By Melissa Riddle Chalos

Of all the parental nightmares, of all we could imagine going wrong — especially during the toddler years — one event is almost inevitable: the temper tantrum. It is going to happen. Little ones hit, kick, scream and hold their breath. They grip ferociously to whatever they know they shouldn’t hold and let you know that you are not the boss of them — at least not in this moment.

Furthermore, it’s most likely going to happen not in the privacy of your home, but in a very public place. At the grocery store with 47 people in line at the register. In the front yard, with all your neighbors looking on. Or at daycare within earshot of all the little non-tantrum-throwing angels.

These explosive emotional events are likely just occasional, “this too shall pass” growing pains that — with patience, persistence and prevention measures — your child will mature out of. Understanding the “why” behind the behavior gives parents options for diffusing the anxiety or frustration before or during the outburst.

But when tantrums become more common or expected and a child appears angry or irritable most of the time, even in between outbursts, it could be a sign of a mental health issue.

Children Need Mental Health Help, Too

Child throwing tantrumEveryday Health estimates that one in five children — including infants and toddlers — exhibits mental health issues. But research from the American Psychological Association shows that children are much less likely to get help because, all too often, adults assume it’s a maturity issue, not an emotional health issue. That’s why it’s especially important for parents to trust their instincts and those of the adults who know their children well.1

“Most parents want to believe that their kids are doing okay,” psychiatrist William M. Klykylo, MD, of Wright State University School of Medicine tells Everyday Health. “But if you feel that something is going on or if someone you trust — a teacher or counselor, a minister or other clergy person, or a coach — says ‘I’ve got a feeling about your child,’ pay attention.”1

Diagnosing mental health disorders in children requires getting underneath the outward signs to understand the reasons behind what’s happening. Not all outbursts are equal. For example, children with undiagnosed sensory processing problems may exhibit emotional outbursts — what psychologists refer to as “emotional dysregulation”— when they feel overwhelmed. And children with learning disabilities may act out to divert attention away from their struggle.2

Other mental health disorders in children include:

Oppositional defiant disorder (ODD): ODD is characterized by a pattern of “negative, hostile or defiant behavior.”2 This pattern might include temper tantrums, arguing, being easily annoyed and other disruptive behaviors over a period of six months or more.

Anxiety disorders: There are different types of anxiety disorders that manifest in different ways. Some children avoid anxiety-producing situations, refuse to leave their parents or even freeze when they experience anxiety. Others lash out or have a meltdown. It varies from child to child.

“Anxiety is one of those diagnoses that is a great masquerader,” Dr. Laura Prager, Director of the Child Psychiatry Emergency Service at Massachusetts General Hospital, tells Child Mind Institute. “It can look like a lot of things. Particularly with kids who may not have words to express their feelings, or because no one is listening to them, they might manifest their anxiety with behavioral dysregulation.”2

Attention deficit hyperactivity disorder (ADHD): ADHD symptoms — such as difficulty focusing, sitting still and waiting their turn, as well as lacking the ability to think ahead and understand the consequences of their behavior — can lay the emotional groundwork for temper tantrums or defiant behavior.2

Disruptive mood dysregulation disorder (DMDD): A relatively newly recognized disorder, DMDD occurs when temper tantrums are severe, long-lasting and with anger that is out of proportion to the situation, and when children are irritable and angry most days, starting before age 10. Some symptoms may overlap with depression, anxiety, ODD and bipolar disorder, which is why it’s important seek help for the right diagnosis.3

Mental health issues like these mentioned above will vary by age and type of disorder, but there are two warning signs that cross all ages and categories:

  • Extremes or peculiarity of behavior, such as being significantly more hyper, aggressive or withdrawn than usual
  • Sudden, hard to explain negative changes in behavior, such as a steep drop in grades1

Is It Time to See a Mental Health Professional?

Before your parental imagination runs wild with possibilities, remember two things:

  1. Every child is different. No two are alike. And what might look like an issue in a given moment may, in fact, be nothing to worry about.
  2. As a loving parent, you are equipped with an amazing radar. You know your child, and you have the ability to see if your child is experiencing symptoms that are not typical for the developmental stage he is in. You, more than anyone, know what is happening in your child’s life, whether there are events or environments impacting his stress level. You are your child’s best, most compassionate advocate.

If your toddler took a tumble and sprained his ankle, there would be no question: You would go see a pediatrician and get an X-ray to make sure the injury wasn’t more serious. You wouldn’t take a “wait and see” approach if your child were in physical distress. You are your child’s voice, her protector and her boo-boo kisser. You should have no reservations whatsoever about reaching out to a mental health expert with any concerns or questions you have.

These questions can help you determine if it’s time to take your child to see a mental health professional:

  • Young children: Does worry or stress make it difficult for your child to function normally in what should be a comfortable setting? Does your child have developmental issues that impact his ability to communicate feelings or interact with others? Does your child experience intense, overwhelming fear — with racing heartbeat or rapid breathing — or express wanting to hurt toys, animals or other children?1,4
  • School-age children: Has your child exhibited ongoing (daily or more than three times a week) anxiety, anger, sadness, extreme mood swings or disruptive, defiant behavior for more than six months? Does she have unexplained weight loss or weight gain, thoughts or feelings of self-harm and/or behaviors that seem foreign to her personality? 1,4

If you’ve answered “yes” to these questions, make a call and begin the process of understanding why you’re seeing what you’re seeing.

Why? Because information is power — for you and your child.

Once you make that call and sit down with a children’s mental health expert, whatever the outcome, whatever the diagnosis, you are not alone. There will be a specific treatment plan led by knowledgeable, compassionate people who specialize in working with children.

Others are walking this path with you, like Ann Douglas, who raised four children with mental health disorders, such as bipolar disorder, ADHD, anorexia, Asperger’s syndrome and depression. Her book, Parenting Through the Storm: Find Help, Home, and Strength When Your Child Has Psychological Problems, navigates the warning signs of mental health problems in childhood and how to pursue a diagnosis. She explains technical jargon, provides insight from child psychology experts and equips parents with coping skills to empower them to be the advocate children need when experiencing psychological problems.5

Whether your child’s temper tantrum is simply a normal phase of development or a sign of something more serious, knowing you are taking steps to guide your child safely toward a healthy, happier life can help you hold steady through the storm. With your advocacy, support and love, anything is possible.


1 Vann, Madeline R. “Mental Illness in Kids: The Surprising Warning Signs.” Everyday Health, May 18, 2011.

2Disruptive Behavior: Why It’s Often Misdiagnosed.” Child Mind Institute, Accessed January 2, 2017.

3 Illades, Chris. “Those Explosive Temper Tantrums Could Be a Disorder.” Everyday Health, May 22, 2014.

4 Mayo Clinic Staff. “Mental Illness in Children: Know the Signs.” Mayo Clinic, February 11, 2015.

5 Newman, Susan. “13 Signs of Potential Mental Illness in a Child.” Psychology Today, September 30, 2016.