March 20th, 2007
Posted By:
Categories: Disorders, Psychiatry

“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.

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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.

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!

5 Responses to “Intermittent Explosive Disorder”

  1. nancyderen says:

    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!

  2. John says:

    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

  3. Julie says:

    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.

  4. I have always felt IED seemed more like a label of symptoms than a diagnosis…

  5. tmoss says:

    IED-A personal story

    Roger Heater took a break from his pro-bono talks to complete writing his autobiography-‘From Institutions to Freedom’. It is slated to be finished by the end of the year.

    However, his passion in sharing his story doesn’t stop with his book. There is so much to learn about this illness that we need to continue to talk to those places, to those people who will take away a piece of this powerful, compelling and motivational story and bring hope to those who may be suffering in one way or another.

    Roger’s story tells us of a boy with such rage attacks that his young mother, having no help and no answers gave custody of him to the State of Califonia. Even the professionals were bewildered with his behavior. They called him ‘incorrigible’. In other words he was incapable of being changed.

    The hospitals gave him drugs like Ritalin and Valium to calm him temporarily but they did nothing to understand why he was acting the way he was. Roger spent a few years in mental institutions. These horrible places were exactly like what you see in the movies… mentally and physically challenged adults mixed with children that were given up on. Violent and unstable children and adults filled the halls, walking around like zombies and screaming for no reason at all. There was Roger in the middle of it all, not knowing why he was there and being forced to live in such horrific conditions because no one know what to do with him. A lonely young boy without anyone to tell them that things would be ok.

    Roger learned to adapt to every situation, to every place he was sent to. He still got into trouble but with his quick wit, he knew how to manipulate the other kids that lived with him and the adults that took care of him. Roger ran away but the authorities always found him and returned him to the place he hated to be-away from his mother and the family that loved him.

    Roger lived in institutions and group homes for about 4 years. They didn’t want to send him to another group home so a group of psychiatrists decided he wasn’t capable of being a productive member of society and would be a dangerous threat to the public. They only thing that could be done to “change” this child was to send him to Napa State Hospital to receive electric shock treatments..

    Want to hear the rest of his story?

    Contact us at http://www.heaterproductions.com to book this amazing speaker. Don’t wait another moment- It all starts with one voice-YOURS

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