Kids who seem oppositional are often severely anxious

Writer: Caroline Miller

Clinical Experts: Jerry Bubrick, PhD , Rachel Busman, PsyD, ABPP , Nancy Rappaport, MD

What You'll Learn

- Why do kids with anxiety sometimes act out?

- What are the signs that a disruptive child might be anxious?

- What happens when anxiety is mistaken for bad behavior?

- What kinds of help are available for anxious kids who act out?

- Quick Read

- Full Article

- Unrecognized anxiety

- A great masquerader

- Problems at school

- Giving kids tools to handle anxiety

- Anxiety confused with ADHD

- How to identify anxiety

The symptoms of anxiety that most of us think of are clinging to parents, avoiding things or being very shy. But problem behavior can also be a symptom of anxiety. That’s because some anxious children feel an overwhelming need to get out of the situation that’s making them uncomfortable. That behavior may look like anger or defiance. 

Signs that a child who is acting out might be anxious include lashing out, throwing tantrums, seeming distracted, moving around a lot (like leaving their seat or even running out of the room), arguing with others, and asking lots of questions. 

Adults may mistakenly think that children who are acting out are being difficult on purpose. Parents don’t feel respected and may be frustrated or exhausted. At school, when kids disrupt class or don’t follow instructions, they offend teachers. Instead of learning to manage their anxiety, they end up in the principal’s office.  

Anxious kids who act out may be mistakenly diagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist or social worker, to find out what’s causing the behavior. Anxiety can be treated very successfully with cognitive behavior therapy, or CBT. Kids learn techniques to calm themselves down when they are anxious, and the anxiety fades over time. Medication is sometimes recommended, too.  

A10-year-old boy named James has an outburst in school. Upset by something a classmate says to him, he pushes the other boy, and a shoving-match ensues. When the teacher steps in to break it up, James goes ballistic, throwing papers and books around the classroom and bolting out of the room. He is finally contained in the vice principal’s office, where staff members try to calm him down. Instead, he kicks the vice principal in a frenzied effort to escape. The staff calls 911, and James ends up in the emergency room.

To the uninitiated, James looks like a boy with serious anger issues. It’s not the first time he’s flown out of control. The school insists that his parents pick him up and take him home for lunch every day because he’s been banned from the cafeteria.

Unrecognized anxiety

But what’s really going on? “It turns out, after an evaluation, that he is off the charts for social anxiety,” reports Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. “He can’t tolerate any — even constructive — criticism. James is terrified of being embarrassed, so when a boy says something that makes him uncomfortable, he has no skills to deal with it, and he freaks out. Flight or fight.”

James’s story illustrates something that parents and teachers may not realize — that disruptive behavior is often generated by unrecognized anxiety. A child who appears to beoppositional or aggressive may be reacting to anxiety — anxiety they may, depending on their age, not be able to articulate effectively, or not even fully recognize.

“Especially in younger kids with anxiety you might see freezing and clinging kind of behavior,” says Rachel Busman, PsyD, a clinical psychologist, “but you can also see tantrums and complete meltdowns.”

A great masquerader

Anxiety manifests in a surprising variety of ways in part because it is based on a physiological response to a threat in the environment, a response that maximizes the body’s ability to either face danger or escape danger. So while some children exhibit anxiety by shrinking from situations or objects that trigger fears, some react with overwhelming need to break out of an uncomfortable situation. That behavior, which can be unmanageable, is often misread as anger or opposition.

“Anxiety is one of those diagnoses that is a great masquerader,” explains Laura Prager, MD, director of the Child Psychiatry Emergency Service at Massachusetts General Hospital. “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.”

The more commonly recognized symptoms of anxiety in a child are things like trouble sleeping in their own room or separating from their parents, avoidance of certain activities. “Anyone would recognize those symptoms,” notes Dr. Prager, co-author of Suicide by Security Blanket, and Other Stories from the Child Psychiatry Emergency Service. But in other cases the anxiety can be hidden.

“When the chief complaint is temper tantrums, or disruption in school, or throwing themselves on the floor while shopping at the mall, it’s hard to know what it means,” she explains. “But it’s not uncommon, when kids like that come in to the ER, for thediagnosis to end up being a pretty profound anxiety disorder.”

Problems at school

It’s not uncommon for children with serious undiagnosed anxiety to be disruptive at school, where demands and expectations put pressure on them that they can’t handle. And it can be very confusing to teachers and other staff members to “read” that behavior, which can seem to come out of nowhere.

Nancy Rappaport, MD, a Harvard Medical School professor who specializes in mental health care in school settings, sees anxiety as one of the causes of disruptive behavior that makes classroom teaching so challenging. “The trouble is that when kids who are anxious become disruptive they push away the very adults who they need to help them feel secure,” notes Dr. Rappaport. “And instead of learning to manage their anxiety, they end up spending half the day in the principal’s office.”

Dr. Rappaport sees a lot of acting out in school as the result of trauma at home. “Kids who are struggling, not feeling safe at home,” she notes, “can act like terrorists at school, with fairly intimidating kinds of behavior.” Most at risk, she says, are kids with ADHD who’ve also experienced trauma. “They’re hyper-vigilant, they have no executive functioning, they misread cues and go into combat.”

Giving kids tools to handle anxiety

When a teacher is able to build a relationship with a child, to find out what’s really going on with them, what’s provoking the behavior, she can often give them tools to handle anxiety and prevent meltdowns. In her book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, Dr. Rappaport offers strategies kids can be taught to use to calm themselves down, from breathing exercises to techniques for distracting themselves.

“When a teacher understands the anxiety underlying the opposition, rather than making the assumption that the child is actively trying to make them miserable, it changes their approach,” says Dr. Rappaport, “The teacher is able to join forces with the child himself and the school counselor, to come up with strategies for preventing these situations.”

If it sounds labor-intensive for the teacher, it is, she notes, but so is dealing with the aftermath of the same child having a meltdown.

Anxiety confused with ADHD

Anxiety also drives a lot of symptoms in a school setting that are easily misconstrued as ADHD or defiant behavior.

“I’ll see a child who’s having difficulty in school: not paying attention, getting up out of their seat all the time, asking a lot of questions, going to the bathroom a lot, getting in other kids’ spaces,” explains Dr. Busman. “The behavior is disrupting other kids, and is frustrating to the teacher, who’s wondering why they ask so many questions, and why they’re so wrapped up in what other kids are doing, whether they’re following the rules.”

People tend to assume what’s happening with this child is ADHD inattentive type, but it’s commonly anxiety. Kids with OCD, mislabeled as inattentive, are actually not asking all those questions because they’re not listening, but rather because they need a lot of reassurance.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How to identify anxiety

“It probably occurs more than we think, either anxiety that looks disruptive or anxiety coexisting with disruptive behaviors,” Dr. Busman adds. “It all goes back to the fact that kids are complicated and symptoms can overlap diagnostic categories, which is why we need to have really comprehensive and good diagnostic assessment.”

First of all, good assessment needs to gather data from multiple sources, not just parents. “We want to talk to teachers and other people involved with the kid’s life,” she adds, “because sometimes kids that we see are exactly the same at home and at school, sometimes they are like two different children.”

And it needs to use rating scales on a full spectrum of behaviors, not just the area that looks the most obvious, to avoid missing things.

Dr. Busman also notes that a child with severe anxiety who’s struggling in school might also have attention or learning issues, but they might need to be treated for the anxiety before they can really be evaluated for those. She uses the example of a teenager with OCD who is doing terribly in school. “They’re ritualizing three to four hours a day, and having constant intrusive thoughts — so we need to treat that, to get the anxiety under control before we ask, how are they learning?”

Frequently Asked Questions

Can acting out be a symptom of anxiety in a child?

Are anxious kids misdiagnosed because they act out?

Anxious kids who act out may be misdiagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist, or social worker, to find out what’s causing the behavior.

How are anxious kids treated? https://standingabovethecrowd.com/?p=16300

James Donaldson on Mental Health - How Anxiety Leads to Problem Behavior

Kids who seem oppositional are often severely anxious

Writer: Caroline Miller

Clinical Experts: Jerry Bubrick, PhD , Rachel Busman, PsyD, ABPP , Nancy Rappaport, MD

What You'll Learn

- Why do kids with anxiety sometimes act out?
- What are the signs that a disruptive child might be anxious?
- What happens when anxiety is mistaken for bad behavior?
- What kinds of help are available for anxious kids who act out?
- Quick Read
- Full Article
- Unrecognized anxiety
- A great masquerader
- Problems at school
- Giving kids tools to handle anxiety
- Anxiety confused with ADHD
- How to identify anxiety

The symptoms of anxiety that most of us think of are clinging to parents, avoiding things or being very shy. But problem behavior can also be a symptom of anxiety. That’s because some anxious children feel an overwhelming need to get out of the situation that’s making them uncomfortable. That behavior may look like anger or defiance. 

Signs that a child who is acting out might be anxious include lashing out, throwing tantrums, seeming distracted, moving around a lot (like leaving their seat or even running out of the room), arguing with others, and asking lots of questions. 

Adults may mistakenly think that children who are acting out are being difficult on purpose. Parents don’t feel respected and may be frustrated or exhausted. At school, when kids disrupt class or don’t follow instructions, they offend teachers. Instead of learning to manage their anxiety, they end up in the principal’s office.  

Anxious kids who act out may be mistakenly diagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist or social worker, to find out what’s causing the behavior. Anxiety can be treated very successfully with cognitive behavior therapy, or CBT. Kids learn techniques to calm themselves down when they are anxious, and the anxiety fades over time. Medication is sometimes recommended, too.  

A10-year-old boy named James has an outburst in school. Upset by something a classmate says to him, he pushes the other boy, and a shoving-match ensues. When the teacher steps in to break it up, James goes ballistic, throwing papers and books around the classroom and bolting out of the room. He is finally contained in the vice principal’s office, where staff members try to calm him down. Instead, he kicks the vice principal in a frenzied effort to escape. The staff calls 911, and James ends up in the emergency room.

To the uninitiated, James looks like a boy with serious anger issues. It’s not the first time he’s flown out of control. The school insists that his parents pick him up and take him home for lunch every day because he’s been banned from the cafeteria.

Unrecognized anxiety

But what’s really going on? “It turns out, after an evaluation, that he is off the charts for social anxiety,” reports Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. “He can’t tolerate any — even constructive — criticism. James is terrified of being embarrassed, so when a boy says something that makes him uncomfortable, he has no skills to deal with it, and he freaks out. Flight or fight.”

James’s story illustrates something that parents and teachers may not realize — that disruptive behavior is often generated by unrecognized anxiety. A child who appears to beoppositional or aggressive may be reacting to anxiety — anxiety they may, depending on their age, not be able to articulate effectively, or not even fully recognize.

“Especially in younger kids with anxiety you might see freezing and clinging kind of behavior,” says Rachel Busman, PsyD, a clinical psychologist, “but you can also see tantrums and complete meltdowns.”

A great masquerader

Anxiety manifests in a surprising variety of ways in part because it is based on a physiological response to a threat in the environment, a response that maximizes the body’s ability to either face danger or escape danger. So while some children exhibit anxiety by shrinking from situations or objects that trigger fears, some react with overwhelming need to break out of an uncomfortable situation. That behavior, which can be unmanageable, is often misread as anger or opposition.

“Anxiety is one of those diagnoses that is a great masquerader,” explains Laura Prager, MD, director of the Child Psychiatry Emergency Service at Massachusetts General Hospital. “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.”

The more commonly recognized symptoms of anxiety in a child are things like trouble sleeping in their own room or separating from their parents, avoidance of certain activities. “Anyone would recognize those symptoms,” notes Dr. Prager, co-author of Suicide by Security Blanket, and Other Stories from the Child Psychiatry Emergency Service. But in other cases the anxiety can be hidden.

“When the chief complaint is temper tantrums, or disruption in school, or throwing themselves on the floor while shopping at the mall, it’s hard to know what it means,” she explains. “But it’s not uncommon, when kids like that come in to the ER, for thediagnosis to end up being a pretty profound anxiety disorder.”

Problems at school

It’s not uncommon for children with serious undiagnosed anxiety to be disruptive at school, where demands and expectations put pressure on them that they can’t handle. And it can be very confusing to teachers and other staff members to “read” that behavior, which can seem to come out of nowhere.

Nancy Rappaport, MD, a Harvard Medical School professor who specializes in mental health care in school settings, sees anxiety as one of the causes of disruptive behavior that makes classroom teaching so challenging. “The trouble is that when kids who are anxious become disruptive they push away the very adults who they need to help them feel secure,” notes Dr. Rappaport. “And instead of learning to manage their anxiety, they end up spending half the day in the principal’s office.”

Dr. Rappaport sees a lot of acting out in school as the result of trauma at home. “Kids who are struggling, not feeling safe at home,” she notes, “can act like terrorists at school, with fairly intimidating kinds of behavior.” Most at risk, she says, are kids with ADHD who’ve also experienced trauma. “They’re hyper-vigilant, they have no executive functioning, they misread cues and go into combat.”

Giving kids tools to handle anxiety

When a teacher is able to build a relationship with a child, to find out what’s really going on with them, what’s provoking the behavior, she can often give them tools to handle anxiety and prevent meltdowns. In her book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, Dr. Rappaport offers strategies kids can be taught to use to calm themselves down, from breathing exercises to techniques for distracting themselves.

“When a teacher understands the anxiety underlying the opposition, rather than making the assumption that the child is actively trying to make them miserable, it changes their approach,” says Dr. Rappaport, “The teacher is able to join forces with the child himself and the school counselor, to come up with strategies for preventing these situations.”

If it sounds labor-intensive for the teacher, it is, she notes, but so is dealing with the aftermath of the same child having a meltdown.

Anxiety confused with ADHD

Anxiety also drives a lot of symptoms in a school setting that are easily misconstrued as ADHD or defiant behavior.

“I’ll see a child who’s having difficulty in school: not paying attention, getting up out of their seat all the time, asking a lot of questions, going to the bathroom a lot, getting in other kids’ spaces,” explains Dr. Busman. “The behavior is disrupting other kids, and is frustrating to the teacher, who’s wondering why they ask so many questions, and why they’re so wrapped up in what other kids are doing, whether they’re following the rules.”

People tend to assume what’s happening with this child is ADHD inattentive type, but it’s commonly anxiety. Kids with OCD, mislabeled as inattentive, are actually not asking all those questions because they’re not listening, but rather because they need a lot of reassurance.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How to identify anxiety

“It probably occurs more than we think, either anxiety that looks disruptive or anxiety coexisting with disruptive behaviors,” Dr. Busman adds. “It all goes back to the fact that kids are complicated and symptoms can overlap diagnostic categories, which is why we need to have really comprehensive and good diagnostic assessment.”

First of all, good assessment needs to gather data from multiple sources, not just parents. “We want to talk to teachers and other people involved with the kid’s life,” she adds, “because sometimes kids that we see are exactly the same at home and at school, sometimes they are like two different children.”

And it needs to use rating scales on a full spectrum of behaviors, not just the area that looks the most obvious, to avoid missing things.

Dr. Busman also notes that a child with severe anxiety who’s struggling in school might also have attention or learning issues, but they might need to be treated for the anxiety before they can really be evaluated for those. She uses the example of a teenager with OCD who is doing terribly in school. “They’re ritualizing three to four hours a day, and having constant intrusive thoughts — so we need to treat that, to get the anxiety under control before we ask, how are they learning?”

Frequently Asked Questions

Can acting out be a symptom of anxiety in a child?

Are anxious kids misdiagnosed because they act out?

Anxious kids who act out may be misdiagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist, or social worker, to find out what’s causing the behavior.

How are anxious kids treated?

https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-anxiety-leads-to-problem-behavior-3/

James Donaldson on Mental Health - More Americans Plan Mental Health Resolutions Heading Into 2026

Washington, D.C. — Heading into 2026, more than one in three Americans (38%) say they plan to make a mental health-related New Year’s resolution, according to new findings from the American Psychiatric Association’s Healthy Minds Poll. This is up 5% from last year. Younger adults are leading this trend, with those ages 18–34 (58%) significantly more likely to report planning a mental health resolution compared with older adults (32% of 45-64-year-olds; 11% of those 65 and over).

A strong majority (82%) of Americans say they plan to make at least one New Year’s resolution for 2026. Physical fitness (44%) and financial goals (42%) remain the top areas of focus, followed closely by mental health (38%), which continues to rise in priority. Other common goals include diet (29%), social or relationship resolutions (29%), and spiritual goals (28%).

“It is encouraging to see more individuals planning to prioritize their mental health in 2026, particularly younger adults,” said APA President Theresa Miskimen Rivera, M.D. “The strategies people are embracing — such as regular physical activity, mindfulness practices, adequate sleep, time in nature and engaging in therapy — reflect a growing recognition that mental health is deeply connected to daily habits. Even small, intentional changes can have a meaningful and lasting impact on overall well-being.”

Looking back on 2025, 63% of Americans rated their mental health as excellent or good, while 28% said it was fair and 8% said it was poor.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Anxiety Heading into the New Year

Heading into 2026, anxiety remains common. Americans report feeling anxious about personal finances (59%), uncertainty about the next year (53%), and current events (49%), with concerns about physical and mental health close behind.

Issues Americans are Anxious About

IssuePercent anxious
(somewhat or very)Personal finances59%Uncertainty of the next year53%Current events49%Physical health46%Mental health42%Job security33%Relationships with friends and family32%Keeping New Year’s resolutions30%Romantic relationships29%

“A new year can bring change, possibility, and uncertainty,” said APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A. “Feelings of anxiousness underscore the importance of paying attention to how we’re doing and taking practical steps, large or small, to support our mental health.”

These results are from the APA’s Healthy Minds Poll, conducted by Morning Consult, Dec. 2–3, 2025, among 2,208 adults. For a copy of the survey results, contact press@psych.org. See past Healthy Minds Polls.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 39,200 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-more-americans-plan-mental-health-resolutions-heading-into-2026/

Washington, D.C. — Heading into 2026, more than one in three Americans (38%) say they plan to make a mental health-related New Year’s resolution, according to new findings from the American Psychiatric Association’s Healthy Minds Poll. This is up 5% from last year. Younger adults are leading this trend, with those ages 18–34 (58%) significantly more likely to report planning a mental health resolution compared with older adults (32% of 45-64-year-olds; 11% of those 65 and over).

A strong majority (82%) of Americans say they plan to make at least one New Year’s resolution for 2026. Physical fitness (44%) and financial goals (42%) remain the top areas of focus, followed closely by mental health (38%), which continues to rise in priority. Other common goals include diet (29%), social or relationship resolutions (29%), and spiritual goals (28%).

“It is encouraging to see more individuals planning to prioritize their mental health in 2026, particularly younger adults,” said APA President Theresa Miskimen Rivera, M.D. “The strategies people are embracing — such as regular physical activity, mindfulness practices, adequate sleep, time in nature and engaging in therapy — reflect a growing recognition that mental health is deeply connected to daily habits. Even small, intentional changes can have a meaningful and lasting impact on overall well-being.”

Looking back on 2025, 63% of Americans rated their mental health as excellent or good, while 28% said it was fair and 8% said it was poor.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Anxiety Heading into the New Year

Heading into 2026, anxiety remains common. Americans report feeling anxious about personal finances (59%), uncertainty about the next year (53%), and current events (49%), with concerns about physical and mental health close behind.

Issues Americans are Anxious About

IssuePercent anxious(somewhat or very)Personal finances59%Uncertainty of the next year53%Current events49%Physical health46%Mental health42%Job security33%Relationships with friends and family32%Keeping New Year’s resolutions30%Romantic relationships29%

“A new year can bring change, possibility, and uncertainty,” said APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A. “Feelings of anxiousness underscore the importance of paying attention to how we’re doing and taking practical steps, large or small, to support our mental health.”

These results are from the APA’s Healthy Minds Poll, conducted by Morning Consult, Dec. 2–3, 2025, among 2,208 adults. For a copy of the survey results, contact press@psych.org. See past Healthy Minds Polls.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 39,200 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org. https://standingabovethecrowd.com/?p=16298

Knowing what makes kids act out is the first step to finding solutions

Photo by Pixabay on Pexels.com

Writer: Caroline Miller

- Anxiety

- ADHD

- Learning Disorders

- Sensory Processing Problems

- Depression

- Autism

- Trauma

Downloadable Resources

- Learning Disabilities and Behavior Problems

When children act out more than occasionally — with frequent tantrums, outbursts or defiance — the first step to dealing with the problem behavior is finding out what’s behind it. And the cause may not be obvious.

Especially when children are young, they may not be able to tell you what they’re feeling. And in fact they may not even know what’s bothering them.

Tantrums and outbursts are usually signs that kids are struggling with feelings they don’t have the skills to manage. They may be overwhelmed by their frustration or anger and not know how to express themselves more effectively, or calm themselves down. They may need help developing skills to control their behavior.

(For more information see How Can We Help Kids With Self-Regulation.)

But if it’s happening a lot, it could be caused by a number of underlying issues.

Anxiety

We tend to think of anxious kids as shy, clingy, or timid, but anxiety can also cause kids to act out. When anxious children are put into situations that trigger their anxiety, they may lash out or have a tantrum in an effort to escape that situation.

It’s not uncommon for it to happen at school, where demands and expectations may put pressure on them that they can’t handle. For instance, if a child who has social anxiety feels criticized, they might throw books and papers on the floor or punch the person making them uncomfortable. And that behavior can be very confusing to teachers and other staff, since it seems to come out of nowhere.

(For more information see How Anxiety Leads to Disruptive Behavior.)

ADHD

ADHD is usually diagnosed when kids are having trouble paying attention. But for many children with the disorder — and their parents — behavior is a big problem, too. They may ignore instructions. And they may lash out, throw a tantrum, or be defiant when they are asked to do things they don’t want to do.

This behavior is often a result of ADHD symptoms. They may not do what they’re told because they are distracted or because it’s unusually hard for them to tolerate tasks that are difficult or boring. They’re especially likely to misbehave if they’re asked to stop doing something they enjoy, like playing a video game. So things like homework, going to bed, getting dressed, and coming to dinner can become battlegrounds.

Children with ADHD are also more impulsive than other kids. They may be overwhelmed with frustration or other powerful feelings, and might impulsively throw a shoe or push someone or yell “shut up!”

(For more information see ADHD and Behavior Problems.)

Learning Disorders

If a child acts out repeatedly in school or during homework time it could be the result of alearning disorder. If, for instance, they have trouble with math problems or a writing assignment, rather than ask for help, they might rip up the paper or start something with another child to create a diversion.

Kids who find learning harder than other kids do can be very frustrated and lose their temper frequently. And if they don’t know they have a learning disorder, they can worry that they’re stupid. So they often tend to hide their struggles. Getting into trouble might be less painful than letting people know that something is wrong with them. Paying attention to when the problem behavior happens can lead to exposing a learning issue and getting a child help.

(For more information see Supporting the Emotional Needs of Kids With Learning Disorders.)

Sensory Processing Problems

Children who have trouble processing sensory information can have extreme and confusing behavior when their senses are overwhelmed. They might do things like scream if their faces get wet or have a meltdown if they’re in a situation that’s too bright, noisy, or crowded. They might refuse to wear clothes that they find uncomfortable or eat food that feels wrong in their mouths.

Kids with sensory problems can also be rigid about routines and get upset or resist changes that seem insignificant to other people. They are also at risk for running away when an environment feels too overwhelming for them. The “fight or flight” response can kick in when kids are feeling overloaded with sensory input, and their panicked reactions can put them in real danger.

(For more information see Sensory Processing Issues Explained.)

Depression

Some children who have frequent temper tantrums have a disorder called disruptive mood dysregulation disorder, or DMDD. These kids have severe tantrums with chronic irritability in between outbursts. They tend to view things negatively and are quick to explode over issues that seem minor to other people.

(For more information see DMDD: Extreme Tantrums and Irritability.)

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Autism

Children on the autism spectrum are often prone to dramatic meltdowns. These children tend to be rigid — dependent on consistent routines for their emotional comfort — and any unexpected change can set them off. And they may lack the language and communication skills to express what they want or need.

Some behavior problems in kids with autism can be caused by medical issues that have gone unrecognized, especially in kids who are nonverbal. These include things like acid reflux, constipation, allergies, menstrual cramps, ear infections, and even bone fractures. All kids exhibit more negative behaviors when they don’t feel well, and kids on the spectrum may explode out of frustration that they are in pain and don’t know how to communicate it, or make it stop.

(For more information see Autism Behaviors: Do They Reflect Medical Issues?)

Trauma

Children who have been subjected to trauma or abuse often have trouble managing strong emotions. As babies and toddlers, children learn from adults how to calm and soothe themselves by being calmed and soothed by adults. If they haven’t had that experience, because of neglect, they can be quick to act out when they get upset and have trouble calming down. They need coaching and practice at de-escalating when they feel overwhelmed.

Kids who have experienced trauma also tend to interpret other people as hostile to them, so they may act out irritably in response. They may develop the belief that they’re bad and what’s happened to them is their fault. This leads to the expectation that people are not going to like them or treat them well, so there’s no point in trying to behave.

Photo by Pixabay on Pexels.com https://standingabovethecrowd.com/?p=16296

James Donaldson on Mental Health - Common Causes of Behavior Problems in Kids

Knowing what makes kids act out is the first step to finding solutions

Photo by Pixabay on Pexels.com

Writer: Caroline Miller

- Anxiety
- ADHD
- Learning Disorders
- Sensory Processing Problems
- Depression
- Autism
- Trauma
Downloadable Resources
- Learning Disabilities and Behavior Problems

When children act out more than occasionally — with frequent tantrums, outbursts or defiance — the first step to dealing with the problem behavior is finding out what’s behind it. And the cause may not be obvious.

Especially when children are young, they may not be able to tell you what they’re feeling. And in fact they may not even know what’s bothering them.

Tantrums and outbursts are usually signs that kids are struggling with feelings they don’t have the skills to manage. They may be overwhelmed by their frustration or anger and not know how to express themselves more effectively, or calm themselves down. They may need help developing skills to control their behavior.

(For more information see How Can We Help Kids With Self-Regulation.)

But if it’s happening a lot, it could be caused by a number of underlying issues.

Anxiety

We tend to think of anxious kids as shy, clingy, or timid, but anxiety can also cause kids to act out. When anxious children are put into situations that trigger their anxiety, they may lash out or have a tantrum in an effort to escape that situation.

It’s not uncommon for it to happen at school, where demands and expectations may put pressure on them that they can’t handle. For instance, if a child who has social anxiety feels criticized, they might throw books and papers on the floor or punch the person making them uncomfortable. And that behavior can be very confusing to teachers and other staff, since it seems to come out of nowhere.

(For more information see How Anxiety Leads to Disruptive Behavior.)

ADHD

ADHD is usually diagnosed when kids are having trouble paying attention. But for many children with the disorder — and their parents — behavior is a big problem, too. They may ignore instructions. And they may lash out, throw a tantrum, or be defiant when they are asked to do things they don’t want to do.

This behavior is often a result of ADHD symptoms. They may not do what they’re told because they are distracted or because it’s unusually hard for them to tolerate tasks that are difficult or boring. They’re especially likely to misbehave if they’re asked to stop doing something they enjoy, like playing a video game. So things like homework, going to bed, getting dressed, and coming to dinner can become battlegrounds.

Children with ADHD are also more impulsive than other kids. They may be overwhelmed with frustration or other powerful feelings, and might impulsively throw a shoe or push someone or yell “shut up!”

(For more information see ADHD and Behavior Problems.)

Learning Disorders

If a child acts out repeatedly in school or during homework time it could be the result of alearning disorder. If, for instance, they have trouble with math problems or a writing assignment, rather than ask for help, they might rip up the paper or start something with another child to create a diversion.

Kids who find learning harder than other kids do can be very frustrated and lose their temper frequently. And if they don’t know they have a learning disorder, they can worry that they’re stupid. So they often tend to hide their struggles. Getting into trouble might be less painful than letting people know that something is wrong with them. Paying attention to when the problem behavior happens can lead to exposing a learning issue and getting a child help.

(For more information see Supporting the Emotional Needs of Kids With Learning Disorders.)

Sensory Processing Problems

Children who have trouble processing sensory information can have extreme and confusing behavior when their senses are overwhelmed. They might do things like scream if their faces get wet or have a meltdown if they’re in a situation that’s too bright, noisy, or crowded. They might refuse to wear clothes that they find uncomfortable or eat food that feels wrong in their mouths.

Kids with sensory problems can also be rigid about routines and get upset or resist changes that seem insignificant to other people. They are also at risk for running away when an environment feels too overwhelming for them. The “fight or flight” response can kick in when kids are feeling overloaded with sensory input, and their panicked reactions can put them in real danger.

(For more information see Sensory Processing Issues Explained.)

Depression

Some children who have frequent temper tantrums have a disorder called disruptive mood dysregulation disorder, or DMDD. These kids have severe tantrums with chronic irritability in between outbursts. They tend to view things negatively and are quick to explode over issues that seem minor to other people.

(For more information see DMDD: Extreme Tantrums and Irritability.)

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Autism

Children on the autism spectrum are often prone to dramatic meltdowns. These children tend to be rigid — dependent on consistent routines for their emotional comfort — and any unexpected change can set them off. And they may lack the language and communication skills to express what they want or need.

Some behavior problems in kids with autism can be caused by medical issues that have gone unrecognized, especially in kids who are nonverbal. These include things like acid reflux, constipation, allergies, menstrual cramps, ear infections, and even bone fractures. All kids exhibit more negative behaviors when they don’t feel well, and kids on the spectrum may explode out of frustration that they are in pain and don’t know how to communicate it, or make it stop.

(For more information see Autism Behaviors: Do They Reflect Medical Issues?)

Trauma

Children who have been subjected to trauma or abuse often have trouble managing strong emotions. As babies and toddlers, children learn from adults how to calm and soothe themselves by being calmed and soothed by adults. If they haven’t had that experience, because of neglect, they can be quick to act out when they get upset and have trouble calming down. They need coaching and practice at de-escalating when they feel overwhelmed.

Kids who have experienced trauma also tend to interpret other people as hostile to them, so they may act out irritably in response. They may develop the belief that they’re bad and what’s happened to them is their fault. This leads to the expectation that people are not going to like them or treat them well, so there’s no point in trying to behave.

Photo by Pixabay on Pexels.com https://standingabovethecrowd.com/james-donaldson-on-mental-health-common-causes-of-behavior-problems-in-kids-2/

Are You Thinking of Suicide? There’s hope if you’re in crisis. You can talk to someone 24/7. Call or text 988.

Bennett McIntosh knows all about the Ask the Question campaign. As a registered nurse who works in the emergency room, it’s part of their screening to always ask the question directly, “Are you thinking about suicide?” She’s also an avid runner who says that physical activity helps her own mental health. But up until a year ago, she didn’t know about the 437 Project.

“I was sitting on the couch watching the noon news, and I thought it was a really cool thing, 12 people are running across the state for mental health and suicide prevention. I’m a runner, so I started following along.”

Connecting With People in the Moment

The more she learned, the more she wanted to help, so she volunteered to run. The group ran 437 miles across the state to raise enough awareness to cut the number of suicides in South Dakota. A simply stated goal that, in her experience, worked based on a message she got after the event.

“Somebody who came to one of our community events reached out to the 437 Project team and they said they had a plan to kill themselves, but then they came to the event, listened to the speakers and then they went to seek help.”

That’s the one story they heard about, but McIntosh prays that’s more common, “There's one life saved and I think it's a pretty amazing thing. That person is so strong and it's really awesome, but one life lost is still too many. Impacting that that one person though, that's what it's all about.”

Why the 437 Project and Suicide Prevention Caught Her Attention

“I was going through some life changes, and there were days I was pretty sad about some things. I knew it was temporary, but it really got me thinking about how some people feel that down and sad to the point where they think things won’t get better and they feel the need to end their life,” said McIntosh. “So that was a big reason why I volunteered, just knowing I could help shed light on this topic to let people know that it will be OK.”

McIntosh said she made connections that’ll last a lifetime. Even now, months after crossing the finish line, she still feels the impact of her trek across the state every day, and not just because of a nagging knee injury.

“You go through so much and you learn so much through the four days you’re out there,” said McIntosh. “When you get done with this huge feat, when you realize that you just ran across South Dakota with 11 other runners, it's amazing.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Running Down Memory Lane to Remember Those Lost to Suicide

Of course it’s not just the running and her fellow runners that left an impact, it’s also the volunteers and the people who cheered them on along the way. Most importantly though, is the reason behind the run, which never strayed far from her mind, especially at the end. The final push to the finish line is called the memory mile, when people who lost loved ones to suicide hold up signs for the runners to see. That memory mile really stuck with McIntosh.

“We go home and we're excited that it's done, but those people go home and they still don't have a son, they still don't have a daughter or a mother or father. That really sunk in when I was away from all the noise and sitting in my house in the quiet with time to reflect,” she said. “You come down from that high, but then you remember that we did this to raise awareness for suicide prevention.”

Once the run begins, someone is running 24/7, except for a few community events along the way, when many of those stories are told. The hope is to encourage people to prevent suicide, in part by talking about it. The project is sponsored by Avera, which advocates for loved ones to not be afraid to ask people directly, “Are you thinking about suicide?” if they see the signs someone might be thinking about suicide.

“I’ve had friends in my life and people in my life that reached out to me and told me stories I had no idea about,” she said. “Suicide is a hard topic to talk about, there's such a stigma surrounding it. I had so many people reach out to me and say they were a suicide survivor. That shocked me, I had no clue and I think we need to normalize people talking about those things because when people hear stories, they’re moved.”

McIntosh returned to work as a registered nurse at a rural hospital with a new perspective and a greater understanding, “It's life-changing. I think it's the best thing I've ever done in my life.”

She’s undecided if she’d run again, but she encourages others to sign up or volunteer.”

“I don't know if I'd run it, but I will absolutely 100% be involved, be an advocate for it. I will be involved for sure in all of the upcoming years.”

Ask the Question to Prevent Suicide

Asking someone directly if they’re thinking about suicide can provide hope. Avera’s campaign to prevent suicide provides resources to talk with your loved one and get them help in the moment. https://standingabovethecrowd.com/?p=16292