The Rage Within

(Episodic Dyscontrol Syndrome)
By: Sharell Tracy D.C.

Episodic dyscontrol syndrome is a recognized condition that disrupts the lives of those who suffer with it and the lives of their families. Characterized by explosive unreasonable rage, once triggered, it is irreversible for that episode. Some who suffer with episodic dyscontrol syndrome can control its outcome somewhat by raging over inanimate objects such as a fist through a wall, throwing furniture, or kicking car tires, while others appear to take out their rage on the supposed offender. Unfortunately, the offender often does not know what they have done to offend because another one of the characteristics is rage disproportionate to the offense.

Episodic dyscontrol syndrome differs from anger and temper in several ways. Anger is more appropriate to the degree of offense, and can be managed. It can even be reasoned with and conversation is possible, and anger is often a learned behavior. Anger and its outcome is also remembered by the angry person, and can be productive. Episodic dyscontrol is either seizure activity, or similar to seizure activity, and the person may not remember their behavior. They are often infused with enormous strength during the episode and there is no reasoning them out of it. The rage itself is more primitive and has no usefulness. Afterwards, the person is quite often remorseful and feels much guilt and shame. He or she may also feel exhausted from the experience.

The cause of episodic dyscontrol syndrome is thought to be neurological in origin by those who have studied it. Its second name, limbic rage, indicates its location to be deep within the primitive part of the brain, called the midbrain or limbic system. Frank Elliott, M.D., one of the pioneers in researching this condition, indicates the cause to be minimal brain dysfunction (M.B.D.). This can be brought on by deprivation of oxygen at birth, high fevers, infections, or trauma. Even small traumas to the brain, like those found in sports or abuse, can cause cumulative damage.

Episodic dyscontrol syndrome is often misunderstood and not accepted. It is also difficult to diagnose because minimal brain dysfunction is hard to diagnose. The most common neurological tools for diagnosis will usually miss it because it usually cannot be seen on the C.A.T. scan or M.R.I. Surface E.E.G. usually misses it because it is a problem deep within the brain rather than the cortical surface. Traditional neurological examinations are insensitive to the subtle deficits of minimal brain dysfunction, and an expanded evaluation of ‘soft signs’ may be the only way to determine the presence of M.B.D.

Stress and alcohol can precipitate a rage episode, so learning stress reduction techniques, avoiding stressful situations, and avoiding alcohol could help to reduce the number of episodes. Because limbic rage is a neurological problem rather than a psychological problem, psychotherapy is of little value in changing the outbreaks. However counseling is helpful for family members, and for helping the affected person deal with the guilt and shame that rage creates.

Once the condition has been diagnosed as limbic rage, an organic problem, it can be treated. There are several medications that have proven helpful with controlling the belligerent aggressive behaviors. They need to be monitored by the prescribing physician until the correct one is found, as a few of them can actually increase the violence expressed in an episode. Another approach is to treat it as a midbrain injury, and use the methods employed for neurological development, stimulating growth and repatterning of the brain. Together, the two treatments work well; one gives relief from the debilitating and destructive behavior, while the other improves the function of the brain itself, so that, in time, it can control rage.