A couple responses to the TDD post

I started replying to comments but decided to post the replies here to the main page, since it's such an interesting and new subject.  Several people have left comments on the TDD post; here are my responses to the last two.

@Essie:
I wonder what the social attitude/stigma towards "Temper Dysregulation Disorder" is going to be in five years time.  I do hope it doesn't become the "spoiled brat" diagnosis.  Then again, it would probably have to compete with ADHD for that label.

I was recently discussing with my friend and neighbor how according to the DSM-V, her son doesn't have Asperger's anymore. He now has plain "autism spectrum disorder".  She said she was actually relieved, because Asperger's has been getting a reputation as "not a real problem".  Her son does so well academically that he's in a gifted program, but he's also got some major special needs and just can't function in regular junior high school without extra supports in place.  They've had to struggle hugely, even to the point of getting a lawyer, over the services he needs to stay in school.  They've noticed that over the last decade as the awareness of Asperger's has grown, and the negative stigma has decreased, there's a sort of reverse positive stigma -- "it's just that they're extra quirky" -- that isn't helpful at all in terms of getting him supports.

It's such a fine line. Labels can help us get help for our kids, but they come with such huge baggage... social stigma, inaccuracies, false predictions.

@marythemom:
I've watched some documentaries on childhood bipolar and read some articles, and from what I can tell, true, unmistakeable mania is way beyond what I've seen from my son. There was a little girl talking -- very calmly and with a smile on her face -- about how she wanted to cut off her mom's head with a knife. Children who thought they were invulnerable and could jump off roofs or out of moving cars. Children who kept seeing weird sexual hallucinations during the daytime. These weren't children who had attachment issues; I think all of them were bio kids from regular families.

I have a feeling that future studies are going to show that some anti-psychotics are going to work equally well on TDD and childhood bipolar.  I really hope someone will do some therapy studies as well. When we started out, we had so many ideas for how to manage fits, but I've had to disregard most of them as worthless.  They may work for regular, developmentally appropriate temper tantrums, but they don't work for my son.

And as a side note, I realize a lot of them are based on "the hydraulic theory of anger", a disparaging term I've heard a few times.  It's the idea that anger builds up inside you like steam, and to get rid of the anger you have to express it somehow in order to release it.  That makes intuitive sense -- we want to believe it's true -- but nobody has really been able to back that up. Extend it to other emotions and it doesn't make sense. If you're happy, and you express your happiness by jumping into the air while pumping your fists and shouting "I FEEL GOOD" does that release your happiness like steam so that you suddenly stop being happy?

I do think anger/rage/temper causes extreme physical and mental tension, and part of defusing it is releasing that tension, but we have to figure out how to release the tension in ways that don't involve expressing the anger, even against inanimate objects.  That just creates a habit of expressing anger.