Nervousness in children and adolescents should not always be seen as a major problem. It must be recognised and treated with respect. But the aim is not to suppress or destroy feelings of anger in children or ourselves. Rather, the objective is to accept them and direct them to constructive ends.
One of the main problems we face when dealing with anger in children is the anger it arouses in us. We have to remember that we weren’t always taught how to deal with this feeling as children either.
Parents and teachers need to allow children to experience all the feelings they have. What we need to aim for is to give the little ones acceptable ways to expressthemselves.
Anger outbursts should not always be seen as major problems; they should be acknowledged and treated with respect.
Here are some signs that emotional outbursts should worry you:
• If children’s temper tantrums occur beyond the age at which they are expected (up to about 7-8 years old)
• If this behaviour is dangerous to them or others
• If this behaviour causes them serious problems at school and teachers tell you they can’t control it
• If they are upset because they feel they can’t control their anger and it makes them feel bad about themselves.
Nervousness in children and its treatment
How to understand nervousness in children
Most children have tantrums when they are nervous. Sometimes they can explode if frustrated or become defiant if asked to do something they don’t want to do. When they do this repeatedly or can’t control their angry outbursts most of the time, it could be more than just typical behavior.
When children continue to have emotional crises. It is usually a symptom of a dissatisfaction. The first step is to understand what triggers your child’s behaviour. There are many possible causes, including:
Causes of Nervousness in children and adolescents
- Anxiety: Children’s nervousness and defiant behaviour often have serious, unrecognised anxieties. E.g. avoidance of painful feelings, fear of failure, low self-esteem, feelings of isolation, sadness, depression, etc. If your child has anxieties, and especially if he hides them, he may find it difficult to deal with situations that upset him. He/she might explode when, for example, the demands of school put pressure on him that he can’t handle. They may refuse to do a certain thing to avoid the source of acute fear.
- Trauma or neglect: Much violent behavior at school is the result of trauma, neglect or chaos at home. Children who don’t feel safe at home can act like little terrorists at school, developing bullying behaviors.
- Learning disabilities: When your child has repeated tantrums at school or while doing homework, they may have an undiagnosed learning disorder.
- Sensory problems: Some children have trouble processing the sensory information they receive from the world around them. If your child is hypersensitive to stimuli, then things like ‘itchy’ clothes, too much light or too much noise can make them feel uncomfortable, anxious, distracted or overwhelmed. This can lead to tantrums for no apparent reason.
Causes of Nervousness in children and adolescents
- ADHD: many children with ADHD, especially impulsive and hyperactive children, have problems controlling their behaviour. They may find it very difficult to follow instructions or switch from one activity to another, and this can make them appear defiant and angry. This does not necessarily mean that they have also been diagnosed with ADHD – in fact, this diagnosis is often ignored in children with severe aggression problems because other issues seem more serious.
- Autism: Children with autism are often prone to temper tantrums. If your child has this condition, they may tend to be stiff. They require a constant routine to feel safe. Any unexpected change can trigger a Nervousness in children and adolescents breakdown that will continue until exhaustion sets in. They may also lack the communication skills to express their wishes or needs.
- Opposition disorder. Opposition Disorder is a behavioural disorder present in children over 6 years of age. Symptoms may appear earlier, but the diagnosis is made after this age. Children with Opposition Disorder are difficult to control, they do not follow the rules set by their parents, they are stubborn, angry, aggressive; (they may raise their hand to their mother or even hit her, scratch her); they have a hard time tolerating refusal from others – for example, their mother’s refusal to buy a new toy, getting easily annoyed and at those moments they cry, scream, deliberately hit objects around them.
The source of this behavior
At present there is no unanimously accepted, clear cause of this disorder. However, it is believed that inherited factors as well as environmental factors are at the root of the condition.
Genetic inheritance: the child’s natural disposition, or certain neurobiological differences in the way the nerves and brain work, or even certain imbalances of certain brain chemicals (e.g. serotonin). Temperament is genetically inherited, it is not influenced by the child’s experiences. From a genetic point of view, it has been found that a polymorphism of the MAOA gene (monoamine oxidase A, a gene involved in the regulation of serotonin, adrenaline, norepinephrine, dopamine levels) can lead to antisocial behaviour in children who are treated inappropriately (Caspi A et all, 2005).
Environment – parenting problems which may involve: a lack of supervision; inconsistent or harsh discipline; abuse or neglect; the existence of serious problems in the parents’ marriage, basically an unstable family environment.
An insecure attachment leads to increased aggression in boys in early grades and conduct problems at school. Other factors blamed are poverty, poor family functioning and crime. (I Dobrescu – Manual of Child and Adolescent Psychiatry).
What are the risk factors
Conduct and Oppositional Defiant Disorder is a complex problem with several possible factors, such as:
- Temperament – a child who has a temperament that includes difficulty regulating and managing emotions, such as extreme emotional reactivity to different situations or difficulty tolerating frustration.
- Parenting problems – a child who has experienced some form of abuse but also family neglect, harsh or inconsistent discipline or lack of parental supervision.
- Other family problems – cases where a child is experiencing a family disorder or has a parent with a mental health disorder.
- Environment – oppositional and defiant behavior can also be reinforced by peer attention and inconsistent discipline from other authority figures such as teachers.
How can I avoid nervousness in children
Protective factors for conduct disorder are secure attachment. A predictable and consistent parenting style applied by all adults in the home (predictability gives the child a sense of security) and harmonious relationships between family members.
However, improvement in family conditions does not always correlate with improvement in symptoms. It happens especially when the child has comorbidities (such as ADHD, mental retardation).
How common is Nervousness in children and adolescents
Kapplan and Saddock (Comprehensive textbook of psychiatry) say that the prevalence of this disorder is between 1.7 and 9.9%, with an average of 5.5%. In DSM IV a prevalence of 2-16% is reported. Other authors have reported a prevalence of 2% to 10% (Maughan et al, 2004; Costello et al, 2003). This disorder occurs more commonly in boys than in girls.
Nervousness in children and adolescents – symptoms
Children with Opposition Disorder are quick-tempered, easily angered and always fighting. They don’t follow the rules, they are always fighting the parents. They always seem to be on the spot and blame others for their mistakes. They are not accepted by the other children because they spoil their game. They don’t play by the rules, get easily upset and break or take other children’s toys. They have a hard time making friends because of this behavior, and they generally befriend children who have the same behavior time. They are dismissive, spiteful and even vindictive. As they grow older, they begin to realize the rejection and resentment of others (including family) and hostile behavior worsens. Hitting, destroying objects belonging to others (DSM IV, ICD 10).
It will be distinguished from the opposition crisis, which occurs in the period 2-5 years, the period of “no”, “because I want to”, this is the period in normal development when the child realizes that he is an individual person, separate from the will of the parents. In its opposition crises, the child does not show ill will towards adults. He/she feels guilty and is afraid of losing his parents’ affection. Opposition is one of the child’s most common defence mechanisms. If this type of seizure persists after the age of 6 years, we are talking about pathologization and the onset of oppositional defiant disorder.
Treatment of nervousness in children
For the treatment of neuroses in children, psychotherapy is the most indicated. It aims to regulate the situation in the family, improve the system of relationships in marriage and correct education.
Main symptoms of Nervousness in children and adolescents
- Angry attitude,
- Frequent loss of temper,
- Annoyance easily, sometimes for no real reason,
- Frequent arguments at school, with teachers or peers,
- The habit of not following the rules, of simply defying them,
- Blaming other people for your own mistakes,
- Lack of self-respect,
- Difficulty maintaining friendships,
- He/she is mean to other people, including family members,
- The desire to deliberately upset or annoy other people,
- Desire for revenge,
Such manifestations can occur in all children, but they become a problem when they last more than 6 months and the abnormal behavioral manifestations are quite severe. These children also have difficulties in their relationship with their families, they often argue with their parents because they are often hostile, even aggressive.
Most of the time, this disorder also leads to the development of other mental problems such as:
- Serious learning and communication disorders.
Last but not least, this disorder brings with it other problems. Specifically, the child may have poor school performance, antisocial behavior, substance use disorders, increased risk of suicide.
It is therefore essential that the parent understands that the child has such a problem. It is important to go with him to the specialist for a correct diagnosis and appropriate treatment. It is also important to mention that treating mental disorders helps to relieve symptoms of Nervousness in children and adolescents. At the same time, it should not be forgotten that it is difficult to treat conduct and oppositional defiant disorder if the other disorders are not assessed by a psychiatrist and psychologist and treated appropriately.
Forms of mental disorders related to Nervousness in children and adolescents
The treatment of child anxiety primarily involves therapeutic interventions that focus on the family. But it can also include other types of psychotherapy and training for the child as well as the parents. But the treatment is long-lasting. Basically it can last from a few months to a few years, depending on how severe the disorder is. Extremely important is to treat other problems that occur at the same time. E.g.: learning disabilities, ADHD, depression, etc.. Otherwise, they lead to worsening of the characteristic symptoms of conduct and opposition disorder.
The psychiatrist will only prescribe medication to the child if the child is also diagnosed with other mental health disorders. Also, if your child has co-existing disorders such as ADHD, anxiety or depression, medication will help and relieve symptoms. This will make therapy more effective. Thymostabilisers, typical/atypical antipsychotic medication and ADHD-specific medication are used.
Specifically, there are currently no drugs for this type of disorder. They are beneficial if used as an adjunct to cognitive behavioral therapy.
Family counselling and family therapy
Counselling will help parents (and other adults involved in the child’s care) to look at and be aware of their behavior and reactions to the child. They will also see the conflict between them regarding each other’s educational style. In most cases it is a disagreement between the parents. Usually one parent tries to impose the rules and enforce the consequences, while the other parent gives the child everything he or she asks for and cancels the punishment (consequence). It happens to pity the child, saying that the other parent is bad, thus undermining the authority of the parent who imposes the rules. In the case of boys with opposition disorder, it is advisable for the father to take more responsibility for their education.
Targets will be set with the family and will focus on ignoring inappropriate behavior. (the parent’s reaction is a reward – the child gets attention), and desired behaviour swill be rewarded. The child will be told which behaviors are good and which are bad. The adults in the home will agree on a set of rules and the consequences of breaking them. They will explain them to the child, and work out a reward with the child for following the rules. The reward should not be very expensive or, at best, not a financial reward. (e.g. going to the park and spending more time at the playground). Adults’ response to children’s unwanted behavior must be predictable and immediate. When all adults behave in the same way, the child will learn what the limits are and will gain a sense of security that will gradually change his/her behavior.
Behavioral therapy sessions aimed at developing problem-solving skills are recommended. Individual treatment is not used at young ages.
When the child is disobedient, defiant and oppositional, it is a natural sign of development. But when these manifestations are frequent, aggressive and you no longer get along with him/her, you should go to a specialist, because he could be diagnosed with conduct and opposition disorder.
The disorder is usually diagnosed around the age of 7, when the child starts school, but there are also cases where the diagnosis is made in adolescence.
A range of therapies can have positive consequences for the child. It should also be stressed that the child can benefit from supportive therapy, play therapy and family psychotherapy. For example: family psychotherapy is used because it helps to improve family interactions and communication. This type of therapy also leads to optimizing the emotional climate and increasing cooperation and support activities between members.
Parents and grandparents play an important role in treating a child’s opposition disorder. Basically, both parties need to be taught what changes to make in order to reach a favorable outcome for the child and especially not to maintain the child’s symptoms. This is why parental counselling is also particularly important.
This is a predominantly educational therapeutic method that involves training parents in the use of techniques designed to relieve the child’s nervousness. In this way, the therapist will help parents to change the way they relate to their child and create new and more effective ways of handling their relationship with their child. At the same time, they are trained to understand when they can be permissive and when they should be authoritative with the child. At the same time, parents are taught ways to solve problems when they arise. Essentially, to achieve positive outcomes, parents and therapist need to form a united and functional team, with the goal of helping the child overcome these disorders.
Tips for parents dealing with Nervousness in children and adolescents
- Whatever happens, try to stay calm and especially don’t show your emotions when your child resists,
- Avoid the power struggle,
- When your child has done something good, when he or she has an achievement, don’t hesitate to praise him or her and give credit where credit is due,
- Make a programme as diverse as possible with activities for the whole family to participate in.
- Talk to your child’s psychotherapist constantly.
FIND OUT MORE:
How can you help an “angry” child?
Medication will not necessarily solve defiant or aggressive behavior. It can relieve symptoms of ADHD, anxiety or other disorders, but the real key in these situations is behavioral approaches.
Find out what the triggers are.
The first step in anger management is to understand what triggers your child’s tantrums. If, for example, the moment he/she walks out the door to go to school is one of these triggers, solutions include time warnings, getting his clothes ready and showering the night before and waking up earlier. Some children respond well to having the actions they have to complete posted on a wall in stages.
Praise him/her when he/her behaves. Make comments such as “I like that you come to the table without being told”, “I appreciate you putting your clothes back on even though you were in a hurry to go play”, “Thank you for being patient while we talked on the phone”, etc.
Deliberately ignore inappropriate behavior that may be tolerated. That doesn’t mean ignoring the child, just the behavior. Do this “planned” and consistently. Even if it can be tolerated, the child needs to know that it is inappropriate.
Offer him alternatives to physical deflation. It is important that young children have opportunities for exercise and movement both at home and at school.
Use closeness and touch. Get close to the child. Toddlers often calm down if an adult approaches and expresses interest in their activities. A child about to break a toy, for example, will stop if an adult comes and asks him to show it to him.
Be ready to show your affection. Sometimes, a hug or other affection is all it takes for a child to regain control. Beware, however, that children with serious emotional problems may have difficulty accepting affection.
Blow away tension with humor. Often, a joke will give your child the opportunity to “come out clean”. But be careful, a joke is not being sarcastic, teasing or ridiculing.
Explain the situations. Help your child understand the causes of a tense situation. Often little ones start to react correctly simply by understanding the cause of their frustration.
Encourage him/her to see both his strengths and weaknesses. Help him/her see that he/she can achieve his/her goals.
Use promises and rewards.
Promises of future pleasure can be used to both prompt and stop a behavior. But this approach must not look like a bribe. We need to know what the child likes and keep our promise.
Say NO! Limits must be clearly set and imposed. The child must be free to operate within these limits.
Teach him/her to express himself verbally. Talking helps children gain control and reduces violent behavior. Encourage him/her to say, for example, “I don’t like that you took my pencil. Now I just want to write with it”.
Create a positive self-image. Encourage him/her to see himself as a valuable and valued person.
Use punishment with care. There is a fine line between educational punishment and hostile punishment. DO NOT use physical punishment!
Be an example of appropriate behavior. You must be aware at all times of the powerful influence your actions have on your child.
Be consistent. When a child has tantrums or defiant moments, the reaction of the parent or caregiver affects the likelihood that the behavior will or will not be repeated.
Here are some key facts about nervousness in children
• Don’t give in. Resist the temptation to end your child’s tantrum by giving them what they want at that moment. All you’re doing is teaching him that tantrums work.
• Stay calm. It will be easier for you to teach him that there are clear, consistent consequences if you control your emotions. Overly harsh or angry reactions tend to increase the child’s aggression, whether verbal or physical. By staying calm, you are also modeling for your child the behavior you want to see in them.
• Use consequences consistently. The child needs to know what the consequences are for negative behaviors, such as depriving him/her of things he/she likes, and what the rewards are for positive ones. And you need to show him/her that you will enforce those consequences every time.
• Don’t speak until the Nervousness in children and adolescents breakdown subsides. You certainly don’t want to get into a dialogue with a hysterical child. He/she won’t listen to you. Try a dialogue with him/her after he/she cas calmed down.
Good discipline creates an atmosphere of calm firmness, clarity and rationality. Bad discipline means harsh and inappropriate punishment. It is often associated with verbal ridicule or attacking the child’s integrity. One of the most important goals is to help your child gain respect for himself/herself and others. And this is not possible without discipline and fairness.
If your child’s behavior gets out of control or creates problems, it’s a good idea to sign up for step-by-step parenting lessons. It’s important to learn to enforce the behavior you want to encourage in your child. It is advisable to consistently provide consequences for behaviors you want to discourage. Most children respond well to a structured relationship, with calm, consistent responses from parents. But if all this isn’t enough, don’t hesitate to seek specialist help – it could be vital for your child’s future development.