The Difference Between Irritable Mania and Irritable Depression

It's important to distinguish irritable mania from irritable depression in a child. Either condition may result in a child becoming violent, intense, or impossible to reason with, and in either case, a child may need to be hospitalized.

In irritable depression, there is tremendous anger, but the child is angry at being rejected by the world and at herself for her own inadequacy. Suppose that a child gets a low mark on her spelling test and that she was depressed even before she got the test back. She becomes angry, and her eyes fill with tears. She then rips up the test paper and throws it to the floor. The teacher tells her to pick it up, but she refuses. She then thinks: "I hate this creepy teacher. I know she never liked me. I can't believe I did so lousy on the test. I'm so stupid. I don't know anything. I always mess up. No wonder everyone is mean to me. My mom tells me I'm smart, but I know she doesn't really mean it. I wish I wasn't born. No one would care if I wasn't here." In irritable depression, the child feels as if she is a powerless victim and the world is against her.

In irritable mania, a youngster's anger is directed at the outside world. The experiences of Monty, age ten, demonstrate how irritability looks on the manic side of the pendulum. One day, Monty came home from school very upset. He told his mother that his teacher was mean and had refused to call on him in class when he had his hand up and knew the answers to some hard questions. The more he discussed the incident with his mother, the more enraged he became. He said that he was sure the teacher didn't choose him on purpose and stated that he was "going to get even with her" by making a bomb in the garage and blowing up the whole school. That would teach her! His mother, obviously alarmed, explained that this was against the law and that many children and other teachers would perish in the explosion.

"I don't care. They deserve it. They won't let me play with them at recess, and all teachers are mean and stupid."

"What about the fact that you'd be in jail for the rest of your life?" his mom pressed.

"It'd be worth it. Anyway, I'll shoot the policemen if they try to get me."

By listening carefully to Monty's words, you get a fairly good sense of how irritable mania sounds.

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