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behavior.
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IN FOCUS
Difficulty managing emotional response to frustration so as to think rationally (separation of affect)
Chronic irritability and/or anxiety significantly impede capacity for problem-solving
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    Separation of affect refers to the ability to separate the emotions (affect) you’re feeling in response to a problem or frustration from the thinking you must do to resolve the problem. While emotions can be quite useful for mobilizing or energizing people to solve problems, thinking is how problems get solved. Kids skilled at separating affect tend to respond to problems or frustrations with more thought than emotion, and that’s good. But kids who lack skill in this domain tend to respond to problems or frustrations with more emotion and less (or no) thought, and that’s not good at all. Learning how to put your emotions “on the shelf” so as to be able to think rationally is an essential developmental skill, and one many challenging kids have failed to develop.
    At the milder end of the spectrum, kids who are having difficulty separating thought from emotion may become highly anxious over, for example, an upcoming test, a new social situation, not understanding an assignment, or being embarrassed in front of their classmates. They may cry over a bad grade, at not being picked first for a team, or when they feel socially excluded. At the more extreme end of the spectrum, their emotions may burst through in such a powerful way that they scream, swear, throw something, hit somebody, or worse. These kids may actually feel themselves “heating up,” but often aren’t able to stem the emotional tide until later, when the emotions have subsided and rational thought has returned. Naturally, the heating-up process will be greatly intensified if adults or peers respond in a way that adds fuel to the fire.
    While separation of affect refers to momentary difficulties in managing emotions, other kids have more chronic difficulties regulating their emotions. All kids are a little sad, irritable, agitated, grumpy, cranky, grouchy, and fatigued, or a little anxious, worried, scared, and nervous some of the time. No one responds especially well to problems or frustrations when they’re irritable or anxious, but some kids experience these emotions far more often and far more intensely. Kids who are frequently irritable or anxious often respond poorly to problems and frustrations. Because they haven’t developed the skills they need for modulating their emotions and solving problems, they respond to problems and frustrations in a way that more closely resembles what we might see in a much younger child. When it comes to managing their emotions and solving problems, these kids are functioning at a much younger developmental level.
    We’ve witnessed a disturbing trend in recent years: the almost automatic inclination to use medication to treat kids who have difficulty regulating their emotions. While medication can be useful, even indispensable, in some instances, jumping the gun on medicating kids whose difficulties are poorly understood is far too common. Pills don’t teach skills, and there are many factors that could set the stage for a kid to be irritable or anxious that medication won’t address. Some kids are irritable or anxious because of chronic problems that have never been solved, such as school failure, poor peer relations, being bullied, or having an unrecognized learning disability. Medication doesn’t solve these problems.
    Equally disturbing is the recent tendency to diagnose kids who have difficulty regulating their emotions as having bipolar disorder. In my experience, the vast majority of kids who have been called bipolar have been poorly assessed and inappropriately diagnosed. 1 These kids certainly don’t meet criteria for adult bipolar disorder, and there are no universally accepted criteria for childhood bipolar disorder. Unfortunately, the recent popularity of the diagnosis accounts for a