36 The Explosive Childtated, cranky, fatigued mood a whole lot more often than
others, and they experience these feelings a whole lot
more intensely. These kids’ capacities for frustration tol-
erance and flexibility are compromised much more
often, and as a result, they may fail to acquire develop-
mentally appropriate skills for handling demands for
flexibility and frustration tolerance.
Are these children depressed? Some mental health
professionals reserve the term depression for children
who are routinely blue, morose, sad, and hopeless, which
actually tends not to be the case for many irritable ex-
plosive children. Do these children have bipolar disor-
der? Over the past five years or so, there has developed a
troubling tendency for some mental health professionals
to equate “explosive” and “bipolar,” to interpret irritabil-
ity as a purely biological entity, and to believe that a poor
response to stimulant medication or antidepressants cer-
tifies a child as bipolar. This probably helps explain both
the increased rates at which bipolar disorder is being diag-
nosed in children and the popularity of mood-stabilizing
and atypical antipsychotic medications.
As you now know, there are many factors that could
set the stage for a child to be explosive; irritability is only
one. And there are many factors that could set the stage
for a child to be irritable; brain chemistry is only one.
Some children are irritable because of chronic problems—
school failure, poor peer relations, being bullied—that
have never been solved. Medicine doesn’t fix school fail-