Charlie Sheen, Mel Gibson and Intermittent Explosive Disorder

Earlier this week, it was widely reported that actor Charlie Sheen, 45, engaged in "disorderly conduct" in a New York hotel room and, after police intervened, voluntarily checked himself into a hospital for psychiatric evaluation. Upon release, Mr. Sheen's publicist attributed the actor's behavior to an "allergic reaction" to an unnamed medication.

Sheen has a history of substance abuse and domestic violence and anger management problems. But he's not the only Hollywood actor with such issues: Mel Gibson, 54, has also been repeatedly in the news for similar behaviors.

Because some forms of antisocial behavior have been classified as psychiatric disorders, we wondered whether anger in some forms could be considered a bona fide mental disease.  So we did some research on the topic and here are our findings.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) includes Intermittent Explosive Disorder (312.34) with the following diagnostic criteria:
  • The degree of aggressiveness expressed during the episodes is grossly out of proportion to any precipitating psychosocial stressors.
  • The aggressive episodes are not better accounted for by another mental disorder (e.g., Antisocial Personality Disorder, Borderline Personality Disorder, a Psychotic Disorder, a Manic Episode, Conduct Disorder, or Attention-Deficit/Hyperactivity Disorder) and are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma, Alzheimer’s disease).
Intermittent Explosive Disorder (IED) is one of a class of impulse control disorders that also includes pathological gambling, trichotillomania, kleptomania and pyromania. According to recent national surveys, IED has an early age of onset (mean age = 14) and has significant associations with comorbid mental disorders (mood, anxiety and substance abuse disorders) which have a later age of onset. Behavioral interventions and pharmacologic treatment options have been described.

Most pathological anger encountered in primary care settings is probably a less severe form associated with other mental health problems, specifically GAD or generalized anxiety disorder.


Other people think anger should be considered a mental illness because they cannot get research grants to study anger from the National Institutes of Health because NIH only funds research on “real diseases.”

For many celebrities, whether their problems are substance abuse, "sex addiction" or something else, treatment and rehabilitation are often seen (perhaps cynically in some cases) as a route to redemption in the public mind.

What do you think?

More information on the diagnosis and treatment of Anger and Intermittent Explosive Disorder