Credit: Rasmus Rasmussen
The following commercial may be coming soon to a television near you.
An LA expressway at rush hour. A 40-year-old middle manager driving a 10-year-old Geo gets cut off by a long-haired teen in a cherry-red Mustang. The elder man raises his hand quickly, but instead of shaking it wildly, he smiles and waves.
Cut to exterior of a Planned Parenthood clinic during a pro-life rally:
A woman entering the clinic drops handbag, splaying condoms and lipstick onto the ground. Protester picks up handbag, passes it to the woman and wishes her a “nice day.”
Cut to a grassy meadow:
“Daily Show” curmudgeon Lewis Black hugs a Starbucks executive (or Dick Cheney).
“If you have three or more outbursts or instances of rage per year, you may suffer from IED, a condition that affects nearly 20 million Americans. Ask your doctor about Simmadoun, a new medicine that may help calm urges to overreact to life’s unfortunate moments. Side effects may include incontinence, vaginal dryness and a tendency to be stared at in Midtown Manhattan. See our ad in Guns & Ammo magazine for more information.”
Irish soccer fan takes Brazilian player into a bar, buys him a beer and pats him on the ass.
According to a report released June 5th in the Archives of General Psychiatry, researchers from the University of Chicago, Massachusetts General Hospital and Harvard Medical School say more than 7% of Americans may require treatment for a condition known as “Intermittent Explosive Disorder,” or IED.
It’s neither a propensity for spontaneous combustion nor anything a big bottle of Bean-o could solve. Rather, it’s a condition described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as an impulse-control disorder that results in violent outbursts or “rages” that cause harm to others or property, and are “grossly out of proportion to the stressor.”
“It’s kind of embarrassing, but anger isn’t something that you think to bring up in a diagnosis,” said Harvard’s Ron Kessler, the report’s lead author. “You tend to focus on sadness or moodiness. The fact is that what psychologists are trained to think of as a mental illness was historically defined over drinks and cigars by aggressive, middle-aged men.”
The scientists say they were shocked to find that there is such a large population of angry Americans. So, in line with our over-medicated ways, they are adding a new entry to the list of popular mental illnesses skulking on the underside of America’s psyche—right between ADHD and restless leg syndrome. Age, race and socioeconomic status don’t seem to be factors in predicting who suffers from IED—but gender does: The study found nearly twice as many men display symptoms than women.
Thus far, IED has mostly appeared on the national radar when used as a defense in court, like in the 2001 case of millionaire transvestite dermatologist Richard Sharp of Lawrence, MA, who claimed that the condition led him to shoot his wife of 26 years.
“This is a biological condition that can be effectively treated,” said University of Chicago’s Emil Coccaro, one of the paper’s coauthors.
Coccaro also pointed to studies—which he admits had very small sample groups—showing that people who have been diagnosed with IED tend to react to annoyances with a lack of activity in the brain’s seat of reasoning (the frontal cortex) and over activity in the “fight or flight” center (the amygdala). IED is often treated with a class of drugs called serotonin reuptake inhibitors, the most popular of which is Prozac.
The new study was a part of a much larger project conducted between 2001 and 2003 called the National Comorbidity Survey, where researchers showed up at more than 9,000 households to test the severity and prevalence of a broad range of mental disorders. To rank IED, interviewers asked respondents to report times when “all of a sudden you lost control and broke or smashed something worth more than a few dollars.” Subjects were also asked whether or not they thought their response was angrier than average. Those who reported more than three over-reactions in a year averaged $1,359 in total property damage.
Despite the damage assessment, some psychologists aren’t buying IED.
“Pharmaceutical companies and research academics are making it so that entries in the DSM become a list of excuses for patients to get their drug of choice and an easy way out for psychiatrists,” said Simon Sobo, a Connecticut-based psychologist who has written extensively on overmedication. “If you walk into a doctor’s office and have strep throat, then he knows what is causing your problem and can give you antibiotics to clear that up.
“We don’t immediately know what causes the problems in our heads,” he continued, “so we shouldn’t dole out knee-jerk medications as if we did—especially not when counseling or rooting out a life problem will do the trick.”
Sobo and like-minded psychologists are worried IED will follow the same path as ADHD—a disorder for which 5 million Americans receive treatment. As studies in the late ‘90s suggested that many adults may suffer from the same disorder as their children, adult use of drugs such as Ritalin doubled in a three year timespan. More recently, editorials in the Journal of the American Medical Association and the New England Journal of Medicine have hinted that these prescriptions may be unnecessary. Prescriptions to children rose at the same rate, leading the Consumers Union—the publisher of Consumer Reports—to issue a warning last September that the drugs were probably being vastly over-prescribed.
For their part, the paper’s authors hypothesize that individuals with hair-trigger tempers aren’t anything new in our society. The problem, they say, is that we live in a world with a lot more stressors, which make the starting point for rage a lot closer to the explosion point for everyone.
“This is why you pick up the paper and see more road rage and more instances of stupid violence,” Coccara said.
Still, Coccara doesn’t advocate relying on quickie solutions like Prozac to buffer our increasingly high-strung lives. Rather, he suggests that those of us who can hold our tempers long enough try counting to 10.
Originally published June 7, 2006