What Is Disruptive Mood Dysregulation Disorder?

Medically Reviewed by Poonam Sachdev on October 10, 2022
4 min read

Mental health is an important topic. With more and more individuals being diagnosed with mental health disorders each year, it’s essential to address underlying conditions and support those who are affected. Untreated, mental health conditions can impact our emotional, psychological, and social well-being and affect how we think, act, and feel. 

Mental health doesn’t discriminate, and disorders can affect anyone at any age. Some conditions, though, are known primarily to affect toddlers and children. One such condition is called disruptive mood dysregulation disorder (DMDD).

DMDD causes children to experience unstable emotions they cannot regulate, including extreme outbursts of anger, leading to temper tantrums. These outbursts often occur in response to something a child doesn’t like, including baths, hair brushing, doctor visits, bus rides, and more. Additionally, children with DMDD are more susceptible to developing other mood disorders. 

DMDD is sometimes confused with simply being in a bad mood, but the two have stark differences. Children can overcome bad attitudes fairly quickly and easily, whereas children with DMDD often cannot do so. 

Due to their emotionally intense nature, children with DMDD often have issues at home, school, and other social settings. They may have difficulty making friends. They may also experience more frequent trips to healthcare providers or faced suspension from school.

In 2013, DMDD was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), listed under the depression disorder module. DMDD is now used to provide more accurate diagnoses in the cases of children who may have previously been diagnosed with pediatric bipolar disorder, helping to prevent overdiagnosing bipolar disorder in children. 

Studies from The Global Burden of Disease reveal that this disease first manifests in early childhood, developing in children from one to ten years old. It also frequently occurs in individuals diagnosed with other mental health disorders such as depression, bipolar, and anxiety. The effects of DMDD peak from the ages of 10 to 29. 

Children with DMDD experience intense mood outbursts such as temper tantrums that result in significant impairment. Sometimes, these episodes require clinical attention. Typically, these outbursts are unjustified and occur several times a week, with the possibility of more general irritability being displayed between more violent episodes. Trouble focusing at home and in school can also cause problems for children with DMDD.

No known causes or risk factors are currently associated with a child developing DMDD.

Parents concerned that their child has DMDD should speak with the child’s doctor. A thorough examination may be conducted, including an assessment of your child’s behavior. During this assessment, you should describe your child’s behavior at home and in public settings. The doctor will then evaluate your child and rule out other causes. 

Your child’s doctor may then refer your child to a mental health professional for proper diagnosis since DMDD can often be confused with other disorders, such as attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, and oppositional defiant disorder (ODD). 

To be diagnosed with DMDD, a child must exhibit the following symptoms: 

  • Extreme temper outbursts, including verbal and behavioral misconduct
  • Inappropriate and unwarranted outbursts that happen more than three times a week 
  • Persistent irritability and anger between outbursts
  • Symptoms that have been present for at least a year 

Symptoms must be present before the age of 10. To receive a diagnosis, the child cannot be younger than 6 or older than 18.

Since DMDD is still a new diagnosis, medical professionals are currently experimenting with treatments. Often, treatments and therapies used to effectively treat ODD, ADHD, and anxiety disorders will also be implemented to help with DMDD. 

Research is ongoing regarding the best treatments for DMDD. Currently, though, two main treatments are used to ease DMDD symptoms: medication and psychological therapies.

Medication 

Several medications are prescribed to children with mental health disorders. Most of these medications are effective in treating symptoms. It should be noted, though, that a few have not been approved by the Food and Drug Administration for use in children. Additionally, all medicines have side effects, so your child’s medication should be monitored closely by their doctor.

Medications used to treat DMDD symptoms include:

  • Stimulants: Frequently used to treat ADHD, stimulants help improve irritability.
  • Antidepressants: Antidepressants can treat irritability and issues with mood regulation.
  • Atypical antipsychotics: Atypical antipsychotics are sometimes prescribed for children who experience extreme outbursts, primarily those that involve physical aggression.

Psychological treatments 

Two primary forms of psychological treatment are effective when treating DMDD patients: 

  • Parent involvement: Parents usually have responsibility for handling their children with DMDD, so they must educate themselves, identify symptoms and triggers, respond appropriately to outbursts, and engage with children who throw temper tantrums. Additionally, parents should adopt positive parenting techniques to help them manage their child’s symptoms.
  • Therapy: Therapy can effectively treat DMDD, particularly cognitive behavioral therapy. Therapists can help a child address anger issues, learn coping mechanisms, practice effective communication, and more.