This article will help readers better understand the differences between medication and therapy as treatment options for DMDD and guide them in choosing the most appropriate treatment plan.
Disruptive Mood Dysregulation Disorder is a type of depressive disorder. It presents with chronic and severe irritability which can take the form of temper outbursts and then an irritable or angry mood in between the outbursts.
It wasn’t until 2013 that disruptive mood dysregulation disorder became a legitimate classification in the DSM, which means there are few studies specifically related to DMDD treatment, but current treatment plans are based on the medications and therapies that have proven most helpful for related disorders like:
- Anxiety disorders
- Oppositional defiant disorder
- ADHD
These typically include some medications and psychotherapy, although it is generally recommended that those who are diagnosed with DMDD start with psychotherapy and then consider adding medication where necessary.
If you or someone close to you is struggling with DMDD, it is important to find the right treatment approach, whether it be medication, therapy, or a combination of both.
Overview of Medication for DMDD
With treatment for DMDD, medication can be a useful part of your overall treatment plan.
Types of medications commonly prescribed for DMDD
Currently there are no specific medications that are approved by the FDA specifically for DMDD. However, there are medications that can be prescribed to help with certain symptoms. Any medications that are prescribed should be regularly monitored to make sure that they are working and that the side effects don’t outweigh the benefits.
How medication works to manage DMDD symptoms
There are several medications that can be prescribed as part of treatment for DMDD, including stimulants. Stimulants are often prescribed for ADHD because they can decrease irritability. This helps to directly decrease the irritability associated with DMDD in between temper tantrums or outbursts.
Sometimes, antidepressants are used to help manage mood disorders as well. Certain medications like antidepressants work well to better regulate some primary and secondary factors that contribute to depressive disorders like DMDD, including issues with serotonin production.
Sometimes, a treatment plan for disruptive mood dysregulation disorder will include atypical antipsychotics. These are FDA-approved for treating irritability typically associated with autism but can also be prescribed for the irritability associated with DMDD. These types of medications are intended for severe outbursts and aggression, not for the irritable mood that takes place in between those outbursts.
Benefits of using medication
A disruptive mood dysregulation disorder treatment plan can benefit from the integration of medication so long as it is monitored for efficacy.
Combining different medications can be useful, particularly early on in a disruptive mood dysregulation disorder treatment plan, as the medication can help preliminarily control symptoms of irritability and outbursts while therapy can offer coping skills and emotional regulation techniques.
Potential side effects
It is important that any medication is regularly monitored because it can have potential side effects. For example:
- Stimulants have a risk of cardiovascular issues like increased blood pressure, irritability, insomnia, depression, moodiness, weight loss or loss of appetite, headaches, and blurred vision. In some children, stimulants may actually make problems of irritability and moodiness worse. There is also a risk that stimulants can increase heart rate and blood pressure for children who are already at a risk of high blood pressure and problems with heart rate because of the physical symptoms of DMDD.
- Antidepressants have many common side effects, including restlessness and insomnia for children, indigestion, constipation, other digestive issues, weight gain, sweating, headaches, and dizziness. Many antidepressants come with side effects that get better after the first few weeks, but there is a slight though severe risk of suicidal ideations and behaviors, particularly in children.
- Atypical antipsychotics can commonly lead to side effects like weight gain, lack of coordination, muscle twitches, and tiredness. But it can also lead to more severe side effects like blurred vision, confusion, drowsiness, problems with blood pressure, and even seizures.
Every type of medication has its potential side effects, some of which are more common than others. It is important that you discuss the potential side effects with a doctor to determine whether a treatment plan that incorporates both therapy and medication is right for your child, and if so, what side effects to look for and when side effects might become a problem.
Overview of Therapy for DMDD
Disruptive mood dysregulation disorder treatment often includes therapy.
Types of therapeutic approaches used for DMDD
There are several types of therapeutic approaches you can include in your treatment plan for disruptive mood dysregulation disorder.
The most common type of psychotherapy used for a treatment plan for disruptive mood dysregulation disorder is cognitive behavioral therapy.
How therapy helps address the underlying causes of DMDD
Many individuals who struggle with disruptive mood dysregulation disorder are not adept at recognizing the impact that their thoughts and emotions have on their behaviors. They also don’t have ways to control those outbursts, and therapy provides an opportunity to build emotional regulation skills that get at the root cause of DMDD.
Benefits of therapy
Cognitive behavioral therapy is particularly useful among children as it teaches children to recognize the relationship between how they think, how they feel, and how they behave. Understanding this relationship puts children in a position to increase their ability to sit with difficult feelings and frustration without letting those thoughts or emotions directly lead to impulsive behaviors like temper tantrums.
With cognitive behavioral therapy, children can learn coping skills to relabel how they view certain things so that they are not nearly as negative. This can have a direct impact on controlling outbursts and improving mood on a regular basis.
Combining Medication and Therapy
With DMDD treatment, combining medication and therapy is one of the most effective approaches.
The advantages of a combined approach to treating DMDD
A combined approach for disruptive mood dysregulation disorder treatment is often a good course of action, particularly early on in recovery. The reason for this is that medication alone does not directly fix the problem or causes of depressive disorders and mood disorders like DMDD but can help control the symptoms. At the same time, therapy doesn’t directly control symptoms but can teach skills to help combat the problem or causes.
For this reason, it is advantageous to combine medication and therapy as part of DMDD treatment for many children because they can complement one another in a way that provides better stability in terms of emotions and irritability or angry outbursts while children are acquiring the skills they need to manage the symptoms long term.
How medication and therapy complement each other
In many cases, particularly for mental health conditions, treatment plans that incorporate medication and therapy actually complement one another. In fact, studies typically find that the use of medication is more successful if it is combined with therapy.
Summing up
Overall, the right treatment for disruptive mood dysregulation disorder is something that works well for you and may or may not include both medication and therapy for DMDD. What is most important is that you work with healthcare providers to get personalized treatment plans and work closely with them to monitor the efficacy of each aspect of your DMDD treatment continually.
