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How is intermittent explosive disorder (IED) related to premenstral syndrome (PMS)?

by Anitra Marie

Created on: September 29, 2009   Last Updated: September 30, 2009


Night after night, we pretend it's all right
But I have grown older and
You have grown colder and
Nothing is very much fun any more.

And I can feel one of my turns coming on...


Anyone who has seen Pink Floyd's rock opera "The Wall" know what those lyrics are leading up to. The main character literally explodes into violence, resulting in a wrecked trailer, a terrifed girlfriend, and a television sent flying out a window. While violent eruptions like the one shown in this movie don't happen everyday, they aren't nearly as uncommon as we'd like them to be.

According to Mayo Clinic, as many as 1 in 14 U.S. adults may suffer from a psychological conditon known as Intermittent Explosive Disorder, commonly abbreviated IED. This conditon is listed in the DSM-IV alongside other impulse control problems like kleptomania, obsessive gambling, and pyromania. A person diagnosed with IED is prone to short bursts of intense aggression that may be directed towards themselves or others. Symptoms of an oncoming outburst include head pressure, tightness in the chest, hearing an echo, migraines, trembling, or palpitations. It is possible for property damage, suicide, or even homicide to result from one of these outbursts. One defining characteristic of IED is that the aggression must be out of proportion in response to whatever triggered it. It is also necessary for doctors to rule out similar conditions such as oppositional defiant disorder, schizophrenia, antisocial personality disorder, and violent behavior due to substance abuse before a diagnosis of IED is made. Men are predominantly the ones that are affected by this disorder, but women may experience IED as part of premenstrual syndrome.

This leads us to an interesting question concerning the link between IED and hormone imbalances experienced during a woman's estrus cycle. It raises the theory that there may be biological causes underlying both these conditons. Serotonin is a neurotransmitter in the brain that controls mood and eating habits. During the two weeks following ovulation, serotonin levels in a woman's body decrease, which can cause mood swings, irritability, and emotional outbursts. Low levels of serotonin have also been found in the brains of men diagnosed with Intermittent Explosive Disorder. This may explain why selective-serotonin-reuptake inhibitor (SSR-I) antidepressants like Prozac and Zoloft have been successful in treating the symptoms of both disorders.

Cognitive and behavioral therapies have also been successul in treating IED, combined with appropriate medications. It is important not to let IED go untreated, as it can seriously impair a person's quality of life.



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