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Teen rage: mental disorder or psychological crisis?

Published: Friday, Aug. 24 2012 10:41 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) 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.

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) 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)

"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.

Criticism

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."

17 year old Amber Walker talks with her parents Scott and Stephanie Richardson as they wait in the waiting room to have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News) 17 year old Amber Walker talks with her parents Scott and Stephanie Richardson as they wait in the waiting room to have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News)

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

17 year old Amber Walker and her parents Scott and Stephanie Richardson have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News) 17 year old Amber Walker and her parents Scott and Stephanie Richardson have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News)

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.

17 year old Amber Walker and her parents Scott and Stephanie Richardson have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News) 17 year old Amber Walker and her parents Scott and Stephanie Richardson have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News)

To say that a teen's anger was provoked by something comparatively miniscule is a total misreading, said Carl Pickhardt, psychologist and author of 25 books on adolescents and teen anger. Those small things are big things in disguise; they are symbolic.

Parents are often taken aback by the way a teen overreacts to something small that they did or didn't do, Pickhardt said. "All of a sudden a small thing is illuminated as a huge issue."

After an angry reaction, parent and child often want to put things aside and decide to leave it alone, Pickhardt said. "But that's a mistake. Because there is some really important data here that needs to be looked at."

Teens need to learn to identify what triggers their anger and how they typically respond when angry, Lohmann said. "Anger is a highly-charged, explosive emotion." Often, parents know what irritates their teen, such as loud noises or nagging. Discovering how to prevent those pet peeves and helping a teen cope with them can reduce the tension.

17 year old Amber Walker and her parents Scott and Stephanie Richardson have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News) 17 year old Amber Walker and her parents Scott and Stephanie Richardson have a short visit with Matt Larson lcsw Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News)

If the teen needs time or space, parents should respect that and avoid pushing their child to respond immediately. Teens should learn how to take a timeout and collect their thoughts, giving them a place where they can seek respite. Lohmann suggests cutting the overhead lights or encouraging them to retreat to an outlet such as a physical activity, music or a book.

Emotional literacy

A major root of anger lies in the inability to positively communicate feelings. Often when teens are cut off from their emotions, they are unable to talk about their feelings, which inhibits them from receiving the kind of supportive response that diffuses the anger, Pickhardt said.

One thing parents can do to combat anger early is to teach the child "feeling words" as soon as the child has gained command of words, Pickhardt said. When a 3-year-old in a fit of anger takes a swat at her father, he must tell the child it is not OK to hit and teach her to use the word "angry" the next time she has the urge to hit. It's important to teach the child to identify these feelings, to put words to them to connect them with experiences.

Matt Larson lcsw talks with 17 year old Amber Walker and her parents Scott and Stephanie Richardson about how they felt the therapy sessions went during a short visit with Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News) Matt Larson lcsw talks with 17 year old Amber Walker and her parents Scott and Stephanie Richardson about how they felt the therapy sessions went during a short visit with Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News)

"What you want is emotional literacy," Pickhardt said.

The value of anger

We are a country that has a hard time with anger, Pickhardt said. He called entertainment media a "marketplace phenomenon" in which very powerful market forces are frantically competing with more and more extreme material to attract attention.

Americans appear to enjoy anger in movies, for example, but struggle with it in daily life. "We don't appreciate it, we don't honor it, we don't respect and we don't use it for what it can do to teach us," Pickhardt said.

Anger has spawned a number of important developments, Lohmann said, from the civil rights movement to women gaining the right to vote to mothers against drunk driving.

17 year old Amber Walker wrights a note to therapist Matt Larson lcsw as she and her parents Scott and Stephanie Richardson wait to visit him Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News) 17 year old Amber Walker wrights a note to therapist Matt Larson lcsw as she and her parents Scott and Stephanie Richardson wait to visit him Tuesday, Aug. 21, 2012 in his Salt Lake City office. (Scott G Winterton, Deseret News)

"I could go on and on about the organizations created because someone felt something was unjustified and they took that emotionally charged anger and pushed it into something positive that bettered society," Lohmann said.

Sometimes teens merely need a nudge in the right direction. "One thing I do know now is that it's worth not giving up on our teens, even when we're tempted to," Tynan-Wood said. "Sometimes pushing them beyond their comfort zone is exactly what will bring a smile to their face."

Email: rlowry@desnews.com

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