DMDD is a new disorder created to more accurately diagnose children who were previously diagnosed with pediatric bipolar disorder, even though they did not experience the episodic mania or hypomania characteristic of bipolar disorder.
- DMDD symptoms typically begin before the age of 10, but the diagnosis is not given to children under 6 or adolescents over 18
- Temper outbursts can involve yelling, pushing, hitting, or destruction of property.
Before Diagnosing, Carefully check:
- Irritable or angry mood
- Severe temper outbursts (verbal or behavioral) at an average of three or more times per week are out of keeping with the situation and the child’s developmental level.
- Trouble functioning due to irritability in more than one place (e.g., home, school, with peers)
- Inappropriate for the child’s age level.
- Behavioral interventions
Coping with disruptive mood dysregulation disorder can present challenges for both children and caregivers. The disorder can make it difficult for kids to function at home and at school, and parents and other adults may find it tough to handle children’s intense temper outbursts.
Some coping strategies that can help:
Understand Your Child’s Triggers
If your child is likely to have a tantrum in certain settings or situations, try to have a plan in place. Briefly removing your child from the situation can sometimes help.
Keep Your Child Safe
If your child is prone to acting out physically, try to keep any potentially dangerous objects out of reach. For example, make sure that all of the furniture in your home is safely secured and keep heavy, sharp, throwable objects out of reach.
Teach Coping Skills
In one case study, a child with DMDD was taught to mentally recite song lyrics whenever she found herself becoming angry. This was also combined with using deep breathing and reciting verbal reminders to help interrupt angry outbursts before they began.
Encourage Positive Behaviors
Reward appropriate behaviors with attention, praise, and privileges. In multi-child households, kids sometimes go unnoticed when they are acting good, but are able to get one-on-one attention when they misbehave. This tends to reinforce misbehavior and discourage good behavior. Break this pattern by making sure that you notice and reward your child’s positive actions.
DMDD can be a challenging condition that can result in significant problems in a child’s life. It can also increase a child’s risk of experiencing depression and anxiety as an adult, so it is important to seek treatment if you suspect that your child may have this condition. While these temper outbursts can be upsetting, appropriate treatment can help your child manage such symptoms and improve relationships in school, home, and social settings.
DMDD was introduced as a diagnosis to address what psychiatrists and psychologists believed to be the overdiagnosis of pediatric bipolar disorder. The key feature of bipolar disorders is the presence of manic or hypomanic episodes.
A manic episode is defined as a period of elevated, expansive, or irritable mood. In addition, a person also has an increase in goal-directed activity or energy. Hypomanic episodes are less severe versions of manic episodes. A person with bipolar disorder doesn’t always experience manic episodes. They aren’t a normal part of their daily functioning.
DMDD and bipolar disorders may both lead to irritability. Children with DMDD tend to be persistently irritable and angry, even when full-blown tantrums aren’t present. Manic episodes tend to come and go. You may ask yourself if your child is persistently in a bad mood, or if their mood seems to be out of the ordinary. If it’s persistent, they may have DMDD. If it’s out of the ordinary, their doctor may consider a bipolar disorder diagnosis.
Additionally, the key feature of DMDD is irritability, while mania may also include:
- euphoria, or extreme positive emotion
- extreme excitement
- goal-directed behavior
Differentiating DMDD and bipolar isn’t always straightforward and should be done by a professional. Talk to your child’s doctor if you suspect either of these conditions.