Does your little one get uncontrollably angry over the smallest of things? Does he throw a tantrum when you take a bath, comb his hair, or even try to get on the school bus? This may not be just plain mischief or stubbornness. In fact, there may be a deeper mental health condition behind this behavior. Today we're talking about one such condition, Disruptive Mood Dysregulation Disorder, or DMDD for short.
What is DMDD?
Simply put, DMDD is a mental health condition in which children are unable to control their emotions, especially anger. As a result, they often have very violent outbursts, which we call "temper tantrums," and that's what they call them. These outbursts often happen when they have to do something they don't want to do.
The important thing is, this is not just a bad mood. Usually, a child's bad mood will go away after a while. But a child with DMDD doesn't do that easily. Their anger and anxiety continue.
This condition was officially included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. Previously, children with these symptoms were sometimes misdiagnosed as pediatric bipolar disorder. DMDD was introduced to prevent this and provide a more accurate diagnosis. This can cause significant problems for the child at home, at school, and in social relationships, such as with friends.
What are the symptoms of DMDD?
These are the main symptoms that can be seen in a child with DMDD.
- Severe Temper Outbursts: This is not just anger. It includes violent behavior that can include verbal abuse, screaming, throwing objects, or even physically attacking someone.
- Frequent tantrums: These severe tantrums occur three or more times a week.
- Worried even when not angry: Even if the child doesn't have a major outburst, he or she may spend most of the day feeling angry, anxious, or irritable . This is very understandable to family and teachers.
- Responses that are not appropriate to the problem: When you look at the reason why the child is angry, the response he shows is completely inappropriate. He explodes over even the smallest thing.
- Difficulty concentrating at home and school: This mental condition makes it difficult for the child to focus on schoolwork as well as homework.
DMDD Diagnosis and Causes
Research so far has not definitively found this to be the cause of DMDD. So as a parent, don't feel guilty about this.
If you suspect your child has DMDD, the best thing to do is talk to your child's doctor . The doctor will ask you a lot about your child's behavior. Be sure to describe how your child behaves at home, at school, and when they are out and about. The doctor will then examine your child to see if there are any other physical causes that could be contributing to these symptoms.
Then, the doctor will often refer the child to a mental health specialist, as DMDD can be confused with other mental health conditions. For example:
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Oppositional Defiant Disorder (ODD)
- Anxiety Disorders
For a child to be officially diagnosed with DMDD, the following criteria must be met. Let's look at this in a table.
| Criteria for diagnosis | Description |
|---|---|
| Severe tantrums | Violent outbursts of word or action that are inappropriate for the situation. |
| Frequency | Usually three times a week or more . |
| Mood when not angry | Feeling angry or anxious most of the day, even during tantrums. |
| Time limit | Symptoms must last for at least 12 months (one year). |
| Age | Symptoms must have started before the age of 10. The diagnosis is only given to children between the ages of 6 and 18 . |
What are the treatments for DMDD?
Because DMDD is a relatively new diagnosis, doctors are still researching the best treatments. But there are already treatments that have shown successful results. Two main types of treatment are used.
1. Medication
Some medications can help control the symptoms of DMDD, especially anger and mood swings. These should only be given under the recommendation and supervision of a doctor.
- Stimulants: These are commonly used for ADHD and help reduce the irritability seen in DMDD.
- Antidepressants: These medications can help relieve anger and mood problems.
- Atypical Antipsychotics: This type of medication is sometimes prescribed for children who are very angry, especially those with behavior that is physically harmful to others.
2. Psychological Treatments
Psychological treatment is just as important as medication, if not more so.
- Parent Training: This is very important. Parents need to be educated on how to deal with a child with DMDD. Parents need to learn to recognize triggers for their child's anger, respond appropriately when it occurs, and praise their child for good behavior.
- Therapy for the child: Direct therapy for the child is also very important. Cognitive Behavioral Therapy (CBT) is very effective here. This helps the child learn to recognize their anger, learn ways to control it, communicate well with others, and deal with problematic situations.
Take-Home Message
- DMDD is not a child's stubbornness or bad behavior. It is a real medical condition that requires treatment.
- The main symptoms are frequent, severe outbursts of anger and a persistent sense of anxiety.
- If your child has these symptoms, be sure to see a doctor for advice.
- This condition can be managed very successfully with medication and psychological treatment (especially parent training and behavioral therapy for the child).
- As parents, your love, patience, and understanding are a great strength for your child to recover quickly.
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