Intermittent Explosive Disorder Deep Dive | Is it really Narcissism or Psychopathy? 

Someone close to me fits this description. He doesnt realize hes anxious or stressed and just explodes with anger seemingly out of the blue. Little things set him off. He usually doesnt know what set him off. He has deep remorse once he's calm again. He yells and damages property. Sometimes he sends angry hateful texts or calls. He hates being this way but feels he cant control it. Mood stabilizers coupled with antidepressants have helped to take the energy and motivation out of his anger so that explosions dont occur. He does suffer from depression and anxiety, and he was verbally and physically abused as a child. He was also emotionally neglected as a child. I believe these things contributed.

The field of psychology seems stuck in molasses when it comes to understanding the lasting affects of childhood abuse and the issues it causes into adulthood. So much that is seen as personality disorders or mental illness are lasting issues from childhood trauma. The effect it had on our brains as kids is brought into adulthood. It’s not an excuse for bad behavior, it’s the beginning of understanding how to recover and get the help you need. But most professionals I’ve seen have no idea how to help people like me with trauma issues even though the topic has been around since Freud first started psychoanalysis. It’s why even though I go to a therapist, usually I end up learning how to help myself. I’ve had one professional in twenty years of looking that knew what he was doing. The rest? A waste of time. Once you find someone who knows what to do, it’s a blessing from God. Once they retire? Frustration.

My girlfriend has I.E.D. It’s been extremely challenging but I’m learning what triggers her, also the outburst are similar to a child that’s throwing an extreme temper tantrum, you have to let them go through it, then 30-60 min later their calm, remorseful and embarrassed. It takes a lot of patience. When she’s normal she’s a perfect Girl, like a Disney princess, an Angel but when her outburst occur, it’s like a Demon possesses her, similar to Amber Heard being toxic with Johnny Depp…

My mum used to say I was like a pressure cooker when I was a younger! I was an abused child and my IED began like that. Unlike sociopaths or narcissists, we don't have the other symptoms personality disorders, we just share one important common ground: we have trouble managing our emotions. I can feel remorse and take responsability for my actions, unlike a narcissists who would probably blame others, or a sociopath who won't feel empathy (it's also why I have more boundaries and try to turn my anger against objects and not people!!) . And explosive anger is not premeditated. It usually begins in response to a compulsive behavior (like binge eating). An outburst is followed by remorse, tiredness, sadness, and lack of understanding (why was I so angry?) But over the years I have developped strategies to manage crisis. Although I can't manage my anger directly, I can feel when I am in a bad day and take necessary precautions, like avoiding certains triggers, and having rituals to try breaking the crisis before it starts. It's also necessary that loved ones are aware of the disorder, so they understand how it works. I had to put distance with my abusive father as well. Lastly, crisis decreased in frequency and intensity with a bit of work (not even that much efforts, only some consistency).

Yeah, it's definitely not narcissism. It's uncontrollable outbursts of rage followed by shame and remorse. Just learning about intermittent explosive disorder. Pretty sure this is one of the things wrong with me. Every now and then I explode and destroy inanimate objects, punch holes in walls. Usually I immediately feel better and calm after putting a hole in the wall. Sometimes it takes more than one hole to calm down.

Every time I hear more teaching re narcisis , BPD or IED I get a fuller view, understanding of what I have lived with for 50 plus years. I knew something was wrong but could not put my finger on it. Now I know

Sincere appreciation Dr Grande. more insight into people who act "BESIDE THEMSELVES"... these outbursts are contrary to who they want to be

I have outbursts of extreme verbal aggression, and one thing causes those outbursts: My BPD mother. As you said, the stress builds over time and that stress has to go somewhere or I will implode. It may sound like victim blaming but she pushes and pushes and pushes because she WANTS that outburst, it feeds her mental illness, it feeds her need for attention. She did it to my father, both my stepfathers and her friends. All have (either died or) distanced themselves from her. There is not enough research into the damage mentally ill people cause to those close to them. My mother has left a psychological and financial path of destruction in her 70+ year wake and there is no changing her, there has never been any help for any of us and the only solution is for people to cut her out of our lives.

My mother had this problem (and others). There came a moment where I saw it definitively for the first time for what it was, even though I and my siblings were essentially inundated by it from day one. When my son was three, I took him to visit his grandmother. She over-cooked the vegetables to the point of being discolored mush. She said to him, "Don't forget to eat your vegetables." He replied, "I don't like them." She suddenly exploded and shouted at him in a very ugly tone. It scared him badly. I saw my whole childhood flash before my eyes in that instant. In fact, my son has always enjoyed vegetables. He does not enjoy being treated harshly. I did not respond in kind. But I did adequately protect my son from my mother for the rest of her life. After she passed away, we learned of the awful, horrendous, dehumanizing trauma she had been put though in her youth.

It gets more fun when dementia comes along later in life. Thank you for the observation that personal responsibility is possible. I've believed that for years.

Watching with interest. My father was a psychopath or maybe a sociopath, he was often extremely angry. In my life I've had episodes of IED and they have ruined my life - employment, friendships etc. Fortunately I've never been physical. But this weird anger has bothered me also because it feels like a legacy from my upbringing and I when it seems I've got it under control then out of the blue it happens again. I'm 60 and have no friends. It's better for me to have no friends because I now have no friends left to lose. The irony is that I think I'm actually quite a nice guy.

I love how you also bring into account PERSONAL ACCOUNTABILITY!!!! That concept has tended to be thrown out the last several years to a decade. Yes, not saying this isn’t a diagnosable condition and can be totally a reason for a situation....but that doesn’t mean that every time you can excuse the person and let them get away with anything because of it. I greatly appreciate that view being stated by a professional

It's extremely difficult to live with a person or people with IED. They're often standoffish, volatile, with random irrational irritability and rage, anger without any reason. It's selfish and petty. I see most people with this disorder self-absorbed and self-important, somehow with some kind of delusion that people who live with them have the neverending capacity to be patient, resilient and selfless putting up with them. I think they are ingrates a nuisance as a horrendous behaviour recurs. I know, how horrible their attitude can get every time they explode. I just despised meltdown; but I often say I had enough after an encounter but still forgive and forget. Only thing is when you love and care for people who have IED you still continue to be selfless and eternally caring. I hope people with disorders take proper meds. People that suffer from their illness needed a peaceful life too. Thanks very much for your words. As always; excellent.

I think it’s real. I had IED growing up It comes on sometimes but not like before. I will go apeshit once I meet my point of no return. Definitely caused me distress and legal issue. To me it feels like an itch I’d need to scratch by “exploding” and once I go off it’s almost like an orgasm. It’s hard to explain. But that’s as close as I got when talking to a therapist. Interestingly enough I do have aspd now but I’d say it’s Comorbid. Minor provocation by family or romantic partner, ied episode, SEVERE EMBARRASSMENT follows. I was remanded to anger management for it. It did help but you need a good anger management counselor.

I was diagnosed with IED years ago. I had never really looked into it. Although I have taken many steps to better myself, I must admit I had never really found out what it meant My anger has since decreased significantly by acknowledging my tendencies, but I cant and could never say I have "full healed", thank you for the video. It's another step of understanding and counteracting this misfortune

Dear Dr. Grande, i have been watching for a few weeks and honestly my life has been a blur most of my life being on pscyh meds my whole life (almost) i was never able to percive my behaviors for myself.... i was diagnosed at age 8 with IED and have been through a few other diagnosis but your videos have helped me (since i have been off meds for a bit now) analyze my un medicated behaviors and be able to bring it to my doctor and explain myself better.... you are an amazing youtuber as well... most people on the internet that i have seen have "seemed" very biased even if it a positive bias... being mentally i hate it when people try to act like "oh your just different and thats ok and all that" i enjoy your calm and seeminly unbiased tone... it keeps me calm when trying to experience these emotions..... YOU HELP PEOPLE... dont stop doing this (posted this here too cuz its more recent)

My brother has IED. It makes being around him very difficult. Thanks for posting this video.

Thank You Dr. Grande, excellent video. For those watching because you suspect you have IED, GET PROFESSIONAL HELP NOW ! It doesn't go away. Those same people who forgave you before eventually will not (and rightfully so) Don't think you could physically hurt someone ? Think again. IED destroys lives, IF you allow it to. Thinking about Anger Management classes ? I did too. Almost 5 years later I was released from prison.

Never heard of IED (sounds like an explosive device, no pun intended), so this was interesting. As always, thanks, Dr. G.!

Thank you for this. I was diagnosed with this when the DSM IV was around and there wasn't much information about it then. But I'm glad there are vids like this that exist I can share with my friends and therapists

Just in my personal in my experiences with others- I see this as a common trait of trauma- relating to Reactive detachment Disorder and cptsd. I have never seen it independently of other disorders. I see it related to depression, anxiety and repressed emotions due to shame, usually triggered by some thing that suddenly provokes shame coupled with an overwhelm and not knowing what to do with a flood of shame. All of the people I have known with this have had childhood trauma and never had a healthy bond with at least one parent. They never learned to self- soothe or how to process painful and negative emotions. There always is some kind of trigger- even if it is not the one that seemed to set it off. Most likely most of these people repress emotion most of the time. They carry pain and can have narcissistic characteristics in that often these outbursts occur when they feel insulted in some way that they can not emotionally handle. They often choose more vulnerable people to explode on, and by doing so show some kind of “restraint” in the outburst by being selective about it. This was a great topic and very interesting as I have had to deal with many of these individuals- though not diagnosed with this, displayed the symptoms. Thank you Dr. Grande for your take on this. I have a question about this as well: Do you think it could be related also to hormonal surges?

The reason why there are not other DSM disorders for sudden outbursts of things like surprise, happiness, etc. is because these would not significantly impair a person. I've suffered from outbursts of anger and it is absolutely devastating in my life. It has cost me many jobs, numerous friends, and destroyed all of my romantic relationships. As for sudden outbursts of fear or sadness, these are likely encapsulated in other disorders.

I live with someone I’m pretty sure has this. It’s hard to live with him, the entire housebound is on eggshells. He doesn’t feel remorse after. He doesn’t even acknowledge he affects others. It gets him in trouble at work now, too.

I lived most of my life with ied and had no idea this was a disorder . I just thought that this is just the way i am . until one day while watching a TV show .A person was on trial for something bad they did .The defence lawyer used something called intermittent explosive disorder as a defence . Seeing this changed my life .I now realized I had this . Never heard of it before. Then I did research on the disorder, and that helped me to understand it . This helped me to start to try and control it, and recognize the possible triggers . So the moral of this story is that ..Until you know you have a disorder . You can',t ever start to work on controlling or improving on it . So if you know someone that may have this .Make them aware that this is a real disorder and try and seek help . Knowing about this helped me for sure. Hopefully it can help you or someone you know that has this .

This literally hit me like a nail on the head. Good to know I'm not crazy and can't wait to figure something out to help me

Also, doctor, apart from being, perhaps, emotionally immature, why might someone feel compelled to smash inanimate objects, such as walls or furniture or anything physical, when angered? Certain interpretations of MBTI make suggestions about why certain types are prone to smashing or breaking objects, such as having extroverted sensing in the inferior function. Thank you very much for these informative videos on mental health topics. You're the only mental health professional who produces prolific, high-quality content.

Thanks again Dr. Grande for another great video! ❤️ I’m glad to hear your thought re: personal responsibility and explosive anger.

Whenever you say "IED", I think pf "Improvised Explosive Device", which seems eerily accurate. I had wondered what to make of it since it appeared to me to be borderline visceral rage or instrumental violence of a psychopath, at a highly dysfunctional level, but without the other diagnostic criteria being met. Except that it can apparently be comorbid with borderline, narcissistic or psychopathic disorder, which is something that, without further quantification, doesn't make logical sense to me. It seems to me causal factors really need to be established better, perhaps with all disorders. Thanks for your discussion, I found it extremely interesting.

Wow, how much Dr. Grande knows about Mental Health has made me feel a lot more confident to trust the Mental Health field, from this I have gotten to know how much a professionals on this field (Dr. Grande), knows abouth human behavior, all of the "flaws and possible flaws" that people may show. I really appreciate you taking the time to share knowledge about the human behavior. I love how any possible misperception of the Mental Health fades away through your channel. Endless thanks. 💗💘😉👍👏👋

Thank you for your videos, Dr. Grande 💐 More informed = less afraid, for me. I’ve decided to go ahead with 26 weeks of dialectical behaviour therapy, finally. We started the intake, yesterday. 🍀

Hmm.. Very interesting deep dive into the history of the DSM and the progression with the disorder. Great approach!

The comingling of disorders really is the rule, not the exception. Tough to consider all the factors to form useful treatments! Great work helping us understand, Dr. Grande!!

One of my best friends on Tiktok has this disorder and it has cost him many dear friends, and I truly feel terrible for him. It's gotten to the point that multiple people have vendettas against him. He can be doing just fine one moment, then one bad thought can escalate to the point where he starts lashing out at people for no reason, saying terrible things out of proportion to the situation. And there's really no stopping him until he runs out of energy. It really hurts my heart to see him go through what he goes through, and all because he literally can't control his emotions.

Excellent description and outstanding delivery in concept and reasoning explanations combined with referenced educational foundations. Thank you!

I always want so much to go with you, because you are logical and your views are well thought out. You probably get these type of notes at times, and I have to say I want to call BS on this "disorder." Not everyone who is prone to pitching fits has a disorder. Sometimes people are real a-holes, and this type of thing is just making excuses for bad behavior. I've worked in several abusive places, and it is no picnic. Worst of all the ridiculous flailing that they do is just a complete waste of time and energy. Love your channel. I thank you for your programs, I enjoy them very much! Lisa Watson Harris

Unfortunately I am currently experiencing this with my gf, IED. The outbursts are now more frequent, almost bi-weekly, highly violent towards me and destruction of my things. There is no logical reason for the start of an outburst, and the energy of the violence is in no way in balance with whatever the trigger was. When it starts it escalates quickly and there is no stopping it, no calming the situation down. The best I can do is try and carefully restrain her or just escape from the situation. I've lost count of the number of injuries I have sustained, from having my hair pulled out, deep scratches, many puncture marks from her nails, punches, kicks, trying to push me down the stairs, throwing a knife that punctured my leg. She threw a heavy speaker at my head the other day and it split my ear open. I love her, but I think I've had enough. She is currently receiving care from a psychologist. I'm not an expert but I guess her mental disorder, her demonic rage is due to past events that may of happened in childhood. If anyone reading this has experienced this, is there hope? Can it be treated to a point it doesn't happen again? There are so many good points to our relationship but these rages, I know, will be the death of me one day, by her .

Excellent video. Thank you. We usually get shunted into anger management classes, when our true problem is situational rage. We don't respond well to moral gaslighting. Especially being laughed at, especially by those who refuse to answer for their detrimental actions to the social/work environment. I gotta take notes on this one..

During the start of the video you said that people with IED tend to explode at people they are in close relationships with, but then you asked at the end of the video why don't they blow up in court in front of the judge...I don't imagine they are in a close relationship with the judge, jury, or lawyers. You kind of answered your own question. Other than that, great video.

My father had this and didn’t start to calm down until he moved into his 40’s and beyond. Likely because he was growing older and more tired. His heart was failing as a result since that kind of behavior like all behaviors have an effect on your long term health. He never had remorse though, but he was also a sociopathic narcissist on top of that. They have no guilt or remorse about bad behavior. Basically he was a child abuser. I don’t trust anyone that has an Intermittent Explosive Disorder. There is no one around me that fits that description anymore because I would never be friends with someone like that.

Fascinating, doctor. I once read about a writer who went into therapy, because they were depressed, I believe. Eventually, the doctor convinced them they had an anger outburst problem, and that it happened too often. Every 28 days, as I recall. The writer could not believe it was so often, but there was no denying it. The doctor maped it out on a calendar. What's more, the writer was equally stunned when told their family did not deserve these outbursts. They may have been right about certain mistakes, or wrongs, but no one deserves to have themselves corrected in such a manner. Based on this video though, I wonder if those outbursts rose to that level or not. But anger is anger. As I learned from the "Attacking Anxiety & Depression" program, anger has its uses, but it costs. Use it wisely, because angry people lose respect.

If it’s controlled rage and used for effect or dominance ... to achieve a goal, probably most often psychopathy then. I watched an attorney turn this technique on and off to his clients advantage...even coming g across the table at the opposing council in a netting room when the judge stepped out for a few mins. 15 mins later this Same attorney was in the elevator laughing it up and having a good time talking about where to eat lunch

Such an interesting topic! That’s the first time I hear about this disorder. I watched the video twice as there is tremendous amount of information in it. I also tend to enjoy when you connect Neurology and behavior while explaining causation:) Thank you for the wonderful video Dr. Grande!

Dr. Grande , Thank you for making this video. It helps me understand myself and I'm hopeful it can help my loved ones understand a small (yet undefining) piece of me too. Take care everyone.

I have an adult (Now over 70) friend I have known since teenage. He is autistic but is moderate in his function. All the obsession, lack of empathy, inability to read other people, clinging to routine elements are there. He has wild and sometimes destructive temper episodes which in children might be called meltdowns. These episodes are triggered, it seems, by what I see as trivia. To my friend, these are far from frivolous or meaningless events. After these episodes, he becomes calm after 45 minutes or so but is unable to identify the trigger, the reason, or the feelings of the impending explosion. He sometimes claims not to have a clear memory of the explosion at all, but I wonder if that is him trying to distance himself from actions about which he now feels embarrassed.

I'm glad you talk about the DSM and diagnose that are not the best way to look at things.

This is very interesting especially with the mentions of personality disorders, specifically NPD. An ex was diagnosed with IED a few times but looking back on the relationship and how he's been since splitting up, he definitely has NPD. I'm not a doctor or counselor BUT I have done a lot of research on NPD and based on what I went through with him, the pieces started to come together. I know it can be difficult (as you mentioned) to properly diagnosis someone with NPD because of not being 100% honest with what the individual is really thinking.

Thank you doctor grande for your unique and interesting content. I have a suggestion if you do not mind , can you please talk about childhood trauma: different types and impact. Providing signs that can noticed in children suffering and adult who had suffered from such experiences.

I experienced a moment of explosive rage when I was ten years old. I destroyed the furniture my Grandmother’s deadbeat Tenant left behind in the basement of her house. I clearly remember the irrational anger and incredible pleasure when I did it. My Grandmother was in total shock. I think I had a kind of brake down. In my mid 40s, I had a break through during therapy. I figured out what happened to me at that age and why my Grandmother’s house might have triggered the anger. The mind is an incredibly sensitive organ, that will suppress things in order to survive. But in my case , it came out in that moment of insanity.

DR. Grande is an awesome person to listen to. I really like how he explains co-morbidity and at least has stats to go with what he says way better then most people who just google and say it is the truth. my biggest question is could IED be an underlying condition where aspd and bpd are present?

Could IED possibly be PTSD? My step sister made me think of it in that light. For her entire life we would hear tales of her meltdowns and explosions. She is the same age as my children so we didn’t live with my dad at the same time. When she turned 14 it went into overdrive with really extreme behavior, and by the second or third time she was ‘arrested ‘ for harming herself we learned my dad had been sexually abusing her since she was 4. He’s in prison for the rest of his life, but that doesn’t do her much good. I’m just wondering if many cases of IED could be reaction to conditions rather than a disorder

Oh my god. I truly believe I may have inherited this from my family or something very similar, everything makes perfect sense, thank you for making this!

Well the narc in my life demonstrates IED without the remorse. He can smile within minutes of the explosion, both verbal or physical. He looks well pleased with himself. Feels narc to me. I do think he uses the rage explosion as a defense when people ask him or bring up something he doesn't want to deal with.

My father had IED. He never was remorseful or ashamed after his episodes. We never knew what would set off the bomb. We lived on eggshells. For years and years. He would "punish" Mom with silence. Sometimes for days, sometimes for weeks. My childhood and teen years were pure hell. His disease ruined my life. I have longed for and feared emotional intimacy all my adult life. Hey, surprise! I'm twice divorced and live alone.

I guess my concern is that a lot of these diagnoses are given without enough info, or given incorrectly, and then it can become a label and an excuse. I have met a lot of mental patients who, when asked their diagnosis, rattle off, "I have this and this and this and this and this and this..." almost as if it's a source of pride. (I have a mood disorder, so I have met fellow patients throughout my life.) Of course that's not always the case, but it's just something I've noticed. So I guess I agree with you, Dr. Grande.

Hi, Doctor. Thanks again for all the work you put into these videos. I'm curious if you would address (or have addressed) how to class angry outbursts that a patient might have *only* when they know they are unobserved by others. Also, what if these outbursts are self-directed, rather than being hurled at an outside target? What if the patient knows full well why they're angry, but can't seem to find a better solution than raging indirectly at the cause? Best to you.

DR GRANDE! can you PLEASE do a video on blind rage ? I’m seeing someone who has all the symptoms of IED and would like to see how your suppose to deal with and help someone who may have this. Thank you 🙏🏼

My son just turned 13. He's on the austism spectrum, and it was confirmed he is XYY. He's been hospitalized 3 times. The last two times was due to potentially violent situations. His primary issues dealing with life stem from his explosive anger issues. He always sees himself as a Martyr. He has also expressed suicidal ideation. We're trying to help him, but our experience working with mental health professionals has been extremely demoralizing. It just seems like nobody cares what happens to kids when it comes to mental health. He's never been abused, and is loved and encouraged by both myself and his mother. We've tried multiple therapists, and medications, but the results have always been short term at best. If anyone has any suggestions they would be appreciated. Both his mother and I are feeling pretty hopeless right now, and I'm afraid for my child.

This is very interesting. I have ASD and ADHD, and possibly OCD. I’ve had a number of rule-outs requested by psychiatrists for IED. The way you break it down really helps me to understand it. The difficulty with interpreting intent, the pressure build up and release, followed by remorse and embarrassment, this all fits perfectly. To add to this, I don’t fall into the category of physical violence, with the exception of hitting myself sometimes and occasionally punching walls. A lot of body tensing and sort of meltdown behavior. I’ve wondered if this could be explained by ASD. Also, while I can’t explain why the situation caused such an extreme outburst of emotion after it happened, I can always give a reason as to what caused it. It never happens for no reason at all. I don’t know if that makes any difference at all.

It does sound metaphorically speaking like a hand grenade going off ..great video AGAIN!

My mother has been this way my whole life, in fact before I was born, according to my dad, she was absolutely worse. She stabbed him in the leg with a crochet hook once, and tried to throw boiling water on him, not premeditated but reactively. Shes constantly high strung and almost compulsively actively looking around the house for something to yell about, even if it's a crumb or piece of leaf on the floor, and then blows up the situation and uses it as a catalyst to bring up any and everything else from ones past, present and future. She also will create her own meanings to things one says and believe her interpretation is the correct one, even if you call it out and tell her she's twisting your words and context, she will never believe you, only what she thinks is real. She's in her 50s now and as steadfast as ever, is still this way, becomes extremely defensive and blows up if you even hint to her she might want to see someone. In all of her outbursts there is a constant undertone of " everyone else is wrong and stupid, im the only one who thinks right and im always justified " this is an everyday, almost all day intermittent experience. Sometimes her tirades can last an hour with constant comments outloud about how someone is stupid or lazy for leaving a dish in the sink (even if it was just then placed there with the intent to wash it after a soak) or how she's the only one who does things the right way, lots of abusive talk about my fathers weight calling him too fat, lazy, or a drunkard ( he is def not a drunk ) any opportunity she gets to make a mean comment she compulsively has to say it, even if everyone is having a very stressless day, she can make a degrading comment to someone that gets her own self worked up and then all the rest of the day is having to deal with her shit talking and high horsing. I have never met ANYONE like my mother and im determined to understand wtf us wrong with her. Im in my 30s and she has been this way since before I was alive. Do you guys think she's got this IED thing?? I've been researching for years and can't peg her on the other disorders, this is probably the closest ive found so far though.

Have you made a video about Oppositional Defiant Disorder? I'm just a transcriptionist but I sometimes feel uneasy when a kid gets diagnosed with this on one interview, like for disability determination. How is it distinguished from say an anxiety disorder or the effects of abuse?

I do agree that it can be so much easier to diagnose a personality disorder and fall back on that as an excuse rather than holding the person responsible for their actions. As there are less and less consequences for actions and more reliance on diagnoses of mental health disorders I would expect to see more people use a personality disorder as an excuse for inexcusable behavior. Yet, placed in certain environments, such as at a trial or incarcerated you see a conformity to social norms because of consequences when in normal life no change to societal norms is seen. Their inexcusable behavior is given a pass because they have an excuse - a handy blank pass of a personality disorder. I do believe that some do have diagnosable disorders, but much fewer than are proclaimed. Just my thoughts.

Very interesting approach. I. Can see your point r/o antisocial narcissistic. Initially emotional dysregulation . Very interesting that verbal aggression came back.

This is 100% my father. Wow. Thank you, my childhood makes more sense now.

My father has this disorder it is really a curse very extreme he has the type of having 3 attacks in a year which are so extreme that they destroy relationships as a victim you fear for your life. So you are pushed in primordial state in which only flight and fight is possible as a response that is very sad cause the good attributes of this person are poisoned and you always must keep distance.

I just found out that I have IED. Thank you for this video

"only 20% will seek help for the ANGER"; THAT NAILED IT. From workmates to neighbours to long time social friends, I've never looked at drug, alcohol, and STUPID behavior and choices to be the end all. There's something buried deeper. Sometimes I or my co=workers can see it, sometimes we can't.

Informative as always. Would you please consider doing a video regarding a Cluster B with the onset of dementia? In my own observation I've noticed a large percentage of the "boomer" population with a Cluster B personality disorder both diagnosed and undiagnosed. With that I have also noticed said "boomers" are developing dementia within their old age. I've heard various discussions regarding Cluster B's and dementia, however, I'd really like to hear your take on it.

I have IED and dystymia. They're pretty interlocked with each other, I know when I'm becoming extremely depressed I also become more hostile, I think the depression hides a lot of my anger, because when I'm depressed I hide in my room and dissassociate from the outside world, but I become irritable and more confrontational with people I trust, my mom and grandma. I definitely see my anger and stress is mechanical, I often call it an emotional battery. When that battery is almost empty, I lose my ability to cope. The hardest thing to regulate is the misinterpretations. I don't read other people well and will often be defesnsive. It's really hard not to. I can also be very blunt and I don't do very well with passive langauge. I don't always know what people are asking of me and get confused. I have really low confidence in my ablility to maintain relationships, and currently I'm refusing to date because I see myself as innately undesirable and unworthy. Not the most healhy perspective but I've seen so many unhealthy and toxic relationships that it feels like the only option. Which is ironic because I have a moral objectivity to anything being "innate," some cognitive dissonce I'm going to ignore there. The hardest part of IED beyond the misinterpetations is probably the name. I really dislike the "explosive" simply because I don't think the majority of people know what intermittent means, and even if they do the word explosive has a particular pop to it (no pun intended) that is the main emphasis. That and the way intermittent explosive disorder is portrayed in movies and other mediakind of reflect this, like in Jolt where it was just "explosive disorder". Though I haven't met another person with IED so I feel like that might be another factor of cognitive dissonce. Maybe I am that mad.

This was fascinating, and - my goodness - do I recognize these described outbursts and parameters! Thank you

This only occurs to me when I get responded in a sarcastic/condescending matter. Other than that Im fine, Im just tired of being treated if I was dumb constantly. Through lots of bullying even to this day. May be related to autism/aspergers. I stopped going outside because everytime I interact with someone I always get a sarcastic remark thrown in my way

Dr. Grande, I am fascinated with your perfectly measured way of speaking.ni have never been able to be aware enough ( i think that’s the reason) to keep it there. Have you always spoken in such a perfectly tempered way or did you teach yourself too? I wish I could control the emotion my voice conveys sometimes.

that disorder sounds like the definition of the expression " Anger Issues " , thought it would be some sub case of Factor 2 psychopathy at first but it turns out that it lacks the" lack of long term goals" and the "criminal components" and the" need for stimulation " criterias ... anyway very enlightning video

I see this disorder as part of several other dosorders: borderline, narcissistic, sociopathic, psychopathic, etc. I don't see it as it's own disorder.

I know someone who I think has IED as they fit the criteria exactly. They don't fit narcissisism, antisocial personality disorders or borderline. They could fit borderline but I don't think so as they don't have the other criteria. They are very kind and genuine & very sad & remorseful after anger outburst. They are a very generous & caring person. Maybe CPTSD

I was diagnosed with I.E.D years ago. I think I've learned to control it for the most part. I was seeing a psychologist and they just put me on ritilan, depecoat, and 2 anti depression pills I don't remember the name of them. Those didn't really do anything but make me a zombie. I quit going back to him, stopped the meds, and tried fixing it my way. Still struggle with it and it's hard. I'm calm as a cucumber when in a altercation. Then if you push me hard enough I just explode. Don't remember what happened at times. I've been able to control it for the most part but not all the time. Not easy at all.

Is this disorder to be distinguished from 'occasional bad temper disorder', 'sometimes rude disorder' and 'mildly irritable disorder'

Thank you for covering this. I know someone who has a severe case of this, and I'd never heard of it before.

Congratulations Dr Grande... ur channel of subscribers is growing very rapidly. Already over 200 k... yay 🙌

I literally feel like I have this. I’m more of the violent type, it literally got me a felony assault on a police officer charge. I didn’t come to until I was in the holding tank. It’s so bizarre because once it dissipates you are completely different. I know right from wrong, but in that moment I’m ready to fight anyone and everyone. It’s almost like I get a high from it.

They seem to explode for no logical reason its almost like an addiction. You cant be around these unstable individuals as they are so unpredictable seeing any excuse to fly into a rage, very dangerous because they see slights where none were intended you never know whats going to set them off.

Intermittent love outburst disorder in the center of Germany today in response to this video 💗 Love debates and disagreements among clinicians. mmmmhhh.🙂 Thank you so much!

Thanks for great video Dr. Grande. You always have great topics.🙏Stay safe out there.

I am going to be open and honest. I was diagnosed with IED at age 18, about a month into my first semester of college. I didn't have a particularly bad childhood although losing my dad at age 14 from cancer was pretty hard and I don't think I had adequate chance to grieve but never was I ever abused or mistreated in any way. I had symptoms of depression and anxiety prior but suddenly I was in a full blown rage. I ended up unwillingly being taken to the hospital and prescribed an antidepressant and was allowed to go back to school. However a week later I had to leave as things were out of control. Believe me when I say I tried everything. So many meds so much therapy and on and on. Meds often just made me sleepy and didn't help. It was like I felt an anxiety or me being upset filling up but it would happen fast like in a few minutes. Soon the balloon would burst and off I would go. People around me didn't understand and things were very bad throughout my 20's even into my 30's. I am serious when I say I dealt with this for so many years being in and out of the hospital and trying to find something that would work. Finally finding meds that work helped as well as knowing warning signs and having someone to reach out to when I feel I am headed in the wrong direction. This is KEY for me, Also make sure the person diagnosed is medically evaluated and not just psychiatrically. A few years ago I was diagnosed with obstructive sleep apnea and was found to stop breathing upwards of 30 times every hour in my sleep for about 5 to 10 seconds each instance. A CPAP machine which keeps my airway open allows me to get significantly better sleep. Also monitoring the depression and anxiety components are key. Knowing your red flags and knowing things are headed the wrong way. Sometimes people may shrug it off and treat things like you are fine but you have to be persistent and say no I am a 9 on a 10 point scale and this is bad. In the last 5 or so years I have not been in the hospital at all and outbursts were very minor and usually controlled (I would stop the car and just scream and scream and let it all out-otherwise I would feel myself turning reckless and that is not something I want to happen behind the wheel.) For me loud noises can trigger me in the wrong direction particularly if you don't know they are coming (such as a fire alarm going off or something of that sort) Now at 47 I am proud to say I made it all the way though college then a masters program for 3 more years. Things weren't great then but I was at that point well enough to go to school and manage the episodes. As I say now my "episodes" are limited to things I feel like I need to do to release the tension like screams or banging my pillow into the bed until I wear myself out. Often a quick sprint up the road (safely) just to wear yourself out enough for it to pass helps. That is the key --make yourself too tired to continue the episode. What I try to do now is talk to kids who are having symptoms of depression and anxiety and anything that in their mind doesn't seem right that there is NO SHAME in reaching out and telling someone something doesn't seem right and to be insistent that it really feels like a building of tension that is going to explode and to tell people and insist that it is serious at this point,. I would love to talk to anyone who has any questions about it. It is tough but not a lifetime sentence to misery. Doctors told me I would never be able to go to college or do anything and they told my mom I would pretty much need constant monitoring. I didn't listen and that is one time I was so glad I was defiant and used my anger very appropriately.

I've worked in an institution for people with down-syndrome. When it comes to extremes, I'm doctor Mengele. How do things look under extreme conditions? Interesting! Besides different severity there are different characters. With one guy communication was with role-play. He was police officer. And I had to curse at him and complain about the situation. This made him engaged and active. Steerable. If we didn't create the explosive situation, he would implode. I'm not a theatrical guy and not aggressive or manipulative. So that was weird. More uncomfortable were the interactions with more impulsive types. There was a ward for dangerous cases. But in general one can expect the unexpected. There is a directness for which I am way too cerebral. These people can also get frustrated. Understandably so. Others are barely conscious. Yet there is an enormous impulsive energy in them. One ran with his head through a wall when he had a feeling he had to take a shit. Problematic, daily. I see people in general in the light of this work experience. From mental stagnation sets of behaviours emerge. These can be found outside of this institution. With a more pleasant appearance. Explosive, frustrated, resentful as a lifestyle, triggered. I've seen it all in bare forms. There is no talking around it there. In general I think there is always a form of frustration behind explosion. Psychologists are often lost in narratives, words. What people think of themselves. They should work with people who do not think much at all. I can't imagine my psychologists having a satisfying job in such an institution. It's a direct struggle with functional communication.

It's like fission. The annoyance is there... Then the thoughts of the inconsiderateness of the other person... Then sadness that they made you angry... Then angry because you're affected, but THEY seem to not be affected... Then angry because you're angry.... And anger at their seeming refusal to acknowledge what started it. Why should I feel bad because of your inconsiderateness? Then anger because of that? Like a loop.. Upset, sad for the anger, then angry for the sad.

Thank you… seriously thank you sir, you have no idea you have helped me by making this video

My husband has these outbursts. He was very frightening for many years, but at 81 has settled down more. He never knows why he does it.

I E D, I do understand how this Diagnosis can be confused with some more pervasive disorders,(like cluster B) and not be given it’s proper treatment. Thanks

I've had several bad outbursts in the past that have ruined opportunities for me. I'll have to find a way to control my angry emotions

My only encounters with this diagnosis have been in very young children who came to me with this diagnosis already assigned to them by a different clinician. In these cases, it was always in a family where the parents, unfortunately had pretty low parenting skills. It seemed to me that the diagnosis was assigned to the child so that the clinician could avoid having a difficult conversation with parents about increasing their parenting skills. In other words, this diagnosis was basically used to inappropriately pathologize developmentally typical behavior, such as tantrums in a preschool-aged child. I have also seen “disruptive behavior disorder” used in a similar manner. I do wish certain clinicians would be more open to communicating with parents about developmentally expected behavior in their children as well as being open to recommending interventions to increase parenting skills rather than simply labeling completely normal childhood behaviors as “disordered”. I have no experience with this diagnosis in older children, teens, or adults so I cannot comment on how it is used in those populations.

A feeling of impending doom, you feel the anxious spiders crawling all over you, perhaps onset by questions of existentialism or ethics, be it a sensation of being overwhelmed or underappreciated, a fluttering revelation of insignificance, something is not right with the universe, there is a heavy feeling in your "nervous stomach" below the solar plexus, uneasy, a black hole of "dis-ease" forms in your gut, the claws of rage can be felt reaching up your spine, gripping the back of your neck and cortex, you can literally feel it gripping you, like a puppet does its master. Now, you know, its coming, you are looking desperately for exit ramps, you recognize that you are about to go through it, you try to talk yourself down, aware of the absurdity, aware of the trap, but "causality" intervenes, you think "if I permit this "injustice (whatever it may be, this time)" once, I will be doomed to keep suffering it", you are standing in a lake of gasoline and cognizant of the match in your hand, you are at that crossroads between the decent human that endears you to people, and the demon-haunted hideous creature that only instills fear and terror in the hearts of your most beloveds, this is that threshold of no turning back and the last moment to avoid irreparable damage, both material and personal. What is it that summons you into that malevolence...pride, some sense of injustice, some lack of control in a situation, some defiance or perceived betrayal of honor or loyalty, some disrespect or humiliation. The match is lit, the remnants of the "reptilian brain" have prevailed, now it is scorch the earth mentality, you are no longer you, you are rage personified, unchecked & tactless, the black hole in your gut has now turned into a nuclear reactor in your chest, and the demons that dwell therein hunger, thirst and lust for hostility and cruelty, venomous rapture, a portal for malice, it is insatiable and feasts on itself, never reaching fulfillment, you are standing beside yourself watching yourself and knowing that you want nothing more than to stop yourself, but you are essentially bullied out of your own body and reason by these savage fiends to whom this feels too good to stop, (yet still aware of authority and consequence, aware of what to break and what to spare, aware of the permanence of suicide) the wrath spews the insults and deconstructions fly without penitence or compunction, it is a high like no drug can provide, your heart is thumping like a drum and your breathing is that of a sprinter, your hair is wet from intensity, you would not be surprised in the least if you were to suddenly self-combust in this moment. Then all of a sudden, when the demons fatigue, the stone that has become your once compassionate heart, momentarily permits a tender spot, perhaps it was the tear of a loved one, the broken heirloom or mirror, the reality of having to replace some expensive casualty of your inner war, or the fear of losing your loved one for good after having hurt them for what you swore was the last time, the last time. Now, you hate everything about you, you feel out of phase with the universe, out of synchronicity with time and society, you always have ever since you were a young child, you curse your existence and wish everyone you hurt had never met you, you wish nothing more than to gather all of your damage and simply cease to be, so that they would have never known the suffering you brought about. You are scarred, you are ruined, you will wear this hideous skin forever more, in the eyes of any who were witness. You've apologized so many times for this, that you feel like a phony, a hypocrite and a fool even suggesting to yourself to contrive yet another "I'm sorry" albeit born of true sincere regret & remorse. Where once there was sincerity in a relationship, now there is distance and distrust, doubt. Nails in a fence, though the nails be removed, the holes remain. That guilt is crushing. It feels deserved & welcome. A shameful brand to wear, the mark of the fool. You feel that you must not forgive yourself, ever. and that anchor gets heavier, exponentially, with every episode. Bit by bit, you relinquish your self-worth, as the "good you" pays the debt for the "bad you", until your self-image is rendered a putrid wretch, incapable and undeserving of any semblance of kindness or love. Your inner dialogue is now cruel, critical, demoralizing, it is at odds with the "child's voice" that once ruled over those inner fields, now turned catacombs. That voice is now silent and scared, held hostage within its own corpus, scared of what is has become, scared of what it will do next, and that feeling starts all over again. There exists on this Earth, a fungus/spore which invades the brain and the function of ants, spiders, insects, frogs, birds..etc, and in possessing its host, it commands their minds, and controls their most innate defenses, rendering them bystanders in their own body, they only serve the purpose of procreation of the fungus/spores. I sometimes wonder if we too are at the mercy of such parasites, passing this down generationally as well. I am nearly 50, just had an episode today, I try perpetually to be present in kindness, I listen to calming sounds, frequencies, rainstorms, Watts, Tolle, Ram Das, etc. I resonate (when I'm not a lunatic) with the messages of hope, John Lennon, Janis Joplin, Bob Dylan, Bob Marley, Nina Simone, etc, I choose to glean the best qualities from various philosophies and religious dogma, I side with inclusion over exclusion, and fairness. I'm a minimalist, functionality over fashion salt of the earth soul. ALL of these qualities make it that much more disappointing when I fail myself. (by force of nature & genetics or of my own volition) Nothing hurts the soul quite like a fall from grace. If only I could carve this rottenness from me. I don't want to take any pharma, it feels like an aversion/diversion instead of true sovereignty & autonomy (still my ego/pride speaking, I concede) speaking form the heart. I partake of cannabis to avoid being an absolute tyrant 100% of the time, although I grew up in a loving family, I did witness the same behavior in my father, when I was young. Finally, I (and my father) were afflicted with a toenail fungus, I mention this with hopes of a correlation study being performed between fungal infections and mental illness. When "candida" penetrates the bloodstream, toxic byproducts also release into your body. This can lead to many different symptoms, including irritability, moodiness, anxiety, depression, schizophrenia and other mental illnesses. There are other ways to come into contact with fungi/spores than just toes, there is skin (ringworms), inhaling spores (resides in the lungs and sinuses). All speculation on my part, granted, but I (and my experiences) am glad to serve as a statistic data in hopes that one day it shall be vanquished from humanity, and the world will be a better place. I've come to the conclusion that on days when I feel like a NEGATIVE integer, I will remove myself from the equation, so that others may have a POSITIVE outcome. In this way, I am respecting them. In this way I can be accountable. But I am missing out on a lot of life experiences, and most of all, time & memories with my most loved ones. If you are reading this because you suffer too, I wish you a sea of patience and compassion with others around you, but most of all with yourself, forgive and improve & stay vigilant, you are worthy of love, you are not a monster, and remember, joy and laughter silence the beast and letting go of your ego/desire to be right, removes the power from the demons, please persist in your betterment. For those of you reading this because you know/love someone, and must suffer this often, I LOVE YOU, thank you for your patience, guidance & understanding. Learn the particular triggers and help us avoid the potholes and pitfalls, know that compassion and tenderness and vulnerability can overpower an episode in mid-rage. Okay, blessing and group hug. Peace find all of us. -me/us

15:33 Regarding causes of the outbursts: could it be a combination of both a buildup of tension and a disproportionate response to a small provocation? This video is fantastic. Personal Insight: I am not diagnosed with IED. I started having explosive outbursts in the 8th grade. Always verbal. When I was a teen, my outbursts initially seemed to come out of nowhere. Inappropriately angry reactions to minor problems. At 14, I could have been too oblivious to identify a buildup to the outbursts, so a buildup may have been a factor at that age as well. From age 19 until now (26): any time I have an outburst, there has been a long buildup of tension, which led to an explosion caused by something minor (my explosions are still mostly verbal, I have broken my own things). I definitely do NOT feel relieved after an outburst. As I'm having the outburst, I can hear myself telling me to stop, but I can't stop. If I take a benzodiazepine as soon as I feel the outburst coming on, I will take about 30 minutes to cooldown from the beginning of the outburst, with the actual fit of rage usually lasting 5-10 minutes. There is no immediate end or relief. When I finally cool down, I feel ashamed, embarrassed, and wish that I did not have the outburst, even if I am alone, and even if I didn't break anything. The outburst does not feel good at any point or cause any feeling of relief or release of the tension. I'm still upset, the outburst is just over. I have spent a lot of time working on addressing the buildup of tension before the outburst occurs and am in a much better place now, regarding my relationship with anger. I rarely have outbursts anymore. My outbursts have never caused physical harm to anyone but myself (accidental). I've broken my own property (intentional and accidental), never anyone else's. I usually yell at myself. When I've yelled at other people, it's usually been because they were directly related to the buildup of tension.

I do believe my dad had this. My mom was more covert but so sadistic and manipulative. My dad only gave me 2 spankings my whole life but his anger was so scary , he would turn red in the face and drive like a maniac and he would be so obnoxious it was insane. Literally locking myself in the bathroom and shaking , to this day if I have visions of his anger ( flashbacks ) I get very uneasy. Not trying to sound dramatic but even this subject kind of triggered me. Great video, thank you dr. Grande

I believe that in some people these explosions are a consequence of ASD. It's the confluence of several traits people on the spectrum struggle with -- meltdown, impulse control, emotion dysregulation,

A psychiatrist is telling me that my 16-year-old child has this disorder.Thank you for the information ❤️

People say this is linked with aspergers, but I don’t see how. I have IED, and I’m extremely manipulative. and Typically use people to my advantage based off my particular skill at being able to understand people well. i can meet you and after 5 minutes understand your personality, to an extent. I can’t tell you who you are, but I can understand how you react and perceive who i am and what I say, and usually how you will respond to me and what I say. I don’t really manipulate people anymore. But when I was younger and wanted things, ex: I wanted an iPod touch really bad when I was like 14. I obviously had no money, so I became friends with someone I knew had one, I waited and planned how I would acquire it, my plan was, I’d take an Advil, carve a random sequence of letters and numbers in it, tell him it’s some form of drug, he’d take it, I’d ask to use his iPod to put a song on, change the subject while using it, (omg dude your breathing so heavy) get him worked up, get him scared, get his mind completely off of the fact that he handed me his iPod, play it out get him worried he’s dying. The console him and reassure him his fine, and that little bit of trauma ultimately led to his iPod being in my pocket. Now, where’s the iPod? Bro you must have dropped it when you were freaking out I knew I should have held onto it until you calmed down. and there you have it. I now own an iPod. I also used to go on dating apps, posing as an underaged girl, (this was when I was 16) and I would lure pedophiles to specific locations, with the pretense that we will be having sex. And then when they got there, i laid 2 options on the table, you can A) empty your bank account, give me your phone, car, whatever I want from you, or... I will take the entire conversation, post it on facebook, destroy your reputation, show your job, family etc, and also give it to police. I made a SHIT ton of money doing that. what can they do? Call the police? Who are they going to side with, the pedophile, or the one confronting the pedophile. with that being said, I disagree that aspergers is correlated with IED.

My son was diagnosed with IED, he has extreme outbursts multiple times a day, we just built a brand new house and he has completely tore it apart, broke windows, window frames, broke/cracked multiple pieces of hardwood flooring, punched holes in walls, he’s constantly hitting/kicking/choking his 5 year old brother. I’m so scared he will really hurt him. He’s only 7, I don’t know if I should discipline him or not? I don’t want to punish him for having a mental illness, and it just breaks my heart. This is such a horrible illness. I don’t know how I’ll make it through, but I won’t give up on my child. He is always very remorseful after hitting or breaking things, he immediately apologizes..and I can tell by the look on his face it’s sincere.

Food for thought! Thank you Dr Grande. 🐛📚🦋

Growing up I was diagnosed with (ADHD) between Kendergarden and 1st grade. Which gave me a bit of a learning disability. It takes me longer to grasp things than it does for most people. So my parents put me on "Phocolen" (Sorry for spelling). It was helpful at the beginning I was calmed down a lot focused in school did better. But come around Jr High (6th, 7th, and 8th grade) I was suspended at least once in those grades for fighting and threatening. But with the fights as I look back on, I do see now each one was more aggressive. 8th grade being the worst. A kid name Sean told another kid to throw flour on me during lunch break. I was minding my own business when all the sudden powder was poured onto my head and covered me. I noticed Sean and his friends pointing and laughing at me. So I walked up to him and started yelling getting up in his face. Sean punch me in the face, everything went silent for a moment then I pushed him to the ground got on top of him and started strangling him. A teacher tried pulling me off him but didn't work. 2 more teachers came and retrained me. After 8th grade was over I feel into a depression faze, spent the whole summer locked in my room playing video games never talked to anyone. Freshman year came I was still depressed although there was a lot of changes to get used to. Well I ended up having a mental breakdown at school I was sick of people bullying me, tired of being locked in my room, and tired of going to therapy thinking that something is wrong with me. The school told my parents I had to be emitted to a hospital or I wasn't allowed back to school. So I spent a week there, even though it was supposed to be only three days I was diagnosed with (IED). I came back out feeling better. But I still felt as I had these road blocks that kept coming one after another. What was I gonna do? I turned to drugs... I was smoking cigarettes everyday. Then Sophomore year came and I got into heavier drugs. I was smoking weed, taking Acid, Shoots, all the way to cocaine. Hid all of it from my parents. Then I started getting into fights with them. Yelling fights everything. I finally stopped taking drugs and the ones that help me threw school. Everytime I took my medicine I would get angry more frequently no matter what. I even started to get angry with my little sister's voice. Sometimes I wished she just never talked. Then Junior year of high school I chilled out a lot but I had the attitude of "I didn't care." The last three days of Junior year I was sent to the principals office. A girl named Klair started tell everyone that I was going to shoot up the school. I wasn't gonna let her say that about me. So those last three days I got up yelled at her in her face everytime would say anything. So I spit in her face and tell her the that shes luck the teacher is here. Senior My father and I aren't seeing eye to eye getting into arguments. He has explosive outburst too. But he makes it seem like I'm causing trouble that I'm not doing what I'm supposed to be doing. Anyway I don't know what to do I'm troubled with this disorder but I know I'm not alone in this. But Hopefully I can get threw it. Do you have any suggestions?