Childhood Disruptive Mood Dysregulation Disorder (DMDD)

According to The Huffington Post, Disruptive Mood Dysregulation Disorder has attracted its fair share of controversy since its addition to the DSM-5 in 2013. Kids who throw huge explosive tantrums can now be labelled, posing the question, ‘Have they really gone too far in calling this seemingly normal behaviour a disorder?’

To answer that question we need to look further into what DMDD is and what the symptoms are.

What is DMDD?

DMDD is classified as a mood disorder in the DSM-5, the 5th revision of the Diagnostic & Statistical Manual of Mental Health Disorders.
Previously known as Childhood Bipolar Disorder, DMDD is seen as a persistent, chronic and severe irritability. The child seems to be in a persistent angry or irritable mood showing frequent temper tantrums and outbursts of anger. These can occur as much as three times a week or more. It is believed that the disorder affects between 2-5% of children. The symptoms interfere with their inability to function at home, school and with friends.
The DMDD fact sheet states, ““Far beyond temper tantrums, DMDD is characterised by severe and recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation.”

Diagnosing Symptoms

While it’s normal for all kids to display a degree of anger, kids with DMDD have severe symptoms that are almost always present.

1. Recurrent temper tantrums that are severe and manifest in outbursts of verbal rage of behavioural aggression towards people or property. These displays of anger are grossly out of proportion to a situation or provocation.
2. These outbursts are inconsistent with the child’s developmental level. An older child may be having tantrums of a two year old for example.
3. Frequent outbursts occur three or more times per week or more.
4. The mood is persistently irritable between temper outbursts. The child will seem angry all of the time and the behaviour is noticeable by others whom the child spends time with.
5. All of the above symptoms (criteria) have to be present for 1 year or more, without a break for longer than 3 months. They must also be present in two settings, (home or school) and be severely present in one setting in our outside of the home.
6. The child has to have the onset of these symptoms before the age of 10 and diagnosis has to be made between the ages of 6 – 18 years of age. Not before or after.
7. There’s never been a particular break where the symptoms have not been present. The only differences would be in the duration of manic or hypomanic episodes.
8. The behaviour is not explained by another mental disorder and don’t occur exclusively during an episode of major depression.

Like with all child mental disorder the symptoms of DMDD cannot be attributed to the effects of substance or to another medical or mental condition and because the symptoms are so severe in children with Disruptive Mood Dysregulation Disorder, naming it a disorder in the DSM-5 seems justified.

Sources
Huffington Post – http://www.huffingtonpost.com/2013/06/17/disruptive-mood-dysregulation-disorder_n_3454372.html
Psych Central – http://psychcentral.com/disorders/symptoms-of-disruptive-mood-dysregulation-disorder/

Where to get help

A school age child diagnosed with the condition may need specialised treatments and help in school and at home. Parents who suspect they might have a child with the disorder would benefit from seeking the help of your family doctor.

Search for a counsellor near you – www.theaca.net.au
Lifeline – A free 24 hour Crisis Counselling service – 13 11 14
https://www.lifeline.org.au/
Kids Help Line – 1800 55 1800 – http://kidshelpline.com.au/