UNM Hospital Child Psychiatrist Discusses Signs of Bullying
They are heartbreaking stories that have become all too common across the country and here in our own communities: stories of teenagers or even younger children who have been traumatized by bullying, sometimes to the point of suicide. Dr. Scott Carroll, a child psychiatrist at UNM and director of child psychiatric consultation services at UNM Hospital, recently talked to me about these tragic kinds of cases, how they relate to bullying and how they might be prevented.
Credit: John Arnold

They are heartbreaking stories that have become all too common across the country and here in our own communities: stories of teenagers or even younger children who have been traumatized by bullying, sometimes to the point of suicide. Dr. Scott Carroll, a child psychiatrist at UNM and director of child psychiatric consultation services at UNM Hospital, recently talked to me about these tragic kinds of cases, how they relate to bullying and how they might be prevented.

What is bullying? What kinds of behavior does it include?

Carroll: Bullying covers a wide range of activities - everything from physical bullying, which includes pushing, shoving, actual hitting, to social bullying such as posting derogatory information or spreading gossip or rumors about a student, often through social media. It can be profoundly stressful to a child - to the point where they can become severely depressed and very anxious. Children can even develop post-traumatic stress disorder from it and in severe cases have attempted or completed suicide.

What should parents do if they believe their child is being bullied, or is bullying other children?

Carroll: Bullying is a common situation that we deal with frequently. I’ve treated many children and adolescents who’ve been the targets of bullies, as well as those who have been bullies themselves. Often the bullies themselves have significant psychiatric problems as well and have been the target of bullying either by older children or by family members. 

If a parent believes their child is being bullied or if they think their child is bullying other children, they need to go their school and inform the school.  And while informing teachers and principals is important, it’s not sufficient in and of itself.  That’s not the entire solution, but it’s very beneficial when school officials and teachers intervene and do what they can to help remedy the situation.

The other thing to do if your child is either a bully or being bullied is to seek a mental health evaluation.  For children who are being bullied, it’s very important to assess them for suicidal thoughts as well as for depression and anxiety.

For children who are bullying, we also need to assess them for suicidal thoughts, depression and anxiety as a result of their negative or traumatic experiences that have contributed to them becoming a bully. 

What kinds of behavior or other signs might indicate a child is being bullied? Or is bullying other children?

Carroll: What you’re looking for is a change - either avoidance of the situations, like when a child says “I don’t want to go to school; I don’t like school.”  They may also become somatic, meaning they’re complaining of headaches and stomach aches.  They may be going to the school nurse at a specific time of the day, always missing a certain class, recess or lunch, where ever the bullying is happening.

One of the most sensitive signs is dropping grades as well. You’ll notice that a formerly ‘A’ or ‘B’ student is suddenly lacking in motivation. They’re just not putting the effort in, so you see the grades drop.  One thing to note is that when children get stressed or depressed, they rarely look sad.  In fact, the most common symptoms you see, besides dropping grades, are actually irritability and oppositionality, meaning that they suddenly start refusing to follow rules or directions. 

You may also see signs of anxiety such as difficulty sleeping, fear of being alone, increased worrying, picking or biting nails, complaints of headaches (from increased muscle tension) and fatigue.  They may also start having nightmares and avoiding places and situation or become more shy.  Also cutting or other self-injurious behavior can start as a result of bullying.  While cutting is not specific to bullying it always warrants a mental health evaluation since it clearly indicates the presence of emotional distress.

As for the bully, the onset of emotional and behavior signs are usually gradual. Oftentimes their traumatic experiences occurred much earlier and not immediately prior to the bullying. What you’ll often find is these children have long standing issues with irritability and oppositional behavior. They may even get into some types of low-grade criminal behavior such as shoplifting.  In more extreme cases they may start setting fires or be cruel to animals.

What are effective ways to stop bullying?

Carroll: The most effective treatment actually involves the entire school.  The children all know who the bullies are and who the targets are. They are the witnesses. So, if the audience refuses to tolerate or give attention or approve to the bullying, the bullying often stops, because the bully is doing it to gain attention or status with his or her peers.

When you engage the popular kids in the class, the natural leaders of the group to reject or disapprove of the bullying, it often stops.  Sometimes, something as simple as having a popular kid befriend the targeted child can help.

It is also important for teachers and school officials to take steps to prevent it such as moving the bully to a different class and contacting the parents of the bullies to get them into mental health treatment.

Parents of the target need to get their child in to psychotherapy as well to help them cope and to work on techniques to emotional defend themselves.

What if a child is being bullied, but does not give any outward indication of trouble, like dropping grades or acting out - is there a way parents might be able to discover trouble brewing below the surface?

Carroll: Parents need to make a real effort to know what's going on in their child's life - both online and in real world. As a parent, I am increasingly worried about the dangers the online world poses to young girls. I think parents need to be aware of everything their children do online. They also need to know who their child’s friends are and how they're truly feeling. Kids with good grades and good behavior can lull you into a false sense that everything is okay. A smart child can hide his or her true feelings if you don't make an effort to learn what is going on in their lives.