ODD and IED: Two Types of Anger Disorders

If you’ve ever been cut off in traffic, felt you’ve been unfairly treated in a personal or professional setting, experienced deep betrayal, or the feeling that you’ve been either taken for granted or taken advantage of, there’s a good chance you know what it’s like to feel angry. Anger is an emotional response that is often triggered by emotional hurt and left untreated it can lead to anger disorders.

Anger affects our bodies, from high blood pressure, rapid and shallow breathing, and fast-beating heart, and we can feel these changes coming over us as we get angry.

Anger is typically experienced as an unpleasant emotion, and it is a response to when we’ve been hurt, when we think we’ve been mistreated, when we come face to face with challenges and obstacles that stand in the way of us accomplishing a professional or personal goal, or when we face opposition to cherished and long-held views.

We can get angry when someone gets promoted over us, when our day is inconvenienced by a long line at the grocery store, when a job interview or exam goes sideways, when a relationship ends and we feel blindsided, or when a friend or relative puts up certain posts and comments on social media. Our anger in those moments can be directed in one or several ways – toward the circumstance, toward other people, toward ourselves, and sometimes even toward God.

There can be no underestimating the power of a moment. One moment could change your life irrevocably, for the good, but also for your detriment. When anger sets in, if you allow it to overwhelm you and guide your responses, there’s a good chance that what you say or do may be destructive and harm you or the people around you. Jobs, friendships, livelihoods, personal freedom and more can be lost through one moment of anger acted upon inappropriately.

Everyone gets annoyed, irritated, or angry at some point in their life, even the most patient person. What will often differ between different people is how easily a person gets angered (their anger threshold, in other words), the frequency of their experience of anger, the duration of those feelings of anger, the intensity of the feelings of anger, what one does with the anger they feel, and whether one feels comfortable experiencing and expressing anger.

But at what point do feeling and being angry become something more; something that can be described as anger disorders? There are several types of anger disorders, which will be outlined below.

Anger disorders

An anger disorder is typified when anger is a dominant force in your life that you struggle to or can’t control. There are a few signs to look out for that might indicate that you have any one of anger disorders.

• You feel angry a lot of the time.
• The people around you, such as your friends, family members, and co-workers have said at one point or another that they think you have an anger problem, or they have distanced themselves from you on account of your behavior. They might say something like “You don’t want to be around when he blows his top.”
• You have a lot of conflict in your relationships, or even with strangers.
• There are business establishments where you’re no longer welcome.
• You’re nursing a grudge or thinking about getting revenge constantly.
• You have been or think about being aggressive or violent when you’re angry.

Although there is no diagnosis for anger problems in DSM-5 or the World Health Organization’s ICD-10 manual, there are several disorders that reflect enduring and dysfunctional anger in a person’s life, and the most common of these are Oppositional Defiant Disorder and Intermittent Explosive Disorder.

According to one Harvard Medical School study, more than 7% of people in the US have experienced intermittent explosive disorder at some point in their lives, making it far more common than previously thought. According to that same study, some 10% of respondents younger than 25 years of age reported explosive outbursts of rage at least three times in their lifetime.

Intermittent Explosive Disorder(IED) is a chronic disorder that involves repeated, sudden episodes of aggressive, impulsive, violent, or angry behavior in which a person reacts grossly out of proportion to the situation. It is also known as volatile anger.

For example, if a person with IED spills their drink, instead of just cleaning it up, they may throw the glass against the wall. Or if someone cuts them off in traffic, instead of maybe just hitting the horn once or twice, they may pursue and tailgate the other driver, possibly setting off a road rage incident.

Some signs of IED thus include incidents of road rage, domestic abuse, shouting/cursing loudly and punching walls, throwing or breaking objects, threatening or assaulting animals or people, and fighting.

An episode of IED may be triggered quite quickly, seemingly out of nowhere, and it usually lasts for less than half an hour. The episodes may be a regular and frequent feature in a person’s life, but they can also be separated by months or weeks. A person with IED finds themselves feeling aggressive, angry, and irritable most of the time.

Not only do these explosive outbursts cause you significant distress, but they also affect your relationships with others, and they will often have legal and financial ramifications. The episodes might leave a sense of fatigue and relief in the immediate aftermath, but later, what might settle in is a sense of regret or embarrassment.

Physiologically, an episode of IED may be preceded by or accompanied by increased energy, tingling, racing thoughts, a tightening of the chest, tremors, and heart palpitations.

Oppositional Defiance Disorder (ODD) is a behavioral disorder that affects up to 16% of school-age children. Rather than referring to either developmentally appropriate temper tantrums or willful behavior from a child, ODD involves something deeper, such as vindictiveness and resentfulness toward other people.

There is often a pattern of argumentative behavior toward and defying rules set by authority figures, acting in ways intended to irritate or anger others, blaming others for their mistakes, and frequent episodes of anger.

It must be noted that a couple of these by themselves do not suggest that a child or adolescent has ODD. For a diagnosis of ODD, these symptoms must not be temporary, but recognizable over a minimum period of 6 months, and they will have at least 4 of these symptoms.

ODD doesn’t just affect children and adolescents though. While ODD generally is not diagnosed in teenagers or adults, childhood ODD can continue into late adolescence and adulthood, especially if it is left undiagnosed and untreated. Some of the same symptoms as with ODD in children and adolescents are present with adult ODD, but in adults there may be additional symptoms, including:

• Defending themselves forcefully and refusing to take on or consider feedback from others.
• Carrying a lot of anger toward the world.
• Lashing out at others when they feel slighted, with a low anger and frustration threshold.
• Frequent tension and conflict, with the result of having trouble maintaining jobs, friendships, and romantic relationships.
• A general feeling that they are unappreciated, misunderstood, or disliked by others.
• Strong attitudes of disdain, dislike, or disrespect for authority figures, find it hard to follow expectations and rules.
• Impatience and irritability.

While the precise cause is unknown, both ODD and IED are thought to be caused by a combination of genetic and environmental factors.

Getting anger under control

People with IED are often misdiagnosed with bipolar disorder, and that is because both types of patients may have explosive outbursts of rage, but people with intermittent explosive disorder do not necessarily experience the same symptoms that those with bipolar disorder do.

You must seek professional medical assistance if you think you may have a problem with anger. Sometimes, what may appear to be an anger disorder is simply a symptom of bipolar disorder, a symptom of depression (especially in men), or post-traumatic stress disorder.

A mental health professional will know the difference and work with you to create an appropriate treatment plan that meets your unique needs and puts you on the track toward peace, health, and wholeness.

For both IED and ODD, according to the American Psychological Association (APA), therapy can help if a person struggles to keep a tight rein on their anger and express it in healthy ways, and mental health professionals recommend a combination of counseling, group therapy sessions, and anger management classes as treatment options for anger disorders.

Cognitive therapy, for example, helps a person find alternative ways of thinking about and reacting to their anger. So instead of thinking horrid thoughts about the other driver who just cut you off in traffic, your response could be, for example, “Yikes! That was a bad accident just waiting to happen.”

In some cases, medication may help control emotions and the chemical reactions in the body that lead to uncontrollable anger. In situations where the symptoms don’t respond to therapy, medication could lead to enough improvement that therapy becomes more effective.

The type of drugs that can be prescribed will depend on individual circumstances and consider other diagnoses, with possible options including mood stabilizers, antidepressants, or antipsychotics.

With ODD in a child or adolescent, what may be required includes family therapy, parent training, and individual therapy for the child. Individual therapy can cultivate an opportunity to learn new methods to deal with emotions and behavior.

In therapy, one might learn skills such as how to manage anger, control impulses, problem solve, make use of relaxation techniques, cope well with stress and frustration, and different ways to communicate effectively.

Not only that, but therapy can foster a safe environment that’s free of judgment in which one can share. Potential contributing factors can be explored, including neglect/abuse, depression, or other mental health problems, learning difficulties, and challenges one might be facing at work or in school.

Would you like to explore options for therapy for yourself or a child who may have symptoms of ODD or IED? Please contact our offices so that we can connect you to a professional today.