Mental Health
More to explosive anger than just bad behavior
By Kathy Jones
Jun 6, 2006 - 2:16:00 PM

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6 June, (foodconsumer.org) - Angry and often violent outbursts are a more common occurrence in Americans than previously thought, according to the findings of a national survey. The condition called as intermittent explosive disorder, or IED is commonly called road rage and manifests in angry drivers.

It triggers extreme reactions in people on the slightest provocation causing them to behave irrationally. Till date these angry outbursts were considered to be bad behavior, but experts point out that it is really a mental illness. The prevalence of the disorder was not known till the results of this survey were released.

The survey says that up to 16 million U.S. adults may have this condition. The study, published in the Archives of General Psychiatry, adds that in any year, 8.6 million Americans are affected by it.

"An awful lot of people in America have IED," said study lead author Ronald Kessler, a professor of health-care policy at Harvard Medical School. "IED is characterized by explosive anger attacks that they can't control and are out of proportion to what is going on in their lives and that lead to physical assault or breaking things."

Intermittent explosive disorder could also be a precursor to other mental illnesses, such as depression and anxiety, and substance abuse problems, the researchers say.

Kessler and his colleagues conducted an analysis of data on 9,282 adults who participated in the National Comorbidity Survey Replication conducted from 2001 to 2003.

Standard diagnostic interviews found that 7 percent of the respondents had suffered the problem at some point of their lived. The researchers defined IED as three or more outbursts in a person's lifetime.

About 5 percent of the respondents met with narrower criteria for the disorder, defined as three anger "attacks" in one year. The prevalence of the disorder was even higher in respondents younger than 25 years. Roughly 10 percent reported explosive outbursts of rage at least three times in their lifetime.

"We found that IED is strongly related to depression and anxiety and other mental-health problems," Kessler said.

He added that the first symptoms started at age 14. This means that early diagnosis could hold the key to proper management of the condition. Surprisingly the survey found that not many people were treated for the disorder, "They usually don't think they have a problem. They think somebody else has a problem," he said.

For example 60 percent of the survey respondents admitted to getting help for some other emotional problem, but only 29 percent got any help for their anger.
The average number of lifetime attacks per person was tabbed at 43. This resulted in $1359 property damage per person. "It is news to a lot of people, even specialists in mental health services, that such a large proportion of the population has these clinically significant anger attacks," Professor Kessler said.

He felt that early diagnosis could be vital, but questions remained. "What would be the implications in the school years of finding these kids, getting them into treatment?" he asked. "Would treatment be effective? Would it prevent later divorce, job loss, drug or alcohol addiction or legal problems?"

The bible of mental illness, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), says that people with IED overreact to certain situations with uncontrollable rage, experience a sense of relief during the angry outburst, and then feel remorse about their actions.

Anger and its implications

*Anger is a normal human emotion and is usually considered healthy. However when it gets out of control and leads to violent reactions, an individual may be considered as having a deep-seated problem.

* Anger triggers several chemical reactions within the body including increased heart rate and blood pressure. Additionally hormones like adrenaline are also released.

* Angry people often react impulsively and regret their "rush of blood" or hotheadedness later

* But suppressing anger is also not the answer, since doing so may result in unexpressed emotions leading to several mental disturbances.

* The goal of anger management basically is to control the emotions and the physiological arousal that anger causes

According to the American Psychological Association, the best way to handle the problem is:
* Breathe deeply, from your diaphragm; breathing from your chest won't relax you. Picture your breath coming up from your "gut."

* Slowly repeat a calm word or phrase such as "relax," "take it easy." Repeat it to yourself while breathing deeply.

* Use imagery; visualize a relaxing experience, from either your memory or your imagination.

* Nonstrenuous, slow yoga-like exercises can relax your muscles and make you feel much calmer.