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Ask Selah R, M.S. LPC Your Own Question
Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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I have a stepdaughter who has been pre-diagnosed (not

Customer Question

I have a stepdaughter who has been pre-diagnosed (not confirmed) with having Bi-Polar depression. She goes in to huge rages, and today she actually hit me. Is this normal and how do I react to this? She is only 11 years old, and her rages result in her fighting like you would expect from an adult and not a child. She is currently on 5ml Epilim, morning and evening, and on Risperdal at night and concerta in the mornings. Her rages are often, but most times I am able to diffuse them. There are certain occasions that no matter how I react, they remain out of control and seem to be getting worse. I need help and advice please
Submitted: 8 years ago.
Category: Mental Health
Expert:  Selah R, M.S. LPC replied 8 years ago.
Thank you for trusting JustAnswer with your important question.

Her hitting is not normal nor should it be accepted as a normal part of her diagnosis. She needs to see a counselor who can teach her better ways of dealing with her strong emotions (such as anger management therapy or Dialectical Behavioral Therapy (DBT)).

Her medications may also need to be adjusted in order to help control the anger and irritability symptoms. You may also want to ask her doctors if there is a support group for parents that you can attend in order to learn how to deal with her rages and the stress of this situation. Other parents dealing with children with mental illness can give you a lot of support and tips.

Selah
Selah R, M.S. LPC and other Mental Health Specialists are ready to help you
Customer: replied 8 years ago.
Thank you for your reply which I completely accept. However, what I would really like to know further is how should I deal with this situation when it arises? Her therapist says to try and remain calm and not respond to her, but she is extremely bright and it seems to make her worse whn I ignore or just respond in a quiet manner. I am a human being -- I have raised 3 children who are now adults, and I have never had to deal with this type of behaviour from a child- and in typical human behaviour I find myself also becoming very angry with her at these times.

I find my patience levels getting lower and lower, and I am the one who needs some advice on the best way to diffuse the situation, or to control my own emotions. She does not behave this way in front of her father and tends to have these tantrums only with her mother and now with me as well. I seem to be rising more and more to the occasion, much to my own dismay. She seems to know the correct buttons to push, to get a response from me. Today she actrually hit me because she could not get a rise out of me...which of course blew me away.
Expert:  Selah R, M.S. LPC replied 8 years ago.
You might want to see if you can get this program from your local library or friends who may have already purchased it. But I've seen good results from parents who have used this system: http://www.thetotaltransformation.com/

Some tips for you are to stay calm, keep your tone calm. She's going to escalate into screaming and tantrums and if you follow her up the escalation chain there is no going back. That doesn't mean you ignore her as if she doesn't exist, which can also trigger her to lash out and escalate ("How dare you ignore me!").

If she starts escalating try different ways to help her calm back down. Sometimes asking the child to have a seat, to try to put what they are feeling into words, or even squishing Playdough in their hands until they can get the words out can help.
  • Engage, listen and remind her of that: "I hear you."
  • Repeat what you've heard, being sure to capture the emotions: "You feel angry because you can not go to the movies tonight. I would feel angry too."
  • Remind her why this negative event has happened: "Do you remember being told that if you didn't clean up your room before 4pm that you wouldn't be allowed to see the movie?" You're not placing blame, but you're reminding her that she had a part in creating the situation.
  • Encourage her to make better choices: "If you clean up your room before 4pm tomorrow, you can go see the movie tomorrow."
  • Redirect her behavior by giving her options: "Which would you like to do now, A or B? (color, read a book, play a games, take a walk, whatever, something healthier than throwing a tantrum).
Sometimes you have to call for a time out, for either you or her. Grab a timer or turn on a timer on the microwave and say "We both need five (or 10) minutes to calm down before we talk about this any further. When this timer goes off, we'll pick this discussion back up (in the kitchen, the livingroom, some place that feels neutral)." Then, don't spend your 10 minutes stewing. Find your calm place, do deep calming breaths, pray, count to 100, say the alphabet, whatever helps slow your mind and calm your own anger back down.

Remind her that hitting is NOT ok. Give her the Playdough to squish in her hands like dough. And as she calms down and gets some of the adrenaline out of her system, ask her to try to verbally tell you what she's feeling. By asking her to use verbal words you're asking her to use a different part of her brain, a more advanced part of her brain, than the part where the rage and hitting is coming from.

For kids her age that can be tough because they may not know enough words to be able to express what they are feeling. You might need to print a list of feeling words off the Internet and start teaching her new emotion words. You should do this while she is in a calm time. Make it like homework. Can she pick two or three of those words every day, tell you what they mean, and what made her feel that way today.

Best wishes,
Selah
Customer: replied 8 years ago.
I am very satisfied with the way you answered as this is what I try my best to do. However, I would like to say that I searched the internet for many hours last night, looking for answers to disturbing questions that I had, in deasling with this child whom I really have only had an eight month realtionship with.

I would just like to point out something that became very apparent to me during my search, and contradicts what you informed me in your first reply.

The rages are very much part and parcel of children with Bi-Polar disorder, and I think that perhaps you might want to check out the sites for yourself. I merely typed into google "how to handle a child with bi-polar" This is where I found your siute first but then went on to click on many sites, and found that this issue came up many times.

Unfortunately when she is in a rage, there is no such thing as trying to calm her, trying to ask for time out, or trying to calmly bring her down. I have tried almost everything except actually lash out, which I feel I am close to because my stress levels are too elevated. This is the main reason I sought help here, because I needed confirmation that remaining calm was definitely the best option.

However, I have indeed enjoyed your responses, and I find they have indeed been helpful in re-inforcing what I thought, and in to bringing me back to the reality of the issue at hand.

many thanks and regards

Lee
Expert:  Selah R, M.S. LPC replied 8 years ago.
rages definitely do happen in children with Bipolar Disorder. But too many parents chalk up hitting as "part of the disorder" as if it can not be changed. Not all children with Bipolar hit (and when they do it is usually aimed at peers or objects), it is not part of the diagnostic criteria, and they need to be taught other ways of handling their rage because of the risk involved (imagine if they started hitting other kids at school, which would open up legal issues and possibly get them removed from school).

Children who routinely attempt physical violence towards others or animals need to be evaluated for a Conduct Disorder and Oppositional Defiant Disorder as well.

Best wishes,
Selah