Disruptive Mood Dysregulation Disorder (DMMD) is a more recent disorder for the DSM-5, only seen in children who have a consistently irritable or angry mood, with several outbursts each week that are disproportionate to the event that triggered them. Bipolar disorder is characterized as having distinct manic or depressive episodes that can last for several weeks or months at a time and can be diagnosed at any age.
Comparing bipolar vs. DMDD can help better understand the prevalence and impact DMDD vs bipolar disorder has on individuals.
Defining DMDD and Bipolar Disorder
What is the difference between DMDD and bipolar? There are several.
What is DMDD?
DMDD is a condition that only affects children between the ages of 6 and 18, though symptoms often occur prior to the age of 10. It is a relatively new condition compared to bipolar disorder, introduced to help avoid misdiagnosis of bipolar in children.
Children who experience this condition may have a wide range of causes, including environmental influences, childhood abuse, or a history of family mental health disorders. When children present with DMDD, they are typically unable to control their emotions, and with such poor emotional regulation comes significant tantrums over minor issues and feelings of constant anger and irritability.
What is Bipolar Disorder?
Bipolar disorder is categorized as a mood disorder, not a behavioral disorder, and it’s something that can affect people of any age, presenting with periods of manic behavior or depressive behavior, categorized with things like irritability during the manic times and angry outbursts.
The manic and depressive mood episodes can last several weeks at a time. Some people experience both, while others only have depressive episodes. Researchers are unsure what the cause of bipolar disorder is, although there are some assumptions related to family history, brain structure, and environmental stress.
Symptoms Comparison
There are a few areas where symptoms overlap, but the primary overlap has to do with irritability. The irritability seen in bipolar vs. DMDD is a bit different because it only manifests bipolar disorder for those who present with manic episodes, not for those who only experience depressive episodes.
Emotional Symptoms
In terms of emotional symptoms, those with DMDD struggle with feeling irritable, cranky, and angry most of the day, most days of the week, and this type of chronic irritability can impede emotional regulation, processing, and more.
With bipolar, someone might experience problems regulating their emotion or identifying what they are feeling, with the actual emotional symptoms changing from one type of episode to the next. The crossover exists when someone struggles with a manic episode and feels very excited, impulsive, and irritable.
Behavioral Symptoms
When looking at DMDD vs. Bipolar disorder, there are many differences in the behavioral symptoms. For example, someone experiencing a manic episode will have behavioral symptoms like:
- Racing thoughts
- Speaking quickly
- Possible delusions or hallucinations
- Impulsivity, particularly with regard to reckless drinking, spending, or sex
During a depressive episode, they might struggle with the following:
- Slowed speech
- Sleep problems
- Appetite problems
The behavioral symptoms associated with DMDD are very similar to the emotional symptoms and have to do primarily with problems functioning in school and home, with peers or family, constant irritability, and severe temper tantrums. The behavioral outbursts are regularly disproportionate to the cause of said outbursts, and they can be verbal or behavioral.
Physical Symptoms
With DMDD vs. bipolar, physical symptoms of DMDD have to do with muscle tension and increased blood pressure or heart rate, all of which tie back to extreme anger or irritability the majority of the time.
With bipolar disorder, there are several physical symptoms that someone can encounter. Sleep issues are one of the most common, and these can be experienced whether an individual is struggling with a manic or a depressive episode. Both can lead to insomnia or hypersomnia, where an individual sleeps too much, especially when dealing with depressive episodes, or not enough when dealing with manic episodes.
Bipolar also presents with physical pain in the form of headaches, chronic pain, and digestive issues, as well as fatigue and appetite changes. Appetite changes, much like sleep changes, relate to the type of episode an individual is experiencing with things like overeating and weight gain, often associated with a depressive episode and undereating with weight loss associated with either episode.
Diagnosis and Treatment Approaches
Both conditions are purportedly difficult to diagnose because their symptoms can indicate the opposite condition. As there are no laboratory tests, a diagnosis must be given by a qualified psychiatrist who will refer to the diagnostic criteria in the DSM-5 and work to rule out other potential explanations of certain behaviors. Both conditions can often occur with an anxiety disorder, which can impede effective diagnosis.
For this reason, it’s essential to speak with qualified mental health professionals to ensure that you get an accurate diagnosis.
Diagnostic Criteria
For a diagnosis of DMDD, one of the most important criteria has to do with the age and how long the symptoms have presented. Symptoms must present in most cases before the age of 10 but not younger than six or beyond the age of 18. The symptoms of things like irritability and severe outbursts over minor things must occur at least three or more times each week in a way that is unusual for the child’s age. More importantly, the frequent irritability and outbursts must cause problems functioning in multiple settings, and they must have occurred for at least a year prior to receiving a diagnosis.
The diagnostic criteria for bipolar disorder will vary based on whether an individual is experiencing manic, depressive, or a mixture of both types of episodes.
Treatment Options for DMDD
DMDD treatment is relatively unresearched in comparison to bipolar disorder because it is a much newer condition in the DSM-5. That said, there is no difference between DMDD and bipolar in terms of how popular cognitive behavioral therapy is, but in this case, cognitive behavioral therapy or dialectical behavioral therapy for children can teach self-calming techniques and how to better connect with emotions and behaviors.
In addition to medication, antidepressants and atypical antipsychotics can be prescribed to help with irritability and temper outbursts, respectively. At this age, it’s very important that parents play a significant role in learning how to respond to the behaviors a child exhibits prior to a tantrum and working with children to develop coping strategies.
Coping strategies with DMDD are more effective ones trigger identification has happened because it allows families to find ways to work around specific triggers and to utilize physical activity like going for walks or breath work as well as yoga and meditation to control stress levels.
Treatment Options for Bipolar Disorder
When you look at DMDD vs. bipolar, some of the differences have to do with the treatment type. There are several forms of treatment that can be included in a multi-disciplinary approach for bipolar disorder.
As bipolar disorder is a condition that an individual has to live with, with no cure, the purpose of treatment is to help an individual learn how to live with their condition and manage the symptoms accordingly. This starts with medication, which can include antidepressants for depression, antipsychotics, or other mood stabilizers.
Beyond medication, talk therapy, like cognitive behavioral therapy, can be very effective for bipolar disorder. Sometimes, electroconvulsive therapy or transcranial magnetic stimulation can provide temporary relief. In addition, support groups, regular exercise, proper sleep schedules, and healthy diets can be useful.
Summing Up
There are many differences when comparing DMDD vs bipolar disorder, with one key similarity having to do with the irritability and outbursts often found with manic episodes and in DMDD. It is important to understand the differences and similarities and seek professional guidance for an accurate diagnosis and custom treatment options.
