Ah, the dreaded temper tantrum. They’re an unpleasant and sometimes embarrassing part of life that all parents experience at one time or another. However, when temper tantrums occur not as occasional, relatively isolated events and instead become a regular pattern of behavior, it may indicate a more serious underlying mental health condition known as Disruptive Mood Dysregulation Disorder, or DMDD.
Parents concerned their child may have DMDD should seek a professional psychological evaluation for their child, especially if the child’s behavior turns violent. Here are some things to know about this commonly misunderstood disorder.
Symptoms of DMDD
The number one symptom children with DMDD display is chronic, severe and persistent irritability. Oftentimes, this persistent sullen mood will be punctuated with severe verbal and physical outbursts of uncontrollable temper.
In order to receive a diagnosis of DMDD, the child should be no younger than six and no older than 18. The symptom of persistent sullen, irritable mood must exist for at least one year, and cannot be attributed to another mental illness such as depression. Temper tantrums, usually well outgrown by this time, must present at least three times per week.
Risk Factors for DMDD
Unsurprisingly, the largest risk factor for developing DMDD is a chronically irritable persona. There have been few studies performed as of this time; however, those which have been performed suggest that the mother’s mood during pregnancy has an impact, as children of depressed mothers are more likely to suffer from DMDD. To date, no other risk factors, either in relation to the structure of the family unit or socio-economic factors seem to play a role in developing the disorder.
Psychological Treatment for Children with DMDD
Several forms of therapy have proven beneficial in the treatment of DMDD. Cognitive behavioral therapy, which teaches children how their thoughts, feelings and behavior are all intertwined, and how certain behaviors can actually increase a disruptive mood. Dialectical behavioral therapy allows children to properly identify their feelings and teaches them how to respond mindfully and minimize frustrations. In addition to working with children, likewise, parent-training can go far in teaching families healthy ways to deal with anger and frustration.
In order to avoid depression, children with DMDD should be allowed to interact in normal environments, although they may need additional supervision and support.
Medical Treatment for Children with DMDD
Medicinal therapy can be beneficial in treating DMDD when combined with therapy and adequate support. Many commonly used psychiatric medications have been used with varying levels of success in treating the disorder. Types of medications used include stimulants such as Ritalin, antidepressants such as Zoloft and Prozac, and even certain anti-psychotic medications have been proven to help in some cases.
Comorbidity Factors and DMDD
Some symptoms of DMDD are also present in other sorts of psychiatric disorders. For example, it can be difficult to differentiate between DMDD and oppositional defiant disorder when the child is having a tantrum. In addition, to oppositional defiant disorder, DMDD also shares characteristics with Attention Deficit Hyperactivity Disorder (ADHD), anxiety disorders and adolescent depression. Because it shares characteristics of many other disorders, the road to a proper diagnosis can be a long one, and parents should be prepared for this eventuality.
Outlook and Coping
As DMDD only became a stand-alone diagnosis in 2013, little is known of future outcomes. For the child, because the disorder makes performance in everyday tasks difficult and sometimes impossible, the disorder is related to ongoing adult depression. Patients also often suffer socio-economic consequences, either as a direct result of acting out or as a consequence of being able to concentrate on studies while in a constant state of irritation.
Parents and caregivers, too, need and deserve support when their child is diagnosed with DMDD. Due to the higher level of supervision necessary, parents can burn out if they’re not in the economic position to afford qualified caregivers who can act as a psychological support system for these struggling kids. In addition, parents may face embarrassment and even ostracism if their child repeatedly acts out in public. It is critical for parents to connect with a strong support network consisting of those who can offer understanding and coping skills.
Luckily, in our technological age, online support groups do exist, even for the relatively new disorder of DMDD. There are numerous online forums just for parents raising children with this disorder. Often, the child’s own psychiatrist or psychologist can also offer additional local resources and support groups for parents living with a child who has DMDD.
The good news is, while it is a long, hard road for many, with adequate support and medical and psychological care, children with DMDD can learn to interact appropriately with their family, peers and community members. And they can go on to achieve success in life. The critical components are finding competent healthcare providers familiar with the disorder and its treatment, instituting safe interventions for when a child shows that they are ready to go out of control, and developing a strong support system for both the child and their parents.
