IED Signs, Symptoms & Effects

Intermittent explosive disorder (IED) is a mental health condition that is characterized by impulsivity, hostility, and recurrent aggressive outbursts.

Understanding IED

Learn about IED

The violent behavior and angry outbursts associated with this disorder are grossly out of proportion to the activating situation. Individuals with IED may attack others, break possessions, and cause bodily harm and property damage. During the aggressive episodes associated with this disorder, a person may suddenly lose control, break or smash things, hit or try to hurt someone, or threaten to hurt someone.

This disorder is typically diagnosed in the early teen years after an individual has had at least three episodes of impulsive aggressiveness at any time. Those with IED describe their aggressive episodes as spells or attacks in which the explosive behavior is preceded by a sense of tension or arousal and then followed by a sense of relief. After the sense of relief dissipates, the individual usually feels upset, remorseful, or embarrassed about the behavior. While this disorder can be extremely disruptive, with the proper treatment and medication, you can learn how to get your anger under control and react appropriately to specific situations.


IED statistics

According to the National Institute of Mental Health, intermittent explosive disorder affects as many as 7.3% of adults, which equates to 11.5-16 million Americans, throughout their lifetime. Of those in the United States diagnosed with IED, 67.8% had engaged in direct interpersonal aggression, 20.9% in threatened interpersonal aggression and 11.4% engaged in aggression against objects.

Causes and Risk Factors

Causes and risk factors for IED

Like most types of mental illness, it is thought that the cause of intermittent explosive disorder is a combination of genetic and environmental factors.

Genetic: There may be a genetic component that causes this disorder to be passed down from parents to children. The likelihood that you may be diagnosed with this heritable condition increases if you have a first-degree relative who also has IED or who struggles with other psychiatric conditions.

Environmental: Some individuals believe that IED is caused by growing up in an environment where unduly harsh punishments were carried out by parents. Children in this environment may grow up believing that violence is the best way to restore damaged self-esteem or to solve problems. Additionally, as a child, they may have witnessed their parents or others close to them act out explosively or in violent ways which could serve to normalize these behaviors.

Risk factors:

  • Being male
  • Presence of a co-occurring mood, anxiety, or personality disorder
  • Certain medical conditions
  • Traumatic brain injuries
  • History of physical abuse

Signs and Symptoms

Signs and symptoms of IED

The explosive eruptions of intermittent explosive disorder usually last less than 30 minutes, resulting in verbal assaults, injuries, and the deliberate destruction of property. These episodes occur in clusters separated by periods of nonaggression. Some symptoms experienced by individuals with IED may include:

Behavioral symptoms:

  • Breaking things and causing property damage
  • Verbal and physical aggression
  • Road rage
  • Constantly getting into fights
  • Increased energy
  • Acts of self-harm
  • Suicidal ideation and/or suicide attempts

Physical symptoms:

  • Bodily tension
  • Fatigue after an aggressive episode
  • Tingling
  • Tremors
  • Chest tightness
  • Hearing an echo
  • Heart palpitations

Cognitive symptoms:

  • Racing thoughts
  • Inability to concentrate or focus
  • Poor performance in school or work settings

Psychosocial symptoms:

  • Low frustration tolerance
  • Intense anger
  • Irritability
  • Rage
  • Depressed mood
  • Guilt
  • Shame


Effects of IED

The long-term effects of untreated intermittent explosive disorder can affect virtually every part of a person’s life. People with IED experience significant impairment in their daily functioning and the longer the disorder goes untreated, the harder it is to successfully recover from IED. Long-term effects of untreated intermittent explosive disorder include:

  • Loss of job
  • School suspension
  • Divorce or problems with personal relationships
  • Impairment in social areas
  • Accidents
  • Hospitalization due to injuries from fights or accidents
  • Financial problems
  • Incarceration or other legal problems

Co-Occurring Disorders

IED and co-occurring disorders

It is common for those with intermittent explosive disorder to have another mental disorder as well. Some of the most common co-occurring disorders include:

  • Anxiety disorders
  • Depression disorders
  • Substance use disorders
  • Bipolar disorder
  • Personality disorders

It was devastating watching our little girl battle her issues and not knowing how to help her. We were referred to Longleaf and it’s truly amazing the difference we’ve seen in just a short time.

– Anonymous Patient
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