Self Help Now: A community blog

Dr. Jacqueline B. Sallade offers advice for maintaining your mental health.

Emotionally Disturbed Children

Written by Dr. Jacqueline B. Sallade, Community blogger | Jun 9, 2014 6:23 PM

It's much harder to diagnose children as emotionally disturbed and, more so, with a specific disorder than to diagnose adults. First of all, they're children, so they haven't lived long enough to establish clear patterns of deviant behavior. They are more easily-influenced by family and environmental conditions, especially traumatic events, but often malleable and resilient with the right help early on. Their behavior, emotions and thoughts vary more from day to day or, at least, month to month.

Secondly, deviant behavior for adults can be normal behavior for children. Moodiness, even extreme highs and lows go along with adolescent hormones and growing pains, for example. Vivid, even bizarre and unrealistic imagination, to the point sometimes of hallucinatory experience go along with creative play of little kids. Tantrums and oppositional behavior may be part of normal limit-testing and identity formation or a reaction to parental difficulties. Some children act out to focus parents on them, rather than on their own relationship problems.

So, although these children need attention and care related to their situations, they don't necessarily need diagnoses and certainly not stigma.

Yet, some deeply depressed children aren't reacting to trauma or situations. They are genetically, clinically depressed and feel themselves falling into a dark hole for no reason, just like depressed adults. There are truly schizophrenic  children who hallucinate and persistently suffer paranoid delusions way beyond normal childhood imagination. There  are bipoloar children, usually diagnosed as teenagers, who get into wild schemes and major trouble when manic and then sink into lethargy when depressed. The latter are not to be confused with those with Attention Deficit, who have trouble focusing on projects and school and can be socially inperceptive, hyperactive, and/or moody.

One nice, gited, talented young high school student described his urges to engage in fantastical and unrealistic activities, such as buying cars illegally, selling things he didn't have online and conducting elaborate surveys, as "something that comes over me, takes hold and I have no control, so it just has to happen." Another sweet girl from a loving family explained her cutting and other self-abusive behaviors by saying, " there's a devil in me which punishes me and I don't know why or what I did wrong, but it's stronger than I am."

I warn fellow psychologists to be careful that the behavior is extreme and persistent, impairs life functioning and can't be explained by immediate circumstances before diagnoses and psychotropic drugs. But, if the child is mentally ill, get working on it fast.

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