Anger Outbursts in Children and Adolescents

The concept of anger is a symptom that can be seen in many mental health disorders, especially in child psychiatry. The key is understanding why the child is experiencing anger or outbursts. Sometimes, parents find themselves unable to stop or deal with these behaviors, or they may inadvertently escalate the situation by engaging in stubbornness or power struggles. Ultimately, when anger outbursts become a primary issue in a family’s life, they often seek help from child and adolescent psychiatrists.

Anger outbursts can be part of a broader range of conditions, such as ADHD, conduct disorders, oppositional defiant disorder, and adjustment disorders, among others. There is also aggression, which is often accompanied by anger outbursts. However, not all children who get angry exhibit aggression. In many cases, aggression is a consequence of the anger outbursts.

It's important to note that having anger outbursts doesn’t necessarily mean the child has a mental disorder. Anger itself is not an abnormal concept. Just like every person has their anger threshold, every baby, child, and adolescent also has an anger limit. These limits are influenced by temperament and vary from person to person. Some individuals are more prone to experiencing anger outbursts than others.

Let's discuss the issue in relation to babies, children, and adolescents:

For a baby (0-4 years), it’s important to distinguish whether the anger outbursts are related to neurodevelopmental disorders or if they’re emotionally and relationally linked to their connection with their mother. Even an inadequate attachment from the mother can trigger such behavior. However, some children experience anger outbursts simply when their desires are not met in the moment. For many of these children, there may not be any emotional causes, but because the behavior seems chaotic and harsh from the outside, parents often interpret it as something that deeply upsets the child. This often leads to increased affection and love. The problem, however, lies in reinforcement: when love, comforting words, or physical affection are offered during the outburst, the behavior is reinforced and becomes stronger. Over time, this can lead parents to feel increasingly helpless and inadequate, and they may eventually seek external support.

The presence of anger alongside crying is significant. When there’s anger, we shift our focus more towards neurodevelopmental issues and reinforcement dynamics, rather than emotional problems. However, it’s wrong to make a definitive judgment like "anger leads to neurodevelopmental issues" without considering each case individually. The family’s attitude and the child’s temperament play a significant role in the child’s emotional and behavioral development.

Identifying the internalized issues behind anger outbursts is extremely valuable. Often, children use anger as a means of expressing themselves, and this can be related to subconscious processes. We don’t expect the child to immediately understand what triggered their anger. The parent may not fully understand it either. Especially with younger children, using play as a tool provides valuable insights.

In older children, relational factors become more important. It’s critical to understand the emotional causes and internalized issues that might be at play. While neurodevelopmental mental disorders may be present, understanding when the child experiences anger outbursts, whether they lose control, how they regulate themselves during the outbursts, how long they last, and how the outburst concludes is key. The presence or absence of regret after an outburst can also point to the underlying causes of the anger.

Adolescents and their anger outbursts… What should we say about them?

First, it’s likely completely normal. Most families know this and just think, "It’s part of adolescence." But we should not forget that even in adolescence, there is often a reason behind the inability to regulate emotions. Just brushing it off as "adolescence" and moving on may not be enough. There are likely deeper reasons that we don’t have to search too hard to uncover.

An adolescent is a world unto themselves, but when they frequently exhibit anger outbursts, parents need to carefully read the process to understand what these behaviors mean. After all, the adolescent is not a child anymore, and the behavior is likely driven by underlying reasons. Sometimes, it’s necessary to offer feedback about how they might be feeling: "I can see that you seem unhappy and very upset. If you'd like, I’m here to listen without judgment." These "open-door" messages can be crucial for the adolescent.

Finding someone trustworthy, who won’t judge, and who can truly empathize and understand the adolescent's inner turmoil, is essential. Often, the difficulty lies in finding someone to share with, and trust is the key factor in this.

When there is a neurodevelopmental background to the anger outbursts, we plan to work on this in therapy and provide the necessary treatment. Often, this approach proves effective. However, when anger stems from post-traumatic stress disorder, exploring the trauma behind the anger requires more effort and a high-quality therapeutic relationship. The therapeutic process starts by building a relationship with the adolescent and gradually uncovering the challenges they’ve faced. This process may sometimes lead to confronting painful memories.

Sometimes, we may encounter a world of chaos hidden within.

For this reason, starting the process of sharing with a therapist is crucial, especially with a professional who is a psychiatrist specializing in adolescents. Many healthcare professionals claim to work with adolescents, but they may not be psychiatrists, or they may be adult psychiatrists without specialized training in adolescent psychiatry.

Working with adolescents requires high sensitivity.

Anger outbursts, though common, also require high sensitivity to address their underlying causes effectively.

Stay calm…