Introduction
Disruptive mood dysregulation disorder (DMDD) is a depressive condition affecting adolescents or children characterized by severe anger, irritability, and intense, frequent tantrums. Its symptoms surpass a child being moody as the children suffering from the condition experience extreme problems at school, home, and with peers, which warrants medical attention and treatment. Moreover, DMDD patients often have high rates of using healthcare services, school suspension as well as hospitalization. The condition can be obtained from a complex amalgamation of environmental, genetic, and biological factors. These factors include co-occurring mental disorders such as oppositional defiant disorder, temperament, childhood experiences as well as genetics. Low parental support, family conflicts, and hostility can also significantly contribute to the development of DMDD. Understanding DMDD will help decrease overdiagnosis and treatment of bipolar disorder in early life, thus improving the quality of life.
Treatment and Therapies
Since DMDD is a new diagnosis, its treatment is mostly based on ones that have been successful for other disorders characterized by the same symptoms of intense temper outbursts and irritability. Disorders with these similar symptoms include oppositional defiant disorder, anxiety disorders, attention deficit hyperactivity disorder (ADHD), as well as major depressive disorder. Children experiencing DMDD find it difficult to perform well in school, form or maintain relationships with peers and family and avoid making friends or participating in activities. Additionally, having DMDD can largely contribute to the development of anxiety disorders and depression in adulthood (Benarous et al., 2020). Therefore, providing treatment for DMDD is significant in helping to improve the quality of life of children and their adulthood. DMDD can be treated either through medications or phycological treatments.
Medications
Most medications used to treat adolescents and children suffering from mental illnesses are most effective in relieving symptoms. Medications used in the treatment of DMDD include antidepressants, stimulants, and atypical antipsychotics. Stimulants are commonly used in attention deficit hyperactivity disorder (ADHD) treatment. The medication is used to reduce irritability symptoms common in DMDD patients and hence can be used as an effective treatment for the condition (Breaux et al., 2022). Moreover, stimulants such as Ritalin can be used to tackle emotional reactivity, which enables adolescents and children to manage their emotions and helps them articulate them more appropriately. Stimulant medications warrant periodic monitoring of changes in blood pressure and heart rate. However, stimulants cannot be used on individuals that suffer from severe heart problems.
Antidepressants can, at times, be used to address mood problems, aggression, and irritability accompanying DMDD. Serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenalin reuptake inhibitors (SNRIs) are antidepressant medications used to treat persistent and chronic anger. The medication can only be prescribed when DMDD co-occurs with other mental disorders such as ADHD and is associated with a risk of suicidal behavior as well as thoughts among teens and children. Atypical antipsychotic medications are prescribed for DMDD patients experiencing severe tantrums with physical aggression toward objects or people. Such medications include aripiprazole and risperidone, which are used to reduce the occurrence of irritability in individuals with DMDD (Bruno et al., 2019). Nevertheless, atypical antipsychotic medications contain various side effects such as weight gain, sedation, hormonal changes, movement disorders, metabolic abnormalities, and suicidal ideation.
Psychological Treatments
Psychological treatments for DMDD include psychotherapy, parent training, and computer-based training. Psychotherapy employs cognitive behavioral therapy (CBT) to help teach adolescents and children how to tackle emotions and thoughts that mostly contribute to their anxious and depressed feelings and regulate their social behavior. In addition, the approach is used to help children effectively control their moods and improve tolerance in frustrating situations (Tapia & John, 2018). Moreover, cognitive-behavioral therapy can be used to train coping skills that can be employed to regulate anger and ways that patients can use to re-label and determine the twisted perceptions that lead to outbursts. Furthermore, psychotherapy uses dialectical behavioral therapy for children (DBT-C), which combines CBT and acceptance-based strategies to help children accept and acknowledge stressors as well as frustrations and come up with methods that can reduce negative responses to these feelings.
Parent training is used for the purpose of helping parents relate with their children in ways that can aid decrease irritable behavior and aggression, thereby enhancing their relationship. Additionally, parent training helps coach guardians on how to effectively respond to irritable behavior, like anticipating actions that may make a child develop a temper outburst and working precedently to avoid the tantrum (Bruno et al., 2019). Furthermore, training emphasizes the significance of predictability, rewarding positive behavior, and enhancing consistency with children, which will help avert anger outbursts and reduce DMDD. Computer-based training is applied to aid children in developing new skills to deal with their symptoms. For instance, children suffering from DMDD tend to infer neutral facial expressions to indicate anger, which can irritate them. Patients with DMDD use computer-based training to process their facial expressions, minimizing irritability, thus helping them easily manage their symptoms.
Conclusion
In conclusion, disruptive mood dysregulation disorder affects adolescents and children and is characterized by severe anger, irritability, and intense, frequent tantrums. DMDD makes it difficult for individuals to form relationships with peers and family, participate in activities and perform better in school, which then interferes with their quality of life. The condition can be treated either with medication or phycological treatments. Medication treatments include antidepressants such as SSRIs, atypical antipsychotics including aripiprazole and risperidone, and stimulants like Ritalin. On the other hand, phycological treatments comprise of psychotherapy, parent training, and computer-based training.
References
Benarous, X., Bury, V., Lahaye, H., Desrosiers, L., Cohen, D., & Guilé, J. (2020). Sensory processing difficulties in youths with disruptive mood dysregulation disorder. Frontiers in Psychiatry, 11(164), 1–11. Web.
Breaux, R., Dunn, N., Swanson, C., Larkin, E., Waxmonsky, J., & Baweja, R. (2022). A mini-review of pharmacological and psychosocial interventions for reducing irritability among youth with ADHD. Frontiers in Psychiatry, 13, 1–7. Web.
Bruno, A., Celebre, L., Torre, G., Pandolfo, G., Mento, C., Cedro, C., Zoccali, R., & Muscatello, M. (2019). Focus on disruptive mood dysregulation disorder: A review of the literature. Psychiatry Research, 279, 323–330. Web.
Tapia, V., & John, R. (2018). Disruptive mood dysregulation disorder. The Journal for Nurse Practitioners, 14(8), 573–581. Web.