Some people are subject to extreme changes in mood state in which they experience very strong emotions. They may become very excited, very irritable, very sad, or very angry. These mood states may last for hours, days, or weeks, and sometimes last longer or shift more quickly. In children, this can be expressed in behavioral problems such as temper tantrums, school refusal, and aggression. This emotional sensitivity and intensity can lead to irritability and other difficulties even between mood states. A family history of bipolar illness may be present. Often described as mood swings, emotional dysregulation refers to this vulnerability to neurochemical changes that interfere with modulating emotions and emotional reactions and behavior. Medication can be very helpful for reducing the intensity of the emotions, and therapy can then provide tools for improving awareness and regulation of strong emotions and maintaining a more neutral mood state, in turn improving attention, learning, and communication