Note: the following descriptions were provided by parents in an Internet discussion group. I am presenting their statements in their own words, unedited, except for redacting any child's name:
"He always has been an extremely difficult child to raise. He has been diagnosed as ADD, TS and OCD. He also has some dyslexia. The biggest problem area is his temper. Almost every day, there will be at least one episode where he becomes unable to control his anger. The least little thing will set him off (e.g. how his food is served to him, being told to turn off the TV, etc.). His anger causes him to become destructive at times. He often will damage or destroy his own possessions. He will do things like throw objects, smash articles, pound the walls, kick things, damage his eyeglasses, etc. He also is very impulsive, distractible, oppositional, rigid and defiant. At the same time, he has many positive qualities.. He has excellent social skills and is very popular. He never has had a behavior problem at school or with other children. He's particularly kind and gentle with smaller children and animals. He'll show remorse with us after he calms down from one of his eruptions."
"They start out of a small frustration. He may be a bit tense or agitated before a rage attack starts, but the trigger is something little not going his way. He may start by pushing me away, or saying extremely rude things. You can see the tension in his body - his hands may be at his sides, but making tight fists. His eyes may open wider. If you have never seen it before, the best description I can give is to think of the 'flight or fight' response of a wild animal. There is that moment of tension where you can see the eyes open wide as the animal chooses to make a run for it or stay on and fight.
As the parent, when I see this reaction, I try to get my son to go to a calming down place that he knows we have designated in the house. He can be safe there, and there is a punching bag for him to let the aggression out. But often it happens so fast that he refuses to go voluntarily. My son is big for his age and very strong, so for one person to physically drag him to the calming down spot is quite a challenge. Before we manage to get there, he may be cursing me, spitting on me, biting me, biting himself, hitting me, scratching me. Again, think of the wild animal that has chosen to stay and fight, using every defensive mechanism it has to attack the other party. He may throw things, pick up anything he finds to use as a weapon, look directly into a lightbulb on purpose - anything that he can think of to injure himself or injure me.
This rage attack may last 5 minutes; it may last 1 hour. Towards the end of the attack he frequently gets extremely remorseful. He may be begging me to forgive him even as he hits me. He may beg me to kill him; he is so ashamed of his actions that he cannot bear it. The rage attack may end with him in tears, or he may fall asleep, or he may let me lead him to a different part of the house and play a specific game with him (one which he has had an obsession about in the past; not just ANY game would work here).
..... The attacks are completely out of character - my son has NEVER been involved in a playground fight, has never harmed an animal, etc. No one who knows him would ever consider him to be a child prone to violence - except during these rage attacks. If there is a big disagreement, true anger, he handles it in a completely different way than the way he handles a small frustration in these rage attacks. And when these attacks are over, he can remember what happened and feels just horrible about it. And he can't understand why or how it happened any more than anyone else around him can."
"My son's eye's would glaze over and he COULD NOT REASON until the attack passed. He would have no direct memory of the attack, and afterwards he was filled with shame, and self loathing. It has been the hardest part of his disorder to deal with by far! I did begin to see a connection between [H's] OCD and the rages. For MY son, the rages were always triggered by an UNFULFILLED OBSESSION OR COMPULSION. It wasn't obvious though, that he was obsessing on whatever it was. He did not have the self awareness or verbal skills to express this stuff. I am speaking of his rage attacks in the past tense. He has really worked on self control, and he now tries to stop it before it escalates to a rage attack by leaving the situation, being alone, etc. He is now 15 years old, and I am seeing real changes. He is now inwardly motivated to change his behavior, as he now realizes it is abnormal behavior.
"[X's] rage attacks would start like a usual tic and escalate into rage, in which his tic was amplified so many times that it was unidentifiable (such as a scream) with arms and legs punching and kicking. He would normally fall asleep when it was over. I would physically have to put him in his room and stand by until it was over. Luckily he was only 5 at this time and it was manageable. I don't think that he remembered them, because he never mentioned them when he woke up."
"My son has what are called 'rage tics' where he screams at the top of his lungs, curses, stomps on the floor, strikes himself, and generally terrorizes our household. Me, personally, I feel like a hostage in my own home. If I sneeze, cough, laugh, speak loudly, clear my throat or blow my nose, my son has a rage tic. They now average 5 mins to 30 mins each.
As a rule, I try to remove myself from within hearing distance of my son so that he does not hear any of these kinds of noises. Sometimes, it's not possible like if I sneeze.
"In an effort to explain.....when [Y] was a toddler he would have times of intense irritability of unkown origin. I remember taking detours around him myself if he were playing quietly for a change. If he distracted he was unconsolable and in a complete frenzy. I remember some days when looking at a story book together something would set him off and he would tear the pages, scratch my face , scream and so on. Other days he was the delightful child I love.
This irritability has remained through his entire life. He cannot pinpoint where it comes from. My husband experiences the same thing. He is [40+] and still cannot identify it's source. He says it just is, and he hates it. He says he is not in a bad mood, work is fine etc., but this feeling for whatever reason rears it's head. What we have managed to is work around it and it seems to work for us.
It is more like a tantrum than anything else.
It is frustration in one of it's purest forms."