The Merriam-Webster dictionary defines a bully as “one who is habitually cruel, insulting, or threatening to others who are weaker, smaller, or in some way vulnerable.” Without articulating a definition, many of us may have an image in our mind when we hear the word “bully.” Maybe an image of some boy who intimidates and harasses others verbally and sometimes physically. While that certainly does describe one demographic within the spectrum of bullying, focusing on this stereotype causes us to miss the other forms of bullying and the structures that perpetuate it.

To that end, we’ve noted people of all ages, genders and backgrounds who have bullied others. From the “mean girls” of middle/high school to the athletic coaches who unnecessarily berate and abuse their players, bullying spans a spectrum and unfortunately now even includes candidates for major political party offices.

This last category marks a significant shift in how bullying is being normalized and the platforms that spread the message. No longer can we rely on the conventional wisdom that the “adults in the room” will obey the standards of common decency that have guided our public discourse.

Bullying has real consequences. As a practicing pediatrician, I have had first-hand experience caring for children in emergency departments who have contemplated suicide because of an insulting post on a social media app. Suicidal ideation has also increased among gender-diverse (i.e., LGBTQIA+) children following the passage of legislation that negatively impacts them — legislation supported by politicians who often use insulting and threatening language directed toward these kids. More recently, we’ve also seen that insulting speech can lead to the closure of schools, canceling of events and the immense psychological trauma that results from being a vulnerable target.

Children today may experience more bullying than those in years past because of social media that provides non-stop interactions with people outside their home. In the past, such interactions often ended at the sound of a school bell or after kids are dropped off by the school bus. And while social media companies deserve scrutiny and some blame, we cannot place full responsibility on them for this form of bullying. The way we as adults engage each other in the public square provides an object lesson for kids’ understanding of how they should talk with and treat each other.

Some people who bully are accustomed to their targets cowering and being meek recipients of their abusive behavior. The act of “standing up” to a person engaging in bullying can give the perpetrator some pause while they consider whether the tactic they are using is effective. And this pause can give the recipient of abuse the opportunity to enlist allies and seek other more productive outlets to address the problematic behavior.

To meaningfully stand up to people who bully, we must recognize the bullies in our lives and those who have enabled them. Embarrassingly, I was one of those kids who would often fail to intervene when someone else was being bullied.

My historic failure to be an active bystander likely gave tacit permission and support to others to continue such behavior. Each one of us can learn about how to be an active bystander and positively intervene when we notice bullying occurring. We can also make ourselves more aware of the warning signs that others are being bullied. Finally, being familiar with local, state and federal laws regarding bullying can help to determine legal methods to address such behavior.

On another level, we should model the types of behavior we want our children to display. We should also speak out loudly when we note those in the highest offices (be that in our workplaces, places of worship, political offices, etc.) using their platform to denigrate and demean others who are less powerful or do not have the platform to speak up for themselves.

October is National Bullying Awareness Month and a reminder for us all to recognize and act against all forms of bullying. Hopefully, we are up to the task.

David Myles is a Rockville City Council member, a general pediatrician at Walter Reed National Military Medical Center, a fellow of the American Academy of Pediatrics and an editorial board member of the journal Pediatrics.