emotion regulation for kids?
January 15, 2020 8:43 AM Subscribe
my friend's 8yo has been having tons of issues with emotion regulation.... help?
my good friend has an 8yo who has already been diagnosed with adhd (let's not debate the topic of childhoos dx's).
BUT she is showing some classic signs that a bipolar might, namely with emotion regulation and distress tolerance. so her mom asked me to dig up some info. i'm not a mom, so i don't know *exactly* what might help, but i was hoping you guys might? i've already sent her some articles on dbt skills for kids, but i figured the hive mind would have more experience!
my good friend has an 8yo who has already been diagnosed with adhd (let's not debate the topic of childhoos dx's).
BUT she is showing some classic signs that a bipolar might, namely with emotion regulation and distress tolerance. so her mom asked me to dig up some info. i'm not a mom, so i don't know *exactly* what might help, but i was hoping you guys might? i've already sent her some articles on dbt skills for kids, but i figured the hive mind would have more experience!
If she can find a mindfulness class for kids that might help.
posted by bq at 9:23 AM on January 15, 2020
posted by bq at 9:23 AM on January 15, 2020
Children with ADHD often struggle with emotional regulation and distress tolerance.
Like Nantucket, I would encourage your friend to work with a professional on the treatment plan for her 8yo. ADHD can manifest in multiple ways (I bear the scars of that truth), and the treatment can be adjusted for the particulars of the child. That is true both for behavioral treatment and medication. A trained psychologist or psychiatrist can be very helpful in this.
For an online resource, I'd recommend Child Mind.
posted by Winnie the Proust at 9:54 AM on January 15, 2020 [10 favorites]
Like Nantucket, I would encourage your friend to work with a professional on the treatment plan for her 8yo. ADHD can manifest in multiple ways (I bear the scars of that truth), and the treatment can be adjusted for the particulars of the child. That is true both for behavioral treatment and medication. A trained psychologist or psychiatrist can be very helpful in this.
For an online resource, I'd recommend Child Mind.
posted by Winnie the Proust at 9:54 AM on January 15, 2020 [10 favorites]
Hi, I have ADHD. ADHD is at its core a lack of executive function, and understanding this will hopefully help with the situation and where to get the best help. You know what regulates your emotional intensity? Yes, your executive functioning! For many with ADHD, it's not disordered emotions we're feeling (they're valid, someone says something rude = you get angry) but a problem with the intensity at the moment they occur. Imagine a song comes on a radio that previously had silence and the volume was set to 11 instead of 4. Your executive functioning turns that down right away, mine struggles a bit. Sometimes it struggles a lot.
Anyway, this is becoming more and more of a topic among people with ADHD because it's such a huge, incredibly overlooked part of our lives. It has a new buzzword term that has debatable utility/validity, but I do feel it intensely, called Rejection Sensitive Dysphoria.
Dr. Russell Barkley has some incredible videos on the topic of ADHD. This entire playlist is amazing, but please watch this one on inhibition and emotions.
ADHD is terribly named in my opinion (also Dr. Barkley's). Emotional regulation is such a huge part of it. There are coping mechanisms, being aware of it on both ends (child and caretaker), medication, etc. This makes socializing and maintaining friends so hard as a child (and adult sometimes), and I wish I'd been diagnosed and treated so much earlier.
posted by OnTheLastCastle at 9:55 AM on January 15, 2020 [11 favorites]
Anyway, this is becoming more and more of a topic among people with ADHD because it's such a huge, incredibly overlooked part of our lives. It has a new buzzword term that has debatable utility/validity, but I do feel it intensely, called Rejection Sensitive Dysphoria.
Dr. Russell Barkley has some incredible videos on the topic of ADHD. This entire playlist is amazing, but please watch this one on inhibition and emotions.
ADHD is terribly named in my opinion (also Dr. Barkley's). Emotional regulation is such a huge part of it. There are coping mechanisms, being aware of it on both ends (child and caretaker), medication, etc. This makes socializing and maintaining friends so hard as a child (and adult sometimes), and I wish I'd been diagnosed and treated so much earlier.
posted by OnTheLastCastle at 9:55 AM on January 15, 2020 [11 favorites]
It’s incredibly common for kids with adhd to have issues with emotion regulation and distress tolerance. For them, life moves at twice the speed, with twice the input and twice the distractions. It’s exhausting keeping it together all day. I would recommend that the mom start keeping a log of when and where the kiddo has issues and make a note of what happened right before the problem happened (unexpected transition, parent corrected them, sibling screaming, etc.) It could be something that has a really easy solution, like making sure that the kiddo eats their lunch at school so they’re not starving and miserable between getting home and dinner.
This might have been a typo and it probably wasn’t meant unkindly, but a lot of people who have conditions like bipolar disorder find it really degrading to be referred to as “a bipolar,” fyi.
posted by corey flood at 9:58 AM on January 15, 2020 [1 favorite]
This might have been a typo and it probably wasn’t meant unkindly, but a lot of people who have conditions like bipolar disorder find it really degrading to be referred to as “a bipolar,” fyi.
posted by corey flood at 9:58 AM on January 15, 2020 [1 favorite]
It doesn't go away in adulthood for many of us, just for the record. Instead I have learned to cope and manage the intense 30-60 seconds I will feel and then act.
I really want to emphasize that there is a difference between ordered and disordered emotions. ADHD is not disordered emotions like in bipolar. It's the level of excitement/anger that is too intensely expressed/felt before the brain turns it down. I'm normally a very quiet person, but if I get excited, I will without knowing become EXTREMELY LOUD AND HYPER. Whereas depression or mania are disordered states of being.
Though ADHD is very comorbid with depression and anxiety due to internalizing negative traits and negative external responses to your behavior.
posted by OnTheLastCastle at 10:03 AM on January 15, 2020 [2 favorites]
I really want to emphasize that there is a difference between ordered and disordered emotions. ADHD is not disordered emotions like in bipolar. It's the level of excitement/anger that is too intensely expressed/felt before the brain turns it down. I'm normally a very quiet person, but if I get excited, I will without knowing become EXTREMELY LOUD AND HYPER. Whereas depression or mania are disordered states of being.
Though ADHD is very comorbid with depression and anxiety due to internalizing negative traits and negative external responses to your behavior.
posted by OnTheLastCastle at 10:03 AM on January 15, 2020 [2 favorites]
Something you can do for your friend that would be hugely helpful both as an information processor and sort of a benign-but-menacing presence in the room: go with your friend to the doctor and handle the notebook with questions and take down the answers.
There are absolutely therapeutic methods for helping kids with overwhelm, sensory processing, emotional management, coping skills, speech or developmental delays that might be contributing to frustration/outbursts, etc but it needs to be real evidence-based treatment directed by the child's doctor. She's going to need to go in with well-articulated examples of ongoing issues, common triggers, approaches they've tried at home. And she needs to ask, clearly so the doctor doesn't handwave at her, for next steps. Your job is to help her deliver all that information and take detailed notes - asking questions where you don't understand the answer, in case she's too overwhelmed to notice gaps in information - for her to execute those next steps.
posted by Lyn Never at 11:16 AM on January 15, 2020 [3 favorites]
There are absolutely therapeutic methods for helping kids with overwhelm, sensory processing, emotional management, coping skills, speech or developmental delays that might be contributing to frustration/outbursts, etc but it needs to be real evidence-based treatment directed by the child's doctor. She's going to need to go in with well-articulated examples of ongoing issues, common triggers, approaches they've tried at home. And she needs to ask, clearly so the doctor doesn't handwave at her, for next steps. Your job is to help her deliver all that information and take detailed notes - asking questions where you don't understand the answer, in case she's too overwhelmed to notice gaps in information - for her to execute those next steps.
posted by Lyn Never at 11:16 AM on January 15, 2020 [3 favorites]
I work with dysregulated kids and their parents and if I were to give you any advice, it would be to STOP giving your friend advice other than for them to read a few books about ADHD. It's pretty clear she doesn't understand how ADHD presents and what's typical, and to ask a friend to help her diagnose mental illness is the beginning of some really disordered stuff.
She needs to learn about her own daughter's profile, what's special and how she engages in the world, and to get her professional help for coping skills.
I'm saying this because I work with so many parents who do not understand ADHD and have all these ridiculous notions and they make these massive leaps of logic that the kid has serious mental illness or conversely, if they stop eating red dye #4 the ADHD will go away.
Tell your friend to read a book or talk to a clinician about ADHD and step away from the DSM-IV.
posted by yes I said yes I will Yes at 4:02 PM on January 15, 2020 [7 favorites]
She needs to learn about her own daughter's profile, what's special and how she engages in the world, and to get her professional help for coping skills.
I'm saying this because I work with so many parents who do not understand ADHD and have all these ridiculous notions and they make these massive leaps of logic that the kid has serious mental illness or conversely, if they stop eating red dye #4 the ADHD will go away.
Tell your friend to read a book or talk to a clinician about ADHD and step away from the DSM-IV.
posted by yes I said yes I will Yes at 4:02 PM on January 15, 2020 [7 favorites]
Is the child medicated for ADHD? ADHD medications can cause dysregulation in kids.
posted by schwinggg! at 5:44 PM on January 15, 2020
posted by schwinggg! at 5:44 PM on January 15, 2020
ADHD medications can cause dysregulation in kids.
And to be fair, nonmedicated kids with ADHD are also dysreglated.
posted by yes I said yes I will Yes at 5:54 PM on January 15, 2020 [4 favorites]
And to be fair, nonmedicated kids with ADHD are also dysreglated.
posted by yes I said yes I will Yes at 5:54 PM on January 15, 2020 [4 favorites]
Definitely endorsing therapist/pediatrician follow-up. Our child has ADHD and is eight years old, and also displays difficulty managing emotions. As people above have noted, it's not that the emotions are inappropriate, but the strength of response is way out of proportion. (For example, last Friday the kids earned an 'electronics party' where they could bring a portable game or phone to school as a reward for collective good behavior. My kid remembered this event at T minus five minutes before the bus arrives. We told them that we hadn't heard about this event from anyone else and would e-mail the teacher, and would bring the Switch in if it turned out to be real and also today. It turns out to be this coming Friday instead and was indeed in the Wednesday newsletter. However, the mild disappointment of not getting to take the Nintendo to school had him moping and complaining loudly to such a degree that the teacher contacted US and told us that she thought the child was playing video games too much and appeared to be addicted.)
My partner and I both have clinical anxiety and depression, and I also have ADD, which was never diagnosed when I was young. We kind of expected that our child would inherit similar issues, both from genetics and from absorbing parental conduct as 'normal,' so we made a point to spend a lot of time talking about regulating emotions, trying to give them the words to describe feelings and strategies for keeping calm. (Breathing techniques, meditation, "I" statements, taking breaks to be quiet in another room when things get too overwhelming in this one, and so on.) Those have so far been fairly successful; his peers and teachers all agree that he's a weird kid, but he's generally well-regarded and hasn't needed huge amounts of outside support or any special ed programs to date. We did get him on a (pretty common at this school) program where he earns points for good behavior (starting work when told, staying on task without too many reminders, etc.) on a class-by-class basis, with a reward at the end of the day for getting over 80% of the points. That sort of short term positive reinforcement has also seemed to help a lot.
Encourage your friend to discuss mental health with the child's physician and then discuss with school or other caregivers strategies to help them learn to regulate better and succeed.
posted by Scattercat at 3:14 AM on January 16, 2020 [1 favorite]
My partner and I both have clinical anxiety and depression, and I also have ADD, which was never diagnosed when I was young. We kind of expected that our child would inherit similar issues, both from genetics and from absorbing parental conduct as 'normal,' so we made a point to spend a lot of time talking about regulating emotions, trying to give them the words to describe feelings and strategies for keeping calm. (Breathing techniques, meditation, "I" statements, taking breaks to be quiet in another room when things get too overwhelming in this one, and so on.) Those have so far been fairly successful; his peers and teachers all agree that he's a weird kid, but he's generally well-regarded and hasn't needed huge amounts of outside support or any special ed programs to date. We did get him on a (pretty common at this school) program where he earns points for good behavior (starting work when told, staying on task without too many reminders, etc.) on a class-by-class basis, with a reward at the end of the day for getting over 80% of the points. That sort of short term positive reinforcement has also seemed to help a lot.
Encourage your friend to discuss mental health with the child's physician and then discuss with school or other caregivers strategies to help them learn to regulate better and succeed.
posted by Scattercat at 3:14 AM on January 16, 2020 [1 favorite]
Is the child medicated for ADHD? ADHD medications can cause dysregulation in kids.
posted by schwinggg! at 7:44 PM on January 15 [+] [!]
Citation?
posted by OnTheLastCastle at 7:21 AM on January 16, 2020
posted by schwinggg! at 7:44 PM on January 15 [+] [!]
Citation?
posted by OnTheLastCastle at 7:21 AM on January 16, 2020
It's well known that ADHD stimulant medications can cause a lot of side effects, including irritability and insomnia, which can lead to emotional outbursts.
Whereas improvement in emotional lability can be expected for many patients with ADHD, in a small minority, stimulants can induce or worsen emotional lability, through increases in irritability.
Plenty of literature on this, plus confirmed anecdotally in the mom groups I participate in for special needs kids. Also emotional dysregulation is not necessarily present in all kids with ADHD.
If a kid responds to meds with new or intensified behavioral issues, then you consider the meds.
posted by schwinggg! at 9:33 AM on January 16, 2020
Whereas improvement in emotional lability can be expected for many patients with ADHD, in a small minority, stimulants can induce or worsen emotional lability, through increases in irritability.
Plenty of literature on this, plus confirmed anecdotally in the mom groups I participate in for special needs kids. Also emotional dysregulation is not necessarily present in all kids with ADHD.
If a kid responds to meds with new or intensified behavioral issues, then you consider the meds.
posted by schwinggg! at 9:33 AM on January 16, 2020
Response by poster: i appreciate everyone's input - i would VERY much like to clarify that NO ONE is trying to diagnose this kid as bipolar, most of all me. my friend approached me because i have quite a bit of experience with dbt, and she was interested in coping skills. not diagnosis, not medical advice, definitely not medication advice, but *behavioral* coping skills that might help her kid get through the day a little better.
posted by megan_magnolia at 4:05 PM on January 17, 2020
posted by megan_magnolia at 4:05 PM on January 17, 2020
In case it helps your search for skills or how the mom communicates the issue to others, I don’t think “bipolar” is the term you mean. DBT is a treatment for borderline personality disorder, not bipolar disorder (NOT saying kid has borderline PD, to be clear), and distress tolerance issues are not hallmarks of bipolar disorder.
I definitely recommend seeking out a child psychologist—especially one with expertise in behavioral treatments for ADHD—to guide her in relation to skills. There’s a lot of garbage advice out there, and this is really best informed by a professional. It’s not a bad idea to talk to a pediatrician, but they’re more likely to go the med route than the coping skills route..
posted by quiet coyote at 6:00 PM on January 18, 2020
I definitely recommend seeking out a child psychologist—especially one with expertise in behavioral treatments for ADHD—to guide her in relation to skills. There’s a lot of garbage advice out there, and this is really best informed by a professional. It’s not a bad idea to talk to a pediatrician, but they’re more likely to go the med route than the coping skills route..
posted by quiet coyote at 6:00 PM on January 18, 2020
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Rather encourage the mom to simply take observation of behavior/symptoms to the pediatrician and/or kid's therapist.
posted by nantucket at 9:07 AM on January 15, 2020 [30 favorites]