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

This video answers the questions: Can I provide a comprehensive review of Intermittent Explosive Disorder (IED)? Can I address the controversy over Intermittent Explosive Disorder?
Is pathological impulsive aggression the same as psychopathy or narcissism?

Definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM)

A. Recurrent behavioral outbursts representing a failure to control aggressive impulses.
This criterion can be met through either of the following ways
1. verbal aggression occurring twice weekly on average for a period of three months
a. physical aggression that does not cause damage or injury
2. three outbursts of physical aggression within 12 month period that result in damage or injury
B. The expression of aggressive behavior is grossly out of proportion to any provocation or stress
C. The aggression is not premeditated and not committed for some type of gain
D. The outbursts cause distress, dysfunction, or legal problems
E. Must be at least six years old
F. Not better explained by another mental disorder, medical disorder, or substance use

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Royce Lee, Konstantinos Arfanakis, Arnold M Evia, Jennifer Fanning, Sarah Keedy, Emil F Coccaro. White Matter Integrity Reductions in Intermittent Explosive Disorder. Neuropsychopharmacology, 2016; DOI: 10.1038/npp.2016.74

Best, M., Williams, J. M., & Coccaro, E. F. (2002). Evidence for a dysfunctional prefrontal circuit in patients with an impulsive aggressive disorder. Proceedings of the National Academy of Sciences, 99(12), 8448–8453. doi:10.1073/pnas.112604099

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[NB-wuzo]

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.

[vbkymoe]

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.

[Anahide_design]

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).

[JayBougie]

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…

[anymaru]

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.

[angelagreen]

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

[kfetjdb]

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

[salinal]

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

[JusticeForNicholeAlloway]

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.

[joshualittlepage]

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 YOU HELP PEOPLE... dont stop doing this (posted this here too cuz its more recent)

[DowntownTasty]

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.

[Paul-dvdr]

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.

[chazmichaelmichaels]

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

[Emilymk]

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.

[ScarletDeath]

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

[rayw]

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.

[DragonSlave]

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.

[wowpwnerX]

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

[roundcornerent]

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 .

[mayrawellington]

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