Intermittent explosive disorder: causes and symptoms.

We explain the characteristics of this complex psychological disorder.

Our emotional state is an area of our psychological life that, on many occasions, reveals itself as something beyond our control. This has positive consequences, some negative, and some involving risks. when certain types of mental disorders occur. 

For example, thanks to feelings and emotions we can live intensely all kinds of moments, learn quickly about the positive and negative consequences of our actions and even achieve better communication with others, but, sometimes, some Biological alterations can make our emotional reactions excessive or even out of place.

Intermittent explosive disorder (IED) is a clear example of this.However, in these cases the person diagnosed with this type of disorder sees his or her quality of life significantly limited by this mental alteration.

What is intermittent explosive disorder?

Along with pyromania, trichotillomania, pathological gambling and many other disorders, intermittent explosive disorder is part of what is known as impulse control disorders in the DSM-V diagnostic manual. In a nutshell, is characterized by sudden and relatively brief outbursts of violence, triggered by minimal situations.triggered by minimally frustrating or stressful situations, and which cannot be explained by substance use or injury.

People with TEI have a very low frustration threshold and any setback, no matter how insignificant it may seem, causes them to suddenly become angry, even if seconds before they were in a very good mood and laughing. Throughout these short episodes of anger, which usually do not last more than an hour, the person loses partial or total control over their behavior and on many occasions may even physically or verbally attack people nearby.

Once the outburst of rage has passed, people with intermittent explosive disorder usually realize for themselves that what they have done has been harmful to others, and will often feel guilty.

Symptoms

The symptoms of intermittent explosive disorder vary somewhat depending on which diagnostic manual is used as a reference, but are primarily based on the following the occurrence of short bursts of anger, expressed through physical or verbal violence, which are disproportionate to their causes and lead to a loss of control.These are disproportionate to the magnitude of their causes and involve a loss of control.

As the rage appears without premeditation, it is frequently expressed by interrupting a positive mood, and the violence does not have an instrumental purpose. The person presenting symptoms of intermittent explosive disorder does not aspire to achieve goals through aggression, but these are the result of his altered state of mind, which cannot be attributed either to substance abuse or to the existence of other disorders or deformed or damaged parts of his nervous system.

Thus, people with TEI can go into a rage in a matter of seconds when they interpret that someone is looking at them too much.The anger outbursts can occur in a wide variety of situations, but they all have one thing in common: they would not be a cause of intense anger for the vast majority of the population. Anger outbursts can appear in a wide variety of situations, but they all have one thing in common: they would not be a cause of intense anger for the vast majority of the population.

As with all disorders, only certain mental health professionals can make a diagnosis of intermittent explosive disorder, almost always with the help of a DSM manual.

Other similar disorders

IED is closely related to bipolar disorder, which is hypothesized to be an early stage. In bipolar disorder, the moments of mania and euphoria may resemble the explosion of intense emotions that occur in intermittent explosive disorder.

However, the difference between both types of disturbances is, basically, that in intermittent explosive disorder, outbursts of rage can occur at any time, while in bipolar disorder they are linked to episodes of mania or depression, times when the mood was already altered before.whereas in bipolar disorder they are linked to episodes of mania or depression, moments in which the mood was already altered before.

As for antisocial personality disorder, in which outbursts of violence are also common, in these cases violence has an instrumental function, so that a specific purpose can be identified, whereas in IED there is no clear objective beyond behaviorally expressing the state of agitation and frustration in which the person finds himself.

Treatment of intermittent explosive disorder

As it is a mental alteration that cannot be linked to drugs or injuries but has to do with the way in which networks of neurons interact with each other and with environmental stimuli, TEI cannot be treated by intervening on a single specific factor, as if it were a wound.as if it were a question of healing a wound. Therefore, in these cases the intervention is usually a combination of cognitive-behavioral therapy and administration of psychotropic drugs (usually mood stabilizers and/or antidepressants).

Psychotherapy is often helpful in recognizing the early manifestations of anger outbursts, implementing plans to increase the level of control over the behavior and prevent others from being harmed, and developing coping strategies for dealing with guilt and feelings of sadness. In this way, patients learn to follow certain protocols when they begin to notice the first symptoms of an intermittent explosive disorder-induced crisis, and learn to regulate their behavior and their ideas about what is happening in a way that reduces distress both in themselves and in others.

Bibliographical references:

• Beck, A.T. and Freeman, A. (1995). Cognitive therapy of personality disorders. Barcelona: Paidós.
• Goodman, H.H. (Ed.). (1987). General psychiatry. Mexico: El Manual Moderno. (Orig. 1984).
• Jaspers, K. (1946/1993). Psicopatología General. Mexico: FCE.