Is your child experiencing chronic, persistent, and severe irritability? Are their mood swings and temper outbursts out of proportion to the situation? They may be struggling with Disruptive Mood Dysregulation Disorder. Parenting a child with DMDD can be challenging, but our parent resources at Shortridge Academy can help.
What is Disruptive Mood Dysregulation Disorder?
Disruptive Mood Dysregulation, or DMDD, is a fairly new mental health disorder introduced in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). DMDD describes children with constant irritability or angry outbursts three or more times a week. They also have these issues in multiple settings.
DMDD is classified as a mood disorder. Symptoms occur before age 10, but DMDD isn’t diagnosed in children under 6 or adults over 18. It often co-occurs with other disorders, such as major depression and ADHD.
Is DMDD a Severe Mental Health Disorder?
If a child receives a DMDD diagnosis, it is severe enough to interfere with their daily life. The emotional outbursts are not age appropriate and resemble severe temper tantrums. Symptoms of DMDD appear frequently and disrupt their education and home life.
If you think you are parenting a child with DMDD, this guide will help you identify signs and symptoms in your child. You will also learn the steps to get a diagnosis and treatment.
Facts and Statistics About Disruptive Mood Dysregulation Disorder
Learning about DMDD and how it can affect children can make parenting a child with DMDD easier. Although it is still fairly new, your child is not struggling alone. The following are some statistics and facts about DMDD and common co-occurring disorders.
- DMDD affects 2% to 5% of children
- DMDD occurs more often in boys than girls
- Approximately 50 to 60 percent of psychiatric admissions are for behavioral outbursts, one of the primary symptoms of DMDD.
- Studies show less than 4 out of 10 children with Oppositional Defiance Disorder (ODD) also meet the criteria for DMDD. However, 7 out of 10 children with DMDD also meet the criteria for ODD.
- DMDD increases the risk of depression and anxiety in adults
- Symptoms of DMDD can be as severe as bipolar disorder
- A study of 179 children with ADHD found 22% had co-occurring DMDD. Nearly 90% of the children with both disorders also struggle with ODD, while 41% struggle with anxiety.
- The same study found children struggling with both ADHD and DMDD typically engage in bullying and have less self-control than children with ADHD without DMDD.
What are Common Co-Occurring Mental Health Disorders with DMDD?
DMDD often co-occurs with other mental health disorders. The most commonly co-occurring disorders include:
- Attention-Deficit Hyperactivity Disorder (ADHD)
- Oppositional Defiant Disorder (ODD)
- Anxiety disorders
- Major depression
- Autism spectrum disorders
If the symptoms meet the criteria for DMDD and ODD, the child will be given a DMDD diagnosis. They will not receive a co-occurring ODD diagnosis.
The Causes and Risk Factors for Disruptive Mood Dysregulation Disorder
Experts continue working to isolate the exact causes and risk factors of DMDD. However, they do agree that genetics play a role.
In fact, children who meet the criteria for DMDD typically have a family history of depression, anxiety disorders, or substance use disorders. Additionally, an irritable personality is thought to be hereditary and can influence the onset of DMDD.
Risk factors include:
- Being male
- Being of school-age
- Having a family history of depression, anxiety disorders, or substance use disorders
- Having an irritable temperament before age 10
What are the Effects of DMDD?
When children struggle with disruptive mood dysregulation disorder symptoms, it leads to various unpleasant effects. Some of the effects can be temporary, while others are long-lasting. While parenting a child with DMDD is challenging, understanding the following effects can help you get them the right treatment.
- Causes family conflict
- Troubled friendships
- Poor performance in school
- Lack of participation in extracurricular activities
- Suicidal ideation
- Suicide attempts
- Needing inpatient treatment
If the above sounds like what your child is struggling with, Shortridge Academy can help your child receive a diagnosis and treatment and help make parenting a child with DMDD less challenging.
Common Questions about Onset and Outlook When Parenting a Child With DMDD
Parenting a child with DMDD can bring up questions about the age of onset and long-term outlook. The more parents know about this disorder, the easier it will be to help their children manage their symptoms.
What is the Age of Onset of DMDD?
DMDD is a childhood mental health disorder. Meaning only children ages 6 to 18 can receive a DMDD diagnosis. Symptoms of DMDD appear before the age of 10 but not before the age of 6. Tantrums are age-appropriate for children under 6, so they don’t qualify for this diagnosis.
Do Children Outgrow DMDD?
Since DMDD does not apply to adults, children, in a way, outgrow DMDD. Experts think that age-related changes in the brain and emotional maturity reduce the frequency and severity of DMDD. However, they are typically diagnosed with one or more different mental health disorders.
What is the Long-Term Outlook for Children with DMDD?
Some of the most severe symptoms of DMDD will subside even without treatment. However, children with untreated DMDD can have long-term adverse effects, including a lack of education and social skills and developing substance use disorder.
When children get treatment for DMDD, they develop the tools to manage their symptoms and build healthy communication skills. Since parenting a child with DMDD takes a toll on the family, treatment generally includes family therapy.
Does DMDD Share Symptoms with Other Disorders?
The symptoms of DMDD can be confused with other mental health disorders, such as bipolar disorder, ODD, and intermittent explosive disorder. But, there are differences in each disorder’s frequency, severity, and symptoms.
DMDD vs. Bipoloar Disorder
Over the past several decades, pediatric bipolar disorder has been overdiagnosed, even when the hallmark feature of bipolar disorder wasn’t present. Those with bipolar disorder have a history of at least one manic or hypomanic episode. This means their mood is grandiose, euphoric, or irritable, combined with high energy levels and a decreased need for sleep.
With bipolar disorder, irritability is sometimes a symptom. With DMDD, irritability is constant and persistent. Irritability like this is also common in children with major depressive disorder, which is more closely associated with DMDD.
Medications for bipolar disorder often have serious side effects. This is one reason it is crucial to work with the right professionals when seeking a diagnosis for your child.
DMDD vs. Intermittent Explosive Disorder (IED)
Some children meet the criteria for both DMDD and IED. If this happens to your child, they will be diagnosed with DMDD. IED does not have an irritable mood requirement, and the angry outbursts occur twice a week for 3 months which is less frequent than in DMDD.
Signs and Symptoms You are Parenting a Child With DMDD
Knowing the signs and symptoms of DMDD can help parents get their children into treatment. The earlier a child gets into treatment for DMDD, the less likely they are to develop other mental health disorders.
Signs and symptoms of DMDD include:
- Having a persistently irritable or angry mood almost all day, every day
- The irritable and angry moods are noticeable to others
- Explosive outbursts of rage or anger – screaming, yelling, physically aggressive
- The outbursts are not appropriate for the situation
- Outbursts occurring for at least 12 consecutive months at least three times a week with no more than three months without symptoms
- Outbursts are not age appropriate
- Symptoms are not due to substance abuse
- Another mental health disorder does not better explain the symptoms
- Symptoms appear before age 10
- Family members feel the need to “tiptoe” around the child to not “set” them off.
- Symptoms occur in multiple settings like school and home
Treatment for DMDD
Since DMDD is still fairly new, treating the disorder relies on effective approaches to treating other disorders with similar signs and symptoms. These treatments include:
- Individual therapy – can help children learn to manage and express their feelings in a healthy manner, learn effective coping and problem-solving skills
- Family therapy – helps the family develop healthy coping skills, communication skills, and how to work together
- Medication – stimulants, antidepressants, and antipsychotics may be used to help manage symptoms of DMDD
What Triggers DMDD?
While experts are still learning about the mechanisms behind DMDD, some believe it is a reaction to dopamine disruption. The outburst typically occurs when a child is asked to stop doing something they find enjoyable. This interrupts the dopamine cycle triggering an outburst.
Evidence shows stress and trauma can trigger or worsen DMDD. Parenting a child with DMDD adds stress to the family unit. In order to provide a healthy environment for their children, parents must also focus on their own well-being.
When Individual Therapy Isn’t Enough for Your Child
For some children, the standard treatments for DMDD, like individual therapy and medication, are not enough. If your child displays any of the following, they may need more intense treatment.
- Refusing to follow treatment recommendations while symptoms continue to worsen
- Engaging in self-harm
- Abusing drugs or alcohol
- Having suicidal thoughts or threats
- The aggressive behavior is putting themselves or others at risk of harm
- Symptoms make it challenging to function in daily life
If your child needs more intense treatment, it may include the following:
- Residential treatment
- Intensive outpatient treatment (IOP)
- Dual diagnosis treatment
Take Care of Yourself
Parenting a child with DMDD is often exhausting and overwhelming. The constant irritability and angry outbursts can push parents to the edge without proper self-care. But how do you take care of yourself when you are always putting out fires?
Even if it’s just a few minutes a day, focusing on your well-being is critical. If you are irritable and exhausted, it will be challenging to support your child.
Some things you can do include:
- Get enough sleep
- Join support groups or find a therapist for yourself
- Find healthy stress management methods – yoga, running, painting, etc.
Don’t give up if you’re struggling to find help for your child. Children with DMDD can grow into productive and healthy adults with the right treatment and support.
Get Help at Shortridge Academy
If your child struggles with constant irritability and angry outbursts, they may have DMDD. At Shortridge Academy, your child builds a healthy support system while developing the tools necessary to manage their emotions and create healthy behavioral patterns. Contact us today to learn more about how we can help you and your child.