Emotional Disorders in Children: When to Seek Help

Childhood Emotional Disorders

Hello Dr.
Chang,
My daughter is four years old and has a very strong-willed personality.
She can cry for an hour if she doesn't want to walk or go to school.
She expresses her problems through crying and gets angry easily.
For example, if someone stops her from playing with water, she screams, or if she asks me to write my name and I happen to write hers as well, she can become very upset and cry for 20 minutes.
Today, I spoke with her teacher, who mentioned that while these incidents happen occasionally, it is noticeable that my daughter often has a very angry expression (holding back tears) and glares at others, indicating significant emotional instability.
She has already completed a school year, and her anxiety should not persist to this extent.
Additionally, she has been a difficult child since birth (easily irritable).
Should I take her for an emotional disturbance assessment? Are there any specialized child psychiatrists in Central Taiwan? Thank you for your response.

mikey, 30~39 year old female. Ask Date: 2004/12/13

Dr. Zhang Jiexin reply Psychiatry

Based on your description, your child may possess some challenging temperamental traits, which are innate and difficult to change.
If the surrounding environment does not adequately understand these characteristics and limitations, it may lead to poor interactions when addressing their emotional behaviors.
This could result in significant difficulties in their future development and may lead to various issues that could impact their physical and mental health.
If you have such concerns, there are many hospitals in the central region that offer pediatric psychiatry outpatient services.
In Taichung City and County, you can consider the following: Taichung Veterans General Hospital, Chung Shan Medical University Hospital, China Medical University Hospital, and Taichung City Hospital.
In Changhua County, there is Changhua Christian Hospital, and in Nantou County, you can visit the Nantou Psychiatric Hospital.
You may take your child for an evaluation at a nearby facility.

Reply Date: 2004/12/13

More Info

It sounds like you are facing a challenging situation with your daughter, and it's commendable that you are seeking help and guidance. Emotional disorders in children can manifest in various ways, and understanding when to seek professional help is crucial for their development and well-being.

From your description, your daughter exhibits several signs of emotional dysregulation. Her intense reactions to seemingly minor frustrations, such as crying for extended periods when she doesn't get her way or becoming very angry when her requests are not met, suggest that she may be struggling with emotional regulation. Children at her age often experience strong emotions, but the intensity and duration of her reactions may indicate that she is having difficulty managing these feelings.

When to Seek Help
1. Persistent Emotional Distress: If your daughter’s emotional reactions are frequent and severe, and they interfere with her daily life, such as her ability to attend school or engage in play with peers, it may be time to seek help. Children should be able to express their emotions, but when those emotions lead to significant distress or behavioral issues, it can be a sign of an underlying problem.

2. Impact on Daily Functioning: If her emotional responses are affecting her relationships with family members or peers, or if she is unable to participate in age-appropriate activities due to her emotional state, this is another indicator that professional evaluation may be necessary.

3. Duration of Symptoms: You mentioned that her emotional challenges have persisted since birth and have not improved over time. If her behavior has not shown signs of improvement despite your efforts to manage it at home, this could warrant a professional assessment.

4. Concerns from Educators: The feedback from her teacher is also significant. If educators are noticing concerning behaviors, it is essential to take their observations seriously, as they can provide valuable insights into her behavior in a structured environment.

Steps to Take
1. Consult a Pediatrician: Start by discussing your concerns with your child's pediatrician. They can provide an initial assessment and refer you to a child psychologist or psychiatrist if necessary.

2. Seek a Child Psychologist or Psychiatrist: Look for a specialist in child psychology or psychiatry who has experience with emotional disorders. They can conduct a comprehensive evaluation to determine if your daughter has an emotional disorder, such as anxiety or a mood disorder, and recommend appropriate interventions.

3. Explore Local Resources: Since you mentioned you are in central Taiwan, you can look for child mental health services in your area. Many hospitals have pediatric mental health departments, and there are also private clinics specializing in child psychology. You may want to check with local health services or community centers for recommendations.

4. Consider Family Therapy: Sometimes, involving the family in therapy can help address dynamics that may be contributing to a child's emotional struggles. Family therapy can provide strategies for all family members to support the child effectively.

5. Monitor and Document Behaviors: Keep a record of your daughter's emotional responses, including triggers, frequency, and duration. This information can be helpful for professionals in understanding her situation better.

Conclusion
In summary, it is essential to take your daughter's emotional challenges seriously, especially given the persistence and intensity of her reactions. Seeking a professional evaluation can provide clarity and direction for addressing her needs. Remember that early intervention can make a significant difference in a child's emotional development and overall well-being. You are taking a proactive step by seeking help, which is crucial for your daughter's future.

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