Disruptive mood dysregulation disorder causes chronic and extreme irritability and anger, as well as frequent, intense outbursts. This condition is a newer diagnosis, appearing in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for the first time in 2013. Because of this, much remains unknown about the condition and its progression.
Disruptive mood dysregulation disorder symptoms usually develop before age 10, often around preschool age. A child with the condition usually has severe temper outbursts three or more times each week. They may also seem irritable or angry for significant parts of the day, nearly every day. Disruptive mood dysregulation disorder can also make it difficult to function at home, school, or with other children.
Experts have a poor understanding of disruptive mood dysregulation disorder’s causes and mechanics. Functional MRI studies suggest that malfunction of the amygdala, the part of the brain responsible for interpreting and expression emotions, may play a role. Young people with the condition also have greater activity in the anterior cingulate cortex and medial frontal gyrus than other people.
While the symptoms may appear early in life, doctors do not diagnose disruptive mood dysregulation disorder before age six or after 18. Because experts lack a full understanding of the condition’s causes, diagnosis requires an evaluation of the individual’s behavior. The behavioral issues must persist for at least a year and involve frequent fits of rage. A mental health professional with experience working alongside children and adolescents may need to assist in the diagnostic process.
Disruptive mood dysregulation disorder’s characteristic symptoms — chronic irritability and temper outbursts — also appear in several other conditions, making it difficult to differentiate between them. Some experts believe these conditions can be comorbid with disruptive mood dysregulation disorder, while others disagree. The most notable conditions with similar symptoms are attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and bipolar disorder.
Due to disruptive mood dysregulation disorder’s recent recognition and its lack of research, experts base treatment on what is helpful for similar conditions, like ADHD or ODD. Some of the most effective treatments are types of psychotherapy and certain medications. Usually, experts will begin with psychotherapy and prescribe medications as necessary.
Cognitive-behavioral therapy (CBT) can help people with disruptive mood dysregulation disorder manage their frustration without having an outburst. It also focuses on identifying and understanding the triggers that contribute to anger. Researchers are also testing dialectical behavior therapy as a treatment for this condition. Most experts find it helpful to involve the caregivers when treating children.
Currently, the U.S. Food and Drug Administration has not approved any medications specifically for disruptive mood dysregulation disorder. Because of this, experts use stimulants, antidepressants, and atypical antipsychotics to relieve the symptoms. Atypical antipsychotics can have serious side effects, however, and doctors will only use them when other methods fail. Antidepressants may increase suicidal thoughts and behaviors in young people, so caregivers and doctors will closely monitor any children prescribed these medications.
Few estimates of the prevalence of disruptive mood dysregulation disorder are available. Current primary studies suggest a rate of 0.8% to just above 3%. Some research shows that around 3% of children have chronic issues with anger and irritability, but it is unclear if these cases are disruptive mood dysregulation disorder.
The outcomes of disruptive mood dysregulation disorder are mostly unknown. Doctors recognize that the characteristic symptoms will persist through adolescence without treatment. Adults with a history of the condition are more likely to develop depression or anxiety disorders. They also have higher chances of adverse health outcomes, low educational attainment, police contact, and impoverishment.
Caring for a child or adolescent with disruptive mood dysregulation disorder can be extremely difficult. Experts advise caregivers to speak with professionals and learn about the condition. Many mental health professionals will involve guardians in the treatment process because managing their own stress levels can have a beneficial impact on the child’s feelings of anger. Many organizations offer additional support to caretakers of children with disruptive mood dysregulation disorder.
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