Does your child have extreme tantrums? Is s/he moody and it is difficult to calm him or her once they lose their temper? It could be that your child has Disruptive Mood Dysregulation Disorder.
Disruptive Mood Dysregulation Disorder and tantrums
Overview
Extreme Temper Tantrums can be very difficult to handle. When your child is tantrumming out of control it can make you feel incompetet as a parent.
Disruptive mood dysregulation disorder (DMDD) is a childhood condition of extreme irritability, anger, and frequent, intense temper outbursts or exteme tantrums. DMDD symptoms go beyond a being a “moody” child—children with DMDD experience severe impairment that requires clinical attention. DMDD is a fairly new diagnosis, appearing for the first time in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013.
Signs and Symptoms
DMDD symptoms typically begin before the age of 10, but the diagnosis is not given to children under 6 or adolescents over 18. A child with DMDD experiences:
Irritable or angry mood most of the day, nearly every day
Severe temper outbursts (verbal or behavioral) at an average of three or more times per week that 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)
To be diagnosed with DMDD, a child must have these symptoms steadily for 12 or more months.
Risk Factors
It is not clear how widespread DMDD is in the general population, but it is common among children who visit pediatric mental health clinics. Researchers are exploring risk factors and brain mechanisms of this disorder.
Treatment and Therapies
DMDD is a new diagnosis. Therefore, treatment is often based on what has been helpful for other disorders that share the symptoms of irritability and temper tantrums. These disorders include attention deficit hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder, and major depressive disorder.
If you think your child has DMDD, it is important to seek treatment. DMDD can impair a child’s quality of life and school performance and disrupt relationships with his or her family and peers. Children with DMDD may find it hard to participate in activities or make friends. Having DMDD also increases the risk of developing depression or anxiety disorders in adulthood.
While researchers are still determining which treatments work best, two major types of treatment are currently used to treat DMDD symptoms:
Medication
Psychological treatments
Psychotherapy
Parent training
Computer based training
Psychological treatments should be considered first, with medication added later if necessary, or psychological treatments can be provided along with medication from the beginning.
It is important for parents or caregivers to work closely with the doctor to make a treatment decision that is best for their child.
Medication
Many medications used to treat children and adolescents with mental illness are effective in relieving symptoms. However, some of these medications have not been studied in depth and/or do not have U.S. Food and Drug Administration (FDA) approval for use with children or adolescents. All medications have side effects and the need for continuing them should be reviewed frequently with your child’s doctor.
For basic information about these and other mental health medications, you can visit the NIMH Mental Health Medications webpage. For the most up-to-date information on medications, side effects, and warnings, visit the FDA website. We at Holistic Counseling Center believe medication should be the last resort, after all other options have been exhausted.
Psychological treatments
Psychotherapy
Cognitive-behavioral therapy, a type of psychotherapy, is commonly used to teach children and teens how to deal with thoughts and feelings that contribute to their feeling depressed or anxious. Clinicians can use similar techniques to teach children to more effectively regulate their mood and to increase their tolerance for frustration. The therapy also teaches coping skills for regulating anger and ways to identify and re-label the distorted perceptions that contribute to outbursts. Other research psychotherapies are being explored at the NIMH.
Parent Training
Parent training aims to help parents interact with a child in a way that will reduce aggression and irritable behavior and improve the parent-child relationship. Multiple studies show that such interventions can be effective. Specifically, parent training teaches parents more effective ways to respond to irritable behavior, such as anticipating events that might lead a child to have a temper outburst and working ahead to avert the outburst. Training also focuses on the importance of predictability, being consistent with children, and rewarding positive behavior.
Computer-based training
Evidence suggests that irritable youth with DMDD may be prone to misperceiving ambiguous facial expressions as angry. There is preliminary evidence that computer-based training designed to correct this problem may help youth with DMDD or severe irritability.
Join a Study
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.
To learn more or find a study, visit:
NIMH’s Clinical Trials webpage: Information about participating in clinical trials
Clinicaltrials.gov: Current Studies on DMDD: List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country
Join a Study: Children – DMDD: List of studies being conducted on the NIH Campus in Bethesda, MD
Schedule an Appointment
We can help you better manage your child's behavior and reduce the impact it has been having on your family. Your child will benefit from learning emotional management techniques. To schedule the first appointment, click on the Book Now button and there you will see our availability for the next two months. You can select the day and time that works best for you. Adapted with permission from the National Institute of Mental Health website. To read about another disorder children may suffer from, click here: Attention Deficit Disorder (ADD/ADHD)