Temper tantrums are often a part of raising children. After all there is a reason for the phrase “the terrible twos” and “teenage angst”. However, some parents aren’t just dealing with anger caused by frustration or their children not understanding why they are being told “no”.

The anger displayed by their child can be destructive and even frightening. Worst of all, it doesn’t seem like a “phase” the child will grow out of.

While your child’s anger could be caused by a number of mental health conditions, it can also be an early sign of bipolar disorder.

Is It Bipolar Or Something Else?

bipolar-anger-and=children.jpgNot all mental health professionals agree that children under 14 years of age should be diagnosed with a type of Bipolar Disorder. While some professionals and parents strongly disagree, it is still being debated in the mental health community.1

This can lead to problems getting the right diagnosis for children, and also means it could take years before kids have a treatment plan that actually works.

In fact the American Psychiatric Association does not believe that there is currently enough evidence to state that Bipolar Disorder exists in children, and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) often used by mental health professionals has included an additional category for kids that are excessively irritable and/or aggressive. It is referred to as “temper dysregulation disorder with dysphoria” (TDD).

Even though opinions vary if kids are really dealing with a form of bipolar, the fact remains that their sometimes uncontrollable anger is more than “normal” tantrums. What parents and their children’s doctors do need to consider is if it is ADHD, or an anxiety or other mood disorder. Sometimes, the symptoms can be similar to those associated with bipolar and this can cause additional confusion when it comes to treatment.

Adding to the confusion is the fact that some illnesses can co-exist with bipolar. Recent studies are starting to show that some children diagnosed as having bipolar are also trying to manage ADHD. They may have problems controlling their actions and concentrating on tasks at hand, even though they are not experiencing a depressive or manic episode.

Anxiety disorders are also seemingly more common in children diagnosed with bipolar. Whether this is a medical fact or physicians are just trying to find a cause for a child’s abnormal anger is still being studied. The best advice is to document all of your child’s symptoms, no matter how minor they may seem, so your child’s mental health provider has all the information they need to try and come up with the right diagnosis.

Remember: Just because your child has issues with anger doesn’t necessarily mean that they have bipolar 1 or 2.

Signs of Bipolar Anger in Kids and Teens

There are some signs that could indicate your child’s rage shouldn’t be considered “normal growing pains”. It also helps to differentiate Bipolar from ADHD and other mood disorders.

Chances are your child is exhibiting anger during mania. Unlike older teens and adults they often do not have feelings of euphoria, instead they are constantly irritable. This can be especially true in the mornings.

It is important to note that just because your child is “grumpy” in the morning doesn’t necessarily mean that they need to be treated for bipolar.

Along with irritability, children often display irrational anger that is usually directed at parents or other adults in their lives. They can become physically aggressive, and this can be frightening for everyone involved.

Other signs that it could be what is loosely termed as “bipolar anger in children” can include,

  • Prolonged bouts of screaming, crying and even spitting
  • Destroying favorite toys
  • Bouts of anger that lasts for hours or in some cases days
  • Often fights with others or tries to provoke an altercation

Children that are trying to manage bipolar often lack fear and aren’t afraid to try anything, no matter how reckless. This can lead to injury to themselves or others, and if they are told “no” to something they want to do rage can take over.

As you can see, these symptoms are similar to those associated with other behavioral or mood disorders. The main difference is that the anger lasts much longer if the child has a type of bipolar disorder.

How to Help Your Child Overcome Anger Due to Bipolar Disorder

“Fortunately, treatments and therapies are available to help bipolar children deal with their anger,” says David Fassler, MD.2

When bipolar is involved everything changes, especially in younger patients. Structure and discipline are important to a child’s healthy development and it can be especially true with bipolar.

Having a set schedule or routine is often an important part of bipolar treatment.

  1. The first thing you need to do is understand the rage your child feels and what is causing it. The reason your child is angry may seem inconsequential, but George T. Lynn MA states “To the child in rage, it is a life and death struggle. As the limbic system flares on, adrenaline spikes, the child becomes stronger, and the thinking brain shuts down.” This means that your child cannot control their anger, similar to how adults can have difficulty ignoring impulses during mania.
  2. Instead of automatically punishing your child for their anger, treat it like you would any other recurring disease. It is still important to have boundaries set, but you do have to use different techniques than you would with a child that isn’t trying to manage a mood disorder. Patience and a calm voice and attitude will be necessary, throughout your relationship.
  3. The right medication is important. The National Institute for Mental Health is studying the similarities between seizures and “bipolar rage” in children. This has lead to new treatments that often include medications for seizures, along with mood stabilizers. The main goal of any bipolar medication is to balance the chemicals in the brain and keep your child’s emotions from getting out of control.
  4. Keeping track of when your child rage occurs or what seems to trigger it can help immensely. Not only will it help their therapist, it can also make finding the right medication/s a little easier. A journal is a great way to keep track of everything, including which meds seem to help.
  5. Therapy for the family is one of the best things you can do, especially if there are other children in the house. A clinical professor of psychiatry at the University of Vermont College of Medicine, Dr. David Fassler states “These therapies help bipolar children tolerate frustration and express angry thoughts and feelings in ways that are less disruptive and destructive.” It also gives everyone in the family time to discuss their feelings and can minimize other problems that can occur when one child is trying to handle anger caused by bipolar.
  6. It is impossible to completely eliminate stress but it can be controlled, in some situations. These will depend on your unique situation and family dynamics, but your child’s psychiatrist and/or therapist can help you with some tips and ideas. Some parents have reported that introducing their child to basic meditation techniques has helped curb some of the anger, but this will depend on your child.
  7. You want to have clear boundaries and be consistent about enforcing them. DO NOT let your child’s angry behavior control the home, simply because it is easier to ignore it. This can only encourage their anger and could set a behavioral problem that lasts through their life.
  8. Children do need to be punished for their bad behavior, whether it is “time-out”, grounding or something else appropriate for their actions. However, sometimes it can be counterproductive when the child is furious and diagnosed with bipolar. Ensuring that they understand that there are consequences for their angry outbursts and destructive behavior when they are calm can help. You DO want to wait until the “angry episode” has passed before you dole out any consequences. Doing so during the outburst often only makes it worse.
  9. Always reinforce your child’s positive behavior. In his book “Survival Strategies for Parenting Children with Bipolar Disorder” therapist George Lynn writes “They help her develop character strength when they note and affirm every time she is able to put boundaries around her own wild emotional reaction. And they stick to their consequences … and compliment her for doing a good job.”
  10. Keeping your emotions under control can and will be difficult, especially when your child is acting out in rage. However, children with bipolar tend to be more sensitive to others emotions and if they sense that a parent is frustrated, stressed or irritable it could make the situation worse. Every parent loses their “cool” every now and then, but this can be detrimental. Family and individual counseling can help, and give you tips on how to manage your emotions.
  11. It’s inevitable, parents and children will disagree. If your child is experiencing unreasonable anger due to their mood disorder this is the last thing that you want to do. It will only make their “rage” worse and frustrate you further. Take a step back from the situation. In his book, George Lynn states “Children with bipolar disorder seem incapable of seeing the other’s perspective in a situation. They will argue incessantly or deliberately twist an argument to justify their position on any issue.” Once again, wait until the episode has passed and deal with their behavior then.
  12. Always try to stay calm, and this can be difficult. Listen to both your head and heart. Your child is going through something that is impossible to completely understand, unless you went through it yourself. Enforce boundaries and keep the consequences consistent and remember that even though your child is angry at the moment, they still love you.
  13. This is important if there are other children in the home. Be open and honest with them about their sibling’s mood disorder. Clearly explain why they’re brother or sister acts out and why the punishment is delayed or different than theirs. Without communication, the family unit often falls apart.

Families Can Thrive

It is possible to have a “happy” family, even if a child has been diagnosed with bipolar disorder.

It won’t happen overnight and will take a lot of work on every family member’s part, but it is possible. Do Not be afraid or ashamed to ask for outside help. Individual therapy and family counseling can be lifelines for parents and other children in the home.

Just remember to keep your “emotions in check” and set boundaries. There are support groups in many cities for families with a child diagnosed as “bipolar” and they will let you know that you are not alone.

Most importantly, your child still loves you even during an episode.

 

References:

1 https://www.sciencedirect.com/science/article/pii/S0165032704002058

2 https://www.everydayhealth.com/bipolar-disorder/bipolar-children-and-anger.aspx