DMDD is a childhood condition in which the child experiences severe anger, irritability, and frequent temper outbursts — that are grossly out of proportion in intensity or duration to the situation. These occur three or more times per week for one year or more.
In addition to the severe, recurrent temper outbursts and persistent irritability and anger between the outbursts nearly every day, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires:
- The above symptoms are to be present in at least two settings (at school, at home, or with peers) for 12 or more months and to be severe in at least one of these settings
- Symptom-free interval to not extend beyond three or more consecutive months
- The age at which the symptoms first manifest is less than ten years, but after six years
- The diagnosis of DMDD is not to be made for the first time before six years because of the peak in irritability in the preschool years and difficulty in differentiating between normal and abnormal irritability during this period.
How Common is Mood Dysregulation?
Since the condition is relatively new, not much data is available regarding its prevalence. However, the results from one study show that DMDD is relatively uncommon after early childhood and often occurs with other disorders, especially anxiety and depression.
What Causes Mood Dysregulation?
Researchers aren’t sure what exactly causes DMDD. Children with DMDD usually display abnormal temperaments, such as anxiousness or moodiness. They also tend to misperceive neutral faces in a more negative way and mildly negative faces as more hostile, to which they react by throwing severe tantrums and having anger outbursts most of the time.
What are the Treatment Options for Mood Dysregulation?
Because DMDD is a relatively new condition, there’s not much research on which treatments are most effective. Therefore, treatment of mood dysregulation often depends on what has worked for other conditions with similar symptoms. These conditions include attention deficit hyperactivity disorder, anxiety disorders, oppositional defiant disorder, and major depressive disorder.
Researchers are still trying to discover which treatments work best for mood dysregulation. The modes of treatment currently used to treat DMDD symptoms include:
- Psychotherapy
- Medications
- Parent training
- Computer-based training
- Neurofeedback
Psychotherapy
Cognitive-behavioral therapy teaches children and teens various ways to identify misperceptions that lead to anger outbursts and learn coping skills to control them.
Medications
Though more research is required to determine which medications can treat mood dysregulation more effectively, psychiatrists usually prescribe stimulants, antipsychotics, mood stabilizers, or antidepressants to treat its symptoms.
These medicines, however, carry tons of side effects. Doctors may sometimes avoid using these medications due to the concern of worsening symptoms of mood dysregulation.
Parent training
Parent training helps teach parents how to anticipate triggering events and plan to ward off the outburst. It helps parents communicate with a child in a way that doesn’t exacerbate anger and irritability.
How Does Neurofeedback Work for Mood Dysregulation?
Children and teens with DMDD show deficits in reward learning, cognitive control, and responses to frustration or threat cues. Reinforcing positive behavior by rewarding them optimizes the likelihood of the desired conduct in the future. If a favorable outcome or reward follows an action, it automatically bolsters that particular response or behavior in the future. This is the theory of positive reinforcement.
Because neurofeedback is based on positive reinforcement, it garners attention as a potential tool for children with mood dysregulation. It enables them to learn and build skills to cope with their emotions and avoid intense temper outbursts.
Moreover, a growing body of literature points to the potential of neurofeedback to re-wire, change, and reorganize the brain — a phenomenon called plasticity of the brain (aka neuroplasticity). This ” neuroplasticity “ accounts for the success of neurofeedback and enables self-control and regulation of emotions even after stopping the treatment.
Most of all, neurofeedback is a non-invasive, safe therapy that doesn’t seem to harm children, unlike medications.
During a neurofeedback session, an EEG brain map is used to locate the exact site(s) where the problem lies in a child’s brain. Then neurofeedback sessions target those brain areas to educate the brain to respond better.
It measures a child’s brain waves in real time and provides visual and sound feedback. Every second, the brain activity is matched to the target for change. If a child meets the target, the system feeds a positive signal or “reward” back into the brain. However, no signal or reward is delivered if the child’s brain doesn’t reach the goal.
“Continuous” neurofeedback treatment sessions are crucial to success. To see the definite benefits and keep the cellular networks of the brain engaged, neurofeedback sessions have to be done repeatedly.
With every session, the cellular networks of the brain will fine-tune and adapt to the new levels of activity. It helps children with mood dysregulation harness their ability to cope with emotions.
Consequently, the child will develop more patience and a positive mood and learn how to calm down the mind, gradually eliminating the symptoms of DMDD.
