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There’s Something About Disruptive Mood Dysregulation Disorder That You Should Know (DMDD)

There’s Something About Disruptive Mood Dysregulation Disorder That You Should Know (DMDD)

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Moodiness is a hallmark of the childhood and teenage years. Even children are bound to show some moodiness from time to time. But what if it is long-lasting and persistent in the way it shows its symptoms in children? If that is the case, then your child is probably suffering from Disruptive Mood Dysregulation Disorder (DMDD). Let’s discuss its main features and how disruptive it exactly is in the words below after we go through the basics of this disruptive mood disorder first. In the end, you will know much more:

Defining Disruptive Mood Dysregulation Disorder (DMDD)

Disruptive mood dysregulation disorder (DMDD) is a type of mental condition in children and adolescents that is defined by persistent and recurrent symptoms of moodiness that usually convert into tantrums even when the reasoning behind them is not that big of a deal. The intensity of these symptoms is so high that they interfere with affected children’s ability to lead a normal life. The onset of this mental condition tends to be at the age of 10, usually. The name comes from how a child is not able to regulate his or her emotions properly when affected by mood dysregulation disorder.

While children and adolescents between the ages of 6 and 18 are diagnosed with disruptive mood dysregulation disorder symptoms, they are more commonly seen in children between the ages of 6 and 10. Additionally, to receive a diagnosis, the child cannot be younger than 6 or older than 18.

Read More: What’s The Difference Between A Mood Disorder And A Personality Disorder?

DMDD symptoms

These are the DMDD symptoms that the affected children experience when these begin around the age of 10:

  • Symptoms that have been present for at least a year
  • Three or more instances of major temper tantrums a week on average
  • Anger and irritation with intervals of tantrums
  • Uncontrollable and extreme emotions

Disruptive mood dysregulation disorder symptoms such as the above tend to intensify if it is left untreated for a long time.

What causes DMDD?

As with all mental conditions in existence, and also considering the relative newness(1) of this type of mental condition can make it difficult to ascertain what causes DMDD. It comes into existence due to a range of different factors such as family history or a complex combination of biological, genetic, and environmental factors.

The Relationship Between Oppositional Defiant Disorder (ODD), Bipolar Disorder and Disruptive Mood Dysregulation Disorder (DMDD)

Similar to dysregulated mood disorder, oppositional defiant disorder (ODD) is a behavioral condition in which your child displays a persistent pattern of uncooperative, defiant, and sometimes hostile behavior toward people in authority. The only difference between these two is that DMDD is more severe and dare we say much more intensified when comparing the DMDD symptoms and the ODD symptoms. It can be a cause of confusion for both the patients and their mental health practitioners. So, when a child is diagnosed with ODD and DMDD, it is diagnosed as a disruptive mood dysregulation disorder to avoid any confusion.

DMDD can also be a cause of confusion when it comes to bipolar disorder as both are highly debilitating and are defined by extreme changes in mood. DMDD symptoms tend to be more chronic and have a continuing streak, which means it’s ongoing while bipolar is episodic. Bipolar is a lifelong condition and on the other hand, DMDD evolves into either major depressive disorder or generalized anxiety disorder. In addition to that, bipolar tends to be a disorder more prevalent in adults rather than children or adolescents, which is where disruptive mood dysregulation disorder is more present.

What is the Difference Between Typical and Severe Irritability (DMDD)?

Experiencing severe irritability (as observed in DMDD) is essentially having difficulty tolerating frustration and having outbursts that are out of proportion. For example, a parent tells the child to chew his or her food properly. Now that child might be frustrated or annoyed but someone with DMDD may become extremely upset and emotional. They may also have an intense temper outburst with yelling or hitting things.

Read More: Understanding ADHD Mood Swings: A Journey Through Emotional Waves

What is the Research Saying About Disruptive Mood Dysregulation Disorder

Research is steadfast in finding the thresholds associated with a condition like disruptive mood dysregulation disorder to uncover more about it(3). Studies are also bent on considering and trying to find out if all stakeholders, especially mental health practitioners can solve the problem of or entirely avoid misdiagnosis of this relatively new condition(2). Early research showed that it may affect around 2% to 5% of children in the U.S.

Disruptive Mood Dysregulation Disorder Treatment

Current studies are more biased toward resolving the main symptoms that are present in similar mental conditions such as anxiety and ADHD: irritability. These treatments, though, do work for the DMDD too.

Let’s start with Psychotherapy

Psychotherapy is the umbrella term for different types of therapies that focus on identifying and changing unhealthy emotions, thoughts, and behaviors of the affected individuals with some type of mental health expert in attendance who paves the way for therapy’s goal by talking to those affected ones.

There are two types of psychotherapies suitable for children suffering from Disruptive Mood Dysregulation Disorder:

Cognitive Behavioral Therapy (CBT)

This way your child will try to understand how their negative feelings are affecting their actions. CBT tries to resolve the problems with DMDD by motivating your child to unlearn negative thoughts and behaviors, which are learned through adopting healthier thinking patterns and habits.

Dialectical behavior therapy (DBT)

DBT is an evolved form of CBT, which teaches your child to regulate their emotions and avoid extreme or prolonged outbursts as it’s specially adapted for people who experience emotions very intensely.

Medication

While the USA’s Food and Drug Administration (FDA) hasn’t passed DMDD’s medication for approval yet, psychiatrists can still prescribe medications to help manage DMDD symptoms, including but limited to:

Stimulants

These are traditionally used for treating attention-deficit/hyperactivity disorder (ADHD). Stimulants are used to induce increased activity of the central nervous system. Research suggests that stimulant medications can help in decreasing irritability in children with DMDD.

Antidepressants

These are medications like Selective Serotonin Reuptake Inhibitors, which include increased production of neurotransmitters like serotonin and norepinephrine, which are associated with symptoms like irritability, something that is prevalent in disruptive mood dysregulation disorder. It can specifically be combined with methylphenidate (a stimulant) and can decrease irritability in children with DMDD.

Antipsychotic medication

These can be sometimes prescribed to treat children with irritability, severe outbursts, or aggression. These are only used when all other treatment approaches fail.

Read More: Everything about Emotional Dysregulation in ADHD

Conclusion

As we have told you before, you will know much more about Disruptive Mood Dysregulation Disorder. You also know the DDMD symptoms and its treatment. If treatment is what you want then look no further than Orange Coast Psychiatry which does not only help in treating DMDD but is also capable of treating mental ailments like MDD, Acute stress, or PMM with additional treatment options like telehealth psychiatry.

References and Footnotes
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
    https://psycnet.apa.org/record/2013-14907-000
  2. Margulies DM, Weintraub S, Basile J, Grover PJ, Carlson GA. Will disruptive mood dysregulation disorder reduce false diagnosis of bipolar disorder in children? Bipolar Disord. 2012 Aug;14(5):488-96. doi: 10.1111/j.1399-5618.2012.01029.x. Epub 2012 Jun 19. PMID: 22713098.
    https://pubmed.ncbi.nlm.nih.gov/22713098/
  3. Laporte PP, Matijasevich A, Munhoz TN, Santos IS, Barros AJD, Pine DS, Rohde LA, Leibenluft E, Salum GA. Disruptive Mood Dysregulation Disorder: Symptomatic and Syndromic Thresholds and Diagnostic Operationalization. J Am Acad Child Adolesc Psychiatry. 2021 Feb;60(2):286-295. doi: 10.1016/j.jaac.2019.12.008. Epub 2020 Jan 29. Erratum in: J Am Acad Child Adolesc Psychiatry. 2021 Jun;60(6):789. doi: 10.1016/j.jaac.2021.03.013. PMID: 32004697; PMCID: PMC9073144.
    https://pubmed.ncbi.nlm.nih.gov/32004697/

Frequently Asked Questions

DMDD likely will not go away on its own, especially if it is left untreated.

It can develop into chronic depression or anxiety in adulthood.

Neurological disability, brain chemistry, family history, and environmental factors such as recent family divorce, death, or relocation, lack of adequate nutrition or vitamin deficiency, and a woman’s pregnancy and postpartum experience.

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Shaheena Gazipura

PMHNP-BC

Richard Samedra, PMHNP-BC, is a Board Certified Psychiatric-Mental Health Nurse Practitioner. He brings over 12 years of experience in the mental health field, working with clients facing a wide range of acute and chronic mental health conditions. His journey began as a Licensed Vocational Nurse and Charge Nurse at Westminster Therapeutic Residential Treatment, where he supported clients dealing with anxiety, depression, schizophrenia, bipolar disorder, and substance use disorders. Richard’s dedication was centered on helping these individuals improve their mental health and transition to a lower level of care, whether that meant returning to their families, a board and care facility, or a sober-living environment.

Motivated by a growing passion for mental health care, Richard pursued his Registered Nurse (RN) education at Saddleback Community College and later transitioned to La Palma Intercommunity Hospital Behavioral Health. In this role, he specialized in geriatric psychiatry, working with older adults experiencing conditions such as Parkinson’s disease, dementia, depression, and anxiety. This experience solidified his commitment to mental health, leading him to work at Bellflower Community Hospital, where he provided care for patients experiencing severe psychiatric crises, including suicidal ideation, manic and depressive episodes, substance use disorders, and exacerbated schizophrenia symptoms.

Inspired by the impactful work of PMHNPs at Bellflower, Richard enrolled in the Psychiatric-Mental Health Nurse Practitioner program at Azusa Pacific University. To broaden his expertise, he worked full-time at College Hospital Costa Mesa while completing his studies. There, he gained comprehensive experience across various units, including adolescent, acute men’s and women’s, stabilization, and detox/med-surg. Now, as a PMHNP, Richard is committed to leveraging his diverse background and knowledge to provide compassionate, comprehensive care to those in need.

Richard currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where he is supervised by Dr. Montgomery.

 

Shaheena Gazipura

PMHNP-BC

Shaheena Gazipura is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) with over 9 years of dedicated experience in both inpatient and outpatient mental health care. She earned her Master of Science in Nursing from Western University of Health Sciences in Pomona, California.

Shaheena began her career working on an adult psychiatric inpatient unit before transitioning to the geriatric psychiatric inpatient unit at USC Verdugo Hills Hospital. In addition to her clinical work, Shaheena also serves as a Nursing Clinical Instructor, guiding the next generation of nurses through their mental health rotations at a large community college.

Shaheena is a passionate advocate for mental health, believing that it is a fundamental pillar of overall well-being. She is committed to reducing the stigma surrounding mental illness and strives to provide comprehensive, compassionate care that honors each individual’s unique experiences and challenges. Her goal is to create a supportive, nonjudgmental environment where patients feel empowered to work alongside her in achieving their mental health goals.

Outside of her professional life, Shaheena enjoys exploring new culinary experiences, staying active through exercise, and planning her next travel adventures.

Shaheena currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where she is supervised by Dr. Barrios.

Clint Nacar

PMHNP-BC

Clint Nacar, PMHNP-BC is a Board Certified Psychiatric-Mental Health Nurse Practitioner. Mr. Nacar graduated from Charles R. Drew University of Medicine and Science. Currently Mr. Nacar works in an inpatient psychiatry unit at a leading academic medical center in Los Angeles, Renewed Mental Health Group, and Orange Coast Psychiatry

Mr. Nacar brings over 7+ years of experience with the mental health population. He works to help patients take control of their mental health through patient education, psychotherapy and medication management. Mr. Nacar’s areas of focus include: Depression, Anxiety, Adjustment Disorder, Bipolar disorder, Attention Deficit Hyperactivity Disorder (ADHD), and Post-Traumatic Stress Disorder (PTSD). Mr. Nacar treats children ages 6+, adolescents, and adults, offering both in-person services and telehealth at Renewed Mental Health Group.

With the collaboration of each patient, Mr. Nacar strives to develop individualized plans of care addressing each patient’s unique situation and concerns. He also encourages each patient to take charge of their mental health through a holistic approach while also employing the latest evidence based practices in treatment.

Clint is one of our most experienced Psychiatric-Mental Health Nurse Practitioners at Orange Coast Psychiatry and is 103NP Licensed in the State of California.

Cristian Cuevas

PMHNP-BC (Fluent in Spanish)

Cristian Cuevas, PMHNP-BC, is a highly skilled board-certified psychiatric mental health nurse practitioner with over seven years of experience in inpatient psychiatry and mental health.

A California State University Long Beach graduate, Cristian also earned recognition as a board-certified psychiatric mental health registered nurse. With a wealth of expertise in adult psychiatric care across the lifespan, Cristian has successfully diagnosed and treated a diverse range of mental health disorders.

Additionally, his specialized experience in child and adolescent inpatient populations further enhances his ability to provide comprehensive and compassionate mental health care.

Cristian Cuevas is the Lead Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry and is supervised by Dr Barrios.

Griselda Hernandez

PMHNP-BC (Fluent in Spanish)

As a licensed Psychiatric-Mental Health Nurse Practitioner (PMHNP) with a robust background in psychiatric and substance abuse nursing, Griselda provides compassionate, evidence-based care to individuals facing mental health and addiction challenges. The core of her practice focuses on promoting holistic wellness, fostering resilience, and empowering patients in their recovery journey. Specializing in the assessment, diagnosis, and treatment of adolescents with various mental health disorders, Griselda strives to create a therapeutic environment where patients feel valued, respected, and supported.
“My approach is grounded in years of diverse experience, including work in psychiatric units and medical detox units for both adults and adolescents. This extensive background has equipped me with the skills and knowledge to manage complex psychiatric and substance abuse conditions effectively. I am committed to staying updated with the latest advancements in psychiatric care, integrating cutting-edge therapies and best practices into my treatment plans. Collaboration is key to my practice; I work closely with multidisciplinary teams, families, and community resources to provide coordinated and comprehensive care tailored to each individual’s unique needs.”
Griselda holds a Master of Science in Nursing with a specialization in Psychiatric-Mental Health from West Coast University, and a Bachelor of Science in Nursing from The University of Alabama, Tuscaloosa. Additionally, she is fluent in the English and Spanish language, enhancing her ability to connect with a diverse patient population.
Griselda currently practices as a Nurse Psychiatric-Mental Health Nurse Practitioner at Orange Coast Psychiatry, where she is supervised by Dr. Barrios.

Dr Barrios

Board-Certified Child and Adolescent Psychiatrist

Dr. Carlos Barrios is a Board-Certified Child and Adolescent Psychiatrist with over two decades of experience in mental health care. His expertise in telepsychiatry has allowed him to serve patients across California and beyond. In his practice, Dr Barrios integrates metabolic and functional methodologies, focusing on guiding patients toward medication independence and emphasizing the connection between physical and mental health.
Outside of his professional life, Dr Barrios is passionate about kettlebell training, which helps him maintain my physical and mental wellness. He cherishes visiting his family in Guatemala, to reconnecting with his cultural roots and rejuvenating his spirit. Dr Barrios is also deeply involved in transcendental meditation and rucking, practices that not only provide him with tranquility but also keep him grounded and connected to nature. These hobbies reflect his commitment to a holistic approach to health, both personally and professionally.