Understanding the causes and symptoms of disruptive mood dysregulation disorder

All children, just like adults, get angry or irritable sometimes. And temper tantrums, while a frustrating experience for parents, are a typical part of growing up for most kids. But when a child constantly struggles to control their emotions or seems angry all the time, it could be a sign of something more serious. 

Disruptive mood dysregulation disorder (DMDD) is a mental health condition that is diagnosed in children who experience severe, frequent tantrums and chronic irritability. If you’re concerned about your child’s mental health, know that you’re not alone and DMDD is treatable. There are effective therapies and parent-training programs  that can be very helpful in supporting kids with DMDD.

What is disruptive mood dysregulation disorder?

It can be hard to tell the difference between typical childhood behaviors, like tantrums, and symptoms of disruptive mood dysregulation disorder (DMDD). But DMDD is more than just the occasional period of crankiness or moodiness. 

Typically diagnosed between ages 6 and 10, children living with DMDD experience frequent, severe emotional dysregulation. They have angry outbursts in response to seemingly minor inconveniences. They also feel angry, frustrated, or irritable most of the time. These symptoms can impact their academic performance, peer relationships, family relationships, and home environment. 

Disruptive mood dysregulation disorder symptoms

To be diagnosed with DMDD, a child must have the following symptoms for at least 12 months:

• Severe angry outbursts that occur an average of three times per week (can be physical, verbal, or  both) that are out of proportion to the situation and/or the developmental level of the child
• An irritable or angry mood for most of the day, nearly every day
• Trouble functioning in more than one environment (i.e. both home and school) and the impairment must be severe in at least one environment

Understandably, parents and other caregivers may be unsure if a child’s behavior is typical or cause for concern. But by taking some time to learn more about DMDD and how it shows up, you can learn to spot the difference. 

For example, imagine telling a child that they need to finish their homework before they can play video games. A child without DMDD might protest a bit or seem annoyed temporarily. But a child with DMDD could become extremely angry and agitated in response to the request. They may yell, scream, kick, or hit, and they would have similar outbursts several times per week.

How disruptive mood dysregulation compares to related disorders

Several mental health conditions share similar features with DMDD. For example, like DMDD, oppositional defiant disorder (ODD) and attention-deficit hyperactivity disorder (ADHD) can cause irritability and anger outbursts. But the frequency and intensity of those symptoms are more severe for children living with DMDD and milder for children living with ADHD and ODD. 

Similarly, DMDD and intermittent explosive disorder (IED) both cause aggressive outbursts. But children living with IED experience occasional uncontrolled anger with breaks between outbursts. Children with DMDD are in a near-constant state of anger and irritability.

Learning how related disorders compare to one another can help you better understand your child’s experience. But it’s also important to know that some of these conditions cannot be diagnosed at the same time. For example,  DMDD cannot co-exist with bipolar disorder, intermittent explosive disorder, or ODD. While these conditions share some symptoms, they’re treated differently and require specialized care.  

What causes disruptive mood dysregulation disorder?

DMDD is a relatively new diagnosis, so there is limited understanding of what causes it. However, there’s some evidence to suggest that having a parent with bipolar disorder may contribute to the onset of DMDD. In addition, there are a few other factors that may increase a child’s risk of developing DMDD, including:

• Genetics: Chronic irritability, a key symptom of DMDD, may have a genetic component. However, there is insufficient evidence that DMDD on its own is an inherited condition.
• Biology: Children with DMDD may have some differences in the areas of their brains that regulate reward processing.
• Environmental factors: Children growing up in a high-stress home environment or who struggle to get along with siblings or teachers may be at greater risk of developing DMDD.

Disruptive mood dysregulation disorder treatment

DMDD treatment is similar to treatment for other childhood mental health conditions and may include any of the following:

• Therapy: Cognitive-behavioral therapy (CBT) has been successfully used to treat DMDD. It can help children increase their frustration tolerance and learn new coping skills. It works by helping children explore the relationship between their thoughts, feelings, and behaviors. CBT can also help children identify and reframe the distorted thoughts that may lead to outbursts.
• Medication: There is no FDA-approved medication for treating DMDD. However, your child’s provider may recommend medication to help manage their DMDD symptoms. 
• Parent training: As a parent, you can receive support to help your child manage their DMDD. This may include learning to spot and avoid your child’s triggers, learning new ways of responding to outbursts or irritability, and rewarding positive behavior.

Find care with Rula

As a parent, it can be difficult to know if your child needs mental healthcare. But if your child is showing signs of DMDD or another mood disorder, know that you’re not alone and help is available. DMDD is a treatable condition, and working with a mental health professional can help ensure that your child gets an accurate diagnosis and the support they need to thrive. 

At Rula, we’re committed to helping children, parents, and families access mental health support when they need it most. Rather than waiting weeks or months for an appointment, you can connect with a therapist who takes your insurance as soon as tomorrow. And if your busy schedule makes it tough to make regular in-person appointments, know that you can see your therapist virtually at a time that works for you — without ever having to leave home.

Find a therapist with Rula