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Life with Disruptive Mood Dysregulation Disorder (DMDD)

Disruptive Mood Dysregulation Disorder (DMDD), relatively new to childhood diagnoses, may explain your child's terrifying outbursts. Could it be DMDD?Most people don’t know what life with disruptive mood dysregulation disorder (DMDD) is like. But if your child is perpetually angry and irritable or you walk on eggshells for fear of triggering terrifying outbursts, these behaviors may point to disruptive mood dysregulation disorder, a childhood mood disorder that can lead a child and his or her parents on a scary and frustrating journey.

The Complex Road to a DMDD Diagnosis

Diagnosing a child is hard. I’m a licensed mental health provider and I didn’t even know DMDD existed. (In my defense, I work with adults, and DMDD is pretty new. See the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition changes). One problem is that disorders like DMDD include symptoms found in many other disorders. Children may get misdiagnosed with countless other things before making it to DMDD. They may have multiple disorders happening at once, so DMDD gets missed because professionals stopped looking after the first diagnosis. My own son’s journey took years.

Disruptive Mood Dysregulation Disorder and ADHD

There is no debate my son has attention-deficit/hyperactivity disorder (ADHD). Look up ADHD diagnostic criteria, and there might as well be a picture of him next to it. Stimulants and behavior modification weren’t getting at everything, though, and ADHD didn’t quite capture his intense moods.

For awhile, the doctors thought it was just depression. He exhibited many of the childhood symptoms: irritability, sleep difficulties, and suicidal thoughts (Recognizing Symptoms of Depression in Teens and Children). They also diagnosed him with anxiety. This is common: both depression and anxiety are seen in kids with DMDD and ADHD. He still holds the anxiety diagnosis.

The biggest problem, though, was anger. My son was angry when he was depressed. He was angry when he wasn’t. He was angry at home and school. Anything could trigger outbursts that ended with our house in shambles. The outburst that got him hospitalized happened in the car, seemingly triggered when my daughter started humming. My son started screaming, unbuckled himself, and began assaulting the both of us. He didn’t stop until we were in the Emergency Room and security guards isolated him in a back room. To this day, he doesn’t remember having that outburst or why it happened.

DMDD and Oppositional Defiant Disorder

By the time he was hospitalized, my son had already been labeled with oppositional defiant disorder (ODD). The main indicator was his interactions with authority. His outbursts tended to happen in response to teachers or parents. It never happened with other kids.

What a psychiatrist at the hospital pointed at, though, was the intent behind his defiance. Kids with ODD deliberately defy or annoy others. My son’s intent wasn’t to deliberately hurt anybody. He suffered from rigid thinking, anxiety, and an inability to control his emotions. In fact, he usually felt deep remorse and shame after coming out of his rages. He’s not a defiant kid. He’s a dysregulated one.

Treating Disruptive Mood Dysregulation Disorder

One thing that pointed to my son’s DMDD was medication. It’s a weird system when the way to confirm a diagnosis is to see if the treatment works, but that’s what happened. The psychiatrist put my son on a mood stabilizer, and there was an immediate effect. As a mental health professional, I knew the side effects of the medication they prescribed. I was scared. However, the effects absolutely outweighed my fears. We have moments of peace at home now. Outbursts do happen, but they’re fewer and less intense. Even better: my son seems capable of feeling content.

Life with DMDD is complicated. You have to work closely with doctors, schools, and family when dealing with a disorder this intense and intricate. It’s the only way to get it diagnosed appropriately. It’s the only way to manage it, and it’s the only way to keep from being overcome by it.

Author: Melissa David

Melissa David is a mother based out of Minnesota. She has two young children, one of whom struggles with mental illness.The support and wisdom of other parents proved invaluable to her in raising both her children; and so she hopes to pay it forward to other parents via Life With Bob. You can find her on Facebook, Google+, and Twitter.

26 thoughts on “Life with Disruptive Mood Dysregulation Disorder (DMDD)”

  1. It’s 3 AM and as usual, I’m wide awake thinking about our almost 8 yr old and what more can I do? He was diagnosed with DMDD earlier this year. He’s in his 3rd school. His challenges started just after he turned 5. I haven’t and refuse to give up hope! I will follow your blog… although I wish there was an in-person support group.

  2. Glad to be able to re- read this during the holiday “break” . Wish there was more information out there . More research, more knowledgeable therapists and psychiatrists. The holiday season ( no school, family who doesn’t want to be around, think he’s “fine” until the screaming starts and they can get up and go home), watching my son binge endlessly while others enable with chocolate etc. ) . Parents, keep trying. Keep taking care of yourselves every chance you get , keep holding onto hope that the development of these complex brains and advances in the field will give all of us ( our children, their siblings and parensts) some future

  3. I am so glad that I found this. I feel for every child and parent who is struggling with this, yet feel so relieved to find that my daughter is not alone. My baby has always been so sweet and happy until bam one day a few years ago she was just angry. Since then she has just become a ball of anger and sadness. It tears me up. She feels so awful afterwards too and never remembers exactly what happens. It was when she was hospitalized that we were blindsided with this diagnosis. But it makes complete sense now why nothing else was working. She was on celexa which did not work, now she is on abilify which seems to be working less every day.

  4. Wow it it feels really good to know there are other parents dealing with the same thing just like me. My daughter was diagnosed with ADHD and ddmd a couple of years back. We focused so much on the ADHD and so did her therapist at the time I never really paid attention to the ddmd and what it was all about. She has always had an outburst and it seems like they are just getting worse, she is always agitated or gets annoyed easily, and definitely does not understand sarcasm or when you are just joking with her. She is going to be 7 in the next couple of weeks. She is currently seeing a therapist monthly in which I think I will have to go with taking her every two weeks now because of her outburst. We have tried doing medication for the ADHD but she seems to always have a side effect. So now it worries me to think of having to put her on a medication for the DDMD? I always feel so bad having to punish her when she gets in trouble. I feel like she is constantly getting in trouble even if I give her mornings and different tools to try to help her make smart choices. Do any of you have any suggestions? How do you discipline your child?

  5. After reading this I was glad to know that I was not alone in this journey. Roller coaster would be putting it lightly. I have been looking for a support group so that I don’t feel so alone when my daughter is having outburst. I will be following you all. She is on a mood stabilizer and ADHD medication

    1. I know exactly what you’re going through. I feel so alone at times because I have no one to relate to or pick their brains on the things their child does that may be similar to my child

  6. My son is 8yrs old and we were just diognosied this summer. Life is one really big roller coaster for us.Glad i came across you. I look forward to following you.

  7. Hi! Thank you for sharing your story, I can relate. Our son is 7 and we are currently trying to find a dr. that will accept State insurance, so that we can start looking into medication. It breaks my heart to watch him battle these demons. He is such a sweet boy, and deserves to be happy.
    If you are willing to share, I am so curious about which medication he is on, the adjustment period and the different side effects he encountered. Thank you

    1. Please keep in mind this isn’t a good replacement for doctor’s advice, but my son is doing well on Seroquel for his mood. They recently put him on Intuniv for ADHD while he was on a stimulant holiday, and it’s super mellowed him out…though it also made him very sleepy for the first few weeks.

  8. I feel like I should comment because I read and re-read this exact blog piece again and again. My daughter is 8 and has anxiety and dmdd. She is hypersensitive to sounds and also attacks her sibling, often in the car. We, too, ended up in the ER and a 5 day hospitalization. Your blog so perfectly captures life with a child with this disorder. Thank you,

    1. Would you be willing to share which mood stabilizer has worked for your son? We are in the same position and the various side effects terrify me.

        1. Thank you! We just started that too. What dose have you found works? Any side effects? Does it help with his anxiety too or is he on something else for that? Apologies for so many questions but we’re new to this diagnosis and it’s difficult to find real people who are dealing with it successfully. 🙂

          1. The quick release dose made him SUPER TIRED. He’d drag himself into bed at night when he was previously a kid who never slept. Now he’s on extended release, and he does sleep, but more like a regular person.

            When not on his stimulant, Seroquel also makes him eat A LOT. This is usually fine because he gets sooooo skinny on the stimulant, but if your child isn’t on a stimulant, you definitely want to monitor for weight gain.

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