Trouble at Home and School: Understanding and Treating Oppositional Defiant Disorder

Depression and Oppositional Defiant Disorder

Children and teens with ODD may have trouble at home, in school and at work. They also often have difficulty with friends and family.

Some researchers believe that ODD is caused by problems with certain chemicals in the brain that help nerve cells communicate. Other factors include environment and childhood trauma.


While all kids are touchy and irritable at times, children with ODD display extreme versions of these behaviors that affect their ability to function. They often argue with parents, teachers and other adults and show vindictive behavior toward them.

They may also have difficulty at school or with friends. Symptoms of oppositional defiant disorder usually begin in childhood or early adolescence and continue throughout the teen years.

A doctor can diagnose ODD if your child’s anger and defiance significantly impacts your family life and interferes with his or her normal social relationships. To qualify for a diagnosis, symptoms must have lasted for at least six months and include angry and irritable mood, loss of temper, blaming others for mistakes, or vindictive behavior. Symptoms of depression can also be present. Symptoms of depression include feeling sad or hopeless almost every day and having trouble thinking or remembering things. They can also include a lack of interest or pleasure in most activities nearly every day and thoughts about death or suicide.


Although irritable and argumentative behavior can be a normal part of development, children with ODD have a persistent pattern of anger outbursts, defiance and arguing. Their negative and hostile behaviors affect the entire family, their relationships with peers and their school performance. They lack the coping skills needed to respond to requests, rules and demands in socially acceptable ways. Children with ODD often have a history of other mental health, learning or communication problems. Depression and anxiety disorders can cause similar symptoms, so doctors need to carefully evaluate all children.

It’s important for parents to know that ODD isn’t just a normal stage of growing up. It’s a serious condition that can interfere with family life, social activities, school and work. Children and teens with ODD may need help from a mental health professional and treatment, including medication. ODD symptoms usually last at least six months. They must occur frequently and significantly interfere with functioning to be diagnosed.


While it’s normal for young children and teens to display oppositional behavior from time to time, if the child’s behavior is persistent and interferes with family or school life, it could be a sign of a mental health condition. Seek treatment from a mental health clinician (typically a psychiatrist or child and adolescent psychologist) as soon as possible to prevent the problem from getting worse.

Psychotherapy or talk therapy for children with ODD is often effective in improving their behavior and relationships. Parent management training (PMT) is a common approach for treating oppositional behaviors. This type of therapy teaches parents how to use positive reinforcement and punishment to decrease negative behaviors and promote prosocial behaviors. Children with ODD may also receive counseling to help them learn ways to manage their emotions. Treating any co-occurring mental disorders can help reduce symptoms of oppositional defiant disorder. Medication may be prescribed if your child has ADHD or depression.


Although some oppositional behavior occurs as a normal part of childhood and adolescence, it’s important to get a correct diagnosis if your child regularly acts defiant, angry or spiteful. Children who do these things frequently and for long periods of time may have a mental health condition called oppositional defiant disorder.

A mental health professional can teach you positive parenting skills that can help improve your relationship with your child and reduce problem behaviors. They also might prescribe medicines to treat other conditions that could be contributing to the symptoms of ODD, such as ADHD or depression.

Some studies show that young people with ODD have higher rates of other problems, such as substance use disorders, mood disorders or anxiety disorders, than others do. Early treatment can help avoid or minimize these complications. Families can learn to recognize the early warning signs of ODD and take action right away. This can ease distress for the family and prevent many of the problems that ODD can cause.

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