The Psychiatric Issues Behind Cyberbullying

Children and teens want to be normal, and when they struggle with psychiatric issues, they tend to have difficulty "fitting in." Differences make these kids vulnerable to bullying.
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Children and teens want to be normal, and when they struggle with psychiatric issues, they tend to have difficulty "fitting in." Differences make these kids vulnerable to bullying experiences and attendant emotional turmoil. And those who experience cyberbullying may be at even higher risk for mental health problems. A study forthcoming in the Archives of Suicide Research found that youth who have been victims of cyberbullying are almost twice as likely as victims of traditional bullying to have attempted suicide.

Whatever more research can show us, it's clear that to effectively deal with cyberbullying, we need to address the psychiatric problems that both motivate it and are exacerbated by it.

Peer aggression is never normal. While it doesn't cause a child to develop a psychiatric disorder, it is a red flag for preexisting mental health problems and can contribute to depression, low self-esteem, irritability and feelings of hopelessness. Bullies usually have problems with impulse control and hyperactivity. Many of them have Attention-Deficit/Hyperactivity Disorder (ADHD) and a co-occurring conduct disorder.

Victims, on the other hand, are more likely than their peers to feel low self-worth and experience depression. Their feelings of low self-worth can be compounded when any form of bullying occurs, but their emotional response to cyberbullying may be especially devastating.

Since cyberbullying occurs in virtual space (and without physical contact), victims can experience the double anguish of being powerless to stop their harassment and unable to prove who's harassing them. As for cyberbullies, they can be more vicious, their feelings of empathy minimized, since they don't see the impact of their meanness.

Amid the whirlwind of complex questions on how to deal with cyberbullying, many parents feel helpless, and schools are unsure where they fit in the solution. The problem can seem too large and bewildering for individuals to address.

But we can all do something about this problem, first by being more vigilant about our children's mental health (a preventative step that may sound obvious in the context of this article, but as a matter of public interest, child mental health has repeatedly received too little, too late).

Fewer than half of the 15 million children and teens with psychiatric disorders in this country ever receive clinical attention, and while approximately one in five teens experiences depression before adulthood, less than 33 percent of depressed teens ever get treatment. Depressed teens, whose symptoms usually include extreme irritability and rejection sensitivity, are the most vulnerable to cyberbullying -- and they are 12 times more likely to commit suicide.

Each of us can make an enormous difference simply by watching for signs of mental health problems in our children and teens. Behavioral changes are the most easily recognized sign of trouble and include angry and tearful outbursts, new patterns of eating and sleeping, a loss of interest in activities once enjoyed, a sudden change in social groups or clothing style and withdrawal from family and friends.

Parents should also talk to their children about normal emotional and physical changes. This conversation should be ongoing and encourage self-respect, self-acceptance, and empathy toward others. Parent-child communication is especially important during the middle school years, because at that time, more than any other, a child's identity and self-worth revolves around peer relationships.

For any child, being "normal" ultimately means feeling good about one's self. It means having the ability to resist peer aggression, make good choices, and acquire independence. We certainly need new anti-bullying policies to help keep our kids safe, but with respect to cyberbullying--and most other pressures kids confront--we can make the most significant progress by first prioritizing children's mental health.

Harold S. Koplewicz, M.D.
President, The Child Mind Institute
Director, Nathan S. Kline Institute for Psychiatric Research

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