Has anyone experienced intermittent explosive disorder?
My husband with Lewy Body dementia had sudden rages prompted by minor triggers, e.g., the arrival of home care workers or not wanting to bathe.
While in hospital after a paranoid delusion, he had a rage for which they sedated and sectioned him. When these rages continued while he awaited placement in a geriatric psych ward, the psychiatrist gave him Olanzapine. The positive effect to his personality was almost immediate. It was like a light switch turned off his over-the-top anger.
I have always wondered why this drug worked so well and never got a straight answer from his doctors; I suspect it was due to the vagaries of how dementia affects different people’s minds.
I recently queried “rage” and “Olanzapine” and discovered a mental health illness called intermittent explosive disorder. He fit it to a tee, including the remorse experienced after it had blown over.
A neuropsychologist diagnosed the IED after a referral from the rehab doctor at the facility where this person received medical care after the stroke.
"While someone with dementia might exhibit aggressive behaviors, it's not generally considered a direct manifestation of Intermittent Explosive Disorder (IED). Dementia-related aggression is often a result of cognitive impairment, confusion, and other factors that make it difficult for the individual to express themselves or understand situations. IED, on the other hand, is characterized by episodes of uncontrolled anger and aggression that are often disproportionate to the situation and are not explained by other factors like dementia or medical conditions.
Here's a more detailed explanation:
Dementia and Aggression:
Cognitive Decline:
- Dementia, particularly in later stages, can lead to difficulty with reasoning, problem-solving, and impulse control, which can contribute to aggressive outbursts.
Confusion and Frustration:
- Individuals with dementia may become confused, disoriented, and frustrated by changes in their surroundings, routines, or interactions, leading to anger and aggression.
Behavioral and Psychological Symptoms of Dementia (BPSD):
- These symptoms, which can include aggression, agitation, and irritability, are common in dementia and are often linked to changes in the brain's structure and function.
Other Factors:
- Pain, infections, environmental changes, and caregiver burnout can also trigger aggressive behaviors in individuals with dementia.
Intermittent Explosive Disorder (IED):
Impulse Control:
- IED is characterized by a lack of restraint in expressing anger and aggression, leading to episodes of intense anger outbursts that are out of proportion to the situation.
Diagnosis:
- To be diagnosed with IED, the aggressive behaviors must not be due to the direct physiological effects of a substance, a medical condition (like dementia), or another mental disorder.
Prevalence:
- IED is more common in men than women and can have a significant impact on an individual's life and relationships.
Key Differences:
Cause:
Aggression in dementia is often rooted in the cognitive and neurological changes associated with the disease, while IED is primarily a mental health condition characterized by a lack of impulse control.
Duration:
Aggression in dementia can be more prolonged and persistent, often occurring over time, while IED episodes are generally shorter in duration, though they can be frequent.
Triggers:
Aggression in dementia can be triggered by various factors, including environmental changes, pain, and caregiver interactions, while IED episodes may be triggered by specific situations or events.
In summary, while dementia can lead to aggressive behaviors, these are usually not the same as the aggressive outbursts seen in IED. Dementia-related aggression is often a consequence of cognitive impairment, while IED is a distinct mental health condition characterized by a lack of impulse control. "
I'm wondering what type of doctor diagnosed your LO? Was it his primary or neurologist? Or an ER doctor?