Disruptive Mood Dysregulation Disorder vs Intermittent Explosive Disorder: Symptoms and Treatments

It’s not uncommon for children to struggle with temper tantrums or outbursts, but when those become the norm, without control, and wildly disproportionate to the provocation, it might be a sign of something more severe.

This article will review the key differences between disruptive mood dysregulation disorder and intermittent explosive disorder. Understanding the distinction between these two is imperative to getting an accurate diagnosis and the right treatment.

When comparing disruptive mood dysregulation disorder vs intermittent explosive disorder, it is important to first note that DMDD is categorized as a Depressive Disorder. The onset of disruptive mood dysregulation disorder has to occur before the age of 10 years but does not apply to children younger than six. The core tenets of disruptive mood dysregulation disorder are outbursts that are the result of dysregulated emotions, usually because of poor development during childhood, temperamental issues, or environmental trauma.

While there are several conditions that have somewhat similar symptoms and conditions that can coexist with DMDD, a professional diagnosis cannot coexist with intermittent explosive disorder.

IED is considered a Disruptive, Impulse-Control, and Conduct Behavior. This disorder is an anger-based impulse disorder where individuals have aggressive outbursts that happen rapidly with no warning and no direct cause. These outbursts tend to last less than 30 minutes, and they might be provoked by something very minor. They include verbal or physical behaviors that may or may not cause damage and harm. The core tenet of intermittent explosive disorder is that the individual is unable to control their impulsive aggressive behaviors in response to provocation.

When you look at intermittent explosive disorder vs DMDD, there are several causes and risk factors for intermittent explosive disorder:

When you look at DMDD vs intermittent explosive disorder, there are temperamental, environmental, genetic, and physiological risk factors and causes:

1. The first is temperamental. Children who struggle with chronic irritability throughout their childhood are at a high risk of developing DMDD. It’s not uncommon for the symptoms to meet the same criteria for ADHD and for children to struggle with an anxiety disorder present at an early age.
2. The second is environmental factors. Children who have disruptions to their family life are more likely to develop the core behaviors associated with disruptive mood dysregulation disorder. This can include things like:
   • Living in a single-parent household
   • Experiencing early trauma
   • Struggling with malnutrition throughout childhood with a vitamin deficiency
   • Going through the death of a parent
   • Parents getting divorced or struggling with parental grief
   • Parents living with a psychiatric disorder
   • Psychological abuse
   • Neglect
   • Limited parental education
3. Finally, some data suggests that a family history of depression is another risk factor for the development of disruptive mood dysregulation disorder.

With disruptive mood dysregulation disorder vs intermittent explosive disorder, you’ll see differences in the diagnostic criteria. For disruptive mood dysregulation disorder, an individual will be diagnosed and assessed based on the following diagnostic criteria:

1. Individuals must exhibit severe and recurrent temperamental outbursts that manifest with things like verbal rages or behavioral traits such as physical aggression significantly disproportionate to the situation or the provocation.
2. Individuals must have temperamental outbursts that are inconsistent with their current development.
3. Those outbursts have to occur at least three or more times each week.
4. The mood in between the outbursts has to be persistently angry or irritable most of the day, as observed in all areas of life by people like parents, teachers, and peers.
5. All four of these first symptoms must be present for at least 12 months.
6. All of the symptoms have to present in at least two of three settings including home, school, and among peers.
7. The diagnosis has to be made between the ages of 6 and 18.

A professional psychiatrist can go through an assessment to determine whether there are any other explanations for the behaviors, such as autism spectrum disorder, post-traumatic stress disorder, or separation anxiety disorder.

There are specific disorders that cannot coexist with DMDD, so during an assessment, a psychiatrist will confirm whether the individual has things that would be disqualifying, like oppositional defiant disorder or intermittent explosive disorder.

For intermittent explosive disorder, an individual will be diagnosed and assessed based on the following diagnostic criteria:

1. Individuals must exhibit recurrent behavioral outbursts that represent a failure to control their aggression, including either of the following:

• Verbal aggression like verbal fights, tirades, or temper tantrums as well as physical aggression toward animals, individuals, or property occurring at least two times per week for an average of 3 months at a time. The physical aggression does not directly result in damage or destruction nor cause any injury to individuals or animals.
• Three behavioral outbursts that involve destruction or damage as well as physical assault involving personal injury within a 12-month time frame.

1. The magnitude of the aggressive nature during those outbursts must be significantly disproportionate to the provocation or stressors.
2. The recurrent aggressive outbursts cannot be premeditated nor are they committed in order to achieve an objective.
3. The recurrent aggressive outbursts have to cause significant distress and interpersonal functioning or other consequences.
4. The chronological age must be at least six.

A professional psychiatrist will run through an assessment to determine whether the recurrent aggressive outbursts are better explained by other mental health disorders or other medical conditions. This diagnosis is commonly made in conjunction with a diagnosis of things like:

• Oppositional defiant disorder
• Autism spectrum disorder
• Conduct disorder
• ADHD

If you are struggling with DMDD, there are several treatment options available.

Psychotherapy is the primary form of treatment for DMDD, including cognitive behavioral therapy, where individuals can learn to increase their ability to tolerate difficulty and frustration without exploding. Cognitive behavioral therapy can provide coping mechanisms for controlling anger and recognizing when angry outbursts or emotions are disproportionate to the provocation.

As this tends to affect children, parent training is equally important because it allows parents and caregivers to respond to those outbursts more effectively and remain consistent in response to those outbursts.

There are currently no medications specifically designed to treat DMDD. However, some medications can be prescribed for specific symptoms, like antidepressants, but you need to understand the side effects of each medication your doctor is prescribing.

Lifestyle modifications and supportive therapies can help individuals manage DMDD. Finding ways to manage stress is very important, and this can include lots of physical activity, yoga, or meditation. Participating in school-based accommodations and support groups can also be effective.

With intermittent explosive disorder vs disruptive mood dysregulation disorder, you have slightly similar treatment options.

Psychotherapy, including individual and group therapy, can provide ways to change patterns of thought, encourage relaxation, and develop new ways of thinking. Cognitive behavioral therapy is one of the most commonly used forms of treatment, and it can help individuals recognize their triggers and reconstruct the way they view frustration.

There are no specific medications currently prescribed for IED, but antidepressants or mood stabilizers can be prescribed to treat specific symptoms.

Lifestyle modifications and supportive therapies can look very similar between the two conditions.

• Problem-solving skills can help individuals learn to solve frustrations with assertiveness instead of aggression.
• Relaxation techniques can help individuals stay calm when there is a precipitating factor that would otherwise lead to an outburst, and these can include things like imagery, yoga, or deep breathing techniques.

With disruptive mood dysregulation disorder vs. intermittent explosive disorder, some of the symptoms might seem the same, but the cause of those symptoms is dramatically different, and that means the subsequent treatment plan needs to be tailored to a correct diagnosis. Seek professional help if you are looking for ways to manage life with either of these conditions or treatment options.