Growing up with DMDD: Temper Tantrums or a Mental Health Condition!

All children go through phases of irritability. Now that we have seen the picture of a young Princess Charlotte throwing a massive fit while boarding a plane, we know that the Princess of Wales is not alone. Almost every child throws a fit during their growing-up years and has to be coaxed, cajoled, or left alone – depending on the circumstances of the tantrum. 

However, when the frequency and intensity of the tantrums increase and become an almost daily occurrence, it could be a sign of a chronic mental health condition called DMDD or Disruptive Mood Dysregulation Disorder (DMDD). DMDD Disorder is a new addition to the list of mental health conditions as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). So, much is not known about it but if you as a parent are worried about the temper tantrums or the irritability that your child displays, do not put it down to the “ growing up stage”, and instead make an appointment with an expert.

What is Disruptive Mood Dysregulation Disorder (DMDD)?

Disruptive Mood Dysregulation Disorder (DMDD) is a mental health condition when children are chronically irritable. This disorder manifests in kids aged 6 to 12 years. After a certain age, children outgrow the condition, however, they then start displaying tendencies of depression as per a report.

While it is normal for children when they are bored, tired, or simply overwhelmed to exhibit signs that they are not comfortable by crying, playing truant, howling, etc.,  for the irritability to be classified as a disorder, the NIMH indicates that the following criteria must be met:

• Severe temper outbursts (verbal or behavioral), on average, 3 or more times per week
• Outbursts and tantrums that have been happening regularly for at least 12 months
• Chronically irritable or angry mood most of the day, nearly every day
• Trouble functioning due to irritability in more than one place, such as at home, at school, or with peers  

Statistics for DMDD: A common condition 

DMDD is a condition whose epidemiology is not well understood yet. Many even in the mental health/medical community have little knowledge about this condition. But for parents and caregivers who are dealing with a child with DMDD disorder and are in the dark timely diagnosis and a thorough evaluation would bring much relief. Whether we like it or not DMDD as a condition is more common than what we would like to believe. 

Though relatively new in the chronicles of mental health annals, we have many parents voicing concerns about their child being more disruptive, disagreeable, and temperamental than a normal child. 

When it comes to DMDD disorder statistics – the numbers can be an eye-opener for the medical fraternity/ mental health professionals. DMDD numbers (steadily rising) indicate that this cannot be shoved under the bed. It has been estimated that roughly fifty percent of children who display severe temper tantrums or irritability issues are likely to have a DMDD onset a year later. Statistics also indicate that 2 to 5 % of children could be living with the yet-to-be-understood condition. So it is imperative that if you suspect that your child has DMDD get him/her evaluated by the health care provider. You could also report how your child’s behavior is irrational and problematic, and report as well what you have observed from people interacting with them on a daily basis such as their teachers or counselors.

Signs and symptoms of DMDD: Not a pre-bipolar diagnosis  

Recognizing disruptive mood dysregulation disorder (DMDD) symptoms in time is the first step towards a cure. We have identified here some of the signs and symptoms of DMDD. 

• To be diagnosed with DMDD, a child must have experienced symptoms underlined earlier for 12 months or more. The child will be irritable and angry most of the time they are awake. This could happen almost every day. 
• As they are irritable, they are more likely to be left alone and less likely to receive the love, care, and affection normal children receive, which could stunt their emotional growth during adulthood. 
• Over time, as the child grows into an adult – then the temper tantrums might disappear – but strangely individuals diagnosed with DMDD in their childhood begin to exhibit symptoms of depression or anxiety during adulthood.
• DMDD does not mean a pre-bipolar diagnosis, though many of the symptoms are similar. With a proper diagnosis and treatment with psychotherapy and medications (as needed), the child would be in control of his/her feelings and become more confident about the ability to express even negative emotions without being overwhelmed or irritable.

Exploring Disruptive Mood Dysregulation Disorder (DMDD) Causes and Risk Factors: Male children are more susceptible 

It is hard to identify what are the causes of DMDD, but it is generally seen that DMDD occurs in children who are born in families with a history of mental health illness or addiction. Most of the children who have had a clinical evaluation are male and hence the risks of DMDD are higher in a child who has been registered male at birth. Again, it is also seen that the incidence or risk of DMDD is higher in families that have a prior history of substance abuse or mental health issues. As a parent, it is necessary to get the right evaluation done as the condition can deteriorate further if it is not addressed when it manifests first and can result in depression disorder once the child grows into an adult.

Effect of DMDD: Tackling the Invisible Demons

The inability to cope with “less-than-comfortable” conditions makes a child with DMDD disorder a bad team player. They are labeled “difficult” because they fail to comprehend that things will not always go as per their wish. Teachers and peers who have had a first-hand experience of their temper tantrums think twice before involving them in group activities and games. Even parents are partial towards a sibling who is better behaved. 

Resentful because they feel they have been neglected, a child with DMDD disorder rarely feels truly happy. Sometimes during severe bouts of irritability, they could inflict self-harm. Hospitalization could then be required. 

Sadly, DMDD does not end with the passage of childhood. Instead, the experiences of childhood are deeply ingrained. And even later in life, invisible demons ( neglect and inferiority complex)  haunt the child. This ruins the ability of a teen to find friends, go on dates, or be a part of a team. Instead, they are depressed and quickly succumb to mental health conditions. 

Comorbid conditions: Extremely high comorbidity 

DMDD shares a high comorbidity with psychiatric disorders and the overlap is highest with oppositional defiant disorder (ODD). It is highly likely that children who have this condition also display, disruptive behavior, anxiety, and even autism spectrum symptoms.

Living with DMDD: 

Though DMDD is a complex disorder, there is good news as the condition can be treated with medications and therapy. We also recommend parent training so parents and caregivers can fathom triggers in advance and mitigate outbursts and temper tantrums. For more information about the condition, you can reach out to us at the earliest.