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Individuals with a history of being physically or emotionally abused, especially as children, are more prone to suffer from IED, as are those suffering from a personality disorder or other serious mental illnesses. IED may also be linked with repeated traumatic experiences of violence or stress, such as the traumas experienced by active-duty military personnel.  Other mental illnesses are sometimes linked to IED include personality disorders, such as antisocial personality disorder, borderline personality disorder, and disorders associated with disruptive behavior, such as attention-deficit and hyperactivity disorder. Just because an individual displays one or more of these risk factors does not mean they suffer from IED. However, the presence of risk factors in addition to the characteristic symptoms of IED, explosive episodes of rage, should be cause for concern. Everyone finds themselves feeling or expressing anger from time to time, and it's perfectly healthy to do so. Rage, on the other hand, is a destructive emotion that can cause us to act in ways we normally would never think to. While anger may influence the way we behave while experiencing it, rage seems to utterly command our behavior and thought, leaving no room for anything else. Explosive episodes seem to come out of nowhere. An IED sufferer may find themselves in a steady, or even pleasant mood, conducting their daily business when, without warning, they find themselves overwhelmingly angry, displaying uncontrollable, violent behavior. While explosive episodes are most likely to occur in private, often after dark, their unpredictable nature means that they may sometimes occur in places where loud or highly visible expressions of anger are inappropriate, such as at work or in public places. Sufferers of IED often become extremely violent, or even abusive, during their explosive episodes. Seemingly tiny arguments or frustrations can lead, in the blink of an eye, to extraordinary and uncharacteristic displays of physical and emotional cruelty. These displays are usually very sudden in their onset, making them unpredictable and dangerous for everyone involved. Common examples of violent behaviors linked to IED include:  Shouting or screaming, even though the person being spoken to is not raising their voice. Invading personal space, often by stepping close and getting "in the face" of those nearby. Throwing, hitting, or breaking objects. Shoving, grabbing, or hitting others. Intentionally hurting oneself, such as by slapping or punching, beating one's head against a wall, etc. Name-calling, or use of language intended to hurt or insult others. Threatening others with violence. While the specific behaviors displayed by an IED sufferer during an explosive episode may vary, they are always characterized by being disproportionate, or "way over the top", relative to the circumstances or events triggering the episode. A true explosive episode can last for several hours before it dissipates naturally.  After an extended episode of rage, the sufferer is likely to feel exhausted, and relieved that the episode has ended. Later, the sufferer may feel intense remorse, shame, and unease while thinking about the things they said and did while experiencing their explosive episode. These feelings can lead the sufferer to become depressed, irritable and removed  An IED sufferer will also often experience much shorter episodes, during which they might momentarily "snap" at someone in conversation, becoming suddenly verbally or physically hostile before returning to normal. Episodes occur irregularly, with gaps of days, weeks or even months in between. Only a medical expert can diagnose someone with IED, or any other mental illness. Your first step, if you suspect that you or someone you know is suffering from IED, should be to consult with a psychiatrist, councilor or medical doctor about the symptoms and risk factors which are bothering you. Once any anger issues have been diagnosed, you and your doctor can begin exploring options for treatment.
Identify IED risk factors. Learn to differentiate rage from normal anger. Recognize episodes of abrupt, unexpected anger. Judge the extremity and violence of any anger-related behavior. Determine the length and after effects of episodes of anger. Seek the assistance of a mental health professional.