Intermittent Explosive Disorder: The ‘Illness’ That Goes On Growing

Philip Hickey, PhD
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According to the APA, intermittent explosive disorder is characterized by angry aggressive outbursts that occur in response to relatively minor provocation.

This particular label has an interesting history in successive editions of the DSM.

DSM I  (1952) 

Intermittent explosive disorder does not appear as such in the first edition of DSM, but the general concept is clearly discernible in “passive-aggressive personality, aggressive type”:

“A persistent reaction to frustration with irritability, temper tantrums, and destructive behavior is the dominant manifestation.” (p 37)

Note the term “reaction” in the definition, implying that the temper tantrums are being conceptualized as a reaction to a frustrating experience, rather than an illness, as such.

DSM-II (1968)

By DSM-II, the diagnosis had acquired free-standing status as a “personality disorder”, and was called “explosive personality (Epileptoid personality disorder)”.  Here’s the definition:

“This behavior pattern is characterized by gross outbursts of rage or of verbal or physical aggressiveness. These outbursts are strikingly different from the patient’s usual behavior, and he may be regretful and repentant for them. These patients are generally considered excitable, aggressive and over-responsive to environmental pressures.  It is the intensity of the outbursts and the individual’s inability to control them which distinguishes this group. Cases diagnosed as ‘aggressive personality’ are classified here. If the patient is amnesic for the outbursts, the diagnosis of Hysterical neurosis, Non-psychotic OBS [Organic Brain Syndrome] with epilepsy or Psychosis with epilepsy should be considered.” (p 42-43)

There are three notable features of this definition.

Firstly, the term “reaction” has been eliminated.  With the benefit of hindsight, it is clear that the term “reaction” which was used extensively in DSM-I became an embarrassment for psychiatry.  In 1952, I believe that many psychiatrists would have acknowledged that the problems they encountered in their work were not illnesses in any biological sense of the term.  By 1960, however, the drugs were beginning to come on stream, and the promise was emerging that psychiatrists, if they made some conceptual adjustments, could ride pharma’s bandwagon and become “real” doctors.  And one of the conceptual adjustments that had to be made was the elimination of the word “reaction” and all that it entailed.  So, eliminate it, they did.  They offered no explanation, but there is this charmingly candid little quote on page ix of DSM-II:

“Consider, for example, the mental disorder labeled in this Manual as ‘schizophrenia,’ which, in the first edition, was labeled ‘schizophrenic reaction.’ The change of label has not changed the nature of the disorder, nor will it discourage continuing debate about its nature or causes. Even if it had tried, the Committee could not establish agreement about what this disorder is; it could only agree on what to call it.”

Secondly, the notion that the person is unable to control the aggressive impulses is introduced as a distinguishing feature of the “diagnosis”.  This is a particularly interesting development, in that it is impossible to determine whether a person is, or is not, unable to control his aggression.  All that can be determined is whether a person did or did not control aggressive impulses on any given occasion.

Thirdly, the definition clearly allows the “diagnosis” to be made on the basis of verbal aggressiveness.

Side note on “epileptoid Personality disorder”:  During the first half of the 1900’s, and even as late as the 70’s, there were frequent references in psychiatric writings to epileptic (or sometimes epileptoid) personality disorder.  It was widely believed that people with epilepsy tended to be generally impulsive, explosive, and egocentric.  The notion was given a good deal of credence and attention.  Psychiatric research purported to identify the traits involved, and causative theories were developed and promoted.  Most epilepsy specialists today consider the research to have been questionable, and the supporting observations to have been cases of people “seeing” what they had been taught to expect:   a lesson that psychiatry generally seems unable to assimilate. 

DSM-III (1980) 

In DSM-III, “intermittent explosive disorder” appears as an entry in the category “Disorders of Impulse Control Not Elsewhere Classified.”  Here are the criteria:

“A. Several discrete episodes of loss of control of aggressive impulses resulting in serious assault or destruction of property.

B.  Behavior that is grossly out of proportion to any precipitating psychosocial stressor.

C.  Absence of Signs of generalized impulsivity or aggressiveness between episodes,

D.  Not due to Schizophrenia, Antisocial Personality Disorder, or Conduct Disorder,” (p 297)

Notice that the criteria are fairly simple, and that, even allowing for the vagueness of language, what’s being described is relatively severe and serious:  “…serious assault or destruction of property.”  In other words, DSM-II’s acceptance of verbal aggressiveness as a criterion item has been eliminated: a rare instance of the APA actually tightening their criteria.  The effect of this, however, was probably minimal, as the “diagnosis” was still described under Prevalence as “very rare”.

The diagnostic criteria in DSM-III-R (1987) were essentially similar to those in DSM-III, though the list of exclusions was expanded to:  “…a psychotic disorder, Organic Personality Syndrome, Antisocial or Borderline Personality Disorder, Conduct Disorder, or intoxication with a psychoactive substance.” (p 322)

Prevalence is still shown as “apparently very rare”.

DSM-IV (1994)

DSM-IV made two changes to the criteria.

1.  Item C from DSM-III-R, which had read: “There are no signs of generalized impulsiveness or aggressiveness between the episodes”, was eliminated. Up till DSM-III-R, the “diagnosis of intermittent explosive disorder” was given only to individuals who were generally even-keeled, but who exhibited episodes of explosive anger that were apparently out of character.  DSM-IV offered no explanation for the removal of this item, stating only:  “The DSM-III-R criterion excluding this diagnosis in the presence of generalized impulsiveness or aggressiveness has been deleted.”  Obviously this deletion widens the scope of the “diagnosis”, and allows a great many more people to be given this label than was formerly the case.

2.  As in DSM-III-R, the “diagnosis” is not to be given if the episodes  “…occur during the course of…intoxication with a psychoactive substance”. DSM-IV added the clarification that this included the effects of “medication” – an implied acknowledgement that psychiatric drugs can precipitate outbursts of violence and destructiveness.

DSM-IV also amended the prevalence from “very rare” to “rare”, though in fact, Kessler et al (2006), using DSM-IV’s criteria, reported a lifetime prevalence rate of 7.3%, and a previous 12-month-rate of 3.9%.  A lifetime prevalence rate of 7.3% is approximately one person in fourteen.  This is hardly rare!

DSM-5 (2013)

In DSM-III and IV, a diagnosis of intermittent explosive disorder required several episodes of serious assaults or serious destruction of property.

But DSM-5 changed all that.  Here’s criterion A:

“A.  Recurrent behavioral outbursts representing a failure to control aggressive impulses as manifested by either of the following:

  1. Verbal aggression (e.g., temper tantrums, tirades, verbal arguments or fights) or physical aggression toward property, animals, or other individuals, occurring twice weekly, on average, for a period of 3 months. The physical aggression does not result in damage or destruction of property and does not result in physical injury to animals or other individuals.
  1. Three behavioral outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals occurring within a 12-month period.” (p 466)

 

Note the word “either” in the lead in, and the proliferation of “ors” in 1 and 2.  This makes for labored reading, but one thing is crystal clear:  under DSM-5 rules, a person can be assigned this psychiatric label on the grounds of “verbal aggression” occurring twice weekly, on average, for a period of three months.  A person can also be so labeled on the grounds of physical aggression that does not result in property damage or physical injury.

Essentially what this means is that a person who, say, habitually rants aggressively and obnoxiously at other motorists while driving is actually mentally ill.  Prior to DSM-5, he wasn’t mentally ill; he was just rude and vituperative.  But now, thanks to the endlessly inspired creativity of psychiatry, he is mentally ill, and can be cured of this malady by ingesting a few pills every day for the rest of his (probably shortened) life.

The authors of DSM-5 offer no explanation for this change.

“The primary change in Intermittent explosive disorder is in the type of aggressive outbursts that should be considered:  DSM-IV required physical aggression, whereas in DSM-5 verbal aggression and nondestructive/noninjurious physical aggression also meet criteria.” (p 815) [Emphasis added]

Note also the specification:  “twice weekly, on average, for a period of three months.”  These kinds of frequency statements occur occasionally in DSM-5, and were included, presumably in an attempt to rescue the “diagnosis” in question from the charge of vagueness and unreliability.  What’s not usually recognized, however, is that the frequency criteria are entirely arbitrary.  Why not three times weekly for a period of two months?  Or four times weekly for four months? The answer, of course, is because the APA says so.  There is no evidence, nor can there ever be any evidence, supporting one over the other.

Age of Onset

Age of onset has been an interesting issue across the various editions.

DSM-I and II made no reference to age of onset.

DSM-III:  “The disorder may begin at any state of life, but more commonly begins in the second or third decade” (p 296) [Emphasis added]

DSM-III-R:  The same as DSM-III.

DSM-IV:  “Limited data are available on the age at onset of Intermittent Explosive Disorder, but it appears to be from late adolescence to the third decade of life.” (p 611) [Emphasis added]

DSM-5:  “The onset of recurrent, problematic, impulsive aggressive behavior is most common in late childhood or adolescence and rarely begins for the first time after age 40 years.” (p 467) [Emphasis added].  Also, Criterion E states:  “Chronological age is at least 6 years old.”  [Emphasis added]

So the usual age of onset has progressed from “second or third decade”, to “late adolescence”, to “late childhood”, and as young as 6 years old!

Discussion

What’s particularly noteworthy in all of this is the progressive loosening of the criteria across time, especially the elimination in DSM-5 of the requirement for serious damage or serious assault.  The lowering of the age of onset is also telling, and DSM-5’s criterion that “chronological age is at least 6 years” is chillingly consistent with psychiatry’s present promotion of the need for “early intervention”.  Here’s a quote from Kessler et al 2006:

“Intermittent explosive disorder is a much more common condition than previously recognized.  The early age at onset, significant associations with comorbid mental disorders that have later ages at onset, and low proportion of cases in treatment all make IED a promising target for early detection, outreach, and treatment.” [Emphasis added]

Promising, one is tempted to ask, for whom?

At the risk of stating the obvious, what psychiatrists call “intermittent explosive disorder” is not an illness in any ordinary sense of the term.  There are rare instances where brain damage can precipitate episodes of extreme anger, and these should indeed be considered illnesses.  But in the vast majority of temper tantrums, there is no neural pathology, but rather the simple fact that the individual hasn’t acquired the habit of controlling his/her temper.

To previous generations, the need to train/school children in this regard was considered a self-evident part of normal child-rearing.

But psychiatry needs illnesses to legitimize medical intervention.  And where no illnesses exist, they have no hesitation in inventing them.  And since they invented them in the first place, they have no difficulty in altering them to suit their purposes.  Of course, almost all the alterations are in the direction of lowering the thresholds, and thereby increasing the prevalence.

The idea of medical professionals arbitrarily inventing, and changing, the criteria for the “illnesses” that they treat sounds so preposterous that most people find it hard to believe.  It is widely assumed that psychiatrists have valid, scientifically-based reasons for making these changes.  But in fact, intermittent explosive disorder is nothing more, and nothing less, than what the APA says it is.  And over the years, in successive revisions of the catalog, they have made these changes, culminating in the sea-change of DSM-5.

And remember, DSM-5 was also the birthplace of “disruptive mood dysregulation disorder” – a pathologizing label for children (aged 6 and over) who are persistently bad-tempered.  In intermittent explosive disorder, the psychiatrists also have an “illness” for children (aged 6 and over) who are intermittently bad-tempered.  In psychiatry, as in fishing:  the bigger the net, the bigger the catch.

The great “breakthrough” for psychiatry in this regard was DSM-III’s definition of a mental disorder:

“…a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is typically associated with either a painful symptom (distress) or impairment in one or more important areas of functioning (disability).”  (p 6)

DSM-III-R expanded this to:

“…a clinically significant behavioral or psychological syndrome or pattern that occurs in a person and that is associated with present distress (a painful symptom) or disability (impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.” (p xxii)

If you strip away the verbiage, and note the frequent use of the word “or”, what this actually means is:  any significant problem of thinking, feeling, and/or behaving.  This was Robert Spitzer’s “great” achievement:  defining mental disorder/illness in such a way that it could include virtually any and all problems.  It was this simple contrivance that made it possible to expand the psychiatric net more or less indefinitely.  And Dr. Spitzer’s definition has been dutifully retained, with only minor verbal changes, by both DSM-IV and DSM-5.  After all:  “if it ain’t broke, don’t fix it.”  Though it should be noted that DSM-5 did manage to relax Dr. Spitzer’s definition even further by the ingenious use of the word “usually”:  “…usually associated with significant distress…”  “Usually” means not necessarily.

It might be asked:  how can they do this?  How can they just invent illnesses for themselves to treat?  And the answer is simple:  they did it gradually and imperceptibly; and nobody stopped them.  Protesters were marginalized and ridiculed as unscientific blamers and stigmatizers, while the psychiatric juggernaut inched forward year by year, decade by decade, increasing its territory, expanding its scope, selling ever more drugs for pharma and – in the process – destroying people’s brains, and undermining our cultural resilience.

In this regard, here are some interesting quotes:

Intermittent explosive disorder:  Treatment and drugs, at Mayo Clinic:

“Different types of drugs may help in the treatment of intermittent explosive disorder. These medications include:

  • Antidepressants, such as fluoxetine (Prozac) and others
  • Anticonvulsants, such as carbamazepine (Tegretol), oxcarbazepine (Trileptal), phenytoin (Dilantin), topiramate (Topamax) and lamotrigine (Lamictal)
  • Anti-anxiety agents in the benzodiazepine family, such as lorazepam (Ativan) and clonazepam (Klonopin)
  • Mood stabilizers, such as lithium (Lithobid)”

Treating intermittent explosive disorder, from Harvard Medical School:

“A number of medications are known to reduce aggression and prevent rage outbursts, including antidepressants (namely selective serotonin reuptake inhibitors, or SSRIs), mood stabilizers (lithium and anticonvulsants), and antipsychotic drugs.”

Intermittent Explosive Disorder, Child Mind Institute, under the subheading “Treatment”:

“…a variety of medications have been used to help people with IED, including antidepressants and anti-anxiety medications, as well as anticonvulsants and other mood regulators.  After a careful evaluation, a psychiatrist will prescribe the appropriate type of medication for an individual case.”

This is not the practice of medicine; this is drug-pushing in the guise of medicine.  Whatever effectiveness the drugs might have in reducing aggression, is far outweighed by the spurious message to the individual, that he is incapable of controlling his aggression without “meds”, and to parents, that their 6-year-old’s temper tantrums are symptoms of a serious lifelong illness that needs prompt psychiatric attention.

This is not the practice of medicine.  This is a hoax.

76 COMMENTS

  1. Phil, Thanks for this article.

    Here are DSM-6 criteria for Intermittent Spontaneous Combustion Disorder:

    – Verbal or physical aggression occurring at least once weekly for a period of two months, or at least twice weekly for a period of one month, or at least three times in one week.
    – Two behavioral outbursts involving damage of property and/or physical assault occurring within a 208 day period.
    – The combustions (aggression) are not due to any observable environmental stimuli.
    – Does not involve actual physical spontaneous combustion.

    Please note that the illness only springs to life during any 208 period during which at least two spontaneous combustions occur. At this point it is entirely appropriate to administer medications to combat the fires.

    I wonder what odds I could get in Vegas for the DSM 6 version being like this.

    As for my real opinion, what a bunch of horsecrap. I’d guess that even most psychiatrists don’t take this kind of diagnosis seriously. But maybe I’m wrong?

    • I used to suffer from “Iatrogenic Neuroleptic Psychotropic Cerebral Cognitive Impairment Malfunction”, but then, by the Grace of God, my condition ameliorated, and now I have learned to enjoy a SHRINK-PROOF life of IATROGENIC NEUROLEPSIS. Yes, truly the pseudo-science of “psychiatry” has taken it’s place where even PHRENOLOGY feared to tread…..
      Psychiatry is a *LIE*, and a *DRUG**RACKET*…. It’s done far more harm than good….
      Genesis, Chap. 1, V.29 has done me far more good, than all those POISON PILLS…..
      (….and i think maybe yur math is wrong. it’s *206* days, isn’t it….????….& 207 in a leap year….

        • Thank-you.
          (rotflmfao)

          What’s really most UN-scientific, is that a “psychiatric illness” is anything a psychiatrist says it is. Or isn’t.
          DSM = Designed to Steal Money
          DSM = Designed to Scam Money
          DSM = Doctors Sell Drugs….

          Ah, but I’ve long ago given up my role as an extra in that mass-multi-player, off-line role playing game. That’s a “MMPOLRPG”….
          I *USED*TO* pretend I was a mental patient, but the drugs made me crazy…..
          etc.,etc.,etc.,….

  2. Is it only psychiatrists who make the diagnosis of “Intermittent Explosive Disorder” or would we find psychologists doing the same? Does a psychologist treating an individual being medicated for IED have a duty to actively dispute this diagnosis when it appears inappropriate and advocate for the discontinuation of medication in such cases?

    • Psychologists do diagnose “IED.” As to disputing the diagnosis, I’m not sure how anyone would really do that, except by maybe measuring the length of time between incidents or disputing whether the property damage done is “serious” or not. There are simply no concrete criteria for determining who does or does not “have” this “disorder.” It is literally anything the clinician wants it to be, as long as there is some kind of anger outbursts in there somewhere. Along with “Oppositional Defiant Disorder,” I have always “IED” the most ridiculous, nay ludicrous and absurd contribution to the DSM, and evidence in and of itself that the whole manual is a worthless bunch of biased social judgments and pseudo-scientific jargon based on absolutely nothing of substance whatsoever. The title itself is ludicrous: “Intermittent Explosive Disorder?” I always visualized someone strolling down a street past some small businesses and suddenly, KABLOOEY! They explode and splatter their brains and body parts all over the sidewalk!

      It would be more helpful and intellectually honest to say, “Joe seems to have some difficulty managing his temper when he gets angry,” but you can’t really justify drugging someone for lacking a skill, can you? The range of drugs offered as “therapy” also prove the lack of integrity of the “disorder.” Anything that can be “treated” by antidepressants, benzodiazepines, OR mood stabilizers is something you’re just chucking drugs at. Why not just let the guy smoke a doobie three times a day? Or provide a dose of smack at mealtimes? It would make just as much sense as a “medical” treatment. In fact, marijuana would probably be a better choice than SSRIs, since occasionally the SSRIs actually CAUSE something very much like the very symptoms they are supposedly “treating.” But you can’t get much money out of selling marijuana compared to SSRIs, so that’s just not a solution, is it?

      —- Steve

      • Psychologists are subservient to psychiatrists and will be threatened with job loss and other such tactics should they ever question the expertise of a psychiatrist.
        How a system this dysfunctional can be given ultimate authority over something that is theoretical and wield that power over other is absurd. They push pills. Pills that don’t (in most cases) work to remedy anything long tern or create recovery. And these are the people trusted to care for the sick and vulnerable?

      • I too had quite silly visions of people exploding all over the place, only to gather up their bits and go on to do it again somewhere else….the intermittently exploding human! And apparently more and more people are developing this troubling ability.

        How anyone can take psychiatry seriously is beyond me.

        It is, however, terrifying that these “doctors” have gained so much power that even though they invent such patently ridiculous “diseases”, their influence continues to increase unabated.

      • Steve~

        I know when you speak of “a dose of smack at mealtimes”, you mean smack, as in *HEROIN*, (or other natural/synthetic/Rx opiates, etc., – same thing here….). And “smoke a doobie 3x day” means weed, medical cannabis, pot, mary-j-wanna, etc., whatever. Right? You’re being facetious.

        Wouldn’t you say that industrial-scale opium poppy agriculture for cash profit, in poorer, less industrialized nations, is the ROOT of the current heroin epidemic? The so-called “WAR ON (some)DRUGS(sometimes)”, is a huge failure in terms of social health policy? (….or huge success for Global organized crime/terror networks?)?….

        And, with the consistent, high-quality and high-potency, and increasing decriminalized & legalized, state-of-the-art, high-tech indoor/hydroponic
        growing methods, the grass is greener than ever? Especially *money* green? Why rack yur lungs on 3 big ole- gorilla-killer doobies? A couple puffs of the chronic, or medical grade, if you prefer, will do nicely….

        And with extractives, tinctures, “hash oil”, edibles, etc., medical cannabis
        is showing PROOFS of non-toxicity, efficacy, and safety under appropriate
        regulation and supervision?….

        Wouldn’t you SAY THAT?….

        Hey, I KNOW you’ll write back if I’m wrong.

        ~Bradford

  3. Psychiatry suffers from the deluded belief that people who are literally not sick are sick, and I don’t see contributing to that delusion as a very constructive enterprise for anybody to engage in. Yes, doctors are in the pockets of pharmaceutical companies, and it’s driven by the drug industry’s quest for new markets and maximized profits. You’ve got the DSM song and dance, and the media licking it up. Given Big Pharma ad after Big Pharma ad on television, things are sure not what they once were. I just wonder what psychiatry is going to be praised for having accomplished next. In the realm of sham medicine, they must surely have a monopoly. Thank you, Phil Hickey, for exposing the truth about a profession that is more and more prone to make its living by telling a whopper.

        • Fiachra

          It is a truly unsettling feeling, isn’t it? I was absolutely amazed by the disconnect, but totally unable to do anything about it. Watching oneself and knowing that you’re out of control but being unable to stop is really very disturbing indeed.

          Those meds are EVIL….and so are the people who prescribe them, especially when you have told them about the weirdness and they FORCE you to keep taking the sh#t!

  4. You got THAT right….
    What I couldn’t see then, as a younger person, I CAN SEE NOW…..
    (….after 20+ years shrink-proof….)….
    The worst of my “symptoms” didn’t appear until AFTER I was on psych drugs….
    And in the past 20+ years, they have mostly disappeared….
    I CURED my “mental illness” by the simple act of no longer believing in it….

    Thnx again, Fiachra….

      • From about age 15, to 35, roughly 1975 – 1995, I was trapped in, and drugged by, the lies of psychiatry and their poison pill drugs. Wasted the best 20 years of my life. In 1977, 1986, & 1994, I was hospitalized for instances of near-fatal toxic medication reactions, which were grossly mis-diagnosed and blamed on my imaginary “mental illness”. There’s a group of mostly guys, a couple women, who I have known here in town since the 1980’s. They still shuffle down to the local “Community Mental Health Center”, and get their “meds”, sometimes by forced injection. I got off that garbage over 20 years ago. They are useless, wastes of time and resources. (I’m not trying to be nasty, or personally insulting – only making a brief description “so to speak”. Some ARE my good friends, and I have compassion for them all….) They are mostly non-functional, and trapped in both *Learned dependance*, and *learned helplessness*, again, because of the “meds”. The LIE of the pseudo-science of psychiatry goes like this: “We shrinks give you drugs for your own good, because you’re too sick to realize how sick you are. You’re sick because we give you drugs for your sickness”….
        I think you see how that’s a bald-faced LIE. Just an excuse to SELL DRUGS, so they can keep their paychecks, and their POWER. We forget that most shrinks are psycho, as in *PSYCHO*. That’s why they are shrinks!….
        Yes, *sometimes*, *some* people do better on *some* “meds”. Sometimes.
        But that not how the scam works. Shrinks prescribe the most drugs, at the highest possible doses, for as long as possible – hopefully “life”, then an early death. That’s the lie of psychiatry in a nutshell.
        The problem, “Fiachra”, is that there are SO MANY DRUGS, both legal/prescribed, and illegal/”recreational”, etc., not even counting
        the latest joke “nutraceuticals” – “nutritious pharmaceuticals” – HAH!….
        We people should have *some* rights to just about whatever drugs we want, in most cases. The psychs say about their drugs : “if some is good, more is better”, and for as long as possible….

        But you and I both know that when it comes to the “meds”, that LESS is MORE BETTER!….
        You’re welcome, TOO!….

        • What you say is so terribly and horribly true! I was drugged from 1992- 1995 and then again from 1998-2013-2015. But, the real joke is on these criminal psychiatrists. I know deep down inside me that I am going to be just fine and that it really is okay to be who I am. I have chosen some other ways to define myself; not by “false drugged mental illness” but by honest, healthy “psychology” that acknowledges our differences as human beings; our uniquessnes, and our potentials. The psychiatrists need to be quaking in their fake boots. I proclaim; “I am not sick! I don’t need help!” And my next stop is to make me a tuna sandwich and thank God for my sandwich, my life, and my freedom from enslavement. Yes, it seems the psychiatrists are the modern day counter-parts of the Egyptians that enslaved the Jewish people.

          • Hey, “rebel”, for all *I* know, you *might* do better on some low dose of *SOME* med or other – for a while.
            Maybe. Maybe NOT.
            But how would you *KNOW*, one way or the other?
            If you’re too “sick” to know that you’re “sick”, which is the Bull-puckey garbage *LIE* the shrinks spout, how are you supposed to know whether all these pills and drugs they’re pushing on you work or not? Right?
            Sounds to me that YOU found a GOOD GOD, that works for you. And doesn’t your GOOD GOD WORK BETTER for you, than all *THEIR**DRUGS* do?…..
            That works GREAT for me TOO, my friend….

        • Rights? How can we have “rights” when the psychiatrists and even the medical doctors do not even know or realize the side effects, long term effects, allergic reactions or the adverse effects of the drugs, treatments, or therapies they prescribe us. I have a great imagination that I am grateful to have and gives me great joy. But, these doctors and psychiatrists live in a made up dream world that really only exists in their limited, fearful minds. It is not the “normal” imagination that produces great art, literature, music, etc. It as my late father would say; a big German word that I can neither, pronounce or spell; but clearly involves living in one’s own little created world and never seeing either the truth or the stars and sun in the sky. Even God’s little mushroom that grows in the cave can see the sunlight more clearly and is thus happier. The “average” psychiatrist is usually more miserable than his “patient” That is one of the reasons he or she chose this illegitimate, fake “profession” that is absolutely not a profession at all; but a masquerade of true human thought and intelligence; and thus a blasphemy to God. Thank you.

  5. The problem with this “diagnosis”, as is the problem with all the DSM diagnoses, is that it is not based on etiology. Off the top of my head, I can think of numerous types of people who could fit into this diagnosis: any normal person who is under severe stress, many children or adolescents who have some emotional struggles, people who have experienced traumas and have certain triggers to that trauma, people who get pulled into gangs, people who come from very socio-economic disadvantaged backgrounds and may feel frustrated with society, people who try to protest significant issues in our society, as well as people with some criminal orientation. Any diagnosis that is not based on a common etiology, and does not lead one to deal with the underlying causes with appropriate treatment is absolutely useless. Of course, the psychiatric industry will do studies with some symptom reduction modality on this diagnosis, show positive results compared to some ridiculous placebo conditions, and then use those results to “prove” that this diagnosis actually exists and that there are “good” treatments for it. It’s this type of circular arguments over made up diagnoses that is destroying psychiatry. Funny, I feel like exploding right now.

    • I agree that a “condition” such as IED could potentially have multiple etiologies, and typically a differential diagnosis is performed to rule out other potential diagnoses. A psychologist uses desriptions that best explain the client’s current behaviors–it’s not a perfect system.

      We are as yet unable to determine etiology of most psychological conditions, and there is so much interplay between biology and environment that will be a difficult task. Nor do we yet reliably know appropriate treatments (not just medications) for these conditions if there are any, or if treatment would be different based upon the etiology of the condition. DSM is descriptive of regularly occurring patterns or collocations of maladaptive behaviors commonly noted in clinical practice.

      In my experience, conditions such as IED and DMDD, oe patterns of behavior that DSM categorizes in this way, are serious and cause significant distress and disability. I have never seen these diagnoses given a rebellious adolescent or teen. Rather, most are verbally and physically aggressive, often involved with the criminal justice system at a young age. Certainly these conditions are largely trauma-based, as you said. I do wish there was more focus on prevention of childhood trauma as we don’t have good therapeutic treatments for these; meds assist in tamping down distressing symptoms I guess until we have better alternatives. Sadly most research is in pharma rather than other therapeutic treatments.

      • I think you may be missing the point. We are unable to determine the etiology of most psychological conditions because THEY DON’T HAVE ONE ETIOLOGY! As long as we keep treating “depression” as if it is the problem rather than a human reaction to some other underlying problem, which could be social, psychological, or physiological, we have no chance of figuring out ANYTHING about etiology! “IED” is not a condition, it’s a description of behavior that could be caused by a dozen different conditions, as Norman describes. So how will research on “IED” ever yield any results, if a tenth of those diagnosed have “IED” due to difficult social conditions, 30% act that way because of childhood trauma, another 10% have physical health conditions, 20% are in inappropriate educational environments, 15% suffer from poor parenting environments at home, 15% are having adverse reactions to drugs they’ve been prescribed, etc.? Diagnosing by symptom is stupid and counterproductive, as dumb as prescribing nitroglycerin to everyone who has a racing heart or doing knee surgery for everyone whose knee is swollen up. Medical problems should be organized around their CAUSES, not their EFFECTS! Otherwise, research gives you stupid answers which relate only to the suppression of the effects and allow the causes to go undetected and untreated in every case. That is what the state of psychiatry is today. We have a bunch of invented “disorders” that don’t have common origins and that don’t respond to the same kind of interventions, and because we lump all these things together and try to “treat” them as measured through symptom suppression, drugs always end up looking like the “best treatment.” And don’t think the drug companies don’t know this, either. That’s the whole game, beginning to end. Find out what your drug suppresses, get those symptoms into the DSM and defined as a “disorder,” and sell your drug to “treat” it. “IED” is only one of many similar examples. “Social Anxiety Disorder,” “Childhood Bipolar Disorder,” “Oppositional Defiant Disorder,” “Premenstrual Dysphoric Disorder,” ALL invented to sell drugs and other “treatments” aimed at making the symptoms go away without having a clue what is going on.

        It’s a multibillion dollar industry. There is no impetus to create alternatives. In fact, there is an incentive to suppress them. And as for actually understanding the causes of people’s distress, that is the biggest threat to the market and the profession that there is!

        You are naive if you believe that the profession of psychiatry is interested in finding and resolving the cause of any of their vaunted “disorders.” Curing people loses customers.

        —- Steve

        • Thanks. When someone is very upset they can have a lot of stress related symptoms and this can continue if they don’t feel like they are in a safe environment.

          But this is not an “illness ” it is normal human behavior. Most of the time problems can be worked out through genuine human contact. I found solutions myself.

      • Sorry, “Orbit”, but we don’t need ANY “research …on other therapeutic treatments.”….
        We ALREADY KNOW how Love, Compassion, Understanding, Caring, Listening, –
        all that stuff – we already KNOW how it all works.
        Inventing imaginary “illnesses” and “disorders”, and DRUGGING folks, does
        NOT work, and that’s why we survivors of the lie of the pseudo-science of psychiatry are here.
        Psychology is *almost* as bad, but I’d rather DESTROY psychiatry, and just work on fixing what’s wrong with psychology.
        What’s WRONG with psychiatry, psychiatrists, and psych drugs, is that they exist at all….
        The only good psych is a dead psych…..
        And yes, that’s just some empty, if extreme rhetoric, designed to smack you upside yo’ mind, and try to get you to *THINK* for yourself…..

      • No one is saying that people don’t have severe distress or or not significantly impacted by certain symptoms. Having categories to give clinicians rough guidelines can be helpful, but the DSM should have a big disclaimer on it’s cover saying : These Disorders Are Not Diseases. Any Research Done On These Descriptions Has To Be Interpreted With Extreme Caution.
        As Bpdtransformation points out below, may psychiatrists these days only look at symptoms and then write a prescription. If one doesn’t investigate underlying causes, then one can’t help a person significantly.
        Doctors are trained to believe that diagnoses are based on etiology. The DSM is not, and so confuses doctors, and also leads to bad research.

        • We need to get REAL. The DSM is a catalog of billing codes.
          A CATALOG of BILLING CODES.
          That’s *ALL* it is, or ever was really intended to be.
          The rest is nothing but psychobabble and gobbledygook, and
          word salad….
          The largest producer of word salad on the planet are the fetid fields of
          the minds of psychiatrists…..
          Psychiatry is a DRUG RACKET, and it’s the largest single organized
          medical and financial FRAUD known to mankind….
          (Yes, there actually are some good psychiatrists. They ALL blog here…..

        • You make an excellent point here, Norman. I notice that many who have been indoctrinated in the “faith” of biopsychiatry confuse denial of the medical basis of psychiatric diagnoses with denial of the symptoms (which few if any of us in the “resistance” movement are doing. If the disclaimer you suggest was put into practice, and if a “drug-centered” rather than “disease -centered” approach was used (as suggested by psychiatrist Joanna Moncrief), then at least there would be some honesty in the process.

        • May I respectfully disagree? The DSM belongs on the scrap heap of history, along with that great FRAUD Freud, and that other pseudo-science, PHRENOLOGY….
          The DSM is a CATALOG of BILLING CODES. There’s nothing “medical”,
          or “therapeutic” about it. An old episode of “Star Trek” has more REAL SCIENCE than *all* of the LIE of the pseudo-science of psychiatry….
          Watching too much Star Trek might rot yur brain. So to speak…..
          Too much psychiatry will FRY YOUR BRAIN…..REALLY…..

    • I have a story related to this debate about symptoms and etiology. Many years ago I went for the first time to see a psychiatrist at a time when my family was in chaos and I was feeling really beaten up because of all the abuse and neglect.

      As a voracious reader and explorer, at that time I already knew much of what I know now about medications, psychiatric diagnoses, and the psychiatric profession. But I had never met a psychiatrist and the idea that someone could be so stupid as to think life problems were illnesses and pills could treat these illnesses seemed impossible.

      But then I met this psychiatrist in person, and he was the strange creature from the black lagoon – a man who asked what I was feeling (I said “depressed”), and then went through a checklist of symptoms, asking me the length and severity of each one in agonizing detail. Next he talked to me about antidepressants and antipsychotics and told me what he thought we should try for different symptoms based on how other patients had responded. He even gave me a talk about how genetics can make us more vulnerable to getting depression.

      It was incredible because in 30+ minutes he never asked me what was happening in my family, never asked me what I was doing in work or school, and never really talked to me at all.

      This was the first of two psychiatrists I lied to and developed my well rehearsed-ability to tell a psychiatrist straight up that I’m taking the prescribed medication when in fact I threw one pill in the trash per day as a deception. It would almost became amusing as we would discuss how the pill was making me feel in great seriousness, only I knew it was a bunch of bullshit! The funny thing is I probably would have reported the same thing if I did take the pill, given the minimal difference between psych meds and placebos. This continued for several years during a time I was dependent on my parents for support and had to deceive both them and the psychiatrist into believing I was actually taking the medication.

      This deceptiveness isn’t exactly a strategy we can recommend to people on here for dealing with forced medication, but it worked for me. But more to the point this strange experience taught me that there really are these bizarre creatures out there who think that people’s problems are reducible to illnesses and that medications can somehow treat the illnesses. It’s still hard to believe.

      • My first experience with a psychiatrist was very similar to yours, except that the guy screamed at me as spittle flew out of his mouth because I stated that I felt that the world was coming down around me because my sister was murdered in New York City the day before. He screamed, “That’s stupid!”!!!!!!! Up until that moment I was under the impression that psychiatrists actually attempted to help people but my eyes were opened as I wiped spittle off my face. Not only are many of them like the monster from the Black Lagoon, they are also emotionally, psychologically, and verbally abusive and then have the audacity to call themselves “doctors”! Flim Flam artists and snake oil peddlers is more like it.

        • Sorry to hear that, it sounds like you got a really bad species, the psychiatrus horribilus. That sucks. Mine was more of a psychiatrus ignoramus, which in my opinion is the dominant species among psychiatrists, along with psychiatrus greediosus. Then there are a minority of psychiatrus benevolus, like some of the ones that have migrated to MIA.

          It’s funny to joke about this and some psychiatrists might be offended if I labeled them psychiatrus greediosus or psychiatrus ignoramus, which many of them are. But it’s not as bad as labeling someone with a fake DSM disease and lying to them that they should take medication because of it. Psychiatrists are committing that crime, and it is a moral crime, every day.

          • Thanks for the laugh! My son actually had a similar experience after a few intense months trying a bunch of drugs and living with a seriously abusive roommate after running away from home. He had to call me at 3 AM to get me to retrieve him when the roommate was arrested, and a couple weeks later was still recovering from the drugs and the shame of having to come crawling back home and feeling like a failure.

            He went to the doctor around this time for a skin rash condition. They did a depression screening, which asked “have you been suicidal in the last two weeks,” to which he answered “Yes.” The doctor came back with a lecture about how “depression is a disease like any other disease, and we have treatments now so you don’t have to suffer…” At no time did the doctor every say, “Wow, you said you were thinking about killing yourself recently! What’s going on that would lead you to think that way?” or “You said you had been suicidal recently – would you be willing to share a little more about what’s been going on?” My son was quite infuriated and insulted by her approach, which amounted to a sales pitch for antidepressants. Needless to say, he didn’t buy into her crap, but it shows how completely useless and downright destructive these diagnoses really are. They allow the clinician to completely avoid the uncomfortable gray area of “what is really happening and what should I do to help?” and go straight to a formulaic response that avoids any need to actually understand what is going on.

            Seriously, the average four year old could have done a better job. At least they’d know enough to ask, “Why are you so sad?”

            — Steve

          • Thanks for your story Steve. I hope your son got out of the diagnosis/medication trap and is doing better now.

            Yes, some four year olds, at least those who are not heavily medicated, would think to ask an upset person what’s going on. Well they might not ask that, but the thought might occur to them, which does not happen in the barren pill-obsessed wastelands that are the inner mental landscape of the species psychiatrix ignoramus.

  6. According to the APA, intermittent explosive disorder is characterized by angry aggressive outbursts that occur in response to relatively minor provocation.

    So if the ruling class as a whole could be diagnosed with a mental disorder (no more absurd than so classifying individuals) perhaps this would be one of the diagnoses, the symptomology consisting of itermittent military aggression against Iraq, Libya, etc. etc.

    • Wouldn’t it have to be “intermittent military aggression by proxy”, because the “GREG B.’s” – the Global Ruling Elites, and Global Banksters” – never actually go to war themselves, but only send we peons and serfs, and wage slaves, and debt slaves, to go fight for them….????….
      You know, if we start lobbying the committee NOW, we can get “IMAP” into the DSM-VI…
      I heard it’s scheduled to be co-released with a remake of the old Zager & Evans classic hit, in the year 2025….
      “Readers’ Digest” got it right over 50 years ago….LAUGHTER is the BEST medicine….

  7. I finally figured out there is nor should there ever be a drug that can stop me from ranting and raving when I drive anywhere in any town and in any state in the nation. And, since, it seems I see a lot of other people do it, then there must be an “explosion of mentally ill” people in the nation; more than enough to keep these greedy, Orwellian psychiatrists happy. But, you see; it might be abnormal to not get “mad” when someone cuts in front of you and slows down to a pace that you could walk; makes the light and you don’t and to top it off; you’re hot, starving; and really got to go to the bathroom. This is what I suggest when the other driver gets to you. You obviously don’t want to run into their vehicle. It would damage your precious one. Do what I do. Turn you music up as loud as you can! I listen to the inspirational station. Maybe, they can get inspired to move their car faster than a walking crawl. If not, you can enjoy the ride and who says this is not a “healthy” way to release the “steam” inside you.
    Personally, I am glad we are all mentally ill. There is a posting today on the “Beyond Meds” website that we are all “mentally ill.” Oh, thank God, it is such punishment to be different in this society.

  8. Oh Dr Hickey,

    reading your articles is like watching water being poured on a hollow paper origami. It just crumbles and ends up mush on the table.

    I, as a highly trained mental health professional can actually smell Intermittent Explosive Disorder, or at least the “potential” for it. I went in to a bikers bar the other night and …. lol

    Don’t stop with the water 🙂

    Regards
    Boans

  9. The author states: “At the risk of stating the obvious, what psychiatrists call “intermittent explosive disorder” is not an illness in any ordinary sense of the term. There are rare instances where brain damage can precipitate episodes of extreme anger, and these should indeed be considered illnesses. But in the vast majority of temper tantrums, there is no neural pathology, but rather the simple fact that the individual hasn’t acquired the habit of controlling his/her temper. To previous generations, the need to train/school children in this regard was considered a self-evident part of normal child-rearing.”

    Gross mischaracterizations! First of all, we don’t know that individuals with explosive rage and mood regulation issues do NOT have altered brain structure, which either causes or is a RESULT of trauma or other environmental influences. Second, it is outrageous to suggest such an individual simply “hasn’t acquired the habit of controlling his temper” as part of “normal child rearing.” Individuals with with markedly poor care during childhood (neglect, abuse) and other trauma during childhood often experience difficulties with mood regulation! I can’t believe you are equating this to failure of mom & dad to “teach” someone to control their temper–as if that is something that could even be “taught.”

    I don’t deny your allegations regarding links between the codification of these “conditions” and Big Pharma’s attempts to make money by treating them, but I urge you not to be dismissive of the significant pain these clients and families are experiencing, or to imply that lax childrearing practices are at fault.

    • Orbit

      uhmmmm……
      “First of all, we don’t know that individuals with explosive rage and mood regulation issues do NOT have altered brain structure, which either causes or is a RESULT of trauma or other environmental influences.”

      …so you recommend they be diagnosed and treated just in case – and the treatment of choice is usually a dangerous drug of some sort that will almost certainly alter their brain structure (ie cause brain damage)?

      How is this helpful, other than it lets everyone except the patient off the hook and provides income for doctors and pharmaceutical companies….and by the time the patient’s brain gets scanned at some future time in a “study” to find the cause of IED and justify its existence, yes, they WILL show signs of brain damage.

      We’ve been there before.

      Some people may be difficult, or upset, or upsetting but perhaps our society’s approach to parenting, nurture, justice, trauma etc is a better place to start than inventing a “disease” because someone has a justifiable and, indeed, at times adaptive, response to adverse events.

    • ….”Orbit”, dude or dudette, whatever….
      YES!, “lax childrearing practices” *ARE* 99% at “fault” for 99% of ALL psych. diagnoses.
      But what’s your definition of “lax”? Whatever it is, it barely begins to address the issue.
      And most “bad” childrearing prectices aren’t “lax” enough! They’re too strict. Too much “punishment” and “discipline”, and not enough correction, re-direction, and LOVE. Too much stress…. And, you say it defensively, as if “lax childrearing” is an accusastion, or allegation, or indictment. ALL dysfunctional parents were themselves raised dysfunctional, by parents who themselves were raised dysfunctional, etc.,… Put you can’t just throw pills and “diagnostic labels” at that, and expect any kind of good results.
      There’s way too much “blame game” going on, and I see *YOU*, “Orbit”, playing it.
      Just *STOP* with the “blame”, and the “fault”, and the fingerpointing.
      As one sterling example, Fathers who sexually abused their daughters would often get those daughters “diagnosed” with some “mental illness disorder”, and DRUGGED (“on meds”), to reinforce that, discredit the daughter, and protect their dirty little secret. The “sanitariums” of the 1800 + early 1900’s were full of such “hysterical” women….
      You need to wake up and smell the coffee, and get off the drugs, “Orbit”….
      Thanks for being here, and please stick around and keep reading.
      You got a LOT to LEARN, kiddo…..

    • First off, it is not the job of non-psychiatrists to prove there is NOT a brain pathology – as the ones making the claim, the burden of proof is on THEM, and as long as that proof is lacking, if we’re being scientific at all, we must assume that there is no such pathology or differentiation that explains the behavior.

      Second, individuals with markedly poor care during childhood are generally NOT taught to control their temper, in fact, they have complete emotional dysregulation modeled for them and reinforced by their environment, which is one of the reasons that they continue to display that kind of behavior into adulthood.

      Third, while there MAY be physiological changes resulting from abuse that may make it HARDER for individuals to regulate their emotions, we are insulting and diminishing individuals we are trying to help by implying or suggesting that they are unable to learn that skill. It absolutely IS a skill and it CAN be learned, and letting folks know that 1) their emotional regulation difficulties are a common and natural result of growing up in a chaotic environment (not a “disease state” at all, but a normal and common coping measure to deal with their world), and 2) that with proper motivation and hard work, they can learn other coping measures that may work better for them in the future, you give a person HOPE and DIRECTION, instead of encouraging pity and a sense of permanent disability.

      I think we would be doing our clients a huge disservice by suggesting that something like temper control can not be taught. My main approach as a counselor is to maximize the empowerment of the individual to learn to take control of his/her life. Suggesting that they are unable to control their emotions provides a ready excuse for not trying and discourages the seed of righteous indignation that generally is found deep inside any abused person and whose presence adds strength and motivation to any attempt to make their lives what they want them to be instead of what others say they should be.

      I also don’t agree with letting parents off the hook. Lax or even abusive or neglectful childrearing practices very often ARE at fault, but it’s never too late to learn, for parents or for their children. But no one learns anything until they have the courage to face the fact that THEY and no one else are responsible for deciding what they are going to do with their lives. Taking that responsibility away is one of the worst effects of the DSM process, because it tells people they can’t change themselves, and that is exactly the wrong message to send.

      — Steve

      • ~STEVE!:

        About your comment above, could you please polish / edit it slightly,
        Print about, oh, 2 or 3 hundred million copies, and make sure we all read
        and fully understand what you’re saying?
        Seriously, that piece of writing should be published widely….

        Wouldn’t you agree that it’s still better, and easier to raise strong,
        healthy children, than to repair broken men and women?….

    • orbit,

      Thanks for coming in.

      To me, it seems self-evident, that a person who habitually rages hasn’t acquired the habit of controlling his/her temper. What’s outrageous about it? We are all born with zero anger control. Newborns exhibit rage if their needs aren’t met. The process by which we transition from this to more-or-less-even-keeled adulthood is called training. And in previous generations, teaching anger-control was indeed considered a normal part of parenting. And why would you say: “as if that is something that could even be taught”? We teach our children to say please and thank you; we teach them to look both ways before crossing the street; we teach them to hold doors open for ladies; we teach them honesty and integrity; we teach them the value of hard work and application; etc., etc., etc. I can’t even begin to fathom what you mean by the notion that anger control can’t be taught or trained.

      I have never suggested that this kind of training is easy. Nor have I suggested that matters such as trauma, bereavement, bullying, etc., don’t present complications. But these kinds of matter have always been present. Nevertheless, parents still accepted, and took on the responsibility of, training their children in anger control.

      The pain that parents might be experiencing in response to a child’s outbursts of rage is certainly something to be aware of, but it is essentially secondary to the issue – that the child needs to be trained in anger control.

      Your use of the term “lax childrearing” is noteworthy, in that it implies that I am advocating harsh childrearing. In fact, what I’m advocating is: firstly, that parents accept the responsibility of adequately training their children (including anger control training); and secondly, that they acquire the skills of effective childrearing. Both of these factors have been systematically and deliberately undermined by the psychiatric hoax: your children are sick; you must bring them to us for healing.

      Best wishes.

      • “To me, it seems self-evident, that a person who habitually rages hasn’t acquired the habit of controlling his/her temper.”

        I used to think that people who exhibit this type of behavior are simply ill-mannered jerks who lacked proper upbringing and that can and often is the problem. Psychoactive drugs also trigger all sorts of aggressive behavior. But there is more to it ..the evidence increasingly shows that far too many people suffer from nutritional deficiencies. Please look into pyrolurea, easily treatable with nutrients.

  10. Once again you’ve hit the nail on the head, Phillip. Thank you for another excellent expose of the chicanery of psychiatry. Funny, as I was reading this I was thinking to myself, “What is that other new bogus childhood ‘syndrome’ they recently came up with?” And then there it was, just a few paragraphs down: “Disruptive Mood Dysregulation Disorder”. What an outrageous crock of crap! As a retired school psychologist, I’m well aware of how parents can be bamboozled and pressured to buy into this pseudoscientific crap! Thanks for your diligent, persistent, articulate presentations. You are giving us good ammunition to counter the harmful lies, half-truths and deceptions of modern biopsychiatry.

  11. “Three behavioral outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals occurring within a 12-month period.”

    I love how arbitrary it is. What if there were two? And what property? Is throwing a plate on the wall the same as burning down someone’s house? These are “medical” symptoms? DSM is such a pile of nonsense…

    Btw, I wonder if you add the lifetime prevalence of all these disorders:
    – is there a single person in the world left who is not mentally ill?
    – how many disorders one has, per capita? 2, 3, 10?
    The people who invent this stuff are either evil or lunatics.

  12. Btw “Whatever effectiveness the drugs might have in reducing aggression” – the “effectiveness is the same as giving one a paralyzing agent or knocking one over the head with a baseball bat. It’s only psychiatry that managed to sell these as “medical”. Unsurprisingly since they used insulin and continue to use ECT to “treat” people.

    • ECT = Electro-Cution Torture
      …..widely used in the DEATH CAMPS, but psychiatry uses the civilian-ized,
      non-fatal(usually….) form of it….
      At least they’ve retired the cattle prods and icepicks.
      Aren’t TASERS and hypodermic NEEDLES better than
      cattle prods and icepicks?….

      “ect” = electro-cution torture…..it’s not harmful, sez the shrink….

  13. The reason the incidence of IED is increasing could be due to the increase in prescriptions for anti-depressants. An inability to control angry feelings was one of the first symptoms I noticed in my son when he started using anti-depressants. The psychosis came later but the rage outbursts came early in his illness. He would scream and throw things in a way he had never done before even as a two-year old. It is a truly terrifying thing to witness in a young adult who was always a very calm and reasonable child and teen-ager.

  14. My mental health treatment history began in 2002 with SSRIs and CBT for PTSD. After some bad nights I found prozac to be tolerable and continued on it at 10mg/day for ~5 years. I will never take another single solitary Psych pill so long as I have a choice in the matter. I severed ties with all things medical in 2008 only to return to psychotherapy in 2014. I experienced several major breakthroughs through ‘talk therapy’, CBT and EMDR.

    Despite the breakthroughs, I still struggled with anger management. I was startled when I read the Mayo Clinics synopsis of IED – “Intermittent explosive disorder involves repeated episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may be signs of intermittent explosive disorder. People with intermittent explosive disorder may attack others and their possessions, causing bodily injury and property damage. They may also injure themselves during an outburst. Later, people with intermittent explosive disorder may feel remorse, regret or embarrassment.”

    I resemble all these things to a T!

    So to all the learned (and self learned) people on this site my question is as follows, If I do not have IED, what do I have?

  15. I don’t mean to minimize, discount, criticize or find your concerns unjustified. Have you ever considered one of two possibilities? The first could be your brain an body’s response to the drugs and therapy which may have dehumanized your precious, unique, sensitive self. The second is that this is a very “crazy” society with much to be angry about and this is just your “normal” way of reacting to a sick and have you noticed; an increasingly angry society.

    This is not really in reference to your situation; but, it has crossed my mind that if there were psychiatrists, bigpharma, and the DSM5 during the time of Jesus; He may have been probably diagnosed with this nebulous IED and “drugged” into submission rather than healing and speaking the truth and helping the poor and disenfranchised. You must remember the incident in the temple with the :money-changer” This is true righteous anger that would have received a “drugged” outcome in the late Twentieth/early Twenty-first century. We can only thank the Good Lord there were no Orwellian psychiatrists and BigPharma in His day. It truly saved our lives forever!

    Perhaps, dear person who is having so much trouble and may believe you might have this “mythical IED” you have righteous anger; an honest and healthy response to a sick and “Orwellian” world. Just quietly say to yourself; “Be still and know God” when angry. Thank you

  16. I opened this link searching for answers to the nightmare of the last ten years with a husband who rages over the smallest pressures or reasons.
    It is disappointing to wade through endless comments from patients disaffected with the practice of psychiatry who clearly have no understanding or experience of the issue, but see these posts as an opportunity to rant.
    By doing so you are preventing desperate people from finding some understanding & hope.
    I too blamed his parenting thinking he hadn’t been taught to control his anger as a child, except I grew up with this man & his parents are competent, caring, non abusive people.
    As remorseful as my husband is after an unprovoked rage, it cannot repair the damage to our marriage, my health, our property & the ripple effect.
    I have not even gotten a pet for company when he is working offshore for months because I am not coping, I could not bring a pet or child into this destructive environment.
    So while some of you glibly label this condition as a ‘normal response to an increasingly angry society’ spare a thought for the victims of what is a very real & highly destructive problem.
    You should limit your opinions to issues you actually have experience of.
    It would have been helpful if this forum had been utilized more by people with the condition & their families. They can share their experiences & ideas.
    Thank you to the two individuals who have this problem, I have spent years trying to explain to family the crazy, impulsive, wild & destructive things my husband does. All they hear is his remorse not my pain.
    At least I know it is a problem, not a reaction to me as many have suggested.

  17. Without reading through this all again I think that the problem people had with the “IED” thing is that it is presented as a medical term to describe behavior.

    Whatever the origin of his bad behavior, your husband does this stuff because he can get away with it. You need to spend less time trying to understand him and more time taking care of yourself, even if that means leaving him. And to me that is what it sounds like. And no I’m not a “professional.” But I doubt anyone here would suggest that it’s you causing him to act this way, and if you’re being guilt-tripped like that you need to find some personal support from some rational people. Good luck.

    • Thank you for your support but to say these people do it because they can get away with it is not true. It is seriously affecting my husband’s health & quality of life & worse is not being able to understand himself why his reaction is so extreme or even remember what triggered it.
      Unfortunately not everyone is in a position financially to walk away & rebuilding your life as a mature person with few resources & little real support a mission.
      I say little real support because the comments to this article alone indicate how little understanding there is of the problem.
      Labeling the problem as a behavioral issue due to poor parenting reduces the severity of the issue & its consequences.
      Mental health issues are very difficult to define & characterize but by putting labels on them we can perhaps start the long journey towards understanding their origins, even if it requires those labels to be redefined along the way.
      Conventional medicine had to start that way & for too long mental health disorders have been ignored by the medical fraternity & relegated to institutionalizing people to separate them from society hence the reluctance to seek treatment.
      Every industry has its quacks but that does not mean the journey to better understanding should not be started because we get some things wrong along the way.
      These forums have a lot of angry posts from individuals on medication because of the way it made them feel.
      That is not a balanced opinion, for that we would need input from the family as to whether their medicated state made life at home more tolerable & they were able to function better in society.
      Research studies not internet diagnoses are the way forward.
      But who will fund the research except pharmaceutical companies in the hope of formulating a medicine they can sell?
      People rant about the hypocrisy of this but they have no problem taking conventional medication for high blood pressure, cholesterol, headaches etc.

      • Unfortunately not everyone is in a position financially to walk away & rebuilding your life as a mature person with few resources & little real support a mission.

        I get that. I’m not giving you advice, just a little feedback.

        These forums have a lot of angry posts from individuals on medication because of the way it made them feel. That is not a balanced opinion, for that we would need input from the family as to whether their medicated state made life at home more tolerable & they were able to function better in society.

        What the family and “society” think are irrelevant They’re not the ones being drugged.

        It’s fortuitous in a way that you brought this up at this particular time, as these matters are broached in a brand new article by Dr. Hickey, just posted today. Wives with raging or violent husbands are mentioned specifically.