other traumatic experiences.
- Genetics: IED may run in families.
- Brain differences: changes in how the brain regulates impulses and stress.
- Other conditions: ADHD, borderline or antisocial personality disorder and substance use.
Alcohol is a common accelerant. It lowers inhibitions, which makes it harder to stop an outburst once anger starts.
Treatment for Intermittent Explosive Disorder
IED responds to treatment. The goal is to stop outbursts or reduce them to rare, mild episodes.
Cognitive Behavioral Therapy
Cognitive behavioral therapy is the main treatment. It helps you spot early warning signs, challenge angry thoughts, use relaxation skills and practice new ways to respond. Many programs also include relapse prevention for anger.
Medication
Fluoxetine, an SSRI antidepressant, is the most studied medication for IED. Mood stabilizers and other medications are sometimes used too. A psychiatrist can decide whether medication fits your situation.
Treating Co-Occurring Conditions
If IED shows up alongside ADHD, depression, trauma or drinking, those conditions need care too. Treating only the anger rarely holds when another condition keeps fueling it.
Conclusion
IED is a real, diagnosable condition, not a character flaw. It causes impulsive outbursts that can damage relationships, jobs and health.
With CBT, along with medication when needed, many people learn to catch anger earlier and respond differently. Getting help early protects the people you care about and your own peace of mind.
Impulse Control Disorder Treatment at Lotus Recovery
Lotus Recovery Treatment Center offers outpatient impulse control disorder treatment in Thousand Oaks, including care for IED. Our team uses CBT and DBT skills to help you manage anger before it takes over.
Our psychiatry services handle diagnosis and medication when it helps. If anger is tied to drinking or drug use, we treat both together. Day and evening sessions fit around your work schedule.
Most insurance is accepted, and same day appointments are available. Call (805) 856-6690 or verify your insurance to get started.
Frequently Asked Questions
What is the cause of intermittent explosive disorder?
No single cause has been found. IED likely comes from a mix of genetics, brain differences and life experiences. Growing up around violence, childhood abuse and trauma all raise the risk. ADHD and substance use are also linked to it.
Is IED a form of bipolar disorder?
No. IED is an impulse control disorder, while bipolar disorder is a mood disorder. Irritability during a manic episode can look like IED. IED isn’t diagnosed when outbursts happen only during mood episodes. A psychiatric evaluation can tell them apart.
Is intermittent explosive disorder a mental illness?
Yes. IED is a recognized mental health condition listed under disruptive, impulse-control and conduct disorders. It has defined diagnostic criteria. It is treatable with therapy and medication.
Can intermittent explosive disorder be cured?
There is no one-time cure, but IED can go into remission. With CBT, many people reach a point where outbursts stop or become rare and mild. Outbursts may also become less severe with age.
What is the difference between IED and anger issues?
Everyone gets angry. IED is diagnosed when outbursts happen repeatedly, are far out of proportion to the trigger and cause real problems at home, work or with the law. Occasional anger that you can control is not IED.
