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Intermittent Explosive Disorder (IED) is a behavioral impulse control disorder marked by strong, abrupt outbursts of anger that seem inappropriate to the circumstance at hand. 

The disorder may continue over an extended period and prove problematic for the affected individual, like leading them to alienate loved ones and friends or even endangering the lives of those in proximity. IED can take a toll on your mental health and it can be really difficult and exhausting for the people around you.

Living with someone who has the intermittent explosive disorder is a real challenge. Nevertheless, if you or a family member, friend, coworker, or classmate is experiencing the symptoms of intermittent explosive disorder, there are a handful of methods, precautions, and treatments you will guarantee your safety and assist the troubled individual.

If you do not seek professional treatment for your intermittent explosive disorder, dealing with IED is likely beyond your control. These strategies, in conjunction with or as part of treatment, may help you to avoid certain instances from spiraling out of control:

Continue with your therapy and treatment. Continue your therapy sessions, exercise your coping mechanisms, and take any medicine given by your doctor. Your physician may recommend maintenance medication to prevent further explosive episodes.

Practice relaxing techniques. Regular practice of deep breathing, mental visualization, and yoga or meditation may help you maintain your composure.

Create novel methods of thinking (cognitive restructuring). Transforming the way you feel about a stressful circumstance by employing rational reasoning, acceptable expectations, and logic could influence how you perceive and respond to an incident.

Use problem-solving. Create a plan to discover a solution to a difficult situation. Even if you cannot immediately resolve the issue, having a strategy can refocus your efforts.

Discover techniques to enhance your communication skills. Instead of speaking the first thing that comes to mind, understand the message the other individual is trying to deliver and then chose the best response.

Change your surroundings/environment. When feasible, leave or avoid upsetting circumstances. In addition, scheduling private time may assist you to face a forthcoming difficult or irritating circumstance more effectively.

Avoid taking mood-altering drugs. Do not consume substances such as alcohol or recreational drugs.

Prepare an escape strategy for emergencies. Ideally, you will not have to escape, but it is more beneficial to be safe than sorry. You should keep a spot in mind, like a friend’s house, where you can flee if necessary. Inform your family and friends about the issue in advance so that they can promptly come to your rescue.

Have a bag prepared and ready for an emergency exit. This bag may include clothing, cash, and other personal things.

Don’t be hesitant to contact the police if the situation worsens and you begin to feel in danger.

Avoid the circumstance. If a colleague or distant acquaintance is experiencing an IED episode, withdraw yourself from the scene. The person’s rage is generally unrelated to you, and you aren’t accountable for his or her emotions. Simply avoid the individual when he or she is experiencing an episode, or avoid them completely if the option is available, except if the individual is close to you and you wish to help.

Be wary of potential hazards. If the individual is experiencing extreme wrath, they may attempt to physically assault you. If you are aware that an incident is imminent, it may be prudent to remove any dangerous or harmful objects, like firearms, from the vicinity.

Find a secure location, such as a closed room or perhaps a safe, to store them until you are certain they are safe.

Learn the individual’s triggers. Many IED incidents may be unexpected, but if you are close to the individual, you should attempt to determine the types of situations that commonly trigger his or her episodes. This could include doing homework, driving, making payments, or any other potentially upsetting activity. Occasionally, it may be specific to the individual and not what you would expect; therefore, pay close attention to the individual’s conduct and the circumstances immediately preceding an episode.

Once you are aware of the triggers, you will be better equipped to either help the individual avoid an episode by guiding them away from the triggers or soothing them to prevent a full-blown attack, or to exit the situation yourself.

Practice using empathetic language. Reflecting on the person’s words is an effective strategy to prevent an IED incident from escalating, particularly if you are the subject of the rage. This will demonstrate that you are interested in his or her feelings, that you are not a threat, and that you are merely attempting to comprehend.

If the person shows frustration at being neglected by a waiter, you can respond, “So you feel insulted by the waiter’s lack of attention?”

Having a partner with IED might be challenging. Therefore, it is essential to have assistance and the proper skills to manage episodes when they occur. Here are four tips for dealing with IED-carrying individuals:

1. Stay calm

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As tempers only last approximately 30 minutes, it is advisable to wait until that time has passed and your partner has returned to their usual senses and emotions. They will probably be better equipped to resolve conflicts when they are in a more tranquil mood. It’s vital to realize that responding to anger with fury is never a good decision and typically leads to a downward cycle of even more furious emotions.

2. Be compassionate

Your partner may certainly feel guilty and ashamed following a tantrum. Leading with more guilt and humiliation will not fix the problems in the long run. Instead, try to consider things through the eyes and viewpoint. This will have a more significant effect on problem-solving.

3. Set Boundaries

Your privacy must always be respected. Thus, you should never feel forced to prioritize your partner’s needs over your own. If you cannot accept your spouse’s rage, you must first establish limits.

4. Restore emotional security

Emotions such as mindfulness and generosity generate a sense of emotional security for your spouse and loved ones, allowing them to rapidly return to a level of stability and composure.

First, you must recognize that you are not accountable for calming down an angry person. They must be accountable for their own behavioral and psychological wellness. If someone you are concerned about has IED and you wish to assist them during their outbursts, you can use certain de-escalation strategies.

An effective de-escalation takes patience and calm. Try to dissociate as much as possible from your sentiments during the incident. It may be advantageous to acknowledge that the IED suspect’s behavior is beyond their control.

Individuals with IED may experience tremendously intense emotions, underdeveloped defense mechanisms (such as denial and projection), and ineffective reality-checking. All of these factors can make it virtually impossible to reason with them. Instead, you defuse. Here are a few particular de-escalation tactics that may be effective in the event of IED explosions:

  • Use gentle language instead of demeaning the individual.
  • Remain close enough to create rapport without invading the person’s personal space.
  • Utilize collaborative problem-solving strategies to reinforce the individual’s sense of autonomy. For instance, you can ask, “What can I do to rectify this?”
  • Don’t give unreasonable demands or engage in internal strife.
  • Recognize the person’s rage. They may express their emotions so long as they do not cause harm to themselves or others.
  • Offer face-saving options to their aggression, such as a period of cooling off.
  • Employ active listening abilities, which demonstrate positive engagement.
  • Offer empathic remarks, such as, “It sounds like you’re in a lot of pain.”
  • Do not revisit what occurred or who was to blame. Continue to consider various solutions to the situation.
  • Use calm nonverbal cues and a sympathetic tone of voice on purpose. Do not add to the drama.
  • Utilize positive reinforcement once the individual has regained control.

If you feel intimidated, you will need to adopt a more assertive stance. You may need to switch from a supportive to a controlling position or relocate to a safe area.

A partner of a person with IED may be familiar with the person’s emotional triggers and notice the signals of an impending outburst. For instance, a person carrying an IED may shake, have chest tightness, or become irritated. However, this does not mean that a partner can avoid the occurrence. They may even serve as the initial line of defense.

A loved one may see intense IED outbursts as emotional tyranny. It is never acceptable for someone to become physically or verbally abusive in an intimate relationship. Completely limit the person’s access to weapons and dangerous objects that they could use to hurt themselves or others. Create a plan of escape that you can implement if you feel intimidated.

Sadly, only a minority of IED sufferers receive treatment. They might never recognize the detrimental effects of their uncontrollable explosive episodes. If the person you love is unwilling to acknowledge they have a problem and work on moderating their impulsive aggression, you may need to leave the situation permanently to protect yourself.

Typically, medication and psychotherapy are the first-line treatments for IED disorders.

Medication

Although there are no particular treatments for IED, there are numerous viable alternatives, such as:

  • Anti-anxiety drugs, like beta-blockers (nadolol and propranolol)
  • Antidepressants like selective serotonin reuptake inhibitors (fluvoxamine, fluoxetine, and citalopram).
  • Anticonvulsant mood stabilizers, such as topiramate and valproic acid.

It is crucial to know that mental health drugs may take up to two months to reach their full impact. In addition, individuals may require a prescription for the long term.

Drugs that are dumped improperly can be harmful to humans, animals, and the surroundings. It is necessary to dispose of unused medications securely. Here is our medication disposal guide.

Psychotherapy

So far, research on cognitive behavioral therapy and IED appears promising, while additional studies are required.

Cognitive behavioral therapy (CBT) can assist you in recognizing uncomfortable thinking patterns and understanding how they may be influencing your behavior. In addition, you may acquire coping strategies, communication skills, and relaxation techniques.

Additionally, dialectical behavior treatment (DBT) may be a viable choice. One study revealed that this method was beneficial to deal with explosive anger in individuals with borderline personality disorder, a mental health problem that is also associated with trauma.

Anger Management Training

Some evidence suggests that training in regulating emotions and anger management helps ameliorate IED symptoms.

These programs may teach you how to respond to situations in a less stressful manner while sharing your emotions directly.

A therapist may be able to direct you to anger management training or support networks in your region. Several online choices offer anger management certifications and other training.

Supplementation with omega-3 fatty acids, vitamins, and minerals may be beneficial for aggressive adults and children.

A recent study in the journal of Child Psychology and Psychiatry provided evidence that cognitive behavioral treatment (CBT) and dietary supplements may reduce violent behavior in children.

Adrian Raine, Ph.D., a professor at the University of Pennsylvania and the study’s principal author, told Pharmacy Times that pharmacists could readily incorporate these findings into their practice.

He said that If pharmacists provide omega-3 and multivitamins to parents whose children exhibit substantial aggressive behavior and do not react to other treatments, there is little downside.

Dr. Raine and his colleagues analyzed a “high-risk community sample” of nearly 300 eleven to twelve-year-old youngsters. The children were randomly allocated into four groups: nutrition-only, CBT-only, nutrition-plus-CBT, and control. The data was collected from 2009 to 2013.

The omega-3 supplement consisted of a daily 200-mL drink providing 1000 mg of omega-3, while the daily multivitamin had 12 different vitamins and seven minerals. The youngsters consumed 1 chewable tablet of this multivitamin, coupled with another chewable tablet containing 600 mg of calcium and 400 g of vitamin D.

The CBT comprised a dozen 1-hour treatments with weekly home exercises for childcare providers. The students were urged to develop their decision-making, coping, and problem-solving abilities.

The control group received several assistance resources, which parents and children were free to use as they thought appropriate.

The researchers assessed child and parent-reported violent, antisocial, and disruptive behavior at baseline, three months (treatment termination), six months, and twelve months.

After the study, the researchers did uncover evidence that the nutrition-only group was less aggressive than the control group. In addition, CBT plus nutrition was more effective at reducing aggression three months after therapy than CBT alone or the control group.

  1. Understanding intermittent explosive disorder (IED), Thriveworks. Available at: https://thriveworks.com/blog/intermittent-explosive-disorder-defuse-angry-outbursts.
  2. How to deal with a person with IED. wikiHow. Available at: https://www.wikihow.com/Deal-With-a-Person-With-IED.
  3. Ways to handle an explosive spouse. Relationship Therapy Center. Available at: https://www.therelationshiptherapycenter.com/blog/2021/9/1/4-ways-to-handle-an-explosive-spouse.
  4. Vitamins and supplements may reduce aggression in children. Pharmacy Times. Available at: https://www.pharmacytimes.com/view/vitamins-and-supplements-may-reduce-aggression-in-children.
  5. Intermittent explosive disorder. Mayo Clinic. Mayo Foundation for Medical Education and Research. Available at: https://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/symptoms-causes/syc-20373921.

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