What it is:
Mood concerns in youth typically involve a pattern of intense and fluctuating emotions combined with the tendency to behave impulsively when emotions are present. We often think of this as “emotion dysregulation”, as it can occur across a wide range of situations and emotions. Youth struggling with emotion dysregulation have emotions that fire easily and quickly (we call this emotion sensitivity), fire very intensely (we call this emotion reactivity), and take a long time to go back to baseline. These difficulties with emotions can lead to emotions or moods that last for hours or days, sometimes with no apparent cause.
Emotion dysregulation or mood concerns can be pervasive, meaning that your child struggles with multiple emotions (e.g., anger, shame, anxiety), or more specific, meaning that your child struggles intensely with one emotion (e.g., panic or anger). In addition, your child may respond impulsively to big emotions, which is usually an attempt to get the emotion to go away (think about emotions as a hot potato). Impulsive behaviors that children may use to regulate emotions could include:
- Taking their emotion out on others (e.g., saying something they don’t mean, threatening, yelling)
- Having screaming or crying fits that are inappropriate to their developmental stage
- Becoming defiant or oppositional to parents or adults
- Throwing or destroying, things, or becoming physically aggressive
- Hurting themselves by biting, head banging, scratching, or hitting themselves
- Running away, hiding, or trying to escape the situation, sometimes in dangerous ways (e.g., running away towards a busy road)
The intense emotions combined with impulsive behaviors can create difficulties in several areas, including difficulties with school, relationships, and/or a sense of self.
Emotional dysregulation difficulties occur on a spectrum for all kids. Developmentally, it is normal for children to have stronger and more frequent emotions and fewer skills than adults for coping with them. Lower level concerns with emotion dysregulation may look like a youth who can function fairly well in day-to-day life (e.g., attending school, spending time with peers), but is often distressed or exhausted by managing their emotions. Moderate concerns may involve greater impairments in functioning, such as more regular or intense tantrums that lead to frequent conflict at home. Youth with severe difficulty with emotion dysregulation may struggle substantially with engaging in school, keeping friends, and getting along with family. These kids frequently have large tantrums marked by physical aggression, prolonged screaming and crying, and extreme statements, including threats of suicide.
Does This Sound Familiar?
- Your child is often moody
- Your kid has angry outbursts or tantrums that may involve yelling, crying, threatening, attempting to run away or break things
- Your child melts down frequently when told “no” or given corrective feedback
- On more than one occasion, your child has said frightening things when distressed such as “I want to die,” “I will kill you,” or harmed themselves by hitting their own body or head-banging
- Your child bounces quickly from emotional extreme to emotional extreme, spending very little time feeling neutral or calm
- Your youth is bothered by things that other kids seem to be able to handle much more easily
- Parenting strategies that have worked well with other children in the home don’t seem to create the same result with this child.
- Your child may work very hard to hold it together outside the home but act like a “completely different kid” when with family.
Associated Concerns:
- Anger can lead to highly problematic behaviors, particularly in adolescents with mood concerns. This may include physical or verbal aggression and interpersonal hostility.
- Children with mood concerns often struggle with chronic anxiety or Obsessive Compulsive Disorder. This underlying distress may be exhausting their ability to cope, leading to more pervasive dysregulation.
- Neurodivergent youth (ADHD, Autism) often struggle with regulating emotions due to broader challenges with executive functioning. Additionally, higher sensitivity to sensory inputs, social challenges, and a greater need for predictability and control all increase the frequency of mood challenges.
Dysregulated children sometimes experience suicidality and self-harm, which can be understandably quite distressing to parents. This most typically looks like “wanting to die” when overwhelmed with emotion, hitting, or scratching themselves. Our child providers are highly-experienced in the assessment and management of high-risk behaviors.
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