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WHAT YOU SHOULD KNOW ABOUT DISRUPTIVE MOOD DYSREGULATION DISORDER (DMDD)


I coach parents who have one or more children with disruptive mood dysregulation disorder (DMDD), ODD, and/or ADHD. Most people don't know what DMDD is, and after a previous blog post, I got questions. It was just added to the DSM-5 in 2013, and even many doctors don't know what it is. DMDD can be crushing to families who have no idea what is going on or how to get help.


The National Institute of Health says that, "DMDD is a condition in which children or adolescents experience ongoing irritability, anger, and frequent, intense temper outbursts. The symptoms of DMDD go beyond a 'bad mood.' DMDD symptoms are severe. Youth who have DMDD experience significant problems at home, at school, and often with peers. They also tend to have high rates of health care service use, hospitalization, and school suspension...."


Many DMDD parents tell me their children remind them of the Incredible Hulk. With the slightest provocation -- something like not having the correct variety of ice cream at home -- their eyes will glaze over, and an extreme temper tantrum will ensue. This can include screaming, throwing things, hitting others, running away, and damaging property. It looks like a toddler throwing a tantrum, but these kids can be 8, 10, 15 years old and can do far more damage. Further, normal methods used to soothe an agitated child often result in making the situation worse and prolonging the episode.


Friends, family and bystanders misunderstand DMDD children and think it is caused by a parenting issue. It is not. The parents didn't do anything to cause it. The child didn't do anything to cause it. Most kids hate it and feel deep shame about it, but they can't control it.


A DMDD episode is a misfiring of the flight or fight response in the amygdala. Neurologically, it bears a strong resemblance to a seizure. DMDD is a genetic disorder that Dr. Daniel Matthews, one of the most prominent DMDD doctors, believes may one day be diagnosed with a blood test. Interestingly, children eventually outgrow the disorder. Adults do not have DMDD.


Because it's newly classified, there is little research on effective treatments. Parents often lose days of work taking their children from doctor to doctor trying to find one who has applicable experience and has treated children successfully. Most doctors use treatments that have been used for other conditions, like ADHD or seizures, with varying success. When these treatments work, they can be truly amazing and put the disorder into near remission. When the wrong protocol is chosen, it can make things much worse, and children often end up needing treatment in a psychiatric hospital to recover. There are many difficult things in life, but the moment you leave your young child in a psychiatric ward and turn around to go home by yourself has to rank pretty high on that list.


These kids desperately need love and compassion rather than judgment, and so do their parents. But while the children receive therapy as part of their treatment, parents are often left to sit in the ashes alone. There are a few parental support groups on Facebook, and these can help, but parents really need much more support.


Although parenting doesn't cause DMDD, there are parenting techniques and strategies that can be used to reduce the frequency and intensity of episodes. These techniques are sometimes counterintuitive and are totally different from how you would parent a child without DMDD. Finding a coach was, for me, a pivotal moment in our struggle with this disorder. It was just as important, perhaps even more important, than finding the right prescription and therapist. I couldn't help my child very well until I found the right support for me. Within six months of being diagnosed, and within three months of finding a coach, we had very good control over my child's DMDD, and it just continues to improve. I feel so lucky.


If you're a parent grappling with DMDD, I've been there. I understand you. I can help. Schedule a free mini session with me and let's see if we're a good fit to work together. No one should have to walk this path alone.




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