Disruptive Mood Dysregulation Disorder (DMDD)

Disruptive Mood Dysregulation disorder (DMDD) is an emotional disorder with severe mood and behavioral dysregulation. It includes significant behavioral challenges but is not a behavioral control disorder. Children with DMDD tend to throw fits very often. They may break things, throw things, scream, yell, and hit. They are highly emotional; often alternating between happy, anxious, depressed, and angry.

What are Disruptive Mood Dysregulation Disorder (DMDD)?

DMDD is a new diagnosis included in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The core features of DMDD include large tantrums that seem have a mood component, that are way more intense than you would expect (occurring multiple times per week), and are combined with a generally irritated mood. These symptoms must be observable and cause clinically significant distress that impacts functioning.   The DSM-5 classifies DMDD under the category of Depressive Disorders while Conduct Disorder and Oppositional Defiant Disorder are classified in a separate section (Disruptive Impulse and Conduct Disorders).

What are the signs and symptoms of Disruptive Mood Dysregulation Disorder (DMDD)?

Children who have significant problems in this area may have any of the following potential disability. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

Obvious symptoms include temper outbursts (seen as either verbal rages and/or physical aggression) and near constant irritability or anger related to mood challenges.  Said another way: dysregulated mood and extremely low frustration tolerance. These outbursts may include anger, despair or seem manipulative or oppositional.  They may be quite frightening. These outbursts are clinically understood as exaggerated and developmentally inappropriate temper tantrums including anger and distress and are out of proportion in intensity or length to the situation.

Other Symptoms

Thoughts of worthlessness. Your child may make a lot of negative self-statements. “I’m not good enough.” “Everyone else can do that but I can’t.” “I never do anything right.”

Withdrawal. Your child may not spend time with friends or family and spend all his or her time quietly in a bedroom. Playdates may increase irritability.

Thoughts of death/suicidal. Your child may report wishing he or she had not been born, may discuss life without him or her, or may try to give away treasured possessions. He or she may express a desire to hurt him or herself and share a plan. Be open to listening to your child and hear his or her feelings instead of saying not to feel that way. Seek support immediately and make sure no weapons or other dangerous opportunities are available. Keep close supervision of your child.

How is Disruptive Mood Dysregulation Disorder (DMDD) treated?

Medication, psychotherapy, and a combination of these are a recommended course of treatment.  Since the diagnosis is still new, research is still being conducted to determine the best course of treatment.  Stimulant medication, antidepressants, and behavior analysis have shown positive outcomes in recent clinical studies. That said, careful monitoring of interventions is critical due to the complex presentation of the disorder. CBT. Cognitive Behavioral Therapy is a modality in which strategies can be taught and practiced. This is often individual therapy but may also be delivered in a group setting. Some goals of CBT include the following: Increase Emotional Awareness. Recognize TriggersImprove Coping Skills. Work to improve self-confidence. Mindfulness. Mindfulness involves recognizing and accepting feelings and allowing them to just be. Techniques include: Relaxation and Meditation and Accepting Thoughts. ABA Therapy is recommended to increase coping behaviors and decrease tantrums. Medication is recommended to treat underlying mood/depressive symptoms of the disorder.

DMDD is a new diagnosis and therefore outcome literature is quite sparse. That said, it is in the family of depressive disorders which are common and treatable. Taken together, it is valuable to obtain a diagnosis and engage in the appropriate therapies as early as is feasible. In this way, children with DMDD are not being misidentified as oppositional or with conduct problems. It is important that the emotional underpinnings of DMDD can be addressed. With supports in place, it is possible to see improvement in behavioral symptoms, better coping skills and emotional awareness, and the potential to live a fulfilled life.

How can Clear Child Psychology help with Disruptive Mood Dysregulation Disorder (DMDD)?

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, it’s time to seek professional help.

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Our Coaching Packages allow us to continually support families as they continue their journeys. Parental coaching, clinical referrals and school advocacy are just a few examples of ways we help.

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