As the parent of a teenager, you might notice that your child has mood extremes. Adolescents sometimes get angry over incidents and perceptions that an adult would likely brush off. This is often due to hormonal fluctuations and the stress of growing from a child into an adult. In some cases, however, particularly when anger seems severe or unwarranted or when it leads to aggressive behavior, such strong negative emotions can be a sign of a mental health condition. Here are seven mental illnesses that can involve anger as a symptom.

1. Oppositional Defiant Disorder

Many teens are defiant at times. They might refuse to comply with what you consider perfectly reasonable requests. You might even be reminded of your teenager’s toddler years, when they would stomp their foot and declare, “no!” Some defiance is normal and a way for teens to pursue their independence. However, when defiance is excessive or goes on for more than six months at a high level, it could be a sign of oppositional defiant disorder, or ODD.

Teens with ODD might do the following:

• throw tantrums that don’t differ all that much from those thrown by toddlers
• become aggressive and do things purposely to upset you or others
• have frequent angry outbursts, swear and scream, and say hateful things when upset
• have low self-esteem
• abuse drugs or alcohol

Treatments include psychotherapy and medication.

2. ADHD

While many children with attention deficit/hyperactivity disorder, or ADHD, are diagnosed during the elementary school years, sometimes the mental health condition is not diagnosed until the teen years. One reason for this is that children can find ways to cope with their difficulties without letting others know that they’re struggling. Once schoolwork becomes more challenging in middle school or high school, however, it’s difficult for teens to continue to hide the condition.

ADHD can cause anger due to frustration and low self-esteem. Many times, kids with ADHD are angry at themselves for not being able to keep up with their classmates, which can lead to their anger spilling over into their relationships with others. Because ADHD can cause issues through adulthood if it’s not treated, it’s important to have your teen evaluated if you suspect that it could be the cause of his or her anger or other symptoms.

3. Bipolar Disorder

Bipolar disorder has two phases:

1. Depression – During depressive episodes, those with bipolar disorder are likely to:

• need a lot more sleep
• find it hard to get anything done
• struggle with sadness.

2. Mania – During manic periods, teens and adults might exhibit behaviors like:

• angry outbursts
• rapid speech
• aggression
• the need for little sleep

If you notice that your teen seems to be cycling between these two extremes, an evaluation for bipolar disorder might be warranted. Treatments for bipolar disorder include medication for both manic and depressive episodes and therapy that will help victims cope with the reality of their condition, as well as give them methods for controlling bothersome symptoms.

4. Antisocial Personality Disorder

Those with antisocial personality disorder can seem angry, callous, and excessively opinionated. Sometimes they might be very charming. No matter which type of behaviors and moods they’re exhibiting, those with antisocial personality disorder do so for their own gain; they tend to lack empathy for others and how they are feeling. People with this mental health condition are sometimes referred to as “sociopaths” or “psychopaths,” but those are not diagnoses. This is a serious personality disorder that requires long-term psychotherapy and, in some cases, medication.

5. Narcissistic Personality Disorder

You might have heard a self-centered person referred to as a narcissist. While it’s a descriptive term used when a person seems not to think of others, narcissistic personality disorder refers to someone who feeds off the energy of others and uses that energy to boost their own self-esteem. Others often notice that people with this mental health condition are not able to communicate with others in a way that values everyone’s thoughts and opinions; instead, they’re primarily interested in their own thoughts and preoccupations.

There are two types of the disorder.

1. Grandiose narcissism causes someone to feel that they are very important to others and that others are looking up to them. People with this type of disorder may need to be the center of attention at all times.
2. Vulnerable narcissism causes someone to be resentful of others, and this can cause a lot of anger when they are not getting what they want.

Treatment for narcissistic personality disorder includes psychotherapy, and sometimes people with the disorder need to be hospitalized or live in long-term residential care.

6. Intermittent Explosive Disorder

A mental disorder that can cause sudden outbursts of unwarranted anger, sometimes to the point of violence, is intermittent explosive disorder. Symptoms usually last 30 minutes or less, and they include:

• rage
• tremors
• racing thoughts that lead to the angry outbursts, tantrums, violence, and property damage

Sometimes road rage and domestic violence can be the result of intermittent explosive disorder. Medications and both individual and group therapy can help people overcome these symptoms and better manage their anger.

7. Psychotic Disorders

Psychotic disorders include schizophrenia and schizoaffective disorder. These disorders cause hallucinations and delusions that can cause confusion, anger, and erratic behavior. People with these disorders often have disordered thinking and incoherent speech comprised of real words but in a nonsensical order. Since these disorders often begin during late adolescence or early adulthood, it’s good to know the symptoms. Most people with psychotic disorders can control their mental health condition with antipsychotic medication if they take it as directed. Often, those with psychotic disorders decide not to take their medication once they feel good, and this causes a relapse of symptoms.

Get an Evaluation

Knowing whether your teen is struggling with age-appropriate anger or anger that could be a sign of one of these mental health conditions can be a challenge. If your teenager seems to have a lot of angry outbursts or aggression, take him or her to their family doctor for an evaluation. From there, the doctor can refer your child to the appropriate specialists who can help.