Intermittent Explosive Disorder

Intermittent Explosive Disorder: Understanding the Fury Beneath the Surface

What Is Intermittent Explosive Disorder?

Intermittent Explosive Disorder (IED) is a mental health condition characterized by recurrent, sudden episodes of impulsive aggression that are disproportionate to the situation. These outbursts may take the form of verbal tirades or physical assaults and are often described by sufferers as occurring with little to no control. While the episodes are brief, their emotional and social consequences can be devastating.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies IED under Disruptive, Impulse-Control, and Conduct Disorders, typically beginning in late childhood or adolescence (American Psychiatric Association, 2013). The National Institute of Mental Health (NIMH) estimates that IED affects approximately 2.7% of U.S. adults annually, with the condition being more common in males and individuals with a history of trauma (NIMH, 2022).

Causes of IED

The development of Intermittent Explosive Disorder is multifactorial, influenced by neurological, genetic, and environmental variables. Key contributing factors include:

• Brain abnormalities: Neuroimaging studies suggest dysfunction in the prefrontal cortex and amygdala, regions tied to emotional regulation and impulse control (Coccaro et al., 2007).
  
  

• Serotonin imbalance: Disruption in the serotonergic system, which regulates mood and behavior, has been linked to heightened aggression (McCloskey et al., 2009).
  
  

• Genetic influences: A family history of mood disorders, aggression, or substance abuse increases susceptibility.
  
  

• Childhood trauma: Abuse, neglect, or chronic exposure to violence during formative years often precedes IED onset.
  
  

Interestingly, many individuals with IED are aware of the irrational nature of their outbursts, which distinguishes the disorder from premeditated or goal-oriented aggression.

Symptoms

Though each episode is short-lived, the pattern is often repetitive and distressing. Common symptoms include:

• Sudden temper tantrums, road rage, or domestic violence.
  
  

• Verbal outbursts such as shouting, insults, or threats.
  
  

• Physical aggression toward people, animals, or property.
  
  

• Physiological arousal like heart pounding, tremors, or chest tightness.
  
  

• Post-episode guilt or emotional exhaustion.
  
  

The aggressive episodes in IED are not explained by other mental disorders (e.g., bipolar disorder, antisocial personality disorder) or substance use, which helps in differential diagnosis (APA, 2013).

Societal Factors and Misconceptions

IED is widely underdiagnosed and misunderstood, particularly in environments where aggression is normalized or valorized. Cultural expectations about masculinity, especially in male-dominated societies, may cause violent outbursts to be dismissed as “hot temper” rather than a psychiatric concern.

In many communities, expressions of rage are not recognized as medical symptoms but are instead viewed through moral or spiritual lenses. This is especially the case when individuals claim to feel “taken over” during their rages—leading some cultures to interpret IED as possession, evil eye, or ancestral curse.

Additionally, individuals with IED are more likely to encounter the legal system than the mental health system, due to the destructive and visible nature of their behavior (Kolla & Zucker, 2020). This criminalization rather than treatment perpetuates cycles of stigma, isolation, and untreated mental illness.

HAQ’s Embrace

At the Home of Abrahamic Quiver (HAQ), we don’t simply see a diagnosis—we see a soul at war. We believe that uncontrollable anger may signal more than just disrupted brain chemistry. For some, it may reflect spiritual unrest, ancestral burdens, or the presence of forces science does not yet understand.

Many who suffer from IED describe feeling possessed, outside of themselves, or overwhelmed by an unknown power. Rather than dismissing this as metaphor or delusion, HAQ listens. We do not reduce these experiences to biology alone. We respond with faith-based intervention, spiritual restoration, and sacred support.

If you feel like something greater is moving through your fury—something unnameable, something beyond control—then HAQ is here. Not to label. Not to judge. But to walk with you into healing.

References:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  
  

• Coccaro, E. F., McCloskey, M. S., Fitzgerald, D. A., & Phan, K. L. (2007). Amygdala and orbitofrontal reactivity to social threat in individuals with Intermittent Explosive Disorder. Biological Psychiatry, 62(2), 168–178. https://doi.org/10.1016/j.biopsych.2006.08.035
  
  

• Kolla, N. J., & Zucker, K. J. (2020). Aggression and impulse-control disorders: A critical review of research. Current Opinion in Psychiatry, 33(1), 62–69.
  
  

• McCloskey, M. S., Berman, M. E., Noblett, K. L., & Coccaro, E. F. (2009). Serotonin and impulsive aggression. CNS Spectrums, 14(12), 647–655. https://doi.org/10.1017/S1092852900024176
  
  

• National Institute of Mental Health. (2022). Intermittent Explosive Disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/intermittent-explosive-disorder
  
  

“The Rage Wasn’t Mine”
A fictional narrative from the perspective of a 30-year-old man living with Intermittent Explosive Disorder

It would start with something small.

A wrong word. A slammed door. A delay at the checkout line. And suddenly, everything inside me would boil—fast, volcanic, like lightning cracking through my spine.

I never planned to get angry. I didn’t want to scream. But in that moment, it was like someone else had grabbed the wheel. I’d black out—not literally, but mentally. I’d feel my voice rising, my hands shaking, something in me—unleashed. Plates shattered. Doors slammed. My fists once went through a wall.

I saw the way my girlfriend flinched when I raised my voice. The way my younger brother stopped inviting me over. The way my boss told me, “You’re smart, but you scare people.”

I knew something was wrong. I tried therapy. Anger management. Even medications. But they made me feel like a zombie. Doctors said I had Intermittent Explosive Disorder. I didn’t know what that meant at first, except that now my rage had a label. But a label didn’t stop the explosions. A name didn’t stop the shame.

The worst part? The guilt after. I’d sit in the quiet ruins of whatever I’d just broken—my mom’s vase, a relationship, someone’s trust—and feel this choking sense of, What just happened? That wasn’t me.

And maybe it wasn’t.

HAQ’s Embrace

At the Home of Abrahamic Quiver, we know there are some things science can name—but not heal.

For those living with IED, the anger isn’t always about temper—it’s often something deeper. A buried cry. A spiritual imbalance. A wound in the unseen part of the soul.

Some outbursts are not just psychological. They may be spiritual interference. Restless ancestral grief. Or even unseen burdens passed down from generations. At HAQ, we do not diagnose. We do not pathologize. We witness.

We offer ritual, spiritual alignment, prayer, and protection—without judgment, without shame. You are not a threat. You are not beyond redemption. We don’t see you as broken—we see you as overwhelmed by something too heavy for one soul to carry alone.

Let us carry it with you.