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Disruptive Mood Dysregulation

A Disruptive Mood Dysregulation Disorder (DMDD) is a mental health disorder typically diagnosed in children and adolescents. It is characterized by persistent and severe irritability and temper outbursts that are out of proportion to the situation or stressor.

Disruptive Mood Dysregulation

What is a Disruptive Mood Dysregulation Disorder?


A Disruptive Mood Dysregulation Disorder (DMDD) is a mental health disorder typically diagnosed in children and adolescents. It is characterized by persistent and severe irritability and temper outbursts that are out of proportion to the situation or stressor. These mood dysregulation symptoms must be present for at least 12 months and must occur in more than one setting (e.g., home, school, with peers).


DMDD was introduced as a diagnosis in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to provide an alternative to the diagnosis of bipolar disorder in children who exhibit chronic irritability, but do not meet the full criteria for bipolar disorder.


Children with DMDD often experience significant impairment in social, academic, and/or other areas of functioning. In addition to irritability and temper outbursts, children with DMDD may also exhibit symptoms such as sadness, difficulty sleeping, difficulty concentrating, and low energy. Treatment for DMDD typically involves a combination of psychotherapy and medication.


Who does Disruptive Mood Dysregulation Disorder affect?


Disruptive Mood Dysregulation Disorder (DMDD) is a newly recognized disorder, and research is still ongoing to determine the exact prevalence of the disorder. However, it is estimated that DMDD affects between 2% and 5% of children and adolescents.


DMDD is typically diagnosed in children between the ages of 6 and 18 years old, with the onset of symptoms typically occurring before the age of 10. The disorder is more commonly diagnosed in males than in females.


DMDD is often comorbid with other mental health disorders, including anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD). It is important to note that while DMDD is a disorder that primarily affects children and adolescents, some individuals may continue to experience symptoms of the disorder into adulthood. Additionally, the impact of DMDD extends beyond the individual with the disorder, affecting their family, peers, and community.


What are the symptoms of a Disruptive Mood Dysregulation Disorder?


A Disruptive Mood Dysregulation Disorder (DMDD) is characterized by severe and persistent irritability and frequent outbursts of temper that are out of proportion to the situation or stressor. The following are the symptoms of DMDD as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):


  • Severe temper outbursts: This may include verbal and/or physical aggression towards people or objects and can occur three or more times per week on average.

  • Chronic irritability: This is a persistently irritable or angry mood that is present most of the day, close to every day.

  • Trouble functioning: The symptoms of DMDD cause significant impairment in social, academic, and/or other areas of functioning.

  • Duration: Symptoms must be present for at least 12 months, and the child must not have three or more consecutive months without them.

  • Onset: Symptoms must begin before age 10.

  • Multiple settings: The symptoms must be present in more than one setting, such as at home, school, and/or with peers.

  • Exclusionary criteria: The symptoms cannot be better explained by another mental disorder or a medical condition.


In addition to these core symptoms, children with DMDD may also experience other symptoms, such as difficulty sleeping, difficulty concentrating, and low energy. Note that the diagnosis of DMDD requires a comprehensive evaluation by a qualified mental health professional.


How is a Disruptive Mood Dysregulation Disorder diagnosed?


The diagnostic criteria for Disruptive Mood Dysregulation Disorder (DMDD) are outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To be diagnosed with DMDD, a child must meet all the following criteria:


  • The presence of severe recurrent temper outbursts manifested verbally and/or behaviorally (e.g., verbal rages, physical aggression) that are grossly out of proportion in intensity or duration to the situation or provocation. The temper outbursts must be inconsistent with developmental level.

  • The temper outbursts must occur, on average, three or more times per week.

  • The persistent irritability or angry mood is present between the temper outbursts most of the day, close to every day, and is observable by others (e.g., parents, teachers, peers).

  • The frequency and intensity of the mood between temper outbursts is consistently and distinctly greater than that which is typically observed in individuals of comparable age and developmental level.

  • The symptoms must be present for at least 12 months, with the individual not having been without the symptoms for more than 3 consecutive months during that time.

  • The symptoms must be present in two or more settings (e.g., at home, at school, with peers) and are severe in at least one of these settings.

  • The onset of symptoms is before age 10 years.

  • The diagnosis of DMDD is not made for the first time before age 6 years or after age 18 years.

  • The symptoms are not due to a substance or to another medical or psychiatric condition.


Note that the diagnosis of DMDD requires a comprehensive evaluation by a qualified mental health professional.


What are therapies and strategies for overcoming Disruptive Mood Dysregulation Disorder?


The treatment for Disruptive Mood Dysregulation Disorder (DMDD) typically involves a combination of psychotherapy and medication. Here are some strategies and treatments that may be helpful for individuals with DMDD:


  • Psychotherapy: Psychotherapy, or talk therapy, can help children and adolescents with DMDD learn to identify and manage their emotions and behaviors. Cognitive Behavioral Therapy (CBT) can be particularly helpful in teaching children's skills for managing their emotions and behaviors.

  • Medication: Medication, such as antipsychotics and mood stabilizers, may be used to manage symptoms of DMDD. It is important to work with a qualified mental health professional who can closely monitor the use of medication.

  • Family therapy: Family therapy can help parents and caregivers learn strategies for managing their child's behavior and can also help improve communication and relationships within the family.

  • School-based interventions: School-based interventions, such as behavioral interventions and accommodations, can help children with DMDD succeed academically and socially.

  • Stress reduction techniques: Stress reduction techniques, such as mindfulness meditation, yoga, and relaxation exercises, can be helpful in managing symptoms of DMDD.

  • Lifestyle changes: Regular exercise, a healthy diet, and sufficient sleep can all help improve mood and reduce symptoms of DMDD.


It is important to work with a qualified mental health professional to develop a personalized treatment plan for DMDD that considers the individual's unique needs and circumstances. Treatment for DMDD can be effective, and with the right support, individuals with DMDD can learn to manage their emotions and behaviors and lead fulfilling lives.


This content is provided for informational and entertainment value only. It is not a replacement for a trained professional's diagnosis or for the treatment of any illness. If you feel like you are struggling with this condition, it is important to seek help from a mental health professional. With the right treatment and support, individuals with this condition can learn to manage their symptoms and lead fulfilling lives. BetterPsych provides full psychological services via telehealth and offers a 100% satisfaction guarantee on our services. For more information and to find a therapist specializing in this disorder, please call (833) 496-5011, or visit https://www.betterpsych.com.

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