When anger is a disorder

Most anger is not a mental health disorder. It is a normal feeling that sometimes gets out of hand. But some people have outbursts that are very frequent, very strong and far out of line with what set them off. For them, anger can be a health condition of its own.²

Anger and irritability can also be signs of another condition, such as depression, bipolar disorder, PTSD or ADHD.^5,6,7,8 This page explains intermittent explosive disorder and a related condition in children. It also covers how other conditions can show up as anger, how a clinician evaluates anger, and when anger becomes dangerous.

Intermittent explosive disorder (IED)

IED is a condition in which a person has frequent, impulsive anger outbursts or aggression. Outbursts can include temper tantrums, heated arguments, fights, breaking things or attacking someone. They are driven by anger in the moment. They are not planned, and they are not used to get money, power or control.²

Each outburst usually lasts less than 30 minutes.² People with IED tend to report lower life satisfaction and quality of life.²

How IED is diagnosed

Doctors in the U.S. use the DSM, the official handbook of mental health conditions. The current edition is the DSM-5-TR, from 2022. Its criteria for IED, in plain words, are:^1,2

The last point matters. Outbursts that are better explained by dementia, a brain injury, a medicine, alcohol or drugs, or another condition such as bipolar disorder are not counted as IED.¹

How common is IED?

A national U.S. survey found that about 7.3% of adults had IED at some point in their lives, and about 3.9% (about 1 in 25) had it in the past year.³

• On average, it started at about age 14.³
• People with IED reported an average of 43 outbursts in their lifetime. These caused property damage and injuries.³
• Only about 3 in 10 had ever had treatment for their anger, even though most had seen a professional for some other emotional or substance problem.³

Treatment for IED

Cognitive behavioral therapy (CBT) is the usual treatment. It focuses on changing angry thinking and building relaxation and coping skills.² A 2025 review of 12 randomized trials found that talk therapy, especially CBT, reduced aggression and helped more people reach full remission. Some medicines, such as the antidepressant fluoxetine, helped with irritability.¹¹ Never start or stop a medicine on your own. See Treatment for anger problems.

Disruptive mood dysregulation disorder (DMDD) in children

DMDD is a childhood condition. It was added to the DSM in 2013.⁴ It is more than the usual moodiness or tantrums. A child with DMDD has:⁴

• Severe temper outbursts, in words or actions, on average 3 or more times a week
• Irritable or angry mood most of the day, nearly every day, between outbursts
• These problems for at least 12 months
• Trouble in more than one setting, such as home, school or with friends

Children are usually diagnosed between ages 6 and 10.⁴ As they grow, outbursts may become less frequent, but some young people go on to have depression or anxiety.⁴

Talk therapy usually comes first. CBT helps children cope with frustration and anger. Parent training teaches parents how to predict triggers, respond consistently and reward positive behavior.⁴ Medicines are sometimes added. No medicine is FDA-approved for DMDD itself.⁴ Grandparents raising grandchildren can ask the child's doctor or school counselor about an evaluation.

When irritability is part of another condition

Anger and irritability are common signs of other conditions. In these cases, treating the main condition is often the best way to ease the anger.

If many kinds of strong emotions are hard to settle, not just anger, also read about borderline personality disorder. Other things that can feed irritability, such as alcohol, poor sleep, pain and dementia, are covered in Signs and causes of anger problems.

How a clinician evaluates anger

If you see a doctor or mental health professional about anger, they will usually:

1. Ask about your anger. How often does it happen, how strong does it get, how long does it last, and what happens during an outburst? Have you broken things or hurt anyone?
2. Use a short questionnaire. One example is the DAR-5, a five-question scale. It asks how often, how intensely and how long you get angry. It also asks whether you want to hurt others and whether anger gets in the way of relationships. Scores above a cutoff of 12 suggest anger that is likely causing problems.⁹ Our MindCheck self-check uses the DAR-5.
3. Look for other causes. They will ask about your mood, sleep, alcohol and drug use, medicines, head injuries and past trauma. They may check for depression, PTSD, bipolar disorder or ADHD, and for medical problems.¹
4. Ask about safety. Expect questions about thoughts of hurting yourself or others, access to weapons, and how things are at home. Answering openly helps them help you.
5. Make a plan together. This may include anger management therapy, treatment for a related condition, or both.

To prepare, keep an anger log for a week or two: what happened, how angry you got on a scale of 1 to 10, how long it lasted and what you did. Bring a list of all your medicines and supplements.

In older adults, a new or growing temper should be checked by a doctor, since medical problems such as a brain injury can change behavior.¹⁰ See Anger and irritability in later life.

When anger is dangerous

Anger becomes dangerous when it leads to threats, violence or control. Warning signs include:¹²

• Threatening to hurt or kill someone
• Using or showing guns, knives or other weapons to frighten
• Hitting, shoving, slapping or choking
• Destroying property or threatening pets
• Threatening suicide in response to something a partner did
• Acting in ways that make others afraid

These behaviors often get worse over time.¹²

Common questions

Is IED an excuse for violence?

No. A diagnosis helps explain a pattern and guide treatment. It does not remove responsibility for what a person does. People with IED can learn to control outbursts with treatment.^2,11

Can adults have DMDD?

DMDD is diagnosed in childhood. Adults with ongoing irritability and outbursts are checked for other conditions, such as IED, depression or bipolar disorder.^1,4

Is anger in dementia the same as IED?

No. Outbursts that are better explained by dementia or another medical condition are not counted as IED.¹ They are treated by finding the cause, such as pain or confusion. See Agitation and aggression in dementia.

When to get help

See a doctor or mental health professional if you or someone close to you has:

• Outbursts that are frequent or far bigger than the trigger
• Outbursts that cause damage, injuries, job loss or legal trouble
• Ongoing irritability along with low mood, high energy, poor sleep or trauma memories
• A child whose temper outbursts happen several times a week and last for months

IED and the conditions above are treatable. Asking for help is a sign of strength.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.