Overview

Intermittent explosive disorder involves repeated, sudden bouts of impulsive, aggressive, violent behavior or angry verbal outbursts. The reactions are too extreme for the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may be symptoms of intermittent explosive disorder.

These explosive outbursts, which occur off and on, cause major distress. They can harm relationships and cause problems at work or school. They also can result in problems with the law.

Intermittent explosive disorder is a long-term condition that can go on for years. But the severity of outbursts may lessen with age. Treatment involves talk therapy and medicine to help you control your aggressive impulses.

Symptoms

Impulsive attacks and angry outbursts occur suddenly, with little or no warning. They usually last less than 30 minutes. These bouts may occur often or be separated by weeks or months. Verbal outbursts or less severe physical attacks may still occur in between these times. You may be irritable, impulsive, aggressive or angry most of the time.

Before an aggressive bout, you may feel:

  • Rage.
  • Irritability.
  • More tension and energy.
  • Racing thoughts.
  • Tingling.
  • Shaking.
  • Fast or pounding heartbeat.
  • Chest tightness.

The explosive verbal and behavioral outbursts are much too intense for the situation, with no thought about what might happen as a result. The outbursts can include:

  • Temper tantrums.
  • Long, angry speeches.
  • Heated arguments.
  • Shouting.
  • Slapping, shoving or pushing.
  • Physical fights.
  • Property damage.
  • Threatening or harming people or animals.

You may feel a sense of relief and tiredness after the outburst. Later, you may feel guilty, sorry for your actions or embarrassed.

When to see a doctor

If you recognize your own behavior in the description of intermittent explosive disorder, talk with your doctor or other health care professional about treatment options. You also can ask for a referral to a mental health professional.

Causes

Intermittent explosive disorder can begin in childhood — after the age of 6 years — or during the teenage years. It's more common in younger adults than in older adults. The exact cause of the disorder is not known. It may be caused by the living environment and learned behaviors, genetics, or differences in the brain.

  • Living environment. Most people with this condition grew up in families where explosive behavior and verbal and physical abuse were common. Children who see or go through this type of violence at an early age are more likely to have these same traits as they grow up.
  • Genetics. Genetics may play a role. There could be a gene related to the tendency to react more easily to stress. This gene may be passed down from parents to children.
  • Differences in how the brain works. There may be differences in the structure, function and chemistry of the brain in people with intermittent explosive disorder compared with that of the brains of people who do not have the disorder.

Risk factors

These factors raise your risk of developing intermittent explosive disorder:

  • History of physical abuse. Being abused as a child, being bullied, or going through other disturbing, shocking or painful events can raise the risk of having intermittent explosive disorder.
  • History of other mental health conditions. Having antisocial personality disorder or borderline personality disorder may raise the risk of also having intermittent explosive disorder. So can having other disorders that include disruptive behaviors, such as attention-deficit/hyperactivity disorder (ADHD). Problems with alcohol and drugs also can be a risk factor.

Complications

People with intermittent explosive disorder have a higher risk of:

  • Problems with relationships. Others often think that people with intermittent impulsive disorder are always angry. Verbal fights or physical abuse can happen often. These actions can lead to relationship problems, divorce and family stress.
  • Trouble at work, home or school. Complications of intermittent explosive disorder may include job loss, school suspension, car accidents, money problems or trouble with the law.
  • Problems with mood. Mood disorders such as depression and anxiety often occur with intermittent explosive disorder.
  • Problems with alcohol and drug use. Problems with alcohol or drugs often occur along with intermittent explosive disorder.
  • Physical health problems. Medical conditions are more common and can include, for example, high blood pressure, diabetes, heart disease and stroke, ulcers, and ongoing pain.
  • Self-harm. Self-injury or suicide attempts sometimes occur.

Prevention

If you have intermittent explosive disorder, prevention is likely beyond your control unless you get treatment from a mental health professional.

After you start treatment, follow the plan and practice the skills you learn. If medicine is prescribed, be sure to take it. Do not use alcohol or drugs.

When possible, leave or avoid situations that upset you. Also, scheduling personal time to allow you to lower stress may help you to better handle an upcoming stressful or frustrating situation.

By Mayo Clinic Staff