Understanding Intermittent Explosive Disorder in TEENS

Published: 01/20/2025 | Updated: 11/18/2025

Authored by: Emma Loker, BSc, PgDip

Edited by: Aja Chavez, LPCC, LMFT

Yelling, throwing objects, spewing words that cut deep—if there’s a teen in your life who’s struggling with intermittent explosive disorder, you may be no stranger to these displays of anger.

Teens diagnosed with intermittent explosive disorder (IED) can be difficult to be around. Their angry outbursts can push you away and place you right at the end of your tether.

But if you can imagine it, the impact of IED on a teen’s life is even greater. IED is often socially isolating and overwhelming and can lead to many uncomfortable feelings, such as embarrassment and depression.

Fortunately, there are many strategies available to help a teen cope with intermittent explosive disorder and ways their loved ones can support them. But first, what is IED in teens?

Key Takeaways

Intermittent explosive disorder (IED) in teens causes sudden, intense anger outbursts that are out of proportion to the situation.
Symptoms include yelling, hitting, property damage, and physical signs like a racing heart or shaky hands.
Causes may include genetics, trauma, brain chemistry, and stressful home or school environments.
Treatment often includes therapy, emotional regulation skills, family support, and sometimes medication.
Early treatment can improve behavior, prevent long-term problems, and strengthen relationships.

What Is IED in Teens?

IED is a mental health disorder affecting around 8% of adolescents.1 It typically shows up as sudden episodes of intense anger, often leading to violence. IED tends to appear in early teen years (around the age of 11) but can pop up from early childhood onwards.¹

The anger that comes with IED appears as if out of nowhere, making it unpredictable and difficult to manage. A child struggling with IED may be overcome with all-consuming anger, leading them to attack or hurt others, insult those they love, or hit objects.

It’s also not generally easy to soothe a teen with IED, as they may struggle to get rid of their anger energy, leading to long periods (often around an hour) of rage.

Teens with IED rarely enjoy being the person who lashes out (although some say they want to hurt others during episodes of rage), and they tend to feel intense guilt after doing so.

Signs of IED in Teenagers

IED looks and feels different for everyone who experiences it. While some teens have angry episodes regularly, other teens may only feel this sort of anger occasionally. Nevertheless, there are some common physical, emotional, and behavioral symptoms of uncontrollable emotional explosions in teens that are worth looking out for.

Physical Symptoms of IED Episodes in Youth

The physical signs of IED episodes tend to be fleeting, typically lasting less than an hour. However, when you’re in the midst of an IED episode, it can be intense and overwhelming. Some signs you may see during an IED episode are:

Racing heart
Muscle tremors
Frantic thoughts
Quickening heartbeat
Tightness in your chest
Tingling in your toes or fingers
Feeling a sudden surge in energy
Increased pressure in your head, sometimes leading to headaches

Those struggling with IED also often describe “seeing red” or everything going blank during an IED episode.

Recognizing Behavioral Patterns of IED in Adolescents

Patterns of impulsive aggression in IED-affected adolescents can be frightening, and the aggression can take many forms. The typical behaviors associated with IED are:

Punching walls
Throwing things
Breaking objects
Heated arguments
Making verbal threats
Getting into physical fights
Physical violence toward others
Lashing out in the form of harsh words

Those with IED often describe feeling a fast build-up of rage that quickly becomes uncontrollable, leading to the behavioral patterns we mentioned above.

Emotional Indicators of Intermittent Rage in Teens

While IED episodes do often come on suddenly, there are some key emotional indicators that can suggest an angry outburst may happen. These include:

Irritability
Intense agitation
Negative feelings about yourself or others
Feeling emotionally detached from your surroundings

After an episode, people with IED may feel guilty, embarrassed, or ashamed of their behavior. They may also struggle to remember exactly what happened, especially if they tend to “see red” or blackout during bouts of intense anger.

Possible Causes of Teen IED

Before we talk about the causes of teen IED, it’s important to clear one thing up: we’re still learning about intermittent explosive disorder, and we cannot categorically say that an experience or factor “causes” the condition. However, scientific studies have pointed to certain risk factors for the condition, which we share below:

Gender: IED is believed to be more common in males than females, with a typical ratio of 2:1.²

Sociodemographic Background: Research suggests that IED is more common in those who are not white, black, or Hispanic.² However, more research is needed to truly understand the nature of this relationship.

Mental Health Difficulties: Teen IED tends to be more common in those also experiencing another mental health condition, such as anxiety, depression, and bipolar disorder.²

Childhood Trauma: Children who have experienced maltreatment in the form of physical, emotional, or sexual abuse, or emotional or physical neglect, are more likely to struggle with IED.³
Age: IED is generally seen more often in people under 35-40 years old. It’s seen less often in people above the age of 50.²

There may be more factors at play with IED, but without solid research confirming this, we can’t say conclusively. What’s more, every teen with an IED diagnosis is different, and the condition is very complex. Therefore, every teen may have a unique combination of possible causes.

Impact of IED on Adolescents

Experts are still trying to learn about the full impact of IED on adolescents’ lives. However, teens with intermittent explosive disorder are more likely to:

Experience Academic Challenges:

Bouts of explosive anger can make school difficult, as they may be given harsh punishments in an attempt to control their rage. However, these methods aren’t typically effective, potentially worsening the angry outbursts.

Struggle With Relationships:

The irritability, fights, and aggressiveness associated with IED can make it difficult to make and maintain friendships. This can be extremely difficult for teens, as peer relationships are often a teen’s main form of support.⁴

Experience Physical Health Problems:

People with intermittent explosive disorder can also struggle with physical health difficulties. Studies show that IED, if left untreated, can increase a person’s risk of coronary heart disease, stroke, arthritis, hypertension, back pain, headaches, ulcers, and other forms of chronic pain.⁶

Have Co-Occurring Mental Health Difficulties:

IED often occurs alongside other mental health difficulties. Although more information is needed, research indicates that an IED diagnosis may increase the risk of other mental health difficulties.

Show Suicidal Behaviors:

Thoughts of suicide, self-harm, and suicide attempts are more common in teens with IED than their peers without IED. This may be due to the condition itself or the impact IED has on a teen’s life as a whole.⁵

Treatment Options for IED in Teens

The picture we’ve painted of IED in teens so far sounds pretty bleak, right? But fortunately, many treatment options are available to help support a teen struggling with IED, and to help them build tools to manage this condition. Let’s explore each in depth below.

Residential Treatment for IED in Teens

Teens struggling with IED often feel like they have next-to-no control over their emotions. They may also be battling friendship difficulties and suicidality as a result of their IED. Inpatient programs for extreme anger in teens can help them learn coping strategies to manage their IED.

Residential treatment can also provide a safe haven for teens with IED, allowing them to express themselves and heal in a supportive, non-judgmental environment. Another major benefit is peer support in residential treatment for IED—teens can make friends with other like-minded people, helping support them on their journey.

At Mission Prep, we focus on providing a supportive environment that allows adolescents with IED to thrive. To learn more about Mission Prep’s treatment, check out Our Adolescent Inpatient Mental Health Program.

Adolescent-Focused Therapy for Explosive Anger

Adolescent-focused therapy can provide teens with the tools to manage their explosive anger. Here are some of the main forms of therapy available to teens with IED:

Youth-Focused Cognitive Behavioral Therapy for Intermittent Explosive Disorder: Cognitive behavioral therapy is a short-term, goal-driven therapy approach that involves learning relaxation training and altering negative thought patterns.

Trauma-focused Therapy for IED in Adolescents: This focuses on the traumatic experiences that can underlie IED in teens, helping them develop emotion regulation skills and process their difficult experiences.
Family-focused Therapy for Youth With IED: Family-focused therapy can help improve family relationships and educate all family members on how to support a teen with IED. It can also address difficult past experiences and help each family member process these.

It’s worth mentioning that a comprehensive residential treatment program for teens with IED will include a mixture of these therapy approaches to best support each teen.

Medication Options

Medication isn’t the right choice for everyone. However, medications can help to stabilize a teen’s mood and manage their severe IED symptoms, allowing them to learn coping strategies to manage long-term.

The main medications for severe teen IED symptoms include:

Antidepressants: Antidepressants, such as selective serotonin reuptake inhibitors, are sometimes prescribed to adolescents with IED to help them manage their symptoms. Antidepressants can be particularly helpful if the young person is also struggling with depression or suicidality.
Anticonvulsant Mood Stabilizers: Mood stabilizers can help a teen regulate their sudden mood changes, helping them feel more in control of their emotions.
Anti-anxiety Medications: These can help teens manage their anxiety levels, which can be particularly useful if they’re struggling with a co-occurring anxiety disorder.

Holistic Approaches

A holistic approach to IED involves considering the teen as a whole and the aspects in their life that may be making their IED more difficult to manage. Inpatient treatment programs tend to use a holistic approach, as this provides a more well-rounded support framework for the teen.

Holistic approaches to IED in adolescent residential care often involve emotional regulation strategies, peer support, group therapy, and mindfulness and coping strategies tailored to teens.

How Families Can Help

Watching someone you love face IED can be incredibly and overwhelming. It’s normal to not know what to do in these situations. So, if that’s where you are right now, you’re not alone.

The first step to helping a teen with IED is recognizing the signs we’ve outlined above. Noticing when a teen may be struggling with IED is the first way you can support them.

Next, seek a professional evaluation from a healthcare or psychiatric professional. They can identify whether it is IED and help the teen get the support they need. You could also reach out to a residential treatment center, such as Mission Prep. We can offer guidance on the best course of action for your teen.

Finally, take part in family-focused therapy and parent training programs so you can learn to support your teen in the best ways possible. The family is a fundamental part of a teen’s recovery, and by doing what you can to support them, you are helping them manage their IED.

Seek Support for IED in Teens Today

Long-term care programs for IED in teens can drastically change their everyday lives, helping them manage their moods and use coping strategies so their lives don’t feel as overwhelming.

If you’re a teen who thinks you may be struggling with IED, or you’re questioning whether someone you love may be experiencing IED, don’t wait to seek support. Left untreated, IED can wreak havoc on a person’s life, including their relationships.

References

Shevidi, S., Timmins, M. A., & Coccaro, E. F. (2023). Childhood and parental characteristics of adults with DSM-5 intermittent explosive disorder compared with healthy and psychiatric controls. Comprehensive Psychiatry, 122, 152367. https://doi.org/10.1016/j.comppsych.2023.152367
Coccaro E. F. (2012). Intermittent explosive disorder as a disorder of impulsive aggression for DSM-5. The American journal of psychiatry, 169(6), 577–588. https://doi.org/10.1176/appi.ajp.2012.11081259
Fanning, J. R., Meyerhoff, J. J., Lee, R., & Coccaro, E. F. (2014). History of childhood maltreatment in intermittent explosive disorder and suicidal behavior. Journal of psychiatric research, 56, 10–17. https://doi.org/10.1016/j.jpsychires.2014.04.012
Telzer, E. H., Fuligni, A. J., Lieberman, M. D., Miernicki, M. E., & Galván, A. (2014). The quality of adolescents’ peer relationships modulates neural sensitivity to risk taking. Social Cognitive and Affective Neuroscience, 10(3), 389–398. https://doi.org/10.1093/scan/nsu064
Jenkins, A. L., McCloskey, M. S., Kulper, D., Berman, M. E., & Coccaro, E. F. (2014). Self-harm behavior among individuals with intermittent explosive disorder and personality disorders. Journal of Psychiatric Research, 60, 125–131. https://doi.org/10.1016/j.jpsychires.2014.08.013
McCloskey, M. S., Kleabir, K., Berman, M. E., Chen, E. Y., & Coccaro, E. F. (2010). Unhealthy aggression: intermittent explosive disorder and adverse physical health outcomes. Health psychology: official journal of the Division of Health Psychology, American Psychological Association, 29(3), 324–332. https://doi.org/10.1037/a0019072

IED in Teens
FAQs

What is intermittent explosive disorder in teens?

It’s a mental health condition where a teenager repeatedly has sudden episodes of intense anger or aggression that are far out of proportion to the triggering situation and are difficult to control.

What signs and symptoms should parents watch for?

Look for frequent and severe outbursts of anger (verbal or physical), destruction of property, aggression toward people or animals, bodily signs like heart racing or tremors before an outburst, and legitimate regret or shame afterward.

What causes IED in teens?

There is no single cause — factors may include family history of mental health issues, early exposure to violence or abuse, abnormal brain functions (such as lower serotonin), and stressful or chaotic environments.

How is intermittent explosive disorder treated for adolescents?

Treatment often combines therapy (especially cognitive‑behavioral therapy), training in emotional regulation and impulse control, family therapy, school support, and sometimes medications to reduce aggression and mood instability.

When should I seek professional help for my teen?

If your teen’s anger outbursts are frequent, severe, causing harm, interfering with school or relationships, or if you notice signs of shame, isolation or co‑occurring issues like depression, it’s time to consult a mental health professional specializing in adolescent behavioral disorders.