Q: My son often acts out, and on a couple of occasions, well-meaning people have called him crazy and told me to get him (or me) professional help. How can I tell what’s “normal” behavior, and what requires a visit to the therapist?

A: This question could be an entire series of columns instead of just a single answer, but I’ll try to make it short and somewhat sweet.

The first question you have to ask yourself is whether you consider your son’s behaviors “over the top.” Is he just being a kid – you know, “boys being boys” – or is there something else going on? Are his behaviors extreme compared to what you’ve seen from other kids inside and outside your own family? Is he at risk of hurting himself or someone else? Does he seem more angry or sad than usual?

Some mental-health disorders can be genetic, so you also need to consider your family’s mental health history. If someone else in the family has ADHD, for example, your son would be at greater risk of having that influence on his behaviors. But remember that family history doesn’t guarantee anything. Don’t assume that your child is psychotic, for example, because he has an imaginary friend at the age of seven while your Uncle Joe (who was diagnosed with schizophrenia) also has an imaginary friend at the age of 39. At seven, it’s part of the normal developmental process to have imaginary friends. At 39, it’s not.

You should also think about unusual stressors. Could your son be reacting to an outside influence? Is he being bullied at school, for example, or is there tension between you and his other parent? Is someone in the family sick? Has your son lost an important loved one? These influences (and countless others) could be causing the behaviors just as easily as a mental illness.

The most important thing to consider, though, is your gut reaction. Nobody knows your family as well as you do, and although there are plenty of mental health professionals who provide quality assistance, they can never be the “expert” on your son and your family. That expert would be you.

Don’t worry about what “well-meaning” people say about your son. What do you think? If you’re unsure, call a professional trained in family therapy for a consultation. Often, children are simply reacting to something that’s happening in the family system, and solution-focused brief therapy could be just what your family needs.

Whatever you decide, remember the first rule of diagnosing a disorder – the behaviors have to negatively impact your son and/or your family. Nobody should diagnose a disorder simply because “well-meaning” people are bothered by your son’s behaviors, and nobody should diagnose a disorder because just because someone acts “different.” Quirky is not a disorder.

(Carl Grody, LISW-S, specializes in family therapy at Grody Family Counseling in Worthington, OH.  For an appointment with Carl, call 614-477-5565. Online sessions may be available as well.)

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