Disruptive Mood Dysregulation Disorder

DMDD is a new diagnosis in the DSM V under the category of Mood Disorders. It’s symptoms go beyond “tempermental” and require professional, clinical attention. When the child is not having a tantrum, they are generally irritable, and angry most of the day, in at least two locations (home, school, peers).

The diagnostic criteria are:

• Severe recurrent temper outbursts manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation.
  
• The temper outbursts are inconsistent with developmental level (e.g., the child is older than you would expect to be having a temper tantrum).
  
• The temper outbursts occur, on average, three or more times per week.
  
• The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by others
  
• The above criteria have been present for 1 year or more, without a relief period of longer than 3 months. The above criteria must also be present in two or more settings (e.g., at home and school), and are severe in at least one of these settings.
  
• The diagnosis should not be made for the first time before age 6 years or after age 18. Age of onset of these symptoms must be before 10 years old.
  
• There has never been a distinct period lasting more than 1 day during which the full symptom criteria.
  
• The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder.

David’s approach to dealing with DMDD is to fully discuss the use of medications for mood management. Additionally, in treatment, David will utilize Cognitive Behavioral Therapy, Play and Art Therapies, Behavioral Modification, Mindfulness and Dialectical Behavioral Therapy techniques. Parental support to help calmly handle outbursts will be an important part of therapy for the family.

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