Understanding Intermittent Explosive Disorder And How To Treat It

By Sarah Fader |Updated March 30, 2022
CheckedMedically Reviewed By Whitney White, MS. CMHC, NCC., LPC


Anger is a normal part of life. It can come on in response to small irritants or major events. For some, anger responses may become unpredictable and cause problems in relationships, at work, and at home. When these interruptions to life occur because of anger, it is time to reach out for help.

Intermittent explosive disorder causes explosive outbursts of anger that are frequently accompanied by violence and disproportionate to the issue or situation at hand. Punching, kicking, screaming, or throwing things may occur. Being at the receiving end of this type of rage is scary, and for those who live with this problem, it can feel frightening to be out of control to such a degree.

An individual that is diagnosed with intermittent explosive disorder (IED) should seek the help of a professional to treat their condition. If left untreated, it can lead to some very dangerous situations. As with any mental health diagnosis, it is important to learn about your condition and what techniques help.

Intermittent Explosive Disorder Causes

You may be wondering where this diagnosis comes from. How can someone seemingly wake up one day and become explosive or dangerous? Where did it come from? Why is this happening? These questions are all very valid. It is likely that these behaviors did not come out of nowhere, but instead are built up throughout a lifetime of increased stress, anxiety, or fear.

While a direct cause has not yet been correlated, the rate of those being diagnosed with intermittent explosive disorder has been discovered to be very high in military personnel. It is largely believed that while the military is trained to focus and sustain life in a highly stressful situation, it leaves them ill-equipped for civilian life afterward. When living in a heightened state of awareness, one's stress level increases and may cause over-reactions to the simplest triggers in life.

Imagine living in a war zone for several years, where enemies are continuously trying to kill you and your friends. You barely sleep, and when you do, you have this intense fear that you will not wake up. Then, you come back into your home community and are expected to put all those experiences aside and go back to life as normal. It is extremely difficult, if not nearly impossible, to do this. Something as simple as a child ringing your doorbell to sell candy can startle you and may even trigger rage.


Given this knowledge, it is safe to say that children who grow up in a household with high tension are much more likely to exhibit signs of this disorder as they grow older. This would include children who have been exposed to war, domestic violence, and child abuse. Children especially have a very difficult time identifying and understanding their anger, which can manifest itself in many ways.

In infants and toddlers, this can look like tantrums, biting, or kicking. In pre-teens and teenagers, it can manifest as violence towards siblings or parents, getting in trouble with the law, or fighting in school. Many times, children do not even understand that they feel anger, they just appear to have reactions out of nowhere. However, these behaviors usually stem from something in the individual’s past or upbringing. By working with professionals, they can identify what is causing these children to act out in such anger and how to help them to choose more appropriate ways to exhibit their feelings.

While the cause of intermittent explosive disorder is not always concretely identifiable, it is essential to recognize the signs and symptoms of this disorder, and take proper measures to receive treatment from a professional.

Intermittent Explosive Disorder In The DSM-5

The Diagnostic and Statistical Manual of Mental Disorders has included intermittent explosive disorder in its Fifth Edition. According to the DSM-5, there are several intermittent explosive disorder symptoms. Some, but not all, include:

  • Unprovoked and unjustified angry outbursts.
  • Physical or verbal aggression.
  • An angered response that is more excessive than what triggered it.
  • Outbursts that occur at least twice weekly for several months.

These angry outbursts can result in abusive behaviors, destruction of property, or lashing out towards strangers. During times of anger, the ability to think rationally about actions and control behaviors may be reduced. Therefore, the chances of someone getting hurt as a result of an outburst are higher. It is important to receive a proper diagnosis and begin treatment as soon as possible.

As stated above, this condition can only be diagnosed by a licensed mental health professional, so it is essential to seek professional help if you or someone you know has been exhibiting these signs and symptoms.

Intermittent Explosive Disorder Treatment

There are several ways to treat intermittent explosive disorder. The most popular form of treatment is medication. Medications for IED aim to lower impulsivity and raise one's mood. If someone is feeling happier and less impulsive, it is less likely that they would respond to potential triggers with anger and rage. It is important to feel in control of your body and mind to live a healthy life.

However, sometimes medications may mask the root of the problem. For that reason, therapy is also used. By speaking with their therapist, one can understand the root causes of anger, along with its triggers, and coping skills for moments of rage. In doing this, the first step is to recognize that the present state of anger and rage is not healthy and must be changed. Then, other treatments, such as anger management or cognitive-behavioral therapy, can be utilized. Therapists can help to establish why the anger is present and how to dissipate it. Additionally, they can help with breathing exercises and other stress-management techniques.


In serious cases of intermittent explosive disorder, an inpatient stay at a mental health facility may be appropriate. There, the patient can be monitored and given appropriate medication and treatment, while keeping the patient and others safe. Often, while admitted, the patient can receive anger management services, therapy services, and sessions with a psychiatrist. Once the patient is stabilized, he or she would be released to practice their newly learned skills while continuing outpatient therapy.

Treatment of this condition is essential. If left untreated, it isn't uncommon to have trouble with the legal system, physical violence in relationships, and damaged relationships with family and friends. By accepting an IED diagnosis and seeking professional treatment, the individual can begin to a treatment plan, and get on the path to living a happy, healthy, and productive life. Family and friends can also help by being supportive and involved with treatment.

Most people can benefit from anger management techniques, not just those diagnosed with intermittent explosive disorder. These are techniques that children should learn throughout their lives so that they can better accept troubles that will occur in their lifetime. Often, though, those experiencing IED will require the help of a mental health expert to manage their symptoms.

Seeking Professional Help


There is an increasingly large body of evidence pointing to online therapy as a beneficial form of treatment for those experiencing emotional regulation issues arising out intermittent explosive disorder. In one case study, researchers looked at the benefits of online therapy, and in particular cognitive-behavioral therapy, when treating IED. The participants reported significantly decreased incidences of aggression, in addition to an increase in positive emotions and self-esteem following treatment. This finding corresponds with the conclusions of a similar study in which anger was successfully decreased after an online cognitive therapy program. Cognitive-behavioral therapy works by helping individuals reframe the negative thought patterns that can often lead to unwanted feelings and behaviors, such as severe, problematic anger, so that triggering situations and interactions are more manageable.

As mentioned above, if you feel as though you or someone you know exhibits signs and symptoms of intermittent explosive disorder, online therapy is a flexible and effective option. BetterHelp has thousands of licensed mental health professionals that are waiting to assist you. With more options than just those therapists in your area, you’ll be more likely to find someone with experience treating your exact symptoms. The qualified experts at BetterHelp are ready to provide you with the tools necessary to control unwanted anger. Read below for counselor reviews, from those who have experienced similar issues.

Counselor Reviews

“I'm happy I had counseling with Glenn. I used to struggle with anger and trust issues towards my husband when I first talked to Glenn. He listened to me attentively and asked questions delicately and politely. I felt that he cared about my case and really wanted to help me. And he did help me solve my relationship problems. Glenn taught me to forgive, manage conflicts, and express and receive love. Now I enjoy my close and intimate relationship with my loved one, and there's no place for anger and hate in me any more. Finally I feel understood, supported, happy and calm. And I'm so thankful to Glenn for guiding me there.”

“Regina helped me pinpoint where my anger issue stemmed from in the very first session, and has been helping me become more self aware of my warning triggers. Very insightful and helpful!”


If you’re living with IED, know that help is out there. You can spend less time worrying about a potential outburst, and more time living a healthy, happy life. Sometimes, reaching out to a professional can make all the difference. Take the first step today.

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