Are Temper Tantrums a Sign of Mental Illness?
A hallmark of the terrible twos is now considered, in older children, a bona fide disorder. What does this mean for parents of toddlers?
As if a child in the middle of a meltdown isn’t hard enough to manage, the nation’s largest psychiatric group now says that temper tantrums could be a diagnosable mental health disorder.
Technically called disruptive mood dysregulation disorder (a.k.a. DMDD), the newly designated diagnosis was approved by the American Psychiatric Association (APA) for inclusion in the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, the guidebook professionals use to identify and diagnose mental health issues. The DSM-V, as it the manual is known, will be published and put into use beginning in May 2013.
Detailed criteria about the condition has not yet been released, but according to the APA, a diagnosis of DMDD will only be applied to children older than 6 and younger than 13 who have three or more temper tantrums a week for more than a year.
Why target tantrums? By having DMDD as a stand-alone problem that can be diagnosed, psychiatrists hope it will stop tantrums from being confused with symptoms of other, more serious mental illnesses, such as bipolar disorder—and prevent potentially wrong diagnoses of bipolar disorder when a kid is just having a tantrum.
Still, some in the child psychology community say making DMDD an option may just end up labeling more children with mental health problems, which doesn’t seem like a good thing. And there’s also the question of whether tantrums in toddlers will eventually labeled as DMDD, too.
As pediatrician and tantrum expert, Dr. Claudia Gold, tells CNN, “The diagnostic description created by the American Psychiatric Association states that a child must be 6 years old to receive the diagnosis. 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?’”
Gold is also concerned that psychiatrists may begin prescribing medication to treat DMDD when there is no research on medication being appropriate in helping kids overcome temper tantrums.
And this last point seems to bring the conversation around to something many parents struggle with: Is there anything that stops tantrums in their tracks? With the stakes for helping children get in control of their emotions suddenly feeling a lot higher, we asked Jennifer Yeager Lloyd, LPC, a Pennsylvania-based professional counselor who specializes in parenting and children’s issues, to share some practical strategies for taming young tempers.
“One of the best things a parent can do is to implement routines and structure. When a child knows what to expect, it makes transition from one part of the day to the next easier to handle,” Lloyd explains. To make the daily routine clear, she recommends using a visual schedule.
Giving toddlers what Lloyd calls a “controlled choice” can also help. “For example, at lunch time, a parent might say, ‘For lunch, we can have a sandwich or chicken fingers.’ The child may then reply, ‘But I wanted a hot dogggggg!’ In a controlled choice situation, the parent then follows up with, ‘I’m sorry, that isn’t one of our choices. Let me know when you decide between a sandwich or chicken fingers.’” By getting to a make a choice, the child’s need for control and independence may be satisfied—without the need to act out.
What else works? “It’s critical for parents to have clear expectations for behavior, and enforce consistent, firm consequences when rules are broken,” advises Lloyd.
And finally, “begin giving your child words to use for how they are feeling, and encourage they use them. When a child throws a toy across the room, say ‘You seem angry. Are you mad? You can tell me you are mad, but no throwing toys.’ A child who can begin to verbally express their feelings won’t feel the need to ‘behave them out’ so frequently.”
Lloyd also says it is important to recognize when tantrums could point to deeper problems—whether or not it’s DMDD.
“If your child has tantrums repeatedly throughout the day, their tantrums consistently last longer than 20 minutes or more, or you feel as a parent that you are doing more ‘damage control’ or ‘reactive parenting’ then enjoying your child throughout the day, it may be time to consider professional help,” she says.
A counselor or psychologist can help you analyze the effectiveness of your parenting approach, fine-tune your parenting skills, or determine if your child is experiencing some other sort of emotional distress that requires additional support.
But what may matter most, says Lloyd, is to not give up—or think the worse—if your attempts to help your child develop more control over their emotions don’t seem very effective at first. “If you feel like something you are doing isn’t working, it may not be!” she says. “Don’t be afraid to admit that you need to try something else. Parenting is a tough job, with multiple different approaches. Doing just one thing differently could make a huge impact.”
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