At age 3, Bella was described as “extremely active and markedly stubborn” by her mother, and these traits were exacerbated by a school setting. At age 6, she was diagnosed with ADHD because of hyperactivity and inattentiveness that impaired her school performance. She was prescribed Stratera by her pediatrician when she was 7 as treatment for ADHD, and her daily medication was one of her triggers that would set off tantrums that could consist of screaming, yelling, crying, and slamming doors (Tudor et al., 2016). After these anger outbursts and meltdowns, Bella would refuse to comply or communicate. In addition, Bella showed physical aggression towards her peers, non-compliance at home and school, and an underlying irritable mood that had her family treating her delicately in order to avoid upsetting her. When displaying signs of physical aggression, she would hit, punch, and shove, and these actions were targeted mostly towards her classmates, teammates, and older brother. Although Bella was generally liked by her teachers and peers due to a hardworking and humorous attitude, her disruptive behavior negatively impacted both her school and home life. According to her mother, Bella was not able to make new friends or excel academically because of her chronic irritation and moods. Because of unprovoked aggression …show more content…
In addition, this environment would have interfered with her learning how to regulate her emotions and gain proper social skills for her age (Tudor et al., 2016). Because she also had difficulty with academics, her struggle to perform well and the consequent anxiety resulting from it exacerbated noncompliance at home and school. In addition to the frequent anger outbursts and meltdowns and chronic irritation, her ADHD diagnosis and symptoms of anxiety also common in being concurrent with a diagnosis of DMDD. To counter her maladaptive and disruptive behavior, Bella’s treatment consisted of therapy and methods that would teach her “age-appropriate skills of managing frustration and communicating with others” (Tudor et al., 2016). Furthermore, Bella’s mother was also introduced to parenting methods that would continue to enforce Bella’s progress in acquiring new emotion regulation and problem-solving