Child Bipolar and Anger: Stages and Phases of Stability

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This page outlines for you how to deal with anger and other behavioral issues by determining what phase of the illness your child is in. First I will explain about anger management in children with bipolar disorder. 

Please click here to learn more about anger and it's causes in general.

 Bipolar children feel anger more intensely then the rest of us.

Anger management in children with bipolar disorder is difficult and complicated for many reasons.  Almost all of us have difficulty with anger, and understanding how to best manage and express it. Bipolar children and adolescents feel anger very intensely. Anger management in children with bipolar disorder is complicated by the fact that they have not yet developed the skills to handle such strong emotions, and anger is more overwhelming for them then for the rest of us. 

Chemistry and Biology. It’s not Behavioral!

 They aren't doing it on purpose, don't treat them as if they are.

If you are a parent of a child with bipolar disorder and anger is a problem in your home this page will be helpful for you. It is important to understand that the chemistry of your child’s body and brain is driving your child’s bipolar disorder and anger . That is why they act aggressive and angry, irritable or hyper. If you had a child who had diabetes, you would not lecture your child about their blood sugar level, or punish them because of this. You would give them medications and the foods they need to manage it. Bipolar disorder is an illness.

Illnessess  do not heal in response  to punishment, yelling, shaming, or time out. This is not a way to help with anger management in children with bipolar disorder.

This is not to say that there is absolutely nothing you can do to manage your child’s aggression, bipolar and anger. You can learn about specific guidelines to help your child with anger at different stages of their illness. There should be consequences for your child’s behavior when they are aggressive or angry to others. However, it is not realistic to  punish the bipolar out of your child. 

So what do you do? You’re a parent of a child with bipolar disorder and anger, and it is getting in the way of how your family functions. The family is in constant crisis, everyone is yelling and screaming, the siblings of your bipolar child seem disturbed and effected by this and you don’t know what the long term effects on them are going to be. You feel like a failure, and everyone on the outside thinks this has something to do with your parenting skills.

. Let’s look at how anger management in children who are healthy develops.

The non bipolar development of emotional regulation and anger management in children

Anger management in children develops through the gradual exposure to situations that are uncomfortable or unpleasant. This begins when an infant experiences discomfort and is first soothed by his mother.  A hungry child cries, experiences frustration and unhappiness and his mother picks him up, coos to him, rocks him and feeds him. He is then emotionally regulated, he begins to learn that he can be soothed when he is in distress. This is the beginning of how we learn to regulate our emotions on our own. Each progressive experience helps us to refine those skills. Usually the second experience for a child of this kind of frustration comes when mom tells them no at this point they are usually crawling. 


Imagine this scenario. A two year old is crawling to the electrical outlet and the mother is too far to catch them quickly. She yells no, loudly.  The child is shocked and feels intense shame, anger, and frustration, but the mother quickly scoops him up to help ease those strong emotions.As a child gets older, they have these small experiences where they feel intense emotions and are required and expected to handle them. They may or may not meet the expectation, but they do learn new skills. This process of learning anger management skills continues to occur into adulthood.

The Bipolar Child and Development of Emotional Regulation

 How do things go wrong for a child with a mood disorder?

Now imagine this scenario. A child is born with a brain chemistry that makes them almost immediately uncomfortable. When his mother thinks he’s hungry, and picks him up he is not soothed. He feels scared and uncomfortable and out of control. Imagine this same child at two, crawling towards the electrical outlet. He constantly feels irritable, he has sensory integration issues he can’t sleep at night, and rarely feels a sense of safety. His mother yells no, and his body is flooded with chemicals that cause him to fight, become aggressive and scream. He feels totally out of control, and never feels calmed or soothed. Is this a child you put in time out, spank, or punish?

This is an extreme example of a bipolar child and the relationship between bipolar disorder and anger, because not every child experiences and onset of the illness at infancy. However, it is an example of how the brain chemistry interacts with the environment to produce a child who has difficulty regulating his anger. Not only is he at the disadvantage of biologically being prone to anger, but his illness has prevented him from ever learning the basic skills to regulate his anger.


What’s the solution?

Medication is the first solution. When a child is stable, the chemical in the brain are restored to a more normal level. This means that they are less likely to be flooded with chemical that cause the anger. When a child is stable, it also allows them to go back and learn the skills they did not learn when they were sick.

Parenting techniques that consider the child's level of functioning and what they can and cannot do are also important when dealing with anger management in children. Learn about these below

Stage 1: Your Child is not Stable

He is raging crying and  psychotic or very anxious. There may be other behaviors that indicate he or she is unstable. He may be cycling between irritability or sadness, and elated behavior.  You never know what to expect and the family is walking on eggshells.

General goals of the family at this stage. 

  • Get the Meds Right

Carefully monitor the impact of your child’s medications and communicate frequently with the psychiatrist. Do not settle until your child experiences relief from his symptoms that allow him to lead the highest quality of life you feel possible. This should be the focus of your family daily. Keep mood charts and behavioral logs in a book with your child’s targeted symptoms, and medications. Understand and familiarize yourself with the signs of mania and depression. Describe these symptoms clearly to your doctor. Don’t give up. The biggest part of how to deal with anger in your child is getting them on the appropriate meds.

  • Take care of yourself and the rest of the family

Each family is different. Everyone in the family should know the child is ill but will get better. Siblings should know this and should be educated about the illness . They need to understand why one child is treated differently, that their brother or sister has a mood disorder, a medical illness, and that they are working on getting better. They also need to have an explanation as to why you deal with anger differently in different situations. Ask your child’s therapist to meet with the siblings or get them their own if possible.

  •  Marriage and Self Time.

DO not allow the child’s illness to drive a wedge in your marriage. Get help and support through a support group , create a support network list ( all the people who understand you are not blame for your child’s illness). Get a babysitter if possible and get out for a few hours or for dinner.

Also take care of yourself. Go to the movies go to dinner with friends, talk to friends. Stay connected with others and do some things you enjoy. If you don’t your child will suffer because the level of stress in the house will decrease. If you or your spouse is depressed which may often be the case, acknowledge it, recognize it and get help.

  • . Practice stress and anger management.

A child who is bipolar is particularly sensitive to stress. If you are stressed, yelling , irritable , or disorganized that will make them worse. The answer to the question of how to deal with anger in your bipolar child entails managing your own. Learn techniques to manage your own stress and your household stress. Make that a priority.

  •  Pick your battles. Decide on deal breakers. 

When your child is unstable, wait until your child is calm before you deal with anger or behavior. Talk with you child about rules that cannot be broken regardless of the chemistry of their illness. It may be that you decide that destruction of property or harm to siblings is where the line is drawn. This way, ahead of time, the consequence is decided upon. After your child has broken the rule, wait until they are calm deliver the consequence without anger. Remind them that you are working on helping him to control these behaviors, and you know that together you will be able to do it. This is not permanent ,however, it is the approach to discipline that you will need to take until your child is stable.  The deal breakers are consequences whether or not the child is stable for the sake of siblings or the rest of the family, even though your child may not fully understand cause and effect behavior while unstable. 


 

Stage 2: Approaching Stability

Kids who are approaching stability show small signs of changes. If they used to get angry and tantrum for four hours the length decreases. If they used to curse at you and put a hole in the wall then they now only curse at you.

How to deal with anger and other behavior in stage two

Goals:

  • . Pick your battles.

Your child should be able to handle more than normal. You may add some more rules to the absolutes and may do some more processing after episodes For more ideas about parenting click here .

  • Take care of yourself and the rest of the family

Continue to monitor everyone’s stress level, to work on yourself your marriage and the other children’s needs. As a family, talk about how the illness is improving and you are working towards stability

  • Keep working  on getting the medications right

Continue to monitor and log behaviors and moods and to work on approaching the most stability you can with your child. Get feedback from your therapist and psychiatrist on what that might be.


Stage 3:  Your Child is Stable

When a child is stable, they return to the child you knew before. Their life is dominated by their illness. They are able to laugh and enjoy some of life, their sense of humor returns, the anger decreases.

Goals

  •  Pick more battles. Determine when your child “can versus wont”

Many parents, who have done the best job at managing their child’s illness, find themselves floundering at this stage and enabling behaviors to continue that don’t need to. Kids need help to see that they can change, and have higher expectations of themselves. It takes careful attention to a childs moods and a stress level to begin to start to push them, set more boundaries and have more expectations of what they can do. Mary Fristad author of “The Moody Child”, uses the phrase “can’t versus wont “ to help parents learn what to do in certain situations and how to deal with anger. I use this phrase in therapy to work with both parents and kids and help them determine what is happening with children's behavior and intentions. 


Jimmy has been unstable for two years. He has rages, outbursts, and cannot attend school. He wants a toy and insists his mother buys it for him at the store. It is not expensive but it isn’t something he needs. The last time she said no in a store the police were called because his behavior got so out of control, and this lasted for several days.

What should she do?

a) Buy the toy for him because he may rage cause a scene and get arrested and wind up in the hospital again. This child should probably not be in the store with you if it can be avoided. 

b) Tell him no hes a selfish brat and he drives you crazy all the time

c) Let him know that right now, he can’t have that toy

 This child is unable to control his behavior. Although you are giving in to him and others will criticize you he is in mission mode and could potentially become volatile if you don’t give him what he wants.

Jimmy has been stable for three weeks. He has had small rages at home, no outbursts, at school and is doing fairly well. This morning, however, he woke three hours earlier than usually. He has had energy and been frenetic all day. He also just ate a candy bar. He wants a toy and insists his mother buys it for him at the store.

What should she do?

a) Buy the toy for him because he may rage cause a scene and get arrested

b) Tell him no hes a selfish brat and he drives you crazy all the time

c) Let him know that right now, he can’t have that toy.

d) Consider buying him that toy because his behavior indicates he was manic this morning and he may get agressive resulting in some unforseen consequences. 

Although Jimmy is getting better and  is approaching stability in  this scenario, the child is showing signs of mania. Your best bet might not be to try out a new limit setting technique right now or to leave him home and not put him in a tempting environment to begin with. 

Jimmy has been stable for two months. He has had no rages, no outbursts, is doing fairly well at school. He wants a toy and insists his mother buys it for him at the store. What should she do?

a) Buy the toy for him because he may rage cause a scene and get arrested

b) Tell him no he’s a selfish brat and he drives you crazy all the time

c) Let him know that right now, he can’t have that toy

 This child can handle this feedback and learn how to deal with anger more appropriately. although you may be scared of the consequences. All indications are that he is able to have more control at his point.

Please know that your child will likely move through all of these phases fluidly. They wont likely be in a stable phase permanently.


Read more about Bipolar Disorder

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