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What is disruptive mood dysregulation disorder (DMDD)?

Disruptive mood dysregulation disorder (DMDD) is a mental health disorder in which children are angry most of the time and have a lot of temper tantrums in reaction to things that don’t seem like a big deal. Children with DMDD are not able to control their emotions like other children their age.

What are the symptoms of DMDD?

The symptoms of DMDD are:

  • Major temper tantrums that happen three or more times a week on average
  • Angry or irritable mood between tantrums
  • Being unable to control extreme emotions

Symptoms of DMDD usually show up before age 10.

How is DMDD diagnosed?

DMDD is diagnosed when a child has temper tantrums that happen three or more times a week on average, along with an angry mood between tantrums. These symptoms last at least a year, and any break in the symptoms lasts less than three months. The symptoms have to show up with the child’s family, friends and teachers, rather than in just one situation.

DMDD usually appears before age ten. It is not diagnosed before age six because temper tantrums are normal for young kids.

How is DMDD Treated?

The goal in DMDD treatment is to help children learn to control their emotions and stop having temper tantrums. Treatment involves behavioral therapy and sometimes medication.

A combination of dialectical behavior therapy for children (DBT-C) and parent management training has been found to be very helpful in treating DMDD.

  • In DBT-C, the therapist doesn’t tell the child they should not have angry feelings. Instead, they help the child gain skills to calm themselves down when their feelings get out of control. Parents also learn these skills so that they can help their child and practice staying calm themselves.
  • In parent management training, parents learn how to reward kids for good behavior instead of giving them attention for bad behavior.

When therapy is not an option or when therapy alone is not working, medication to help the child control their emotions is sometimes given. Antidepressants and stimulants are the most common medications for DMDD.

What are the risks of developing other disorders?

DMDD is different from other disorders that can look similar, like bipolar disorder, autism spectrum disorder and oppositional defiant disorder. But kids with DMDD can have certain other disorders at the same time, including ADHD, depression and anxiety.

Kids with DMDD also have a bigger chance of developing serious depression or anxiety as adults.