Intermittent Explosive Disorder: Could It Be the Reason for Your Teen’s Outbursts?

Another day, another angry outburst from your teen. At this point, you’d be surprised if 24 hours went by without screaming and door slamming. But if your teen is having over-the-top, violent outbursts, it may signal a type of teenage rage disorder.

Psychiatrist Jess Levy, MD, offers guidance on intermittent explosive disorder (IED).

Signs you’re dealing with more than just an angry teenager

“Parents hear the term intermittent explosive disorder and automatically think, ‘That’s my kid!’” says Dr. Levy. “But most teen blow-ups are normal. It’s when they smash objects or threaten to harm someone that I would categorize their anger as problematic.”

Intermittent explosive disorder occurs in kids over age 6. To diagnose the disorder, psychiatrists look for these factors:

• Excessive: Your teen’s response is disproportionate to the stressor at hand. For example, you ask them to turn off their video game, and it results in a full-blown destructive meltdown and threats of harm.
• Aggressive: Doctors look for verbal or physical aggression (that doesn’t cause injury or damage) two times a week over three months, or three stress physical outbursts (to property, people or animals) in 12 months.
• Impulsive: Your teen’s behaviors are the result of problems with impulse control and anger management. Their outbursts aren’t premeditated.
• Not explained by something else: Your child’s aggression is not related to another disorder.

Teen rage: Take action before they detonate

If you feel like the above statements ring true for your child, talk with their pediatrician. At the same time, warns Dr. Levy, take all safety concerns seriously.

“Never attempt to call a child’s bluff,” says Dr. Levy. “Yes, sometimes teenagers say things they don’t mean or say they want to hurt themselves or others. But you’re not in their head, so you must assume they are telling the truth.”

Your child’s pediatrician will want to rule out other reasons your teen may be exploding on the daily. For example, doctors might screen for drugs or alcohol, especially if you’ve noticed a drastic change from your child’s usual disposition. A mood disorder or sleep disturbance might also cause similar behaviors.

Once diagnosed, behavioral therapy is the first-line treatment for intermittent explosive disorder. Your child’s provider may also recommend medications. But whether or not your child has IED, some behavior-based approaches can help build impulse control and quell outbursts.

Avoid tantrum-inducing situations

“Find ways to avoid power struggles, which lead to temper tantrums,” says Dr. Levy. “The biggest pitfall parents face is not validating a child’s emotions and brushing off their concerns as being petty.”

Get on your teen’s side with these tips:

• “I hear you”: Verbally acknowledge that you heard what your teen says but don’t tell them how they should feel.
• Don’t take it personally: Your teen may make a blanket statement like, “You never listen” or “You never take my side,” even if it’s not true. Instead of fighting back, say, “I know it might seem that way to you” or “How can I do a better job of listening to you?”
• Set expectations: And enforce the limits you’ve set — whether it’s a curfew or how much time they can spend on their device. Arguments go nowhere when negotiation isn’t an option.

Find natural consequences and enforce them

Patiently guide your teen in learning that tantrum-ing is not acceptable behavior. “Model good behavior by staying calm and neutral,” says Dr. Levy. “And enforce the consequences for their behavior.”

Dr. Levy says punishing for the sake of punishment rarely works. Instead, find natural consequences that might inspire them to change their behavior. For example:

• Clean it up: If your teen gets angry and makes a mess, make sure they clean up once they calm down.
• Help pay for it: If they break something, ask how they will help pay for it and create a payment plan.
• Say you’re sorry: Ask your child to apologize in writing. “When they write what they did wrong and why it was wrong, they are more likely to avoid repeating the bad behavior.”

Praise them for mature behavior

“Outbursts serve a function for teens with or without intermittent explosive disorder,” says Dr. Levy. “They might be seeking attention, the use of the car or a way to get out of a chore. But you can help teens find more efficient ways of asking for what they need.”

Help your teen find words to communicate what they’re feeling. You might say, “You seem mad. Is something stressing you out? Are you tired?” When you see mature behavior, reward it with praise. “Teenagers love to be told they’re mature, so point out when they handle things responsibly,” says Dr. Levy.

Dr. Levy offers a final pearl of wisdom for parents: “Parents should attend to their own health. It’s hard to be in a good place and calmly deal with a reactive teen if you aren’t taking care of yourself.”