Aggressive and destructive behaviors stemming from anger can be a problem for any age, but especially for kids who haven’t yet developed the skills to cope with difficult emotions.

When children act out their anger in destructive ways it becomes a problem for those who witness it or are the target of it, whether at home with family, at school with teachers, or on the playground with peers. It can also be dangerous if a child in a rage flees the school campus, darts into the street, or injures someone by hitting or kicking or throwing things. Children can do a lot of damage to property as well like punching or kicking holes in walls or doors.

Kids can be taught to manage their behaviors when they are angry. Learning that it’s alright to get angry is the place to start. This helps the child feel more normal and that there is nothing “wrong” with them. Then learning useful techniques like removing themselves from the situation, deep breathing exercises, muscle relaxation, and visual imagery increases their coping skills. Physical exercise or even sleeping it off are positive ways to deal with anger. Learning to voice their concerns when calm will help them speak up for themselves, let others know how they are feeling, and lead to improving problem solving skills.

The best way to express anger is calmly with words by either telling someone about their anger or writing about it in a journal. Kids who cannot put their feelings into words or are too young to write can draw pictures of their anger or even just scribble on paper colors that represent their anger.

Many parents who bring in children for counseling who struggle when they get angry report that they have the same struggle with anger and often lash out verbally to their children. This sets a bad example. When I teach anger management in counselling, I usually teach it to the caregiver at the same time so they can reinforce it to their children at home and more importantly, learn it for themselves. Kids learn more about dealing with anger by seeing their parents deal with their own anger than by having someone tell them how to do it. If acting out anger is a family pattern then the whole family can work on improvement together. Kids are more eager to implement positive coping skills when they see other family members doing the same.

About the Author

Sam McCage, Ph.D., LMFT, LPC, is a licensed psychologist at Cook Children's Medical Center. Our experienced psychologists understand the wide-reaching impact of a behavioral disorder, or emotional problems and we will give your child and family all of the tools you need to manage your unique situation. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our Intake Department at 682-885-3917. Click here to learn more.

I think in “Inside Out,” Riley’s family is always trying to be positive and give Riley joyful memories throughout her childhood. As the family moves and life starts to unfold negatively, we see other emotions; fear, anger, sadness and disgust, start creeping up in.

We see Joy work harder to keep Riley’s emotions as joyful as possible. Joy is an important part of our memories that we like to revisit. As a child life specialist at Cook Children’s, I try to help normalize the day and make joyful memories with patients and families.

These memories will help children cope with other struggles that they overcome and find joy in their life. As adults, we have a hard time with this because we have so many experiences with sadness, fear, anger and disgust it’s hard for us not to project our feeling on children especially when they are in the hospital.

Children that come into the hospital may experience different emotions, but joy can be found through these emotions, even when as adults we may think there is no joy.

Sometimes kids find so much joy that they don’t want to leave Cook Children’s because it has become a fun and not so scary place. We need to remember to look for joy with all that may go on in a hospital setting.

We might not think children do a great job at a procedure because maybe they cried. However, they may have held still and been able to recover with playing by the end of procedure. This can create a joyful memory with having families at the bedside showing comfort.

Sometimes going through these different periods of our life while growing up and experiencing many things good and bad allow our emotions to interact.

In “Inside Out,” we see that the character Joy realizes toward the end of the movie that you can mix your emotions and this can be considered normal. Joy realizes that you can cry tears of joy. So as a child life specialist we help families realize that tears in a difficult experience may help a child in the future to help to control his or her different emotions. The tears also allow us to look at our long-term memories and see how there might have been joy in that moment after all and change that core memory to be better than we thought.

This allows us to empower children with all these different emotions, especially joy, in their daily lives, in or out of the hospital. Joy is a great emotion which we all deserve to look for daily in our lives and others that live with us. What Joyful memory do you have?

Previous stories in our "Inside Out" series:

• Anger
• Disgust
• Sadness
• Fear

Heather Bayers is a Child Life specialist at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

These moments can be quite amusing to watch because, let’s face it, we can all relate to having angry outbursts!

Anger is many times perceived as the ultimate negative emotion, however “Inside Out” gives us an interesting perspective that could teach us a few things. When Joy introduces us to Anger, she describes him as someone who “cares about what is fair.” If we really think about it, most of our anger is the result of feeling as if we have been wronged by someone or when a situation does not go as we feel it should.

Children and teens who are dealing with an illness, injury, and/or hospitalization have MANY reasons to feel as if they have been put into an unfair situation. They are missing out on events with friends and family, missing school, having to endure sometimes painful and scary procedures and experiencing so many things that they have so little control over.

The first step in helping kids cope with anger is to acknowledge why they feel angry and to let them know they have a right to feel angry about a difficult situation.

Big life changes and overwhelming situations can shake up our emotions and cause them to go into panic mode as they try to make sense of what is happening. This is what we see with Riley’s emotions when her family moves away. However, when Anger is able to fully take over Riley’s control board, she makes an impulsive and unsafe decision to run away in an effort to feel better and to fix what she sees as an unfair situation. She breaks her hockey stick, rolls her eyes, yells at her parents and is disrespectful. When children begin to show these negative behaviors (even when they are sick or hurt), they need clear reminders of what behaviors are not acceptable while validating the feeling behind them. Say to your child, “It is OK for you to feel angry. It is not OK for you to hurt yourself, hurt others or be disrespectful.”

But if we are going to remove the only way they know how to express anger, we must replace it with an acceptable and healthy outlet. Some simple activities may include punching a pillow, pounding play dough, breaking ice cubes outside, participating in sports or outdoor activities, taking deep breaths or tearing up paper. Providing these options prevents anger from being bottled up and eventually blowing up!

Is there a positive side to Anger?? Definitely. Anger is strong, determined, passionate and protective. Those are all things we want children to be. Children can learn to see things that are not fair and stand up for themselves and others. Anger can be an excellent motivator for change and reaching solutions. If we can teach a child to use their anger in a positive way, we can empower them to overcome difficult situations.

Related "Inside Out" topics:

• Disgust
• Sadness
• Fear

About the author

Angie Bradley is a Child Life specialist at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

She is especially protective of Riley when looking out for her well-being. She’s on vegetable alert. Remember the peas and broccoli pizza? Disgust also acts as Riley’s social situation monitor, helping her make new friends.

So what really is the value in our children's everyday lives of feeling disgusted? To feel disgust, means we are offended by something, or have an extreme dislike.

When was the last time you said, “That’s disgusting!”? Was someone acting in a way you felt was inappropriate, or was there food on your plate that you truly didn’t want to eat? We can see disgust acted out in kids all the time.

Food sometimes just has to look like it doesn’t taste good, for them to turn up their noses and say, “yuck, not eating that!” Think about all the times you’ve tried to get your child to take medicine that they refuse, or spit back out at you. Those may not seem like the most positive examples, but they’re probably the most realistic. But, if disgust is protective, then it may also keep your child from eating something they shouldn’t, such as bugs, plants or medicine that’s not theirs.

Disgust in the role of acceptable social behaviors has the potential to be very important. If we teach our children there are certain values that are important, and morals to follow, they have the potential to be offended (disgusted) when behaviors opposite to their values are displayed. It may keep them from getting involved in substance abuse, risk taking actions and becoming sexually active. If disgust helps them to live up to the expectations they know are important, then it plays a very positive role with the voices inside their heads.

Disgusted behaviors aren’t always the most positive if you look at sarcasm, being snarky and generally thinking they know everything. We may laugh when we see children react to situations with some level of egocentrism, except maybe when they are our children and we think they’re being rude. So, lesson learned, how children (and adults) display their disgust is important. Just like anger, it’s OK to feel disgusted, but there may be certain behaviors that are unacceptable, such as throwing peas, when we are expressing our disgust. Providing examples of what is acceptable behavior when disgusted, such as using words, not actions, is definitely a teachable moment.

Disgust, in all her green-ness in Inside Out adds a certain level of humor that is probably better understood by adults because it’s subtle and mature. But, don’t we all want to have a little bit of her humor in our heads every day? I know I do.

Related 'Inside Out' topics:

• Sadness
• Fear

About the author

Jill Koss is director of Family Support Services and Child Life at Cook Children's. We know that a child’s illness or injury can impact a family physically, emotionally and financially. Fortunately, you don’t have to face these challenges alone. We provide a growing number of services for patients and families, all designed to help support, heal and encourage you through every step of your journey.

Depression is a biological illness with a strong hereditary link. Generally, 35 to 40 percent of depressed children have inherited their disease. Usually, parents notice that their child is depressed around the teen years. 

Teens with chronic illness, such as depression, are no different than any other child and generally want to be treated just like any other kid. But they should receive professional help and be assessed for anxiety and depression. 

Parents should watch for any change in mood like sadness, depression, hopelessness, irritability, anger and hostility. You may see more tearfulness and changes in activity level. Watch for more withdrawal from friends and family, change in friends and loss of interest in activities once enjoyed. Other signs include sleep disturbance, change in appetite, restlessness, agitation, fatigue, lack of energy/motivation, feelings of worthlessness and guilt. Depressed kids may have difficulty concentrating, making decisions and may even see a drop in grades. 

Always be aware of signs of depression and keep a close eye on your child. Never ignore symptoms.  If you see signs of depression, contact your physician and obtain referrals for a psychologist or therapist who is trained in pediatric and adolescent care. 

Children threatening suicide may be trying to get attention or may be struggling with depression. But it doesn’t matter. You must take the threat very seriously. If a child is talking about suicide, get help immediately. It is critical not to ignore this cry for help regardless of their reasons. 

Know that if your child is struggling with a chronic illness, including depression, it will impact the entire family. Families will require a lot of support: emotional, financial and physical. Most importantly, the support needs to be ongoing. It’s important to allow family members to vent frustration and grieve. Therapy is very helpful. If your teen is struggling with this problem, the entire family will need help to get through it. The good news is it’s available. If you feel your child needs help, please call 682-885-3917 for a referral into Cook Children’s Psychology department.

About the author

Lisa Elliott is a licensed psychologist and clinic manager of Cook Children’s Behavioral Health, located at 3201 Teasley Lane, Ste. 202, Denton, TX 76210. To make an appointment, call 940-484-4311. Cook Children’s Psychology provides care focused on children’s behavior, from ages 3 years through 17.