Continuing our series on adolescent behavioral and emotional disorders treated at Red River Youth Academy, this week our focus is on disruptive mood dysregulation disorder (DMDD). It is common for youth to have temper tantrums and be angry, irritable, moody, and upset on occasion. However, when these behaviors are severe, persistent, and unusual for the child’s developmental age, you may be dealing with DMDD.

The characteristics of DMDD, as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), include:

  • Severe, recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation. Outbursts can include verbal rage and/or physical aggression toward people or property.
  • Outbursts occur, on average, three or more times per week for one year or more.
  • Outbursts are inconsistent with the child’s developmental level.
  • The child’s mood between outbursts is persistently irritable or angry most of the day, nearly every day, and is observed by parents, teachers, peers, or others.
  • The child has trouble functioning in more than one place, with symptoms present in at least two settings (home, school, with peers, etc.) for 12 or more months.
  • Symptoms must be severe in at least one of the above settings without a gap of three or more consecutive months.
  • The onset of symptoms are evident before age 10.


DMDD can be very disturbing and disabling for youth and their families. For the youth, it can lead to lost friends, strained relationships, suspension or expulsion from school, difficulty participating in activities, and decreased quality of life. Increasing levels of aggression create dangerous situations for the family, peers, and the youth. Experiencing DMDD in childhood also increases the risk of developing depression or anxiety disorders as an adult.

DMDD was a new addition to the DSM-5 to replace the diagnosis of childhood bipolar disorder. The diagnosis should not be made for the first time before age 6 or after age 18. Symptoms associated with DMDD, such as outbursts, aggression, and moodiness are also present with other mental health disorders, such as oppositional defiant disorder and depression, and a child may have more than one overlapping disorder. It is important to have a qualified mental health professional conduct a comprehensive evaluation to determine an accurate diagnosis.

Treatment for DMDD should be structured for the youth’s individual needs and may include psychotherapy, family training, and medications. Parents and caregivers should work closely with the therapist and care team to make sure their child is receiving the right treatment for their unique needs.

The content of this article is for informational purposes only. The content is not intended to substitute for professional mental health advice, diagnosis, or treatment. Always seek the advice of your psychiatrist, psychologist, licensed mental health professional, or other qualified health provider with any questions you may have regarding a mental health condition.