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In a few weeks school will reopen and many children already are beginning to feel anxious.  Many of them were victim of Bullying during the last school year.  Bullying is a very common experience of many children, even in middle school.  Some surveys indicate at least 10% children are Bullied on a regular basis.

What is Bullying?
It is a behavior by one person attacking other, either emotionally of physically. Examples of Psychological Bullying by intimidation include making fun of one’s physical appearance, their race, calling names, teasing, making remarks on ability of the person---academic or other area of functioning, which may humiliate the person in public, etc. Physical Bullying is physically attacking the person.

Most of the bullying occurs in relative unsupervised settings. Example include playgrounds, lunch rooms, bathrooms,
and the school bus. Recently bullying has begun appearing in the web sites. Namely on Myspace and You tube.

Why Children become Bullies?
Children growing up in a hostile environment has lot to do with these kinds of aggressive behavior.  Bullies become
Bullies over time.  They themselves do not like the way they behaves, or treat others.  Many of them suffer from severe
depression, substance abuse problem, victims of domestic violence or neglect, sexual abuse , other mood disorders,
or are raised in a home where possibly the primary care taker has a significant mental disorder.  Many times these children
identify themselves with the aggressors in their life after trying to cope other ways.  Inside of these children they have very low self esteem and they are ashamed of themselves.  The trauma they experienced in their life, they are unable to processes their emotion in a healthy way.  They feel very angry and out control.  Eventually they project their feeling to others by Bullying others.

Who are the Victims?
Children, who are mostly isolated, easily get intimidated either because of low self esteem, anxiety or depression, new kid in the class, outstanding students, passive, anxious or having some sort of talents. In reality anyone may become a victim.

Psychological Consequence of Bullying:
Anxiety, social withdrawn , depressed mood, separation anxiety , school refusal, poor academic performance, poor sleep,
nightmare, poor quality of health, loss of wellbeing, symptoms of Post traumatic stress disorder and many more which
eventually not only affect the victim also their friends and families .

In interviewing one very young child in preschool reported that the way he treats others in class including his teachers because
‘supposed to through things, or hit when you get upset because dad do all the time and I am so scared’.  One second grade student developed symptoms of PTSD and refused to go to school bathroom, as he was physically abused and humiliated in the bathroom by older kids. 

Girls mostly use verbal threats with other girls, as a target.  Bullying may begin with some type of jealousy or conflict
between the two.  School refusal is one of the indications that something is not going well for the child. It is very important
to communicate with our children, as to why they do not like to go to school and develop plans for home schooling.  Many
times children are afraid to tell their parents, as they may feel ashamed they are unable to protect themselves and the parent
may think less of them.  Parents and schools need to intervene as early as possible.  School shootings across the country
can be tragic results of extreme Bullying.

The victims of Bullying need to be evaluated by professionals in the field, to determine what type of support and care
they need. School psychologists, counselors, primary care physicians, Child and Adolescent Psychiatrist may play a significant
role in care of these children. 

School need to establish clear rules, that Bullying and teasing will not be tolerated at any cost.  Bullies also need to be evaluated and get proper treatment. Bullies left untreated stay in society and eventually negatively impact society, as they may eventually develop conduct disorder to antisocial personality. The treatment of these children is often complex and challenging.
Treatment can be provided in different settings depending on the severity of the behaviors. Understanding these children is very important, so that proper treatment plan may be implemented.  Behavior therapy and Psychotherapy are essential, to help these children to express their feelings appropriately and learning anger management. Sometimes parents will need expert assistance in carrying out special management and educational program at home and in school.  Some may need medication for inattention, impulse control, anger problem or depressed mood. Some may need court order for their treatment.

Schools can positively impact Bullying by managing to monthly group meetings conducted by the School Psychologist
or Mental Health Counselor, on violence prevention, educating children how to handle, be assertive and behave certain way, so that they may avoid violence.  Both parents and teachers need to communicate with children about their needs and emotional wellbeing. Early treatment of both the Bully and victim provide the child a better chance and hope for successful future.


Syeda N Sultana, M.D. Child, Adolescent and Adult Psychiatrist, is Board Certified Psychiatrist by American Board of Psychiatry
and Neurology. She completed her fellowship, at the University Florida Shands Hospital, Gainesville, FL, in Child and Adolescent Psychiatry.  She did her Residency in Adult Psychiatry from St. Louis University Medical Hospital, St. Louis, MO. She is President and CEO of Bay Hill Psychiatric Associates, a full service mental health provider. Located at 6068 S Apopka Vineland Road, Suite # 3, Orlando, FL 32819 She can be reach at Phone: 407-903-9696 or visit her at www. BayHillPsych.com



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August 2008

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