top of page
  • Brad Ploof, MS, ALC

All About DMDD (Disruptive Mood Dysregulation Disorder)

Boy Screaming in Anger

DMDD stands for Disruptive Mood Dysregulation Disorder. It is a childhood mental health condition characterized by severe and frequent temper outbursts that are disproportionate to the situation. Here are some key facts about DMDD in children:

  • Causes: The exact causes of DMDD are unknown, but it is thought to involve a combination of genetic, neurobiological, and environmental factors. Brain imaging studies show differences in the prefrontal cortex of children with DMDD.

  • Symptoms: The main symptoms are severe, recurrent temper tantrums that occur, on average, three or more times per week. Tantrums are inconsistent with the child's developmental level and occur in response to common situations. Between tantrums, children with DMDD have persistent irritability most of the day, nearly every day.

  • Age of Onset: Symptoms must begin before age 10, though the condition often becomes more apparent around age 6-7.

  • Prevalence: DMDD affects approximately 2-5% of school aged children. It is more common in boys than girls.

  • Diagnosis: DMDD is diagnosed by a mental health professional based on observation of symptoms and parental reports. Detailed criteria must be met regarding the frequency, severity, and duration of symptoms.

  • Treatment: Treatment involves psychotherapy such as cognitive behavioral therapy (CBT) to teach the child coping skills for managing emotions; parent training is also an effective addition to effective. Medications may be used to treat accompanying anxiety, depression or ADHD. Early diagnosis and treatment is important to prevent problems in school and relationships.

  • Prognosis: With appropriate treatment, many children can improve their emotional regulation and outgrow DMDD by late adolescence. Without treatment, symptoms are likely to persist and cause ongoing distress or functional impairment.

DMDD is a disruptive mood disorder that causes frequent emotional outbursts in children. Early recognition and treatment of DMDD can help affected children develop better anger management and coping strategies.

What are the most common therapies used with DMDD?

The most commonly used treatment strategies for youth with disruptive mood dysregulation disorder (DMDD) in approximate order of effectiveness:

  1. Parent management training (PMT) - Focuses on teaching parents strategies for managing their child's behavior and emotions. This can include improving parent-child relationships, setting clear expectations, and using praise and time-outs effectively. PMT has been shown to be very effective for reducing symptoms of DMDD.

  2. Cognitive behavioral therapy (CBT) - Helps youth identify and modify irrational thoughts, connect thoughts to feelings, and develop coping strategies. CBT aims to reduce emotional reactivity and improve emotion regulation. Research shows CBT is effective for DMDD.

  3. Dialectical behavior therapy (DBT) - Uses mindfulness, emotion regulation, and interpersonal skills training to help youth tolerate stress and regulate emotions. DBT has been adapted for youth with DMDD with good outcomes.

  4. Psychopharmacology - Medications like mood stabilizers, antidepressants, and antipsychotics may help reduce irritability, aggression, and emotional reactivity in youth with DMDD. Medication should be used cautiously and in conjunction with therapy.

  5. Emotion regulation therapy - Focuses on identifying emotions, reducing emotional avoidance, and developing skills to manage intense emotions effectively. This can help youth with DMDD improve self-control.

  6. Interpersonal therapy - Aims to improve interpersonal relationships and communication skills. This may help reduce conflict and improve family and peer interactions for youth with DMDD.

  7. School accommodations - Things like modified assignments, frequent breaks, andPositive behavioral supports in school can help minimize behavioral incidents for youth with DMDD.


The most effective approach often involves a combination of psychotherapy, education, and coordination between home, school, and medical care. Early intervention and parent involvement are key for successful outcomes. Treatment plans should be tailored to the individual needs of the child and family.


bottom of page