child upsetThe anxiety generation.

The tantrum generation.

What is going on?!

What is with the huge jump in anxiety and anger in our kids? New diagnoses are actually being created to describe this new level of need. 

In the United Kingdom, there is now Pathological Demand Avoidance Syndrome (PDA) for those kids who become anxious with almost any demand. And not a little anxious. These kids are freaked out by common daily events, such as going to the park or school. PDA is slowly filtering over the Atlantic Ocean and being brought up by parents in the US for their kids who anxiously avoid the typical adventures of childhood.

In the United States, we had to make a new diagnosis in the last Diagnostic Manual (the DSM-5), used by psychologists and psychiatrists. Many kids were being labeled Bipolar due to extreme anxiety or meltdowns. Researchers were monitoring these children and realized they were not growing into bipolar adults as expected. Their meltdowns, outbursts, and tantrums were not progressing to a depression/mania cycle in adulthood.

So the diagnostic “powers that be” created a whole new category: Disruptive Mood Dysregulation Disorder (DMDD). It is basically for children and adolescents who are melting down or having tantrums several times a week outside of age-expected ranges. 

mom and childThis stuff is for real. Frazzled parents everywhere are wondering what they did wrong….and, more importantly, how to fix it.

There are many issues at play here. It’s not poor parenting. It’s not a spoiled child. And for those kids with trauma in their history, it may not just be the impact of the trauma (though trauma will alter brain chemistry as well). We have got deep factors at play, as well as the obvious ones.

There are some great “top down” strategies that have emerged to help parents with kids who cannot control their anger or anxiety.  Any parent of an extremely angry or anxious child can tell you that “old school” strategies of bribes or punishments just don’t work with these kids.

The new strategies of modeling calm and reason work better. Ross Greene’s Collaborative Problem Solving (CPS) is great. Karyn Purvis’ Trust-Based Relational Intervention (TBRI) is also highly attuned to the needs of children with extreme emotions.

And I love this ad of Santa Claus rethinking the concept of naughty.

But top-down strategies are often not enough. Firm, consistent, loving, active parenting is not working (or not working well enough) for many families.

As it turns out, solutions may be found in Child Decoded‘s philosophy from the beginning: dig deeper, especially into biological systems of the body that can have huge impact on emotional regulation, cognitive function and focus.

There are several systems in our body that are closely intertwined and affect a child’s ability to cope with the world.

  • Sleep.  Poor sleep or not enough sleep doesn’t just make a child grumpy. It affects cognitive ability.  More importantly, it affects the immune system and causes inflammation in the body and brain. Important things are happening when we sleep and these are necessary to stay healthy physically and mentally.
  • Pollution. We are just starting to understand the impact of the chemicals that we are now commonly exposed to. This is thought to be a factor in the rise of auto-immune disorders. That, in turn, is linked to changes in the body and brain. Air pollution has been linked to increased anxiety.  The Learning Disability Association has initiated the Healthy Children Project to educate people regarding the impact of toxins on learning and behavior, as well as to reduce these exposures.
  • Diet, Nutrition, and Gut Health. Our diets, quality of food, and gut health have changed drastically in the last hundred years or so. Don’t think that is not having an impact on our children’s brains. I see some poorly regulated kids who have poor diets, but I also have parents who serve extremely healthy diets and their kids still can’t regulate. That’s when I wonder if gut health is a problem. A good diet may help some, but it is not healing that gut. Our understanding of the relationship between the gut and the brain continues to grow. It is an amazing relationship, but one that is not obvious to most of us.  There is a similarly close relationship between our gut and our immune system that also impacts mood.
  • Inflammation (related to sleep, gut health, and immune system health). Arthritiswoman stomachcauses inflammation in the joints. A sinus infection causes inflammation in our sinuses. We can also have inflammation in our brains. A simple strep infection can trigger an inflammatory response in the brain if the immune system has a faulty response. There are the big problems related to injury or illness (such as meningitis and PANDAS, the aforementioned strep reaction). But what if there is a chronic low level inflammation in the brain secondary to diet or poor immune health or some other deep system factor? We are increasingly linking inflammation with our mood. There is even a relationship between bipolar disorder and inflammation.

And all of these systems are closely intertwined. You can’t separate sleep, immune system, gut health, inflammation and brain function. We just don’t think about these hidden relationships much.

For some parents, this information might be scary. More things to worry about?

But this is for the parents in the trenches with their extremely anxious or angry children. They are already trained in CPS and TBRI.  They have a therapist on board to support their child and a parenting coach to advise them. But they still struggle.

For these parents, I say, “You may have to dig deeper.”  This is why we wrote Child Decoded.  Interventions at the top without considering the deeper issues will be like driving with the brakes on.

What can a parent do? Here are some possibilities:

  • We certainly realize the benefit of good psychiatric and psychological support. Western medicine does have options aimed at keeping a child safe and more able to participate in daily activities.
  • Look for a functional medicine doctor (there are even functional medicine child psychiatrists) who can look at gut health, the immune system and possible inflammation.
  • Look for an experienced nutritionist, one that focuses on children with learning or behavioral challenges. A healthy diet may not be enough if gut health is askew.
  • With the guidance of a physician or nutritionist experienced in pediatric nutrition, check out the biomedical protocols that are being used to support children at these deep levels.Some, like GAPS or FODMAP, are quite complex. But some, like the Nemechek Protocol, are fairly simple and easier to maintain. Here is one parent’s story.

With extreme anxiety or extreme anger, don’t blame yourself and don’t blame your child. This child does not feel good. Use the good top down strategies, but also go deep. Look into the very foundations of your child’s biological functioning to see if there are ways to help your child feel better.

As Ross Greene says, “Kids do well if they can.”