What is the difference between a tantrum in a 5-year-old and actual aggressive behavior?

Temper tantrums are a normal and common part of child development. They are a way a child shows he/she is angry, frustrated, hungry and/or uncomfortable. Behaviors can range from whining and crying to screaming, hitting, kicking, and breath holding. They’re equally common in boys and girls and usually happen between the ages of 1 to 3.

During age two, also known as “The terrible twos,” is a common age when kids have more frequent, intense and difficult-to-manage tantrums. This is a time when their language skills are beginning to develop and because they have challenges with saying what they want, need or feel, they become frustrated and may cause a tantrum. As their language skills improve, the tantrums decrease.

Some kids may have tantrums during the later years. This may be a sign of a few circumstances: they don’t know how to ask for something they want it, they continue to struggle with language skills, they may desire control or require more attention than what they are given. Simply, they may feel their needs are not being met, so they may revert back to a behavior that worked when they were younger.

Unlike tantrums, a child with aggressive behaviors, as seen in children with oppositional-defiant or conduct disorders, may be living with these mental health disorders that are categorized as disruptive behavior disorders. They display behaviors that are beyond the “normal/natural” aggressive behaviors observed in early childhood and adolescence.

In general, these behaviors are recurrent and persistent and interfere with a child’s family and peer relationships as well as their school functioning. The severity of these behaviors are moderate-severe and their nature can consist of anger that turns into rage (uncontrollable anger) towards authority figures, constant disobedience, defying rules, threatening harm without remorse, stealing, and even violence in some cases. These behaviors need to be managed and require the assistance from a team of mental health professionals.

Would you use these same characteristics to label a psychopath or sociopath on a toddler? Aren’t their behaviors part of early development and learning?

Behaviors of screaming, kicking, and showing frustration and anger are indeed a part of “normal/natural” development. The difference is that toddlers with age-appropriate and developmentally age-appropriate behaviors show remorse and learn from carrying out bad behaviors.

Receiving consequences for their poor behaviors teaches toddlers what is appropriate and helps them to start understanding the behavior expectations of the caregiver or authority figure, distinguishing good from bad behaviors.

I have a niece that’s bipolar schizophrenic and she has two children – I have one of them. Is there any way possible that the daughter may have the same thing?

Schizophrenia is not passed on directly, like hair or eye color. Other conditions that are not fully understood, are necessary because other factors are involved. Otherwise, schizophrenia would always develop in both identical twins, since they have the same heredity or genetics.

The causes of schizophrenia, like all mental illness, are complex and multi-factored (occur due to a number of different causes or influences.) Schizophrenia is more than a genetic disease but people who have family members (blood relatives) with schizophrenia may be more likely to get the disorder themselves.

If both biological parents have schizophrenia, there is nearly a 40 percent chance that their child will get it, too. This happens even if the child is adopted and raised by mentally healthy adults. In people who have an identical twin with schizophrenia, the chance of schizophrenia developing rises to nearly 50 percent.

My son is 3. I’m concerned about the amount of anger I see and a few other things. Some people say it’s normal but idk. I’m a worrier by nature so am I over-reacting or should I get him to someone now?

I encourage you to always go with your parental instincts and knowledge when considering your child’s health and well-being. Showing behavior signs at age three is not too young. People typically “mean well,” but may unintentionally minimize your concerns about your child for many reasons.

I would advise you to be careful to take advice from individuals who are not professionally trained or experienced in dealing with child behaviors.

Instead, I would encourage you to act on your concerns, alleviate your anxieties and seek a professional’s opinion. Early intervention always helps.

When it comes to  antisocial behavior; is it seen in teens diagnosed with autism and a family history of depression? What happens if  the teen was on antidepressants but parents took them off because they felt teen was better behaved off meds?

Research has shown that Autism and Antisocial Personality Disorder (ASPD) are marked by problems with an individual showing empathy, yet the differences between the two conditions couldn’t be more distinct.

Children/teens with autism generally, may have anxiety and misread social cues, but they typically care about not harming others; they are also often incapable of manipulation. Individuals with Conduct Disorder (which is a required child diagnosis in order to diagnose ASPD as an adult), however, are calculated experts of manipulating people to get what they want, using fear tactics. They actually enjoy causing people pain.

Having a family history of depression does not increase the risks of an individual developing ASPD. Depression is a “mental illness,” whereas ASPD is a “mental disorder.”

My professional opinion is that mental illnesses can be managed with the help of medications (if the depression is of a biochemical cause) and psychotherapy (for psycho-social causes like a developing depression due to the loss of a loved one). Mental disorders (i.e. personality disorders) require intense psychotherapy treatment that should involve the individual’s active participation- which can be difficult, since they do not agree that their personality and behaviors are concerning.

Family therapy and community support services should also be a part of the treatment plan. Medications are often prescribed in cases where personality disorders have co-morbidities of other mental illness, such as depression and anxiety. ASPD cannot be treated with the use of medication.

Depression can be treated with medication, particularly If the mental illness was caused by a biochemical reason. So, it is not unusual even for some children/teens to take anti-depressant medications for a duration of time and no longer need them, since the depression eventually resolves, and they feel better.

For other kids/teens, longer use of antidepressants and/or combination individual and family therapy may be recommended, particularly if their depression results due to a number of biochemical, psychological and social causes. I highly advise consulting your child/teen’s child psychiatrist when the parent or child/teen no longer wants to take medication for their mental illness.

You just described my 14 year old nephew. How do I get the rest of my family to recognize and admit that this little boy has serious mental issues? He has pre-exposure to this behavior from his mother and father. Thank you!

It can be difficult for parents to accept the possibility that your child has a mental health condition. As a loved one or friend of a parent(s) whose child you are concerned about and depending on your relationship with their parent(s), here are some things to consider if you choose to discuss your concerns with them:

1) Let the parent know that you need to have an important conversation with them. This sets the serious tone for the conversation.

2) Pick a good time and place. Consider having this conversation in a private and comfortable place for the parent(s).

3) Approach them with empathy. You might say something like “I know this is really hard for you, but I’m talking to you because I love you and our/your family. If I didn’t care, we wouldn’t be having this talk.”

4) Be prepared for the person to be upset – and try not to get defensive. This is difficult to hear from someone they also love.

5) Use “I” statements, such as “I’m concerned about your child.” Avoid using “you/your,” as it can insinuate blame.

6) Offer to pay for the appointment, if possible. A common excuse is that mental health appointments are too pricey.

7) Show your support for medical and mental health care. Attend your own appointments, my example.

8) If you are close to the parent(s) and child, you can offer to take them to the appointment, and /or wait in the lobby. They may need your support, especially if they receive unexpected news.

9) Don’t use words like “crazy” or “abnormal.”

10) Be a listening ear AFTER treatment is started. It can be very difficult for a parent to care for a child with a mental condition or even decide the next steps for their child. They also may be dealing with their own mental health issues.

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