Disruptive Mood Dysregulation Disorder
Disruptive Mood Dysregulation Disorder. NRNP 6665: Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I This study source was downloaded by 100000806925124 from CourseHero.com on 07-02-2022 15:46:58 GMT -05:00
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July 5, 2021 By Stephanie Jones
As a parent, you have watched your children grow, taken care of them, and gotten to know who they are. You know their behavior, their character, and their attitude better than anyone. So what do you do when you start to notice that they have begun behaving in unexpected ways that concern you?
It is easy to label troublesome behavior as ‘growing pains,’ but we can’t dismiss these changes when their behavior seems uncharacteristic or excessive, and it begins to interfere with our child’s daily routine.
This blog will define Disruptive Mood Dysregulation Disorder, outline signs and symptoms of DMDD, and offer pharmacological and nonpharmacological ways of treating DMDD. Lastly, it will discuss community sources available to help in the treatment of DMDD in children.
What is Disruptive Mood Dysregulation Disorder
DMDD is a condition in which a child experiences chronic, severe irritability and anger. It only presents in children 7-18 years of age (Hilt & Nussbaum, 2016). A diagnosis of DMDD is considered when symptoms occur before age 10 and have been present for at least 12 months in more than one environment (e.g., at home, school, or with peers). A diagnosis of DMDD is also more common in boys than in girls (National Alliance on Mental Illnesses, 2018)
Symptoms of Disruptive Mood Dysregulation Disorder
All children can become irritable sometimes. It is a normal response to frustration. DMDD is a relatively new diagnosis. It first appeared in the DSM-5 in 2013. The American Psychiatric Association DSM-5 (2013) has a specific list of diagnostic criteria, as follows:
Severe temper outbursts that may manifest verbally or behaviorally and are out of proportion to the situation and inconsistent with developmental level.
Chronically irritable or angry mood most of the day, nearly every day.
Trouble functioning due to irritability in more than one place.
The temper outburst occurs, on average, three or more times per week.
by Unknown Author is licensed under
Disruptiv e Mood
Dysregula tion
Disorder
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If you think your child may be experiencing symptoms of DMDD, talk to your child’s health care provider and describe their behavior, what you have observed, and what you have learned from talking to others, such as a teacher, school counselor, or family friend. DMDD can be treated with medication, psychotherapy, or a combination of both. As parents, we must work closely with the health care provider to make decisions that are best for our children.
Pharmacological Treatment of Disruptive Mood Dysregulation Disorder
Currently, there are no FDA-approved medications specifically for treating children and adolescents with DMDD (National Institute of Mental Health (NIH), 2019). However, health care providers may prescribe medications such as stimulants, antidepressants, and atypical antipsychotics to help relieve your child’s DMDD symptoms (NIH, 2019).
Stimulants: research suggests that stimulant medications may decrease irritability in youth (NIH, 2019).
Antidepressants: are often used to treat irritability and mood problems that children with DMDD may experience (NIH, 2019). Studies suggest that Citalopram (an SSRI) used in combination with the stimulant Methylphenidate has successfully treated children with DMDD (NIH, 2019).
Atypical Antipsychotic: certain atypical antipsychotic medications are used to treat children with severe outbursts, irritability, or aggression (NIH, 2019). These medications, however, are often used only when other approaches have not been successful due to side effects associated with them (NIH, 2015).
Nonpharmacological Treatment of Disruptive Mood Dysregulation Disorder
Cognitive-behavioral therapy (CBT): focuses on identifying cognitive distortions that may lead to depressed mood and utilizes problem- solving, behavior activation, and emotion regulation skills to help manage and combat depression (Thapar, 2015).
Dialectal behavior therapy for children (DBT-C): this type of therapy can help children learn to regulate their emotions and avoid extreme or prolonged outbursts (NIH, 2019).
Parent Training: it can be effective to combine therapy for children and adolescents with parent training. Parent training teaches parents more effective ways to respond to irritable behavior, such as anticipating events that might lead a child to have a temper tantrum and working ahead to deter it (NIH, 2019).
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Community Sources or Referrals for Children with Disruptive Mood Dysregulation Disorder
Children and adolescents are our most significant investments in the future. Region 8, where I am currently doing my practicum, offers a few different community services for children with mood disorders.
Day Treatment Program: addresses the varied and unique behavioral challenges of children and adolescents. It offers a focused curriculum of social skills enhancement, anger management, positive self-esteem building, and behavior modification techniques (Region 8 Mental Health Services, 2021).
Community Support Services: are dedicated to improving the quality of life of children and adolescents with disabilities/mental illnesses by enhancing their independence, productivity, and full integration into their communities (Region 8 Mental Health Services, 2021).
Peer Support: Region 8 offers group psychotherapy for children and adolescents experiencing the same difficulties/mental disorders; thus, providing them with peer support and letting them know they are not alone.
Other community services provided by Region 8 Mental Health Services include nursing services, pharmacy services, and case management.
This adage still holds true today. As parents of children with DMDD, we have experienced the challenges that come along with this diagnosis. Being proactive with our children will establish consequences with them before the problem behavior occurs; thus, allowing them to make an informed choice about their behavior. Additionally, learn to listen to family members, peers, teachers, and counselors when they express that your child is behaving differently than before. Having a well-established support system will go a long way in promoting your child’s health care as well as your own.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). American Psychiatric Association Publishing
Hilt, J. R. & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental
health. American Psychiatric Association Publishing
National Alliance on Mental Illnesses. (2018). Beyond Growing Pains: Children and Mood
Disorders. Retrieved from https://www.nami.org/Blogs/NAMI-Blog/June-2018/Beyond-
Growing-Pains-Children-and-Mood-Disorders
National Institute of Mental Health. (2019). Disruptive Mood Dysregulation Disorder: The
Basics. Retrieved from https://www.nimh.nih.gov/health/publications/disruptive-mood-
dysregulation-disorder/
Region 8 Mental Health Services. (2021). Day Treatment Program. Retrieved from
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell
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