Impulse Control Disorders Intermittent Explosive

Sometimes anger management issues go far behind the occasional slammed door and harsh words. People with an anger disorder, or “intermittent explosive disorder,” have angry outbursts that seriously affect their lives and the lives of those around them. They may have lost jobs, been kicked out of school, gone to jail, strained relationships or been injured because of their anger disorder.

Recognizing Intermittent Explosive Disorder Episode

People with explosive anger disorder experience strong impulses to act dangerously and aggressively, and are often unable to control themselves. These individuals often experience growing tension before outbursts, and may initially feel relief after letting out their anger. Shame, remorse, regrets and embarrassment also frequently follow anger disorder attacks. Other symptoms include:

  • Growing feelings of rage
  • Heightened energy and intensity
  • Pressure in the head
  • Racing thoughts
  • Tightness of the chest
  • Tingling
  • Tremors.

Diagnosing an Anger Disorder

According to the DSM-IV, patients must meet the following three criteria in order to receive an official explosive anger disorder diagnosis:

  • The patient has a history of several episodes of serious assaults and/or damage to property due to an inability to resist aggressive impulses.
  • The aggressive response is completely out of proportion to any precipitating event or stress.
  • All other causes have been ruled out, including head injury, substance abuse, medication side effects, conduct disorder, personality disorders and attention deficit/hyperactivity disorder.

Many patients with an intermittent explosive disorder diagnosis have other mental illnesses, making it difficult to determine which problem spurs the other. In children, symptoms of an anger disorder may be linked to a more general conduct disorder, while in adults, patients with certain personality disorders may also exhibit challenging aggressive behavior.

Causes of Intermittent Explosive Disorder

Researchers studying the causes of explosive anger disorders suggest a combination of environmental and genetic factors. Intermittent explosive disorder patients often grow up in violent homes, suggesting that a tendency toward an anger disorder could be both learned and genetic. Seizures, hormone imbalances, migraines and other medical conditions have also been linked to intermittent explosive disorder.

Explosive Anger Disorder Management

Helping patients gain control over their aggressive behavior is the goal for treating patients with an explosive anger disorder, but sometimes — if the patient refuses treatment or is in crisis — the first step must be protecting or removing those around the affected individual. Contact a doctor or a domestic violence hotline for more information.

Cognitive behavioral therapy can help intermittent explosive disorder patients manage their behavior. Group therapy can also be effective. A range of prescription medications, including antidepressants, anticonvulsants, anti-anxiety drugs and mood regulators, has helped many patients cope with an anger disorder.


Hucker, S. J. (2005). Impulse control disorders. Retrieved July 12, 2010, from

Mayo Clinic. (2010). Intermittent explosive disorder. Retrieved July 12, 2010, from

Ploskin, D. (2007). What is intermittent explosive disorder? Retrieved July 12, 2010, from