Teen rage: mental disorder or psychological crisis?

Published: Friday, Aug. 24 2012 10:00 p.m. MDT

Scott and Stephanie Richardson and their daughter 17 year old Amber Walker have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office.

Scott G Winterton, Deseret News

It was the same question she had asked about the dent in the fridge and the hole in the wall: Why?

"Why did you burn Dr. Epstein's book?" Christina Tynan-Wood asked her 14-year-old son, Cole, who towered four feet above her, after she found the book she'd been reading in the fireplace.

"You have to stop reading all this (stuff) about how to control me!" Cole screamed, his face reddening.

It wasn't his first outburst. And like the others, it troubled his mom.

As teens straddle the line between childhood and adulthood, many exhibit frightening signs of rage that may be more serious than hormonal mood swings. Nearly 6 million teens meet the criteria for intermittent explosive disorder, showing a pattern of persistent, violent, unwarranted anger attacks that aren't related to substance abuse or a medical condition. Fortunately, experts say they can provide solid, research-based tools that parents of teens with anger problems can use to understand their teens and help them combat their anger in positive ways.

"The problem is enormous and the need for interventions is urgent," Ronald Kessler, the lead researcher and Harvard Health Care Policy professor, wrote to the Deseret News.


Intermittent explosive disorder has sparked controversy since its formal approval as a mental disorder diagnosis in 1980, said Christopher Lane, author of "Shyness: How Normal Behavior Became a Sickness." Skeptics worry that these startling statistics could trigger a "manufactured epidemic" that labels extreme cases of typical adolescent behavior as mental illnesses that require drugs that may have long-term effects.

The criterion for the disorder, Lane said, remains debatable. As teens face the pressures of job loss, home foreclosure, poverty, debt issues and drug and alcohol addiction, "it's still a big, unsettled question whether their periodic anger and threatened or actual violence should be considered a lifelong mental disorder rather than a psychological crisis."

Uncontrollable anger outbursts and related violence are undoubtedly critical issues that demand attention, Lane said. But so is telling teens that their anger attacks signify a mental illness that requires medication.

While 38 percent of the study participants with intermittent explosive disorder received treatment within the year prior to the study, only 17 percent of those teens had been given treatment specific to anger.

One thing the study shows, professional school counselor Raychelle Lohmann said, is that a lot of angry teens do not know how to cope with emotion. "As professionals, educators and parents, we need to do a better job of reaching out to these teens." When you go back to the physiological effects that emotion can have over a course of time, Lohmann said, "It's pretty scary."

Underlying issues

Tynan-Wood speculates that her son's anger is grounded in frustration. At 14, Cole is too young to drive, work or open a bank account. "When I stopped to think about how frustrating that must be for a tall, intelligent, able man in the prime of life, I felt like flying into a temper, too."

Anger often conceals other emotions — fear, anxiety, hurt — at the base of the reaction, Lohmann said: "It is almost a Band-Aid emotion that we throw on top of other things." Lohmann works with angry teens by digging in and exploring their true feelings. Once they are able to identify that they are hurt or frustrated, she works on that emotion.

Tynan-Wood asked her son if he had read the book he had burned: He hadn't. She told him it was about treating teens like adults. Cole pulled the book from the fireplace and handed it to her, suggesting that there were still some readable pages. The anger began to disperse.

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