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Parenting Children with Special Needs Blog

03/20/07

Intermittent Explosive Disorder

Posted by : Julie in Parenting Children with Special Needs Blog at 06:56 am , 502 words, 513 views  
Categories: Psychiatry, Disorders


“You know,” Super Dad commented, “LuLu is a great kid when she’s not out-of-control.” Yep, he’s got that right. And last weekend was great for LuLu. No explosions and lots of times when she turned around what could have been a meltdown. It was a nice conclusion to an overall peaceful weekend.

Friday, there was an explosion, though – a wall-kicking explosion that ended with another (sigh) hole in the drywall of our upstairs hallway. The effect of the hole explosion was immediate. I was on the phone about church business, and LuLu was upstairs cleaning her room with the hope of her allowance payoff and a trip on Saturday to the Disney store. Apparently something she had picked up fell off her bookshelf and frustrated her. One holler, one “boom” and the hole was there.

LuLu was immediately “scared” – or at least that’s what she said. “Scared of what?”, I asked. Scared that we would be mad or disappointed was what she reported. (And maybe in her shame-riddled self image, this is true.) I calmly told the person on the phone that I would need to call him back and worked to quickly calm LuLu.

And quickly it was. But she was dismayed (just like the $1 levied for using her dad’s mustache scissors), when I explained that she would need to pay for the wall repair out of her allowance. (After all, just before Christmas we hired a young man to repair the holes – so now it was her turn.) No Disney store for quite a few weeks. But, she accepted it and mostly dreaded telling Super Dad about the damage.

I tipped ol’ Super Dad off before he got home from work, so he wouldn’t inadvertently feed her fear by showing a strong disapproval (no yelling). And it quickly became a non-issue and a peaceful weekend.

Intermittent Explosive Disorder is a label LuLu wears. What is IED?

Intermittent explosive disorder (IED) is a mental disturbance that is characterized by specific episodes of violent and aggressive behavior that may involve harm to others or destruction of property. Usually, these episodes follow minor incidents and are out of proportion to the trigger.

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This is the diagnosis she carries instead of ODD (Oppositional Defiant Disorder) because she is not always oppositional and she is so darn remorseful after her explosive episodes.

IED is vastly more common in males than females, although it has been reported as part of Premenstral Syndrome (PMS).

Treatments range from medications (SSRIs, anticonvulsants, mood stabilizers) to cognitive behavioral therapy to neurofeedback.

Some researchers are looking for a link between IED and seizure activity in the temporal lobe.

There is still much the psychiatric world doesn’t know about IED (often associated with road rage) – and like so many disorders defined in the DSM, it is often referred to as “controversial”.

But around here the fact that LuLu has unprovoked explosions and that she is highly remorseful after the explosions – there’s nothing controversial about that!

Comments, Pingbacks:

Comment from: nancyderen [Member] Email
One of the controversial things about this diagnosis (and a reason I think it is way over-diagnosed) is that it gets used as a catch-all when doctors don't want to take the time to figure out why a person may be having explosive episodes. I've worked with lots of neurologically impaired people who had this diagnosis, and during treatment it became pretty clear that most of them actually had PTSD, depression, or bipolar disorder, and when these issues were treated, the explosive episodes decreased tremendously or stopped completely. My daughter has this diagnosis, too, along with many others, and I'm still not sure with her how much is PTSD (which she has), how much is depression (which she has), and how much is just how her brain is wired ("pure" IED, which is more like a seizure disorder in many ways). I have so far never met someone with IED who didn't have extremely valid reasons, based on either past trauma or present situation, to have enormous amounts of anger. Somehow I don't think this is a coincidence!
PermalinkPermalink 03/20/07 @ 11:08
Comment from: John [Member] Email
I have a 19 year old son with IED, and as Nancy says, he's Bi-Polar, and PTSD, and yes he has valid reasons for enormous anger. He was in a psych hospital at 16, the BiPolar and PTSD was known, they added IED.

My son had always had periodic severe outbursts. The BiPolar meds worked well, but didn't touch this. The Psychiatrist changed the meds and added therapy. He has had no outbursts since that time.

I wonder if this might be hereditary, his birth father was refered to as 'a tower of rage' by every social worker who dealt with him.

Thanks for the topic Julie, this isn't something that gets a lot of coverage.

John
PermalinkPermalink 03/20/07 @ 12:34
Comment from: Julie [Member] Email · http://special-needs.adoptionblogs.com/
Nancy - I have been looking for info on psychogenic seizures -- interesting you should bring up seizure activity with IED.

Someday the neurologists/psychiatrists really will figure all this out - I'm sure of it. Meanwhile we're stuck with some lousy labels that overlap and don't always describe the complex neurological dysfunctions.
PermalinkPermalink 03/20/07 @ 17:06
Comment from: Nancy Spoolstra [Member] Email · http://attachment-disorder.adoptionblogs.com/
I have always felt IED seemed more like a label of symptoms than a diagnosis...
PermalinkPermalink 03/24/07 @ 22:36
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