Disruptive Mood Dysregulation Disorder

What Are the Symptoms?

Symptoms typically appear between age six and age 10. The diagnosis is not given to kids under six or adolescents over 18. To receive this diagnosis, a child must steadily demonstrate the following symptoms for 12 months or more:

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• Feelings of intense anger all day, every day
   

• Alarming verbal or behavioral outbursts at least three times per week that are inconsistent with the situation or with the child's level of development
   

• Inability to get along with family, friends and teachers due to chronic irritability
   

• Tic disorder can sometimes develop in kids with ADHD. The origin of tic disorder is unknown.

Who Is At Risk?

Researchers don't yet know how many children in the general population have this condition. However, it is becoming increasingly common among kids who visit pediatric mental health clinics.

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Children and adolescents diagnosed with this condition are predisposed to depression and anxiety in adulthood. Researchers are working to identify the risk factors and brain mechanisms at play.

How Is This Condition Treated?

Because this is a novel disorder, treatment options are usually based on what has worked for similar disorders in the past. Similar disorders include oppositional defiant disorder, major depressive disorder, attention deficit hyperactivity disorder and anxiety disorder.

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If your child is chronically angry, and you suspect that this condition is to blame, it's important to get help as soon as possible. Besides the negative effects on mental health, chronic anger can cause physical problems including heart issues, high blood pressure, irritable bowels, depression, poor sleep and worse.

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Although studies are underway to determine which therapeutic agents work best, psychological therapy and medication therapy are presently the treatments of choice.

Psychological Therapy​

 

Cognitive behavioral therapy helps kids and teens to manage unpleasant thoughts and feelings that can lead to depression and anxiety.

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Children learn coping skills that help them to identify, own and regulate angry feelings. They also learn to relabel perceptions so they won't cause outbursts.

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Psychological therapy should always be considered first. Medication can be added later, if necessary, or it can be provided with psychological treatment from the start. Treatment with medication alone is not recommended.

Parent Training

Parent training is an effective treatment for a variety of mental health conditions. Parents can reduce tantrums and positively affect the parent-child relationship by practicing consistency and predictability when interacting with the child.

Computer-based Training

Chronically angry kids can misperceive ambiguous facial expressions and interpret them as angry. Computer-based training helps children to accurately identify a wide variety of different facial expressions.

Medication Treatment

Medications are currently available to relieve the symptoms of most mental health disorders. Nevertheless, not all of the medications are FDA-approved for children and adolescents.

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Most medicines have side effects ranging from mild to severe. Drugs that treat childhood mental health disorders should only be used as a last resort when the benefits of the medicine clearly outweigh the risks.

Stimulant Medication

When angry kids with ADHD were treated with stimulants like Adderall and Ritalin, the stimulants decreased irritability. Stimulants should not be prescribed for anyone with heart issues. Kids who take stimulants should be checked regularly for blood pressure and heart rate.

Antidepressant Medication

Antidepressants are sometimes used to reduce irritability in children with especially intense outbursts. Researchers are investigating whether antidepressants are safe for kids with this diagnosis.

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Although antidepressants are safe and reasonably effective for most people, they can still give rise to suicidal thoughts and behaviors in children and adolescents. Children should be closely monitored while taking antidepressants, especially during the first few weeks of treatment.

Atypical Antipsychotic Medication

Kids with unusually intense outbursts may become aggressive toward people and property. They are sometimes treated with atypical antipsychotic drugs like risperidone and aripiprazole.

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Both medicines are FDA-approved for extreme irritability associated with autism. However, they are also prescribed off-label for DMDD.

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Because atypical antipsychotics have some concerning side effects. they should only be prescribed after a careful assessment of the risk-benefit ratio:

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• Suicidal thoughts and behaviors

• Movement disorders

• Weight gain

• Sedation

• Diabetes

• High cholesterol

• Decreased sex drive

• Seizures

 

As children grow and develop, their symptoms may fluctuate or change. Adolescents and young adults might stop having tantrums only to develop depression or anxiety disorder. In such cases, treatment protocols must be changed as well.

Our Team Leaders

The psychiatric team at Spark Wellness Group in Orlando is dedicated to high-quality care for Orlando residents with mental health and substance use disorders and their families.

Luis Betancourt, M.D.

Dr. Betancourt graduated from Duke University Medical Center with a degree in child and adolescent psychiatry. He is especially interested in the connection between spirituality and psychiatry, and he speaks fluent Spanish and English.

Alan Stuart, PA-C

Alan earned his undergraduate degree in neuroscience at Florida Atlantic University. He then completed an M.S. degree in physician assistant studies from Nova Southeastern University.

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Alan provides a broad range of services for kids and adults with psychiatric conditions. He is fluent in Russian and English.

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Call us now to learn more about our mental health services or to schedule a private consultation.