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October 24th, 2011
08:17 AM ET
Labeling tantrums a mental illness doesn't helpDr. Claudia M. Gold is a pediatrician and author of "Keeping Your Child in Mind: Overcoming Defiance, Tantrums and Other Everyday Behavior Problems by Seeing the World Through Your Child's Eyes." In the winter of 2010, there was a lot of talk in the news (and I wrote an Op-Ed in The Boston Globe, "Warning label on new diagnosis") about a proposed new diagnosis for children, then called temper dysregulation disorder with dysphoria, or TDD. The committee that is assigned the task of creating the new DSM-V, the diagnostic manual for mental health, got a lot of flak, so now they have changed the name to disruptive mood dysregulation disorder, or DMDD. Many thought that including the word "temper" would make temper tantrums, a normal and healthy part of development, a disorder. So is the new label an improvement? I think the whole discussion is misguided. It diverts our energies for addressing the real problem, namely that there is not enough help in this country, in the form of primary care, mental health care or community support, for struggling parents who are on the front lines raising the next generation.
DMDD is being created as a new diagnosis to stem the rising tide of diagnosis of bipolar disorder in children. But I fear that this label will have the same fate, as clinicians feel helpless in the face of these troubled young families. For the majority of these children diagnosed with some variation of mood dysregulation (it doesn't really matter what you call it - that is the underlying problem), the trouble started way before age 6. This is why, rather than devoting huge amounts of time to what to call this - and really, this discussion is driven by the health insurance industry because clinicians who treat these problems need to know what to bill for - we need to look closely at the origins of these problems. We need to focus our attention and resources on early intervention. Here is a typical case of "disruptive mood dysregulation" that I see in my behavioral pediatrics practice at age 6 or above. Often, the pregnancy was very stressful. There may have been anxiety, depression, abuse or abandonment. There is evidence that stress in pregnancy has effects on an infant's capacity for self -regulation and is associated with later behavior problems in childhood. Infancy is similarly described as stressful. Mothers tell me about babies who cried all the time and were difficult to feed. They speak of terrible depression and feelings of being completely alone. Having a very challenging baby can lead to feelings of inadequacy and severe sleep deprivation, both of which may exacerbate a preexisting depression. Entering toddlerhood, a stage that under normal circumstances is challenging as children strive to assert their emerging selves, can be a nightmare when a child already has difficulty with self-regulation. These children often have a variety of sensory sensitivities. They decompensate in the grocery store, overwhelmed by all of the sounds and sights. Putting on clothes can be an hourlong ordeal if they can't stand the feel of shirt sleeves, labels or "sock bumps." Preschool is similarly fraught. Children may have severe separation anxiety, which is commonly associated with years of conflict and struggle between parent and child. Children often have difficulty with personal space, another manifestation of sensory processing difficulties. The explosive behavior seen at home may carry over into the classroom setting. Parents may describe terrible marital conflict. Or mothers may be raising a child alone. Not uncommonly, mothers and fathers have themselves experienced significant traumas in their own childhoods. I believe that an extended discussion of what to call this "mood dysregulation" at age 6 and above is completely off the mark. These children are certainly not "normal," as is often mentioned as the alternative to giving them a diagnosis. They and their families are suffering terribly. But giving them a label does not accomplish anything. It only makes it easier to bill for services and, even worse, to justify using powerful psychiatric drugs rather than treating the underlying cause.
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The diagnostic description created by the American Psychiatric Association states that a child must be 6 years old to receive the diagnosis. If this entity does make it into the DSM-V, I hope that clinicians respect this aspect of the diagnosis. However, with pediatric bipolar disorder, this has not been the case. Often, parents of children as young as 18 months come to my pediatric practice with the question, "Does he have bipolar disorder?" One 
Every kid tries the temper tantrum thing. The cure (for many kids) is for the parents to ignore it. Walk away. The kids will finish and realize it didn't work. Most won't try it again. By the time they get to 6 or above, that stage is long forgotten. A kid who gets a rise out of the parents, though, will try it again and again. I know a few adults who have the occasional temper tantrum when they don't get their way, because they haven't learned any other way to be. The older you are, the more difficult that becomes, and the worse the effect on your social network.
Having said that, there is a small minority of children who really are ill, but I'd say the tantrum is the manifestation and not the illness.
Agreed.
Very True!
there are tantrums and then there are the early warning signs of mental health issues. one woman whom I know had serious tantrums that were so extreme her parents were at wits' end; she later developed a serious mental disorder – bipolar disorder. if it's a 2-yr-old throwing a simple tantrum; you're idea could be right. if it's not, ignoring a potential warning sign is not a good idea. however, parents are usually fairly perceptive in realizing the difference. if they feel it's beyond them, that the behavior is too out there professional intervention is needed.
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As corporal punishment disappeared these "diagnoses" have increased.
Really?!! Sure, why not? Let's come up with yet another excuse to drug children into "zombieness"!
I'd say so. My dear, sweet mother had tantrums all the time and she is a crazy old cow. From what I have observed in my travels, it seems to be a common affliction among German females, possibly due to their being treated as second-class citizens for so long. After all, women have not fought in their stupid wars.
I would have to agree. Even a friend of mine last year had a foreign exchange student from Germany and he was rude, belittled her and was a general terror to be around. The german side of my family? Same way. Women are supposed to simper and be at the beck and call of their men and they bully all they want and are rewarded for this.
Shirt tags and sock bumps? Really?
I was hypersensitive as a kid. Hell, I still am. I couldn't stand the seam on the ends of my socks if it wasn't perfectly smooth. And I still need that. The seam has to be over the top of my toes, not at the end, or it drives me batty. I still cut the tags out of EVERY shirt and pair of underwear, and the advent of the "tagless" undergarment has been one of the best developments in modern history, as far as I'm concerned. Yes, I had a tendency to get overwhelmed by too much noise.
But... this is a disorder? SERIOUSLY?
I'm 31, an Army veteran, and a fully-functioning member of society who has never been on a single "psychological" drug. I didn't have tantrums as a kid because my mother knew how to work with me. I learned to behave myself. This isn't a disorder or psychological condition. It's just one of the variations of how kids are, and parents need to learn to cope with kids who aren't perfect little automatons.
OCD anyone?
I agree with Heid.
I think all that Leo was saying is that its not some kind of OCD, its just him being human. He doesn't have some mental disorder that needs to be treated by questionable prescription drugs. All those things are just what makes Leo, Leo, and noone else is exactly like Leo.
leo, you may tell your life story but they won't get it. The easiest way: I don't want to be responsible for anything, including my own kids, let's label them as sick and school has to deal with them and government will pay for kids' drugs so they are quiet and high home. ADD was not a disease back in old days, they just had to study harder and be more diligent, ended up as good and successful people. These days? Oh, well, lets stuff them up with drugs and it'll be not our problem anymore.
@Commenter & @Dana – it's all very well saying that everyone is unique, Leo is just Leo and then railing against big, evil "Pharma", but the truth is, someone who obsesses over the lines of the seams in his socks, cuts the labels out of his clothes and was overwhelmed by a "busy" environment is describing some quite clear characteristics of OCD. Ignoring this, saying it's just idiosyncratic behavior and part of what makes Leo be Leo is just as bad as overly diagnosing ADD, ADHD (and whatever other acronym we're using these days) and then over-medicating kids. One coin, two sides…...
What Leo is describing isn't OCD but a sensory issue - there are all kinds. Sensory processing disorder is basically when one or more of the senses are hyper-sensitive, and that includes neurological input. It is VERY real and best treated with various therapies, not drugs.
I have an Asperger's child who has sensory input issues that are common with Asperger's and some days are better than others. There have been times when we've had to go through a few outfits to find one that's comfortable (he says things itch, burn, scratch, etc.) or taken shoes off four times trying to get the socks just so; I've had him tear more than one shirt because he's gotten so upset by the tag that he is in a panic. Loud noises are triggers, and even small noises (the ones none of us really hear) will break his attention. He gags on many foods or will store them in his cheeks because he cannot swallow them (it's not taste but texture). Smells can send him into a rage and playing on the computer or watching more than a few minutes of TV turns him into a kid who's just eaten a pound of candy. The worst part, though, isn't dealing with the stress of his 'issues' every day, but the looks and whispers we get in public because so many people don't know what's going on or refuse to believe I'm not a bad mom who lets my son run wild (I have other kids who are very well behaved). Of course, there are also the ones who think I should put my son on 'something' to make him better. Bottom line, we all need to learn to educate ourselves on things before we make our comments about other people and/or their kids. I was certainly guilty of giving a look here and there when a very unruly child crossed my path, but now know that that child may not be in control of themselves and that their mom/dad/guardian may be stressed beyond imagination and simply trying to get through the day.
I hope Heidi isn't a doctor.
I am guessing at some point in the far future, history will have written about the few decades surrounding this time and label it the wishful thinking period in our history. We have so many mental health "professionals" who are looking to make a splash with their doctoral thesis and be in synch with politically correct societal trends that they are deluding people looking for a label for every behavior, a manual to explina it from a child "expert" and a drug to administer to make sure the child fits the parents, schools and experts vision of what they should be at every age.
The fact is small children have ALWAYS thrown temper tantrums – and always will – it is their age and they do not understand other ways to express their frustrations or interactions yest (despite their parents view that their own child is perfection on earth and could not possibly do this – so something muse be wrong!). They test limits and determine what behavior will get them what they want – they ultimately learn (or not depending on the parents response) as they mature that this is not how people operate in society in general, and there are other ways to interact with people. It has always worked this way and always will. Ignoring it, being with them, talking with them – and letting them talk to you about it, holding them and yes sometimes a tap on the bottom help get through this stage – and 99.999999% turn out fine.
Yes there will be a handful of people who unfortunately have children with real problems – and hopefully over time more can be done for them. However it is foolish for parents to continue on this dangerous trend of prescribing medication to kids who just need more attention from their parents – instead of parents that "just can't deal with kids behavior" ... and rely on "experts" and drugs to sedate the kids so they act like zombies.... and save the responses of "you don't know" – umm yes I do, and we did not use any drugs to control our kids behavior.
Thank you. Sometimes I feel like one of the few parents willing to teach my children how to act appropriately. Kids will throw tantrums and they will test you, but you're not hurting their little psyches when you tell them no or remove them from a place so they don't disrupt other people or when you show them their behavior has negative consequences, like when you put them in their rooms for a time out or when you refuse to go somewhere because they just are having a bad day. (And some days are like that. They need to be at home to have their bad day.)
Katie, you are definitely not alone! My two year old has mastered the art of the tantrum and knows that the louder he gets, the faster he gets what he wants. At least with his dad, that is. He's also learned that mom isn't having it; I simply don't have time in my day to play battle of the wills. He's spent plenty of time in his room all by himself (gasp!) and knows he's not coming out until he can mingle with the rest of us without the tantrum. There have been days where I've left the grocery store or playground, much to his dismay, because he's tried his hand at manipulation through tantrums. I thoroughly believe that kids need to be allowed to show any and all emotions, including anger, but that they also need to learn to control it and keep it from negatively affecting everyone around them.
I agree with most of what you say. I am a vetran mother of a now 34 yr old son who is full persuasive Autistic. Li, and other disabilities. 34 yrs ago other than the movie Rain man there was no autism awareness. I began reading, researching, traveling around the country learning. And of course like any mother after getting the proverbial bomb dropped. I wanted to cure my son. But I refused to give him meds. He at age almost 18 asked me if he could try. I'm glad I did not medicate him as a child . Because I did not want to mask other disabilities that can show their ugly faces around puberty. And even though I was pretty dang sure my son had autism b4 any Dr did. You really can't get a proper DX b4 age 41/2 or later. When I see parents of 9 month old or a 2 yr old asking for meds because their child is different it drives me bonkers. I'm studying DMDD . As vetran mom . I want to learn about this. I am finding a lot of very young teen mothers. Or parents who themselves are not coping. I know some these children are not compleatly normal 24/7. But I also see a pattern of sorts. So many parents say the kids are great at school. But when they come home they have tantrums. So is DMDD a condition? Or is DMDD a disability? A condition is like the weather it can change. Go away. Come back. A true disability can be managed. But the disability is always there. I'm hoping young parents, caregivers journal the journey with their kiddos. We just don't know enough yet. I'm opening my mind. Because back in the dark ages Autism was blamed on cold mothers. My son and I are survivors of that era. He is and always will be not NT. But I am so proud to be his mother. Because whatever my son does he puts 110% into it. NTs might give 30% doing the same job. His passion toward life motivates me and all around him to be better. I would not change a hair on his darling head. I hope to give some insight to help more young parents of children with DDs. I'm just not sure DMDD is or is not one yet.
Entry into the DSM-V = "BILLABLE"
Every kid has something that they have drama over...it's part of growing up, My mom said I went through a phase where I would throw a fit if I couldn't wear panty hose and "clicky shoes" and my sister had a thing with shorts for awhile...even in the winter. My four year old doesn't like the feel for underwear and my three year old with sandals...they are completely normal no matter how frustrating that makes me sometimes. Apparently too many people want to label non-zombie like people as having disorders and drugging them up...geez and we wonder why we have a prescription drug addiction problem among our teenagers. My daughter is on a team with a girl whose ADHD meds seem a bit strong...she looks lost and doesn't comprehend a SINGLE thing anyone tells her....it's so sad.
It probably makes some parents happy that they can dismiss their out of control kid with a label. It probably forces insurance companies to have to write a policy to cover doctor visits for this disorder. It gives doctors a reason to deal with out of control parents and clueless parents who tie up a professional's time because they can't/won't discipline their children (or won't with any degree of consistency) and it certainly helps the pharmaceutical companies who will now start glossy ads for some control meds so parents can have children who behave.
If only parents would just remember who is the adult and who is the child and learn to be constructive about discipline so their children learn from early days what is acceptable behavior and what is not. Consistency is the key. Be an adult. Be a parent.
figures, heres yet another big score for the drug companies. 'your kid is (doing what kids do)defective, these fits just need to be medicated away ... here's the latest drugs to 'fix' them .. oh that didn't work ... well here's another dozen to try ... let us know if he/she/it has any ... odd reactions' ... sounds ludicrous but sadly that's the way it works these days and idiot parents buy into the fear and as another poster said 'drug them into zombieness'
I have one of these children it is really easy to sit there and judge when you haven't lived it. My daily life is a series of wars. not normal struggles. this isn't my only child and the others are fine. A lot of people do make excuses, but the author is right we need to devote more time to figure out a way to help these kids rather than finding a label that fits so that the insurance companies will pay the bill. A lot of the time this starts out as a mild neurological disorder and is exacerbated becuase the child can't function in the lifestyle that is being lived by the rest of the family. I do have one of these children and he is not medicated and I work my tail off giving him what he needs. In the hope that someday he will be aware enough of the world around him to regulate himself.
I have 2 small children and I am a scientist (physicist). I've been observing my children (and loving them) since they were born. I have come to the hypothesis that cartoons in TV and computer games are faster paced than real life and are overwiring litlle children's brains. I don't have a TV, so they can spend time playing, making up games, puzzles, reading, (slower paced), and I used to let them use the computer on Saturday. I started observing that their behavior would change and they would just be hyperactive and rebelious afterwards. So I would "gain" 2 hours more of rest, but then the rest of the day it was a hazzle. So I decided to not let them watch any cartoons: no animated TV shows, no animated movies, nothing like that. About a month ago, we started watching movies with real child actors about once a week. I think it has been good. They play a lot, they make up plays, games, they sing , or dance. I let them see some music videos with me there.
I know a lot of parents are tires and let their kids watch animated cartoons on TV or video games and then complain because their children are hard to handle. Children have imagination, they are able to play by themselves (maybe after 2 years old), but they need time to practice it. They would be more calm and content. I suggest to any parent to try not letting their child see carttons. If it is hard, you might have a child addicted to cartoons. I don't think it is so absurd, there are people addictive to computer games and the internet, to fast paced things, and they are 'bored" with slow things. The mind can get used to normal paced. Chilren are very smart and they have great imaginations. Let's give them time to use it. For the future, we need children with great imagination, so they can produce great ideas to solve our many problems. Give children some down time.
Lina - Am. Ped. Assn. just came out with advising against television for those 2 years old and younger. I think you're on to something.
Ditto. It's hard not to think, "Why can't you be like the rest of the family?"
Everybody thinks I throwing a tantrum but I'm not. That's just the way I dance.
I am overwhelmingly dismayed by the responses to this article. It's not just about temper, it's MOOD dysregulation. These are children who have a very difficult time managing their disproportionately strong emotions, kids who are often hypersensitive to physical, aural, visual and mental stimuli, these children also have a tendency to be hyperactive. So in the interim, while we wait for a diagnosis code to come out in the DSM, we are stuck with the not entirely accurate dx of ADHD co-morbid with ODD. It's a dx and it works for now, but it doesn't give the full picture of the disorder. I agree completely with Dr. Gold that we should be concentrating on early intervention, I don't know where my family would be without having received the early intervention services we received, and the special ed services we continue to receive. My family is fortunate, as my husband and I are able and willing to be involved and be a strong advocate for our child. Other families don't have the skills or the means to do this for their child, all the more reason early intervention services, and a diagnosis are vital to the success of these children. There aren't enough services out there for children with mental/emotional disorders and these disorders are highly stigmatized in this society. My child was expelled from three day care centers, but no one was willing/able to talk to us about the underlying problem. Everybody would say, "it's just a stage" or "boys will be boys" but that was not the case at all and it took me dozens of calls and multiple consultations to finally discover the early intervention program. My plea to the other commenters, is that they try to understand the disorder and the complication involved before making a snap judgement.
Be kind, for everyone you meet is fighting a hard battle.
"My child was expelled from three day care centers" Maybe they need their parents more than 10 hours in a daycare M-F? If you are married and a two income family, consider staying home while your child is not in school, and interacting with them as a parent. It could make the school years much smoother. I know too many people, even people who volunteer, that take their tots, even infants, to daycare before 8am, and get home around 6, to have dinner, give them a bath, and put them to bed. What kind of interaction is that for a child, having a parent 2 hours a day, and 2 days at the week end? Consider being more one on one with your child.
Many of the symptoms listed in the article are also signs of autism. Sensory Processing Disorder is an autism spectrum disorder. I have an 11 year-old who is high functioning autistic–autism runs in both my husband's family and mine. What you experience with these kids are not tantrums–they are meltdowns, and they are often violent, and no normal parental tactics work against them.
We struggled for years with my son, and the condition was exacerbated by well-meaning relatives and even therapists who suggested severe consequences. We did not seek medical help until he was 6, because it was at that point that it could not be regarded as a "normal" developmental issue.
We are two highly-successful, educated, professional parents. Our son was wanted. I ate a whole food, mostly organic diet when pregnant, and I took a year off of work to be home with my son after he was born. It was evident, from the minute my son was born, that something was going on. Its the first time I have ever seen an anxious newborn; he was difficult from minute one, and I am a very nurturing, calm mother. Made no difference.
Thankfully, a few years ago we found an autism expert who has worked very closely on self-regulation and my son has made enormous strides (and like the other mother who commented, my other children are "normal"). He is mainstreamed in a very academically challenging school, plays team sports, has friends, and to anyone who doesn't know his history, he seems (now) like a very smart, polite, well-mannered, slightly quirky kid, but it has been a lot of work and it has been very expensive.
It was suggested when my son was about 7, that he suffered from depression. My husband and I resisted medication until my son was 9 (because we believed children should not be medicated) but that was the age when my son attempted suicide.
I kick myself now. While antidepressants are overused and overprescribed, there are people who need them. They made an enormous difference in my son, who interacts with people instead of withdrawing, who can problem-solve instead of exploding. The behavioral therapy was necessary but the medication also necessary.
Our doctor says that if my son's mood is stable through puberty, there is a good possibility his brain will "learn" the stable pattern, and he won't need medication into adulthood. But if he does, he does. I would rather that than have him return to being withdrawn, forlorn, hopeless and explosive, issues that are much worse in grown men than little boys.
These issues are complex, and require a lot of education and research on the part of parents, they require good and competent medical and psyciatric help (our doctor is a neuro-psychiatrist who is expert in autism) and that's hard to find.
I am opposed to medication as a first resort, and I am opposed to medicating very young children, but that doesn't mean that medication is never appropriate.
On a final note, I would add that if boys with these issues are not treated, they often grow up to become kids who bring guns to school, or people who shoot congressmen. These are serious issues and there needs to be more information available and more affordable, medical help.
Simple-minded people who haven't lived through this have no basis for comment.
Sensory processing disorder is NOT autism. It can run concurrent with many things – ADHD, dyslexia, learning disabilities and a host of emotional problems. I have an SPD child and I cannot tell you how much grief and bad approaches we have had to endure because non-professionals want to call in autism and treat it that way.
Same situation in our family. Our son has finally been officially diagnosed with High Functioning Ausitm, Anxiety and Bipolar NOS. Some of you may understand my need to write "finally" after years of testing, therapy, questionairres, doctor visits, bruises, scrapes, broken toys, hurtful words said to you and endless tears by both your child and self. If you have not lived it (I have stayed home w/my son his entire 8 years and my husband and myself are extremely involved w/his therapies and just his simple daily living), you have not one clue what the entire family experiences, and the heartache the kids feel for not knowing exactly what they are experiencing or how to regulate those emotions. We knew something "was up" w/our oldest son, always doubting our parenting skills for not knowing how to help him. When our 2nd son was born 4 years later we understood that we were doing our best and that we needed help in all forms for his big brother. I do not leave my son at daycare, sit him in front of a TV to keep him busy or ignore meltdowns he may have for 4-5 hours on end. I engage him, comfort him, talk to him, hold him and encourage him to express his feelings in an acceptable and fulfilling way so that he knows he is understood. Do not judge me for wanting to help my child and my family go to school, join scouts, visit a park, join the extended family during the holidays, sit down for an entire meal and be able to tell me with his words....his calm expressive words just how he is feeling at that very moment and that he loves me for helping him and listening.
My 4 year old got a label -. It did not make me dismiss it and accept his tantrums – It gave the problem a name which helped us to adjust our parenting to better help him learn to regulate himself. While we were already working harder than many parents around us, we had to work even more, but with a plan. We had to get him to occupational therapy and to think about how little things to us, might overwhelm him so maybe a trip to a grocery store at the end of the day was never going to happen.
3 years later, he was a different kid and now 11 years after the diagnosis he is an easygoing and a respectful teenager. Having a name to call something can really help. Don't dismiss all issues as bad or lazy parenting or drug company boons. (we never used any drugs for this) Sometimes knowing that something is going on that really is out of the norm helps parents figure out the route that they need to take. And remember they may be working harder than you know.
Thank you for this post. My son too (at 4) would scream "I'm going to kill myself" (not something he heard anywhere else) and try to hurt himself. I've also had bloody lips, bruises, from his attacks. When I started to understand that this wasn't just him trying to get away with something, it was a call for a different kind of attention. Your post and some others makes me glad there are parent advocates for their children out there.
People who haven't lived with one of these diagnoses shouldn't make comments. Just saying. Until you've been through it, it's so easy to say "oh just discipline them" or "oh just don't let them watch tv / feed them fruit loops / ???" You think you have all the answers because you have been able to succeed with *neurologically normal children.* These kids have a disgnosis because they are facing significantly different challenges and struggles. It's enough to break up many families, and living it is a nightmare even before you get ino the judgement from other parents. Either be supportive, or keep quiet.
I've worked with hundreds of kids with these "disorders." It's my profession. I can tell you right now that most of these behaviors start with failures in parenting. There are exceptions, but usually parents just act like they cannot control a kid because they are too lazy to disipline or they don't educate themselves or both.
Thank you for your post. What many, including Opp, who may have worked with "hundreds of children" and claims to know that the majority of these kids are victims of poor parenting, don't know is that mood disregulation disorders are very real and many of those suffering from these problems show distinct differences in FMRI scans when compared to people not suffering mood issues.
We have been dealing with just such an issue for years with one of our kids and it's killing us. Are we bad parents? One is at a high level, private university after nearly graduating high school with an associate degree. One is a well adjusted teen, generally happy and easy going. One is smart as a whip and funny as all get out.
The other? Compassionate, sympathetic, highly intelligent, prone to wild outbursts, one suicide attempt, extraordinary anger, and uncontrollable rages, all starting as a child. Did we do something wrong? We aren't perfect parents but this child is radically different than their siblings. We walk on eggshells around them because don't know what will set them off and there is no pattern to their behavior.
Medications are bad? Yes, there is over medication in many cases but the combo of two drugs our problem child is on has made a huge difference and we're grateful for it. BTW- the drug combo was found after I researched effective meds and suggested the combo to my kid's doctor. He is a psychiatrist and he had never heard of this particular combo before but the difference is very real. (Prozac and Abilify in case you're wondering).
All of the posters here slamming parents or medical professionals should shut their mouths. I am a parent who is hardly lax or permissive but this situation has nearly ruined me and my family. Mood disregulation is a serious problem and should not be viewed a poor parenting or as someone who is "weak" and can't control themselves. You simply don't know what you're talking about if you post with such a point of view. Even great parents can hit a brick wall when it comes to trying love and cope with a child with a disorder like these. It's a living nightmare.
BigDogMom – I don't think anyone here is not appreciating the tough job it is to be parents. It's just that today everything is a disorder. Everything is bi-polar, autism, ADD, ADHD and now a "temper tantrum disorder"??? Just watch tv for a couple of hours – I bet there are more advertisements for anti-depressants, stimulants, additives to stimulants and anti-psychotics for your children than there are for toys now. It's too easy a solution. It's not fixing the problem, just masking it. It's like weeding a garden, but not pulling up the roots.
Thank you, MidwestMatt, for your posts. The ignorance prevalent in some of these posts is so disheartening. I have three boys, and only one of them is dealing with emotional/mood issues. He was diagnosed with Temper Dysregulation Disorder – after years of going to different therapists and psychiatrists. He is NOT on medication currently, and I feel like I've hit a roadblock. Our lives are in turmoil living with such a child – it affects everyone in the family. I am an educator, have worked with "troubled" kids for years, and know the value of consistency in parenting. We are firm, we are consistent, we don't "let him get away" with his behavior, and yet he still continues to behave in a manner that has us walking on eggshells most of the time. I work hard every day trying to figure out the best way to deal with him – I am not lax, or lazy, or simply looking for an excuse to pop pills into his mouth as some on this site have suggested. I am a mother who is very sad for her son, sad that he has such a hard time in the world, and sad that I'm just not sure what to do next. I'm not ready to try mood altering meds, which would be the next step. I came on this site looking for some support, some answers, possibly suggestions in how best to handle a child with an ILLNESS, and am so surprised at how many people out there are so willing to judge and blame parents for their child's psychiatric disorder. Yes, disorder – I'm not talking temper tantrums here or a child who isn't disciplined, I'm talking about children who rage out of control over little things, who can't handle stressors, who continually talk about how they would rather be dead, who cry and feel terrible over the littlest slights. And for those of you who haven't delt with this type of child, who haven't spent time out of each and every day questioning and analyzing your own parenting, whether you "got it right" or or how better to deal with the child, questioning what else can be taken as a consequence when everything has already been taken away – who are you to judge? So thank you to those who have actually been through this struggle, or are currently going through it and had something worthwhile to add!
Also, no one is really commenting on what was written in the article. This is one of the best pieces CNN has run in a long time. Here is a contributor focused on what needs to be looked at – why is this happening and what can be done about it. Not how do we label it. This is plain good common sense.
The woman in the small photo above has some major teeth.
And that's relevant because . . . ???
Sometimes a good pat on the behind will cure the brat and will save you tens of thousands of dollars ... it worked with me, it worked with my children, and we never needed therapy. We are all fully functional individuals. Just saying...
AMEN!!! For the record, if any of my kids would show me a face like the one in the picture, they would be taken off the Spongebob and spend some serious time counting the ceiling tiles in their room....Discipline, discipline, discipline. Even with a diagnosis, you still have to keep routine and consequences. These children have an even MORE need for discipline and order to keep them feeling secure. AND PLEASE PLEASE PLEASE, if you have one of these kids and your shopping, take them OUT of the store. I know it's hard for you, and your doing the best you can, but I don't bring my drunken, obnoxious relatives around your kids, why do I have to listen to your hassles? Take them home to decompress and hug them and love them.
Please spare us the "If you only disciplined your child..." line.
I have 4 kids and we disciplined all of them equally and were never permissive parents. However, one child is distinctly different and has been all their life. Wild mood swings, horrible outbursts, extraordinary anger and rages no matter the parenting style (We've tried everything from harsher penalties to far more accommodating and there is no rhyme or reason to what keeps the peace).
We are very loving parents, never missing a chance to hug our kids and say "I love you" and we've always been there with discipline, too. A swat on the behind? Sure, if it was necessary. We've done everything but nothing works with this one kid at all times. We're just waiting it out until they're old enough to move out while we support them with love, counseling and meds (all have helped but are no cure).
Until you've personally dealt with a situation like this, don't judge. You don't know what you're talking about.
Wow – thanks for the enlightening response. Why haven't we thought about just beating our "brats". I'm wondering why we even need the field of psychiatry – all we needed was some advice from you!
Wow, looks like the pioneering doctors who drugged me(prescribed me mood stabilizing pills for tantrums) at age 4 and 5 for having normal behaviors have garnered enough followers to zombify others.
As if they did not have enough guinea pig drug testing fun with kids like me. I have been on just about everything, most of which was not even meant for the disorder I did have till age 16 which was a rare form of complex partial epilepsy that caused brainstorms that should have fried my brain.
I also was one of the kids told I had to take synthetic growth hormone because I was short and a later bloomer due to a genetic issue, I still am short btw.
Oh yes now they have a whole new pool of younger test subjects, and I can guarantee you they will overdiagnose this new disorder too so they can test test test thier pills. And parents will just sit by and say "it's ok, now take your pill baby" when the kid throws a tantrum.
When will doctors stop having to label normal developmental stages and reactions as a "disorder", it is wrong and besides tantrums are generally a cry for attention and can be fixed with good parenting methods.
But no it seems the "pop a pill" method is the new thing, nevermind that the long term side effects can be severe in the social arena because obviously using good parenting skills is so hard.
I am not saying this sort of diagnosis is not real, I am just saying that it WILL be overdiagnosed and doctors will overprescribe pills.
It has happened before and it will again.
Lableing only serves to lower one's response-ability. Labels allow people to shrink, play small and become a victim of the label. Example even simple labels like; I'm too old, too young, too fat, too skinny, too busy, too tired etc... allow human beings to shrink and play small. Centuries ago Soren Kiekegaard told us; "When you label me, you negate me". Live With Intention, DrBillTothCom/blog
this is the operative phrase for this whole NON issue – money. Kids will be kids and to suddenly make this an official "disorder" is bogus and bankrupt. Come on, people, wise up. this is total nonsense. I'd like to use stronger words for this b ull sh it but I'd either be "moderated" or told I have a "dysfunction."
"this discussion is driven by the health insurance industry because clinicians who treat these problems need to know what to bill for"
I'm with "Migo". I'm tired of the drama surrounding children's issues. I see children, not toddlers, behaving like wild beasts often and theiir parents response is usually to immediately soothe, cave in, and give them whatever it is they want.
Most children do not have disorders; they have behavior issues due to their parent's or guardian's influence and lack of consistent parental skills. While I recognize some children do have a true mental or medical issue, parents need to learn to parent and not rely on the medical industry, whose sole purpose is not to help but to cash in.
Bingo! and thanks. The best "pill" for a snotty kid trying on the "brat" role is to have a PARENT who is willing to back up rules with consequences.
Pills are not solutions in the case of most child behaviors. Pharma companies just want more excuses to prescribe and make more money. Pretty soon simply being alive will be considered a disorder. And yes, most child behaviors start with the parents.
YAY more disorders *eye roll*...uh oh, that might get me a diagnosis!
I have an almost 6-year old who still throws violent tantrums, and a 3 year old who doesn't. Doctors, preschool teacher all agreed there is something different about it, agreed with the symptoms (weak small motor, difficulty with change, confused easily with emotions, difficulty recognizing patterns), though no solutions. I found, accidentally, a book call Non-Verbal Learning Disorders by Maggie Mamen and it helped tremendously. In my case (and I hear a lot of parents complain about these symptoms too), it helped me recognize that a. it wasn't my fault; and b. there was something I could do about it - no drugs, possible tutoring down the road. Here's the deal – some children can process verbal cues with great ease and are good talkers (my son spoke in sentences, clearly at 18 months, and regularly corrects my pronunciation), but can't 'read' faces, have difficulty with comprehension, difficulty with inferences, difficulty with full comprehension (especially pictures), difficulty later on with math, and are simply 'lost' when things happen that they weren't given full verbal explanation in advance. Social situations are like solving a puzzle for them (and they are bad at solving puzzles to start with), and forget about it when they are tired or hungry. Read this book. I think we (I) often mistake mental illness with learning disabilities or even learning weaknesses. We need to give our kids the self esteem they need to work through new/ changing situations that they simply, through no fault of their own, can comprehend. I wish there was more information out there on NVLD for parents to read. . . I literally have this conversation everyday with parents I encounter who list the same symptoms and haven't been able to figure out the answers. Also, these kids tend to get labeled 'lazy' because they seem so bright and well spoken, and often compensate for their weaknesses by being 'helpful' and attach their self-esteem to be accepted.
Out of over 40 responses or comments only 1 or 2 people have this figured out. You can save thousands of dollars by using the cheapest medicine for a tantrum available. A butt whipping will surely cure what is causing these tantrums. May take a couple of doses but is gaurenteed to work.
There are kids whose behaviors can be linked directly to poor parenting, poverty or environment. There are also kids with nurturing parents, wholesome environments and consistent discipline who exhibit behaviors far beyond the norm. There is no magic pill and no magic "butt whipping" solution. I currently teach at a school for kids with behavior disorders and have worked in group homes with a wide range of kids. Two of my own kids excel academically and socially and one was diagnosed with ADHD and prescribed ritalin. She went from failing grades to a B average. Believe me, I tried every type of behavior modification out there before resorting to medication.
While there may not be a magic cure, assigning blame to parents, teachers, society and doctors does not help anyone. Every kid and every situation is different. My heart goes out to the parents who have written in telling about their day to day struggles of raising a child with a behavior disorder. Parenting my one child with challenges took more effort than my other two combined – and her issues were relatively mild.
I work with many kids where poverty, ineffective or no parenting and a drug and gang ridden environment have had a devastating effect on both their education and behavior. On the other hand, some of the kids have both parents and a strong support system and still have behaviors that make them unable to function in a standard school setting.
Kids eventually become teenagers and adults and we should strive as a society to work together to give kids the best chance possible of maturing into productive adults. If these kids fail, we reap the consequences right along with them. Support early childhood education and intervention, parenting classes, research, volunteer at a library or school. There are plenty of kids, parents and teachers out there who would welcome a helping hand getting through the day instead of a finger pointing in their face.
Why does everything have to be a disorder. To me, anger management is a learned skill unless other underlying mental issues are at play. But just throwing a tantrum is not a disorder. It's how parents, family, educators, etc. react that will teach children to manage their anger.
I have vivid memories of my sister having terrible temper tantrums and would literally destroy anything in her reach. This went on for several years because my parents didn't handle it properly. Even today, almost on the brink of 30, my sister assumes that everything should go her way and still "throws tantrums". To me this is the perfect example of a behavior that was never corrected.
And she's not the only example. I've seen some tantrums in the workplace all because people were never taught to manage their anger.
If this is going on 30 years later, your sister suffers from a personality disorder (borderline or narcissism) and both disorders show differences under an FMRI or she has an underlying mental illness.
Maybe you should help her instead of falling back on the old, thoroughly disproven, idea that she just needed better parenting. She is not "normal" if these problems have persisted for all these years and help is available.
First the label than the drug..
I am so sad at some of the reactions to this article. This doctor is spot on. Until you go through raising a child who has these issue, you have no idea what life is like on a daily basis. How you all can possibly comment on something that you have no experience with is truly heartbreaking. Families that deal with these problems need help and understanding. You can have all the opinions you want and read all the articles you want, but you have no idea about this unless you go through it.
We understand that there are RARE instances when a kid has real problems. The issue is calling normal behaviors illnesses. Making normal behavior into a billable item is what's wrong here. The other thing poorly addressed here is sloppy parenting which exacerbates bratty conduct.
YES, there are those (rare) kids with real developmental, mental problems but lets not use that as an excuse for calling nearly every kid sick and needing BILLABLE treatment by a "professional."
I've raised a child with these behaviors and more. He is 17 now. Guess what? The doctor wasn't spot on or the counselors that came to my home 4 days a week. The school suggested this to the school counselor who then decided that it was in the best interest of my family to have my child diagnosed with a mental problem. He was diagnosed with ADHD and several other diagnosis throughout the program and put on medication. It didn't help. These people came into my home and pushed me to change the way I discipline my children. They even stated that part of the problem was that I made my children do chores and wouldn't let them play the video game or watch TV doing the school week. In their words, "I was too strict". It didn't matter that the reason for the lack of my not letting them watch TV and play video games was due to poor performance and behavior in school. Because of their intrusive behavior in trying to find a medical reason for his misbehaving at school, etc., they overlooked the logic of this child is doing this just because he didn't want to obey authority. After 1 1/2 year of these people coming into my home, the son that didn't misbehave started misbehaving and the child that was diagnosed started misbehaving at home too. When the program came to an end, guess what the doctor and the counselors suggested to me? I was told that I need to implement what I was doing before they came into our lives. In addition, I was told that all the other diagnosis wasn't the problem, that there wasn't any medical reason for his behavior, and that since they had intervene that the behavior didn't get any better; it got worse.
My point is as parents, we need to stop trying to take the easy way out and blame the behavior of our children on a medical condition. More times than not, a child behavior stem from not correcting and discipline the behavior a child demonstrates from the time they understand the meaning between "right" and "wrong". When your child can shake his/her head and tell you "No" when you tell them to not do something, then they are capable of understanding that their behavior is wrong and should be punish for displaying it.
My son's behavior problems came from the fact that he was born with a terminal illness and everyone around me used his terminal illness as a reason for him to not be discipline. I won't get into how much flack I received from others for trying to discipline him for bad behavior. My motto was and still is.........there is no excuse in letting a child get away with bad behavior. Do what ever you have to do to correct it. That might include having to redirect the way you do things in your home to fit the needs of the child. However, do what you can to avoid medicating your child or having a doctor give a diagnose that make you feel better in excusing the child's behavior. In having the experience with a troubled child, I do understand that the best approach to helping your child is not giving up and in so easily by having them labeled mentally ill and put on medication. The best approach is educated yourself on the behavior that your child is demonstrating to find solutions that will keep your child off of medication and receiving mentally ill diagnosis. This will take patience, hard work, a lot of time, and it will be frustrated; but you will want to make sure that you have covered all your basis before you go for the medical diagnosis. That diagnosis will go on your child record and will have an impact on his/her future.
wow how misguided! intaesd of bombs, insert the bullets from guns. that's how mostly Bed-Stuy peeps are being killed by.always protesting up the wrong tree. There were more projects peeps being shot & killed than U.S Army Soldiers fighting a war in Iraq. Go figure!?
I think it is important to understand that there truly is a neurological condition, such as dyslexia, that prevents some children from being able to process anger management, except with regular, purposeful and guided assistance from parents and sometimes professionals (including just researching articles). And the people on this forum who have tried everything to regulate tantrums, have tried everything and are at the ends of their wits. Hitting has more to do with a parent losing control (I've tried everything, maybe this will work, I'm at wits end) and the child may not tantrum again, but if that is truly the case, these tantrums talked about in the article have nothing to do with your child. The doctor in the article is right – it is not enough to be a 'mental illness' and excuse for one box fits all, but tantrums at older ages (and I'm talking a child throwing themself on the ground, screaming and kicking walls and people because he/she needed to bring milk to school and they thought that might be breaking a rule - and rules very important to kids who have certain neurological conditions). The same kid who screamed if you moved or had a slightly different when nursing. It is a neurological processing issue. And when kids don't understand patterns, they have difficultly linking "I'm beginning to melt down" with any kind of negative behavior reinforcement that we try (time-outs, frowning faces on calendars). We have been working on anger management for many years, and only now that I realize that – a. he clearly understands what he is supposed to do when he gets upset (he can recite to you the proper way to cool down, and has helped his friends with this advice), but something prevents him from following through (even with gentle reminders) when he is melting down; b. the more I talk, the worse the melt-down gets; c. he needs/ craves attention and has failed to get it in positive ways (too bad, that's life sometimes, but I need to remember that is what is happening); d. reinforcing my love for him helps him come out of it better, especially when I say, I know you are going to be able to turn this around, even though it doesn't feel like it right now; e. I remember he is confused and mad and anxious that he's out of control - he doesn't want to be throwing a tantrum any more than I want him to be, it just a frustrating situation that neither of us knows how to stop; and f. if i make him laugh, it ends sooner. . . usually he yells at me not to look at him (he's embarrassed), and I tell him not to look at me, not even a little glance, and after a moment or two, he's laughing (especially when I tell him he's not aloud to laugh because he is miserable) and you can almost see the anxiety lifting as he calms down. We do a lot of talking about different ways to manage anger, and about being flexible, and about making mistakes, when he's not upset, and about different resources he has to help himself when Mom isn't around. I also found a large reduction in tantrums when I learned how to help him be more organized – verbal check lists (grocery shopping, check, dry cleaner check, next up, put groceries away) and written ones; and when I put up with much less whining/ back talk (meaning, I would label the behavior better instead of just reacting to it "that was a whine, and it is hard for me to understand what you want when you whine. Please try a do over." or simply "would you like a do over on that, because it made me annoyed when you growled at me". Counting to 10 is a god-send too for me because it gives his little brain a few seconds to process what I've said, to react negatively (who can blame him, I don't want to pick up my toys either), and then to comply and everyone stays calm that way. The fact remains, he forgets patterns and needs a lot of help figuring out what comes next, remembering spelling, remembering the process for writing letters, remembering number patterns, etc., but has the vocab and imagination of a child twice his age. I don't want him labeled mentally ill, but I do want resources and understanding for him – by teachers and doctors alike, and to have a better set of skills for myself as I try to figure out how to calm an hour long tantrum and get him back into control, without completely losing it myself. See http://www.nldontario.org/articles.html. A lot of good resources that, if you've read this far, you might find useful.
Psychiatric diagnosis does not excuse bad behavior or automatically mandate medication; these actions represent the misuse of psychiatry. However, understanding the the underpinnings of behavior or learning that one is not alone in dealing with a problem is often a big help to patients and their families. Sometimes that is all that is needed to allow people to move on in the right direction.
Am i the only one that actually read this?? Were not talking about temper tantrums that most children go through usually around 2 . Were talking about children 6 and older and its not necessarily a temper tantrum but rather That they get so overwhelmed with the world around them that they dont know what to do with themselves. They have a lower stress tolerance. along with that they may have sensitivity to textures its not just one or the other its all the things combined Do we need "pill" for it here I see the benefits and downfalls. But where hes most right is that a new diagnosis code isint what people should be worrying about its how to help the child the family the teachers etc.
I'm a 27 year old woman who has suffered from depression since my teens. I later developed anorexia and in order to get help I had to agree to use antidepressants. Safe to say it didn't work, After 6 months and still not feeling any better, I decided to quit. This was 4 years ago. Last year my depression got worst, I went through light-therapy, and finally started new meds (prozac) since things were getting worst and I really didn't feel like I had a choice anymore. I'm shocked at how unprofessional most doctors are these days. The first thing on their mind is to prescribe drugs, without following up. One doctor took some blood tests, but said everything was within what's "normal", but I wonder if they consider weight, and other factors when they find that you are within the "normal" numbers. I've been in and out of hospitals since I was a few months old. . My family and I knew it was food allergies, but the tests were negative. Don't know if it's the meds, spring, or anything else, but I do know that as soon as I stopped eating certain foods, I was feeling better. I'm just frustrated that I can't prove it, because after all, everything was "normal" in my blood tests. What I've been told now, is that I'm someone who is likely to get severe depressions throughout life, and that I probably will be on meds the rest of my life.
Lady Gaga Rebron
Antianxiety-drugs.com
I think children are over-stimulated. From birth to adult life we are handed something shiny with flashing lights and noises. Think of TV commercials, its constantly flashing to new frames. Even when I am sitting still I feel the need to grab something to look at. We try and give our kids toys that don't require batteries, and allow their own imagination to flourish. And I've noticed my two year old can focus on projects longer. When we put movies in for him he gets to hard to please and has more tantrums. I know he is two, but it is worth a try. Its sad when children get mis-diagnosed and put on medication. I think we parents mess up kids...they come all new and perfect and somehow we find a way to mess them up. Oh yeah, and then put them on medication to fix our mistake.
I have to say, many of the posts appall me. How can people be so sure they know the answer to "these parents"? Really? You really think it is possible that real parents with real children would casually medicate them or drug them into oblivion? This seems wildly improbable to me, judgemental, and even a little superficial. The logic at work here, is: I am a thoughtful and careful and reasonable parent, but those people, who have resorted to ends I can't imagine, must all be bad, stupid, lazy selfish people...because I can't imagine what would make me do that." That's right. You can't imagine. YOU HAVE NO IDEA what you are talking about! Parents who choose medication do so because this is the best solution for a family tragedy that has befallen them. Their kids are borken. No one chooses meds first...No one chooses meds because it's easier than parenting..it's not easier, it's much harder. That is just ignorance. Actually it's worse than ignorance.
I think its difficult for some people to imagine how intense and prolonged tantrums can be in non-neurotypical kids, such as children with sensory processing disorder. I remember a mom from an online support group years ago calling me after her four-year-old became upset by the question, "Do you want your bedroom door slightly open or open all the way?" Two hours later, she was still screaming and Mom needed some moral support. What's more, SPD tantrums can be self-abusive which is scary as all get out.
SI therapy for OT which retrains the nervous system to function more typically–especially if the parents make sure the sensory diet of activities set up by the OT is carried out at home and at school–can make a HUGE difference.
http://www.sensorysmartparent.com
Depression in children must be treated very carefully by specialists not necessarily with medication, as in adults.
Taj Burrow Yho
Antianxiety-drugs.com
I started having panic attacks about 9 years ago. It took me about 2-3 years to figure out that they were cause by drinking coffee. I was 32 at that time. After not drinking coffee for a few years, I started drinking it again and was fine for about 6-8 months. Then I started having them again. I stopped drinking coffee and rarely drink anything with caffeine. However, in the past few months, I have been under a tremendous amount of stress over personal things (relationships, lack of work, bills, bad work conditions, etc) and the panic attacks came back. After reading information like here and following the advice given, it has really helped me to deal with them and they are less in power. I don't want to take Xanax or any other pills for this as its expensive and I could become addictive so dealing with Panic Attacks naturally is preferred. I'm very grateful for this article as it has really helped me to know more about it as well as not feeling like I'm the only one out there or that I'm losing my damn mind.
Antianxiety-drugs.com
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