Disruptive mood dysregulation disorder (DMDD) is a fairly new diagnosis – first appearing in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. It’s a childhood condition that’s characterized by severe irritability, anger, and frequent temper outbursts. ¹
While it’s common for children to experience moodiness, DMDD goes beyond what we normally see in a moody child.
Throughout this article, we’re going to take a deeper look at DMDD and how to properly treat it. At the end, we invite you to ask further questions.
What are the Signs and Symptoms?
DMDD begins before the age of 10, but isn’t prevalent in children under 6 and adolescents over 18. The most common symptoms of this condition include: ²
- Angry mood or irritability most of the day
- Difficulty functioning due to irritability (i.e. at home, in school, with peers)
- Intense temper outbursts (both verbal and behavioral) occurring three or more times per week
DMDD can debilitate a child’s development as it may keep them out of specific situations. For example, a child with DMDD will likely not be able to participate in after-school activities with his/her peers as irritability is to big an issue.
Furthermore, in order to be diagnosed, a child must struggle with these symptoms steadily for 12 months or more.
What are the Risk Factors?
Since DMDD is such a new disorder, the risk factors for this condition remain unknown.
However, researchers have noticed it’s more common in children who visit pediatric mental health clinics than the general population. This means other mental disorders, such as anxiety and depression, may lead to DMDD.
Other studies have revealed the following may also lead to DMDD: ³
- Low maternal level of education
- Maternal depression during the first years after childbirth
- Maternal mood symptoms during pregnancy
However, we still don’t know exactly what’s causing the condition. Current research is looking into brain mechanisms and both genetic and environmental risk factors for DMDD.
How to Treat Disruptive Mood Dysregulation Disorder?
As of this time, medical professional haven’t developed a DMDD treatment for those newly diagnosed. Instead, DMDD is treated similar to other disorders that have symptoms of irritability and temper tantrums. These include:
- Anxiety disorders
- Attention deficit/hyperactivity disorder (ADHD)
- Major depressive disorder
- Oppositional defiant disorder
If you believe your child is struggling with DMDD, it’s important to seek out treatment as soon as possible. Untreated DMDD can diminish a child’s quality of life, school performance, and inhibit his/her relationship with peers.
Furthermore, DMDD may increase the risk of a child developing other mental health conditions later in life, such as anxiety disorders or depression. ⁴
In order to treat DMDD, your child will be given both of the following treatment methods:
The U.S. Food and Drug Administration (FDA) has not approved of any medications for the treatment of DMDD in children or adolescents. However, some may be beneficial, according to studies. These include:
- Antidepressants – Used for a variety of mental health conditions, antidepressants can help relieve irritability and other mood problems. ⁵ However, their use in children and adolescence should be closely monitored as it can bring about suicidal thoughts and behaviors. ⁶
- Atypical Antipsychotics – May be useful in children who struggle with irritability as a result of autism. ⁷
- Stimulants – Common among those with ADHD, stimulants can help to decrease irritability in children. ⁸ However, those with heart problems should avoid stimulants as it can change the heart rate and blood pressure. ⁹
Since researchers are still observing how medication affects those with DMDD, there is no clear indication as to which is most beneficial for your child.
Furthermore, all these medications come with the risk of serious side effects. You should consult your doctor about these side effects before administering these medications to your child.
Before medication, parents should see if psychological treatments for DMDD help to relieve symptoms. The most common include:
- Psychotherapy – Such as cognitive behavioral therapy (CBT) can help children identify their thoughts and feelings while allowing them to develop coping skills for frustration. ¹⁰
- Parent Training – May help in your interactions with your child and how you work with them to reduce irritable behavior and aggression. This training can help you identify predictable natures, how to be consistent with a child, and how to reward positive behaviors. ¹¹
- Computer-Based Training – Studies have found that children struggling with DMDD may misperceive certain facial expressions as angry. ¹² Therefore, some preliminary evidence suggests computer-based training can help identify this specific problem. ¹³
While we still have a lot to learn about DMDD, what we do know can help identify and treat this condition early in childhood. The earlier treatment occurs, the better chance they have at overcoming symptoms.
Currently, lots of research is being done to better understand this disorder. If you’re interested in participating in a study, you can learn more here:
- NIMH’s Clinical Trials webpage for those looking for more information about participating in clinical trials
- Clinicaltrials.gov: Current Studies on DMDD for a list of clinical trials funded by the National Institutes of Health (NIH)
- Join a Study: Children – DMDD for a list of studies taking place on the NIH Campus in Bethesda, MD
Still have questions concerning disruptive mood dysregulation disorder?
We invite you to ask them in the comments section below. If you have any further knowledge to share – whether personal or professional – we’d also love to hear from you.
¹ National Institute of Mental Health (NIMH): Disruptive Mood Dysregulation Disorder
² Neuropsychiatric Disease and Treatment (Dovepress): Disruptive mood dysregulation disorder: current insights
³ Journal of Affective Disorders: Perinatal and postnatal risk factors for disruptive mood dysregulation disorder at age 11: 2004 Pelotas Birth Cohort Study
⁴ The American Journal of Psychiatry: Prevalence, Comorbidity, and Correlates of DSM-5 Proposed Disruptive Mood Dysregulation Disorder
⁵ Journal of Child and Adolescent Psychopharmacology: Effectiveness of Antidepressant Medications for Symptoms of Irritability and Disruptive Behaviors in Children and Adolescents
⁶ Food and Drug Administration (FDA): Suicidality in Children and Adolescents Being Treated With Antidepressant Medications
⁷ Journal of Child and Adolescent Psychopharmacology: Atypical Antipsychotics for Irritability in Pediatric Autism: A Systematic Review and Network Meta-Analysis
⁸ HHS Public Access: Using Stimulants to Treat ADHD-Related Emotional Lability
¹⁰ HHS Public Access: Psychosocial Treatment of Irritability in Youth
¹² National Institute of Mental Health (NIMH): Imaging Studies Help Pinpoint Child Bipolar Circuitry
¹³ Journal of Child and Adolescent Psychopharmacology: An Open Pilot Study of Training Hostile Interpretation Bias to Treat Disruptive Mood Dysregulation Disorder