A clinician considering disruptive mood dysregulation disorder would look for severe temper outbursts that occur, on average, three or more times per week for at least a year. In addition, the child’s mood between outbursts must be angry or irritable. The symptoms must be consistent, without a break of three or more months. Outbursts or elevated or expansive moods that last for longer than a few hours or for days on end are more likely to be signs of mania, which would rule out DMDD. The diagnosis of DMDD should not be made before age 6 (when outbursts or tantrums are part of typical development) or after age 18, and the onset of symptoms typically takes place before age 10.