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Key Takeaways:
- Disruptive mood dysregulation disorder (DMDD) is a mental health condition diagnosed in children and adolescents who show frequent behavioral issues related to anger and hostility.
- Symptoms of DMDD typically show up between the ages of 6 and 10. This condition cannot be diagnosed after the age of 18.
- DMDD is different from oppositional defiant disorder and bipolar disorder.
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Temper tantrums are a natural part of childhood. As a result, many parents have learned how to handle situations that may trigger an emotional episode in their kids. However, if the tantrums seem out of proportion and are happening more often, then it may be a sign that your child has disruptive mood dysregulation disorder (DMDD). Here, we’ll go over what DMDD is, its symptoms and causes, how it’s diagnosed, and how to provide support.
What is Disruptive Mood Dysregulation Disorder (DMDD)?
Disruptive mood dysregulation disorder (DMDD) is a mental health condition that can be diagnosed in children and adolescents who show frequent behavioral issues related to anger and hostility [*].
While it is normal for children to be moody, DMDD lasts longer and is more severe. Temper outbursts are usually significantly out of proportion in duration and intensity relative to the situation. This condition also disrupts a child’s daily life.
What are the Symptoms of DMDD
Some of the disruptive mood dysregulation disorder symptoms are the following [*]:
- Major temper tantrums that occur three or more times a week on average
- An irritable or angry mood in between tantrums
- Inability to control extreme emotions
- Difficulty functioning well in two or more settings (at home, school, or with peers) due to anger, irritability, outbursts, or tantrums
- Having tantrums or verbal outbursts inappropriate for their age or maturity level
Symptoms of DMDD typically show up before age 10.
What are the Causes and Risk Factors of DMDD?
Some factors may increase a child’s risk of developing DMDD, including:
What Age Does DMDD Typically Occur?
DMDD typically emerges and is diagnosed between the ages of 6 and 10. However, the condition can apply to children and adolescents until age 18. Older children who are diagnosed with DMDD need to have experienced the initial symptoms by age 10.
What is the Difference Between DMDD, ODD, and Bipolar Disorder?
DMDD is often confused with other disorders, such as oppositional defiant disorder and bipolar disorder. Let’s go through their differences.
ODD is a behavioral condition that causes a child or teen to display a continuing pattern of defiant, uncooperative, and sometimes hostile behavior toward authority figures, such as parents. Some symptoms of this disorder overlap with DMDD, but the latter is considered more severe as it has a mood component.
Children who meet the criteria for both DMDD and ODD are only diagnosed with DMDD.
Bipolar disorder, on the other hand, is a lifelong disorder that causes intense shifts in mood, thinking patterns, energy levels, and behavior. These shifts can last anywhere from days up to months and can interfere with one’s ability to carry out day-to-day tasks.
While some similar behaviors may overlap between DMDD and BD, the symptoms of the latter are contained within episodes. DMDD symptoms are ongoing. Furthermore, bipolar disorder is less common in children and adolescents. BD is typically a lifelong condition, whereas DMDD can develop into other disorders later in life.
How is DMDD Diagnosed?
There are no diagnostic tests to confirm DMDD. Instead, mental health professionals will learn about a child’s symptoms and behavioral history from their parents or caregivers and teachers. These details will help them make an accurate assessment and diagnosis. During an assessment, other conditions, such as ODD, bipolar disorder, depression, anxiety, and ADHD will be ruled out.
Mental health professionals will typically ask about the frequency and intensity of the child’s tantrums, whether behavioral or verbal. They will also ask how long each tantrum lasts and whether they lead to aggressive behavior, such as shouting, slamming doors, destruction of property, or physical attacks on others. They may also ask about the child’s baseline mood to figure out how often they are actually irritable, angry, or hostile.
Different scales or checklists may be used to determine whether a child’s irritability, temper, and aggression levels may qualify as DMDD. However, keep in mind that there are no validated scales that are designed to diagnosed DMDD.
To be diagnosed with DMDD, a child must show the aforementioned symptoms between 6 to 10 years of age. The diagnosis cannot be made before the age of 6 or after the age of 18 [*].
What are the Treatment Options for DMDD?
Therapy and medication may be used individually or together as a form of treatment for DMDD.
Psychotherapy
Cognitive behavioral therapy (CBT) helps children and adolescents learn to improve how they manage the relationship between their thoughts, feelings, and behaviors. This reduces the intensity and frequency of tantrums and outbursts.
Medication
Several types of medications can help reduce symptoms of DMDD. Stimulant medications, for instance, can reduce feelings of irritability.
Antidepressants, whether selective serotonin reuptake inhibitors (SSRIs) or serotonin noradrenalin reuptake inhibitors (SNRIs), may reduce the intensity of irritability and negative moods.
There are also atypical antipsychotics, including risperidone and aripiprazole, which can reduce irritability and aggression. Anticonvulsant medications like valproic acid can also decrease aggressive behaviors.
How Can Parents and Caregivers Support a Child with DMDD?
If your child has DMDD, aside from consulting a mental health professional, you can help them and yourself in these ways:
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Learn about DMDD. Talk to your child’s healthcare provider or mental health professional to learn as much as you can about DMDD. By understanding the symptoms and other details of the disorder, you will be much more equipped to help your child manage.
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Work closely with your child’s teacher or school counselor. A joint effort between you, your child’s teacher, and the school counselor can make things easier. Together, you can develop strategies to help your child thrive in school.
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Take time-outs or breaks. Dealing with DMDD is challenging. If you are about to worsen a conflict with your child, take a break and step away first. This will set a good example for your child. Support your child as well if they initiate taking a break to prevent things from escalating.
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Practice self-care. Manage stress by maintaining interests and hobbies you enjoy. This will allow you to approach your child with the right attitude and energy as they manage DMDD.
The Bottom Line
It's normal for kids to get cranky sometimes, but if your child is constantly irritable and causing problems, it could be a sign of DMDD in children. Parenting a child with DMDD can be challenging, so it’s best to consult a doctor or therapist for support. They're there to answer your questions and support you.
Coping skills for anger can sometimes help to reduce symptoms of DMDD. Check out our collection of anger management worksheets for additional resources.
References:
- National Institute of Mental Health. Disruptive Mood Dysregulation Disorder: The Basics. 2023.
- The American Academy of Child and Adolescent Psychiatry. Disruptive Mood Dysregulation Disorder (DMDD). May 2019.
- DMDD.org. DMDD Diagnosis.
