Kid's Health topics

Angry kids

Hi there parents and carers!

This has been a really tricky article to write.  There are so many reasons why kids can present as “angry” or with emotional dysregulation and I knew it would be a real challenge to cover them all sensitively and in completeness.  In this way, please excuse the length of this post… it is long, but in the end I hope it is helpful.

Through the course of my work as a kids’ doctor, I remain mindful that I see a very skewed part of the general population of under 18’s.  Generally parents and families don’t seek contact with a paediatrician, unless there is something “wrong” that they need help with, or that could do with fixing.  In this way, I less often see kids who are doing really well, and more often see kids where things are not-so-great.

A large proportion of children we see are when kids have troubles with emotional regulation and self-calming, who might lash out at their family, friends or teachers… in other words, angry kids. 

 

Often by the time these children are brought to see me, things have been bad and getting worse for some time.  Parents will report that they are at “breaking point” or they are despairing because they don’t know what to do.

Sometimes aggressive, violent or angry behaviours are intimidating and difficult to manage but I guess I wanted to write this blog post today to reassure you that all is not lost.

In the vast majority of cases, taking the time to understand the child and to figure out WHY they are so angry is the key to making things better.  The answer isn’t always simple, in fact sometimes it is really complex and made up of a combination of factors.  The aim of this blog is to help us to think about some reasons why children may seem angry, and then hopefully give us some insight into how we might unravel this to improve things.  Don’t expect an easy, quick fix. It most often takes time, therapy and emotional investment on the part of the family, the parents, the child and the therapist to change things…  but if you have a good therapist and a solid commitment to change, improvement is entirely possible and achievable.

REMEMBER:  anger is a completely normal emotion.  Everyone feels angry occasionally, and for all of us (adults and kids), it is an opportunity to learn and to grow.  Anger doesn’t necessarily have to be suppressed, we just need to learn how to transition from what might become a negative reaction (eg pushing, hitting, yelling) into something that may not necessarily be pleasant (eg a different release of emotion – directing the anger into a punching bag/pillow, crying, talking it out), but can help us deal with the feeling, learn from the situation and then move on.

 

COMMUNICATION

Kids can get very frustrated if there is failure of effective communication.

Children need to be given both time and space to make their needs known and this is particularly important in children that have speech and language delays. Similarly when they are being spoken to, children need to be given enough time to take on board (and process) what is being said to them.

Children can become angry if they perceive injustice, or feel they are being “picked on.”  This perception may or may not be founded, but it is important that the parent also verifies if (what might be) an assumption of guilt, is actually true.

One major source of frustration for my 5 year old daughter is when she feels she is not being listened to.  I freely admit – it is HARD to listen to her ALL the time – because she is 5 and she talks incessantly. Being mindful though that this is actually developmentally normal for their age and giving children enough time to explain/complete their story or to ask questions can help to keep them calm.

 

ENVIRONMENTAL FACTORS

Everyone on earth has a “tipping point.” For some very patient people (like my dad for example) it takes a lot for them to lose their temper, for others not so much.  Some of this is due to our genetic make-up (and we have no control over this), some due to what we have learned ourselves growing up, some due to how we choose to react to a situation but there are also environmental factors that come into play.

Kids are less likely to be able to control their emotions when they are overstimulated.  This is why some children “lose the plot” in busy, multisensory environments (eg a shopping centre or at the Ekka) and cannot be calmed until that high level of stimulation is removed.

Children need space to breathe. If their stress is high (eg some hard homework or other school task) and they are not given the opportunity to take a break… guess what might happen?

Too much screen time. I have written on this before, so I won’t harp on it again BUT – too much screen time not only NEGATIVELY affects a child’s ability to self-regulate and stay calm (see my other blog post on screen time http://www.kids-health.guru/screen-time/  and the article by Ruest published in July in the (American) Journal of Pediatrics. (Ruest S, Gjelsvik A, Rubenstein M et al. The inverse relationship between digital media exposure and childhood flourishing. J Pediatr. 2018 Jun;197:268-274.e2.) but also interferes with sleep, interest in school and ability to complete tasks.

 

PARENTAL INTERACTIONS

Now I’m sure we are all acutely aware how much our interactions with our kids affect their mood and the way they learn to handle situations of stress.  This is not intended to guilt you as a parent (goodness knows that I am very aware of how parents feel guilty *all the time* about every single thing we do for fear of “ruining” our kids), but just to make you think about your interactions and perhaps change your approach if and where you can.  Parenting is so incredibly tricky… balancing the right mix of discipline and encouragement is what we all strive for so that our kids can grow up well adjusted, well-regulated and decent, successful human beings. Every parent loses their cool at some point, every parent gets stressed and I am pretty sure that every parent yells at their kid or says something to their child they later regret at SOME stage of their lives.  But there is a real difference in doing this on a rare occasion in a moment of weakness, versus adopting this as your default approach to every day.

Children can develop anger when unreasonable demands are made of them (that is, demands requiring them to do what they are not developmentally able to do) at home or at school.  Think about why your child is angry or kicking back – are you expecting them to do something they simply just cannot?

Failure to have clear boundaries and routines.  This is one of the most common things I see in practice.  In this day and age of “political correctness,” whilst allowing children the freedom to choose what they want out of life and allowing them autonomy and independence is undeniably important, we cannot forget that a simple truth remains…  Kids NEED clear boundaries, and thrive on structure and routine – this includes around meal times, getting ready for school in the morning, the use of electronics, homework and bedtime.  Why do we need this you ask?  Simple.  So that kids know where they stand and what is expected of them.

In the same way as routine and predictable structure help children to regulate and keep calm, consistency in our reactions to our children is equally important.  If we are inconsistent – happy and gentle one minute, angry and dismissive the next, our children won’t know if they’re ‘coming or going!’ It also sets a bad example of how to behave.  At the same time – a lack of kind, gentle, generous words and acts of kindness by parents or carers can also cause a child to lose motivation to participate, follow directions or behave well – because “Why bother if no one notices when I behave well, and everyone notices when I misbehave?”

Make sense?

 

FAMILY/SOCIAL ISSUES

Anger can come from a place of grief or from a lack of feeling a part of the family unit.  Stress and big changes can also trigger unwelcome changes in children’s behaviour.

Grief is a difficult and unpleasant emotion for everyone (regardless of how emotionally regulated you are).  If a child loses someone they look up to (death, illness, separation) unless they are well supported (and sometimes even if they are) there is a awful hole that suddenly opens up in their lives and often they struggle to deal with this.  Even when there is no “loss,” as in the case of parental separations, a lack of predictable plan for who, how and when contacts will occur affects children in a negative way.

It is human nature to crave contact and to have a feeling of belonging.  Attachment to our primary caregivers occurs VERY early in life (as early as the first few months after a baby is born), and if this fails to occur securely, it can affect the nature of an individual’s relationships and interactions for the rest of their lives.  Even when attachment does occur typically, an ongoing lack of involvement of parents in normal childhood activities and genuine family time (including inside and outside play) can adversely affect a child’s mood, feelings of self-worth as well as their attitude towards and contribution to family life.

Big changes in a child’s usual routine can influence their ability to emotionally regulate effectively.  Examples include (but are not limited to) a big house move (eg defence families), a change in schools, parental separation, a previously single parent finding a new relationship, accident/illness/hospitalisation of a family member or even the birth of a new sibling.  With time, space and support, most children adjust to the changes but in some cases children will have persistent alterations in mood, behaviour, sleep or all of the above.  If you are worried about any of these things for your child, it would be important to seek the advice of a health care professional such as your GP, a child psychologist or similarly trained mental health care professional such as a counsellor, occupational therapist or social worker.

 

EXPOSURES

Unfortunately in my line of work, we see kids who have been exposed to things that they never should have been.  I’m talking about yucky things like exposure to violence or inappropriate sexual activity/material (including domestic violence, television shows they shouldn’t be watching or video games they shouldn’t be playing), humiliation, emotional abuse (being constantly put down), neglect (this can mean failure of providing basic living needs for children like adequate food and clothing to a lack of parental/carer involvement in day to day interactions (this can include parents/carers being on social media instead of connecting and being present with their children)).

Even exposure to people in their lives who do not set a good example by demonstrating how to control their emotions effectively, OR those who are unpredictable in their responses and emotions can have a significant and negative impact on children and the way they learn to respond.

 

PERSONAL FACTORS

It would be completely remiss of me not to mention that factors such as personality, learning disabilities, developmental challenges and mental health issues (eg anxiety) that are unique to a person play a huge part in our ability to regulate our emotions and control our anger.  Whilst some of these factors are beyond our control, are able to be altered with mindfulness and practise.

MEDICAL ISSUES

There are of course medical (and potentially reversible) causes of irritability and poor emotional control.  These can include (but are not limited to) tiredness from a medical ailment such as iron deficiency anaemia, thyroid dysfunction or lack of sleep due to obstructive sleep apnoea, anxiety or stress or sometimes a poor sleep routine.  Your paediatrician is a great person to talk to about how we can go about rectifying these problems so you and your child can get on with life without the drama.

 

Phew.  That was just as long as I expected it would be.

I hope if you have read down to this point, that you have found it at least a little helpful.

If you have an angry child and you are struggling to understand and help them, go and see your GP and perhaps get a referral to your paediatrician, paediatric psychiatrist, paediatric psychologist or counsellor.  We can help you to understand and help your child.  It’s our job.

 

Let me know your thoughts in the comments below

Catch you soon!

 

xxDr Megs

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