What I Want You to Know About Having Intermittent Explosive Disorder

Ever have the feeling something was wrong, but you couldn’t really put your finger on it? Then, at the end of the day, you realize the common factor in all of your issues is… well, you?

I always seemed to have problems with relationships growing up: romantic, platonic, family and anything that involves personal or emotional feelings and some other being. However, the most potent and terrible fall-outs were always to do with romantic relationships. If I had to chalk up all the feedback from exes, the critiques would include words such as “selfish, dramatic, conceited, attention seeking, jealous,” and so on and so on. Now, let’s add a little depression and anxiety to the mix. Not really painting a pretty picture in the mind. When taking a small little sip of this concoction, all I could believe was that it was me — that I really was all of these negative adjectives, and I just needed to be more level-headed and relax, or as Dua Lipa says, “IDGAF.”

It wasn’t until I opted to seek help (mostly for the anxiety) that I was introduced to the possible diagnosis of intermittent explosive disorder, or IED. At the core of it, IED is more often associated with those who have bipolar disorder, post-traumatic stress disorder (PTSD), and more commonly diagnosed in men. IED is not something people will generally be able to self-diagnose, and in many cases, it is diagnosed while people are seeking help for a different issue (like I had been).

So, what exactly is it? At its core, it’s an inability to properly manage emotions, which results in episodes or outbursts. More often, IED commonly can result in angry episodes and outbursts in a violent manner.

Uhm… wait, what? I’m the most non-confrontational, introverted and unconfident person in the world. I’m scared to even tell a person elbowing me in the head at a rave to please move aside, let alone throw a punch. Did my psychiatrist diagnose me incorrectly?

After doing a bit of digging, reading up on some of the DSM-5 criteria, it started to actually make a little bit of sense. IED is anger in any form, not limited to just physical disruptions, but also emotional, or in my case verbal. See, there’s two main types of IED: criterion A1 and criterion A2. A1 is what I fall under, which is verbal or physical aggression, such as tantrums, verbal arguments or physical fights which can occur repetitively within a specific period of time (generally short-term) but does not lead to any kind of physical damage or injury. Criterion A2 is a few episodes over a longer period of time, which results in physical damage and/or injury. Not to bore you with DSM-5 mumbo jumbo, the next two (and probably most important) criterion is what really hit home for me:

Criterion B: Aggressive behavior is grossly disproportionate to the magnitude of the psychosocial stressors.

Or in layman’s terms, you tend to overreact.

For me, this really made sense when I started to pick at my brain and found all the fights and times I overreacted and said something I didn’t mean to. I mean, the other day, I yelled at one of my friends for simply trying to catch up and make plans to hang out with me. In relationships, I would make a big deal out of little things, and take it to a whole other level just because it made me feel better. I could yell at those I loved and cared for most, just for the sudden relief, and later on feel absolutely terrible about it. In some cases, I was lucky enough that they understood I didn’t mean what I had said, and we worked through everything and continued to be friends. In other cases, it was just irrevocable.

Criterion C: The outbursts are not premeditated and serve no premeditated purpose.

The following, and probably the most important criterion to me: you did not plan it, and you did not mean it.

I always thought it was some kind of secret underlying desire I was trying to get from them — that I was to blame and at fault, and I was just a bad person who subconsciously and unknowingly wanted something, and that was what caused the outbursts and episodes. But after kind of reviewing the DSM-5 criteria, I’m starting to learn I can’t help my emotions and impulses. After all, IED is categorized under “Disruptive, Impulse-Control, and Conduct Disorder” in DSM-5.

Although I am at the beginning stages of my diagnosis, the main takeaway has been as follows:

Don’t be afraid to talk to those around you.

Although some will be hesitant, it may not necessarily be because they think ill of you; it may be that they don’t know how to approach it and just need a little bit of guidance.

IED doesn’t seem to be a super common diagnosis. According to a study conducted from 2001-2003 by National Institute of Mental Health (NIMH), although about 7.3 percent of the population has it, and about 82 percent of those people also have a secondary disorder (such as depression, anxiety or substance abuse), only 28.8 percent have actually received treatment for their anger. If you’re looking at 100 people, that means 7.3 out of 100 have it, 6 out of 100 have a secondary disorder, and only 1.7 out of 100 have actually received any treatment for their anger. With those numbers, it’s quite surprising that IED isn’t better recognized.

In my case, I was actually pleasantly surprised by the support I received from a majority of those to whom I spoke. If for some reason your outcome is not as positive as mine, always remember that someone cares. I may not know you, but I extend to you my friendship and whatever guidance I can provide. I mean, it’s the least I can do because you’re listening to me rant, after all. But not even just me; your family, friends and mental health professionals are all included in that mix.

As someone with IED, my diagnosis has made it easier for me to understand and evaluate situations that have happened in the past. I am now also able to explain to my loved ones what to expect, such as a high likelihood of outbursts or me saying things I don’t mean when distressed, triggered or put into difficult-to-manage situations tied directly to my emotions. I’m also able to explain how to react — with patience and understanding I don’t mean what I say and can’t help what I mean — in order to better equip them with how to help me. If they don’t know what my diagnosis is, how can I expect them to be able to help me? Before being diagnosed, even I didn’t know what it was.

After diagnosis, speak with your mental health professional to figure out a treatment plan. For me, it is a mix of medication (antidepressants and anti-anxiety medication) along with weekly therapy with a licensed therapist.

I hope I’ve been able to shine a little light on what IED is, and if anything at all, provided you with better knowledge to help equip yourself or your loved ones to work with one another to get through this.

Lots of love,

Mia