Key Takeaways

  • Intermittent explosive disorder (IED) is a mental health condition characterized by sudden and intense aggression. These episodes aren’t thought out beforehand and are usually disproportionate to the situations that triggered them.

  • It’s common for people with post-traumatic stress disorder (PTSD) to experience extreme anger, but not everyone with PTSD will experience IED. 

  • If intense anger is impacting your quality of life, consider meeting with a mental health professional right away. Treatment for IED and PTSD typically involves talk therapy and medication.

Intermittent explosive disorder (IED) is a mental health condition involving frequent episodes of anger and aggression. While anger is considered a natural human emotion, IED involves extreme outbursts that are disproportionate to the situations that triggered them. 

The disorder is thought to affect as many 7% of Americans in their lifetimes, with symptoms first appearing during childhood and adolescence. IED frequently co-occurs with mental health conditions like anxiety, depression, and substance use disorder. Some research also suggests an increased prevalence of IED among people with post-traumatic stress disorder (PTSD).

People living with both IED and PTSD may have an increased risk of aggressive behavior and suicidal thoughts and actions.* Learning how to recognize and treat symptoms of these conditions can help people manage anger, address underlying trauma, and build a more empowering future.

*The 988 Suicide and Crisis Lifeline offers 24/7 confidential support through trained crisis counselors. If you or someone you care about is experiencing emotional distress, self-harm, or a suicidal crisis, please call or text 988. For life-threatening emergencies or immediate assistance, call 911. 

Signs of IED in people with PTSD

It’s common for people with PTSD to find it difficult to manage their anger, but not everyone with PTSD has IED. To be diagnosed with IED, a person must experience repeated episodes of impulsive aggression that are disproportionate to the events or incidents that caused them. 

If you have PTSD and are experiencing heightened anger and aggression, here are some signs that your outbursts may be associated with IED. 

  • You can’t control your anger. If your anger is impulsive and difficult to control, it may be a symptom of IED. Frequent tantrums and aggressive outbursts are common among children, while heated arguments, angry rants, and threats of harm are often observed in adults with IED. 
  • You don’t know what’s causing your anger. PTSD anger is typically triggered by sights, sounds, smells, and other reminders of the traumatic event. With IED, outbursts are often unrelated to trauma triggers and can occur for no apparent reason.
  • There’s a pattern to your outbursts. IED is associated with aggressive outbursts that occur an average of twice per week for a period of three months. Outbursts usually last 30 minutes or less.

Can PTSD cause IED?

The exact cause of IED is unknown, but it’s thought to be the result of environmental and biological risk factors. People who experienced childhood trauma — like physical abuse and emotional neglect — are more likely to experience excessive anger later in life. Some research has found an association between IED, PTSD, and greater trauma exposure, but the exact nature of the relationship is still being studied. 

How does IED affect people who have experienced trauma?

According to the American Psychiatric Association (APA), people with IED tend to have lower life satisfaction and quality of life. Unmanaged anger, impulsivity, and aggression can cause problems with work, school, and relationships. These emotions and behaviors can even have legal consequences. For example, people with IED are more likely to be involved in violent crimes and arrested for chronic assault than people without the condition. 

Co-occurring IED and PTSD can also affect your mental and emotional well-being. Research shows that having both conditions is associated with an increased risk of anxiety, depression, and suicidal thoughts and behaviors. 

How can IED and PTSD be treated?

People with IED may feel hesitant or resistant to seeking treatment, which is common in people with conditions involving intense emotions. But getting help early can help you learn ways to reduce the intensity and frequency of outbursts, improving overall well-being. A comprehensive evaluation can help your provider make an official diagnosis and create a treatment plan for your symptoms. 

IED and PTSD are both treated with a combination of talk therapy, medication, and skills training. One of the most effective therapeutic approaches for both conditions is cognitive behavioral therapy (CBT). With CBT, people learn to identify and challenge unhelpful thought patterns and replace them with more balanced beliefs

Although CBT is considered a first-choice approach for both conditions, treatment goals may vary. For example, people with IED may learn how to manage anger, control impulsive behaviors, and develop healthier coping mechanisms. People with PTSD may focus on processing trauma, identifying triggers, and reducing avoidance behaviors. With both conditions, therapy can teach people the skills to improve their communication, emotional regulation, and problem-solving abilities.

Clinician's take
PTSD-related anger is typically triggered by reminders of past trauma, like sounds, smells, or situations that bring up painful memories. On the other hand, IED involves sudden, intense anger outbursts that often happen without an obvious trigger. Understanding these differences helps clients and families recognize when treatment is needed for trauma versus impulsive aggression or both.
Brandy Chalmers, LPC
Brandy Chalmers, LPC
Clinical reviewer

Find care with Rula

If you’re finding it difficult to manage anger or heal from past trauma, know that trauma-informed mental health support is available. At Rula, we’re here to help you connect with a therapist who understands your mental health concerns and is qualified to provide the right type of support for your healing journey. Our teletherapy platform makes it easy to find a provider who accepts your insurance and has availability to see you via live video call from the comfort of home as soon as tomorrow.

About the author

Alex Bachert

Rula's editorial process

Rula's editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.

Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.

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