Causes & Symptoms of IED

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Understanding IED

Intermittent explosive disorder (IED) is a mental health disorder that involves repeated episodes of impulsive, aggressive, and violent behavior or verbal outbursts in which a person reacts exceptionally out of proportion to the given situation. Those with IED may attack others and their possessions, often causing bodily harm and property damage. Furthermore, they may even harm themselves during an outburst. People who suffer from IED have described feeling as though they have suddenly lost control of their emotions and become completely overwhelmed by feelings of extreme anger. Additionally, they report that, prior to their episode of acting out, they feel a sense of tension building up as a result of their rage. Following the outburst, that individual may feel remorse, regret, or embarrassment. The good news is that while IED can be extremely disruptive to an individual’s life, as well as to the lives of those around him or her, it can be successfully managed through proper treatment. 


Intermittent explosive disorder is said to affect approximately 1 in 12 teenagers. It is also believed that nearly 82% of people who have IED are also suffering from another mental health disorder, with the most common being depression, bipolar disorder, and/or substance abuse disorders. 

Causes and Risk Factors

While the exact cause is unknown, the development of intermittent explosive disorder is believed to be the result of a combination of genetic, physical, and environmental factors, as described in the following: 

Genetic: Researchers and other professionals in the field have hypothesized that there is some genetic component to the presence of IED because the traits have been known to be passed down from parents to children. However, there has not yet been any specific gene identified as having the most prominent impact. 

Physical: It has been suggested that IED may occur as the result of abnormalities in the parts of the brain that are responsible for regulating behaviors, arousal, and inhibition. Impulsive aggression is also thought to be related to abnormalities in the areas of the brain that inhibit or prohibit muscular activity through the neurotransmitter serotonin. In the brain of those who have IED is has been shown that serotonin works differently.  

Environmental: Many people believe that the environment in which a person grows up can have a significant impact on whether or not he or she will develop the symptoms of intermittent explosive disorder. For example, it is believed by some that children who grew up in a home where they were given harsh punishments will develop the symptoms of IED because they are following the examples of the violent behaviors that were set by their parents. 

Risk Factors: 

  • Being male (IED is said to be more prevalent in males than it is in females) 
  • Exposure to violence 
  • Having been physically, sexually, or emotionally abused 
  • Growing up in a chaotic environment 
  • Traumatic brain injuries 
  • Certain medical conditions 
  • Family history of mental illness, especially mood disorders 
  • Family history of substance abuse 
  • Personal history of substance abuse 

Signs and Symptoms

The explosive eruptions associated with IED usually last about 30 minutes and may occur in clusters or be separated by weeks of nonaggression. The exact signs and symptoms of IED will vary from person to person. Examples of symptoms that a child or adolescent suffering from intermittent explosive disorder may exhibit can include: 

Behavioral symptoms: 

  • Physically attacking people 
  • Verbal aggressiveness 
  • Excessive, unprovoked angry outbursts 
  • Road rage 
  • Breaking or smashing things 
  • Damaging property 
  • Self-harm 

Physical symptoms: 

  • Muscle tension 
  • Increased energy 
  • Headaches 
  • Tightness in the chest 
  • Tingling sensations 
  • Tremors 
  • Heart palpitations 

Cognitive symptoms: 

  • Racing thoughts 
  • Feeling a sense of losing control 

Psychosocial symptoms: 

  • Irritability 
  • Shame 
  • Extreme anger 
  • Low frustration tolerance 
  • Periods of emotional detachment 
  • Depression  
  • Rage 
  • Guilt 


Without treatment, the long-term effects of IED can be detrimental on the lives of children or adolescents. Additionally, the ramifications of their behaviors have the possibility of being carried over into adulthood. Some examples of the negative effects of untreated intermittent explosive disorder can include: 

  • Academic failure 
  • Being suspended or expelled from school 
  • Low self-worth 
  • Inability to develop and maintain healthy interpersonal relationships 
  • Social isolation or impairment 
  • Substance abuse 
  • Depression 
  • Financial problems  
  • Legal problems / incarceration 
  • Self-harm 
  • Suicide attempts 

Co-Occurring Disorders

It is common for people who are suffering from IED to suffer from symptoms of other mental disorders as well. Some of the most common co-occurring disorders include: 

  • Conduct disorder (CD) 
  • Depressive disorders 
  • Oppositional defiant disorder (ODD) 
  • Personality disorders 
  • Anxiety disorders 
  • Attention-deficit hyperactivity disorder (ADHD) 
  • Bipolar disorder 
  • Post-traumatic stress disorder (PTSD)