Intermittent explosive disorder becoming more common

Over the years I have written columns about most of the commonly occurring psychiatric disorders.

One disorder that hasn’t been covered so far, but which is now known to be much more common than once thought, is called intermittent explosive disorder.

The name describes it pretty well. It is a condition involving impulsive aggression. Individuals experiencing intermittent explosive disorder tend to blow up from time to time in aggressive outbursts.

Of course, many people have the occasional outburst when faced with particularly stressful situations or people—when we’re overly tired and the irritants of the day seem to be relentlessly pursuing us.

In order to be diagnosed with this particular condition though, the individual has to have periodic aggressive outbursts that are impulsive in nature and involve aggression (verbal or physical) that is grossly out of step with the provocation or stressor involved.

Aggressive behaviour that is labeled intermittent explosive disorder must not be easily explained by another mental or physical illness or substance use.

These are aggressive outbursts that clearly go beyond the scope of a normal snappy remark or shouting match.

Think of extreme road rage scenarios as a good example.

Stopping at an intersection to get out and use a golf club to seriously smash up a stranger’s vehicle because of getting cut off—this goes well beyond a normal reaction to an admittedly infuriating experience.

People experiencing this condition often describe their outbursts as brief (lasting less than an hour), being accompanied by physical symptoms such as sweating or palpitations and immediately followed by relief and later remorse.

Obviously, outbursts such as these are extremely destructive for the people having them and everyone around them.

Until recently, this condition was thought to be quite rare.

Research over the past decade has now shown it is just as common as many other psychiatric conditions—affecting anywhere from three to seven per cent of the population.

It can begin in childhood, adolescence or early adulthood and it is chronic in nature.

Studies have found it can persist for as few as 12 years or for most of adult life.

Although it is considered a unique disorder, intermittent explosive disorder often co-exists with other psychiatric conditions such as bipolar disorder, depression or anxiety. While there are some treatments that seem to help, much more research is needed.

Cognitive behaviour therapy helps some people with impulsive aggression to recognize their behaviour and learn to control it.

Some antidepressant medications have also shown promise in treating intermittent explosive disorder. If you think you or a loved one may experience intermittent explosive disorder, speak with your doctor about it.

You will likely need an assessment from a mental health professional to rule out other conditions and determine the best option for moving forward.

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