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Intermittent Explosive Disorder and the Berserkergang

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Road rage. “Going Postal.” Explosive temper. Everyone knows or has heard of people who are prone to irrational and excessive outbursts of temper and anger. People prone to such temper issues are prone to violence even in situations where violence is unwarranted, and often become bullies and sometimes abusers of some sort or other. People with such problems are often thought of as being bad tempered and undisciplined. However, it appears that not all people with such problems are so simply described. Many of them actually suffer from a medical disorder. Intermittent explosive disorder (IED), also known as Militant Episode Disorder (MED), is a disorder of the brain characterized by explosive, usually violent outbursts of behaviour, usually disproportiionate to the provocation. It is a type of impulse control disorder, and seems to be related to other impulse control disorders such as kleptomania, pyromania, and pathological gambling. It, like all impulse control disorders, is characterized by the repeated experience of impulses (in this case violent ones) that are difficult or even impossible to resist, even if the impulses are clearly harmful to the self or others. The impulsive aggression typical of this disorder is not premeditated.

Signs and symptoms of this disorder include:

1) Tension, mood changes, and changes in energy levels prior to an outburst.

2) Tingling, tremors, chest palpitations, headaches preceding an outburst.

3) Hearing echoes prior to an outburst.

4) Altered awareness during the outburst.

5) Feelings of relief and/or pleasure accompanying the outburst.

6) Feelings of remorse after the outburst.

7) Linked with temporal lobe epilepsy.

8) Loss of cells/abnormalities in the left hemisphere of the brain.

9) Higher prevalence in men than in women.

10) Associated with mood disorders such as bipolar disorder.

11) Average outburst lasts 22 minutes.

12) Associated with dissociative states.

13) Abnormalities in the frontal lobe.

14) Affects approximately 5% of the population.

15) Disproportionately violent reactions to stressors.

16) Associated with low levels of serotonin.

17) Abnormalities in the amygdala.

Diagnosis of IED is generally made when other mental disorders that may cause violent outbursts (such as antisocial personality disorder, borderline personality disorder, ADHD, etc.) have been ruled out (McElroy, 1999; McElroy, Soutullo, Beckman, Taylor Jr., & Keck Jr., 1998). Furthermore, the acts of aggression can’t be due to another medical condition such as a head injury, Alzheimer’s disease, substance abuse or medication.

Treatment is achieved through both cognitive behavioral therapy and psychotropic medications. Therapy aids in helping the patient recognize the impulses in hopes of achieving a level of awareness and control of the outbursts, along with treating the emotional stress that accompanies these episodes. Drugs used in treatment are typically tricyclic antidepressants and serotonin reuptake inhibitors (SRIs) such as fluoxetine, fluvoxamine, sertraline, as well as GABAergic mood stabilizers and anticonvulsive drugs such as gabapentin, lithium, carbamazepine, and divalproex.

While only discovered by the modern medical community in recent times, it appears that this disorder has actually been known since ancient times, just under different names, such as the berserkergang and running amok.

The berserkergang was the practice of a type of elite viking warrior known as a berserk or berserker. Berserks were generally used as shock troops, used to break through the enemy lines. And shocking they indeed were, for their style of combat was entirely based on transcendental animalistic fury. They howled like animals, bit their shields, and were completely impervious to pain or fear. They attacked relentlessly, never retreating and seemingly giving little thought to defense. And this was not merely their way in war, they seemed to be born prone to this sort of extreme rage, for even in times of peace they would often wander the land looking for fights and duels, living as bullies.

Running amok was a very similar practice of certain Malaysian warriors, who fought like the insane, screaming and howling, and who would be prone, even in times of peace, to going on violent or even murderous sprees which could only be ended in death. And indeed, such people engaging in such practices are found all over the world, throughout history, such as the Leopard-Men of Africa, the Riastradh of the Celts, the Wild Men of the Woods in Medieval Europe, and so forth. Intermittent Explosive Disorder is hardly new. Indeed, it couldn’t be. A genuine genetic disorder like that has likely been part of human history for a long time, such things don’t just crop up overnight. And while the ancients may have lacked modern medical knowledge, they were hardly stupid, so it shouldn’t be surprising that they’d have been aware of this condition, even if they did look at it differently than a modern MD might.

What is different is the way the ancients dealt with it. They did not try to alter the personalities and brains of the affected with drugs and medications. They didn’t actually view these people as “suffering” or “disordered” at all. Instead they simply viewed such people as being different. Instead of trying to suppress these differences the ancients instead made use of them, took advantage of their unique traits. Such people were often highly valued as warriors, and were often treated as nobility in an effort to retain their services as such. They were often viewed as heroes, for their abilities to perform feats of strength and bravery no one else would or could, and for their willingness to do so for the benefit of their families, friends, and nations. Indeed, another term for the Celtic Riastradh was “The Heroic Feats”. And such people were known for more than their abilities at war. They were also prized for their ability to perform backbreaking physical labor, and also for their tendency to go into trances where they sometimes offered prophecy and advice that was supposedly inspired by the gods.

This stands in very sharp contrast to the approach the modern medical community holds. While therapy designed to put someone suffering from IED in contact with his or her own mind well enough to understand and control the outbursts is of course a good idea, drugs are not necessarily so. Many, if not all, of these psychotropic medications have horrible side effects. Some of them decrease the ability to think or reason well. Others have a depressing effect on the emotions, leaving the patient free not only of outbursts but also of positive emotions such as joy and arousal. Indeed, some of these medications can destroy the sex drive entirely. Some affect or even ruin the memory. Many of them will leave the patient with a vague but horrifying sense that there’s “something wrong”, or that they are incomplete. Many people with IED truly hate what the medications do to them, and so take themselves off of them, leaving the disorder unchecked, or remain on them and live lives full of suffering and loss.

This does not seem to be the ideal way of dealing with things. It is true that unchecked transcendental rage is a truly bad thing. But the psychotropic medication approach seems like using a sledgehammer where a scalpel is called for. It simply does not seem sensible to try to mentally cripple people with IED in an attempt to control it. Such people are born different than others. They are genuinely not like other people. Why does that make them “diseased”? Why should that difference be seen as a reason to try to force their brains to operate in a pattern alien and unnatural to them?

The ancients did not see these people as deficient. They had places for them. They played to their strengths. They saw these people as maybe not normal, but functioning and whole. And so we are.

I am a berserker. All of my life I have been prone to entering berserk rages at the drop of a hat. It has been a lifelong struggle of mine to come to terms with this, to learn why and how, and to learn to control it. It is the same for every other self-identified berserker I have met, as well as for those identifying in other ways, such as Leopard Men and those who run amok. When we discovered the existence of Intermittent Explosive Disorder we were shocked. We knew of the manners in which the ancients looked at people like us, and we knew that we were prone to being viewed as crazy in various ways by the modern medical establishment. But we had never before heard of IED, and when we did, we identified with each and every sign and symptom of it. So thoroughly that most of us are convinced that we have IED. To explain why this is so, here is a list of the features we had found common to our natures as berserks and such:

1) Feelings of tension, irritability, and heightened energy preceding a gangr. (“Gangr” is the term for the berserk rage.)

2) Tingling and itching feelings, shakes, tremors, spasms, headaches preceding a gangr.

3) Hearing voices, echoes, seeing everything shine prior to a gangr.

4) Altered awareness during a gangr.

5) Feelings of pleasure accompanying a gangr.

6) Feelings of guilt and remorse after going too far in a gangr, a conviction that we are “evil”, “bad”, and “sick”.

7) Many of us suffer from temporal lobe epilepsy, or are undiagnosed but have symptoms of it, such as absence attacks.

8) Loss of language skills and rational thinking abilities that may be impaired, or other left-brain associated abnormalities.

9) Many more men than women are berserkers and whatnot.

10) Many of us suffer from various forms of depression and mania, and many of us have been diagnosed with bipolar disorder.

11) Most of us have noticed that a gangr naturally lasts about half an hour on average.

12) The gangr is universally associated with dissociative states, in which the berserk “goes off into his mind”, or has the experience of taking on a completely different personality, sometimes an animal one.

13) Loss of discriminating thought, the sort of thought that says something “is this” and “is not that”, a function of the forebrain.

14) At one point we tried to guess how prevalent the “berserker genes”, as we called them, were. Taking ancient records of sizes of armies and sizes of berserker contingents within those armies, we arrived at a rate of 2%.

15) The defining characteristic of the gangr is a disproportionately violent reaction to all stressors.

16) Many of us during a gangr find we have increased pain tolerance, feelings of well-being, heightened rates of blood clotting, and other things indicative of high use of serotonin. Outside the gangr, especially immediately after it, we tend to suffer from depression, chills, confusion, carbohydrate cravings, insomnia, and other things associated with low serotonin levels. (Perhaps part of the reason they are low is that we use up too much during the gangr.)

17) Impulse control issues and a lack of mid-range emotions, both things associated with problems with the amygdala.

There are far too many matches here for this to be coincidence. It seems to most, if not all of us, that the berserker nature is identical to IED. Does this not mean that there are better ways of dealing with this nature than medication into a near comatose (or at least unbalanced and injured) state? Many of us have run into doctors that have tried to ”fix” us by drugging us. And virtually all of us found the experience of the medications to be horrible, found it leaving us feeling like we’d been mutilated in some profound way.

And even when drugs are not prescribed as a treatment, still the therapeutic approach seems to come from the point of view that the patient is sick, wrong, diseased, “not right”. This lies in direct opposition to the patient’s inner feelings, that are telling him (or her) that this is right and natural. This approach can lead to depression and feelings of unworthiness, and can even cause serious psychological complexes. In some cases these complexes can even lead to such patients taking beatings or abuse because they don’t dare defend themselves, having been taught that that part of themselves is wrong and sick, and needing to be kept under wraps no matter what. Such unfortunates often come to have very low feelings of self worth. And more, many of us berserker types spend most of our lives feeling like we are at war with ourselves, that we have a divided nature. We often never know a feeling of rest or peace. This sort of therapy only exacerbates this condition.

All in all I, and most other berserker types, do not feel that the modern medical community is very well equipped to handle this condition. They just don’t understand it well enough, and are approaching it from a culturally prejudiced point of view. We feel that we are not sick. We are not “wrong”. We are not unwell. We are simply different. And those differences in nature mean we need differences in treatment.

If you have been diagnosed with IED, or suspect you suffer from it, consider that the modern medical community might not really be the best source of information on how to deal with the problems it raises. There are other ways. Older ways. We modern berserks and such have taken lessons from the ancients, learned to take advantage of what this nature can do for us. Learned what makes us tick. Learned to take this knowledge and find a balance, a way of living that does not suppress our true inherent natures but also does not let us run away into expressions of inappropriate violence. We approach things from a spiritual perspective, as the ancients did. And in that spiritual perspective we have found an answer. Maybe it is an answer that would work for you too. If you are interested in learning more about this from our perspective, try these websites:

http://www.uppsalaonline.com/uppsala/berserk.htm

http://www.uppsalaonline.com/uppsala/somafera/somafera%20-%20the%20body%20wild.html

There is also a discussion forum for dealing with these issues from the spiritual and experiential angle. If you wish to join the somafera forum to talk to others with these issues, and to find alternate ways to deal with them, e-mail me. Include your experiences, and why you wish access to the forum.

My e-mail: wayland@uppsalaonline.com

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