Pathways and Triggers 37ure, poor peer relations, or being bullied. There are many
“bipolar” children whose explosiveness is far better ex-
plained by lagging cognitive skills and whose difficulties
are therefore not well addressed by the multiple mood-
stabilizing medications they have been prescribed. If the
only time a child looks as if he has bipolar disorder is
when he’s frustrated, that’s not bipolar disorder; that’s a
learning disability in the domains of flexibility and frus-
tration tolerance.
What’s crystal clear is that the explosiveness of many
children is being fueled by a fairly chronic state of irri-
tability and agitation that makes it hard for them to re-
spond to life’s routine frustrations in an adaptive, rational
manner.
Mother: Mickey, why so grumpy? It’s a beautiful day
outside. Why are you indoors?
Mickey (slumped in a chair, agitated): It’s windy.
Mother: It’s windy?
Mickey (more agitated): I said it’s windy. I hate wind.
Mother: Mickey, you could be out playing
basketball, swimming... you’re this upset over a
little wind?
Mickey (very agitated): It’s too windy, dammit!
Leave me alone!Anxiety falls under the “emotion regulation skills”
category as well because, similar to irritability, anxiety