Temper tantrums and explosions of rage are typically written off as features of a bad attitude, or some negative personality trait. But new research suggests there may be more behind rage than previously believed. The study, conducted by University of Chicago researchers and published in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, found that people who have frequent rage attacks had smaller brain regions associated with emotions.

Instead of simply calling it rage, the researchers refer to the condition as intermittent explosive disorder (IED) — defined as impulsive, frequent, and violent outbursts that are an overreaction to the situation. Previously, researchers believed that IED was caused by the environment (for example, growing up in abusive homes), genetics, or an imbalance in brain chemistry. Of course, a huge amount of things can contribute to emotional brain development, such as parental absence during childhood, among others, but for the first time researchers examined brain density more deeply.

“Intermittent explosive disorder is defined in DSM-5 as recurrent, problematic, impulsive aggression,” said Dr. Emil Coccaro, professor and chair of psychiatry and behavioral neuroscience at the University of Chicago and the lead author of the study, in a press release. “While more common than bipolar disorder and schizophrenia combined, many in the scientific and lay communities believe that impulsive aggression is simply ‘bad behavior’ that requires an ‘attitude adjustment.’ However, our data confirm that IED, as defined by DSM-5, is a brain disorder and not simply a disorder of ‘personality.’”

The researchers used high-resolution magnetic resonance imaging (MRI) scans to analyze the amount of gray matter in the brains of 168 subjects. Fifty-seven of the participants had intermittent explosive disorder, 53 were healthy control subjects, and 58 were psychiatric control subjects. Gray matter contains the majority of the brain’s neurons, and is involved with regions that maintain muscle control, seeing, hearing, memory, emotions, speech, self-control, and decision-making. A higher density of gray matter is typically associated with more skills and abilities, higher IQ/intellect, and more experience.

When examining the MRIs of the participants’ brains, the researchers found that people with intermittent explosive disorder had lower levels of gray matter in the orbitofrontal cortex, ventral medial prefrontal cortex, anterior cingulate cortex, amygdala, and insula compared to healthy control subjects. The amount of gray matter in these areas was associated with aggression, the researchers found.

“Across all subjects, reduced volume in frontolimbic brain structures was associated with increased aggressiveness,” Dr. Cameron Carter, professor of psychiatry and behavioral sciences at the University of California, said in the press release. “These important findings suggest that disrupted development of the brain’s emotion-regulating circuitry may underlie an individual’s propensity for rage and aggression.”

IED can cause significant complications in people’s lives, from impaired relationships to health risks. When we’re angry, our brain activates physiological responses that have an impact on our physical state; our blood pressure goes up and hormones like epinephrine and norepinephrine are released. Research has shown that bouts of rage — whether during a fight with a spouse or road rage — can have a detrimental effect on our cardiovascular health. So finding a way to treat IED is important; psychotherapy and counseling can be one way to deal with it. Certain medications, such as antidepressants, may also be an option.

But perhaps the most effective way to approach the condition is to learn how to control anger by developing a plan, avoiding alcohol and other triggers, and learning to cope with issues that upset you. Because the brain’s response during anger lasts only a few seconds, taking a moment to breathe and calm down before responding to a situation may help you avoid exploding.

Source: Coccaro E, Fitzgerald D, Lee R, McCloskey M, Phan K. Frontolimbic Morphometric Abnormalities in Intermittent Explosive Disorder and Aggression. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2016.