DMDD vs. bipolar disorder: similarities and differences

Disruptive mood dysregulation disorder (DMDD) is a mental health condition that affects children between the ages of 6 and 18 years. Bipolar disorder (BD) is a condition that can cause extreme changes in mood. The symptoms of DMDD and BD can be similar.

DMDD is a relatively new diagnosis. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition introduced DMDD as a way of reduce the number of BD misdiagnoses in children.

Misdiagnosing BD in a child will result in them taking unnecessary medications. The long-term use of these medications in children could lead to side effects such as:

  • weight gain
  • lipid and glucose abnormalities
  • reduced brain volume
  • reduced number of neurons in the brain

Read on to learn more about the similarities and differences between DMDD and BD, as well as their treatments.

According to the National Institute of Mental HealthDMDD occurs in children aged 6–18 years old and usually develops before the age of 10 years.

DMDD results in a child feeling angry, and it can lead to tantrums occurring over minor issues. A child who has DMDD may not be able to control their emotions as well as other children their age.

Although the cause of DMDD is currently unknown, the researchers behind a 2020 study believe that it has certain risk factors, such as:

  • Environmental influences, such as parental divorce or socioeconomic background
  • child abuse
  • being male
  • family history of mental health disorders
  • relationship problems with siblings

Additional research from 2018 notes that DMDD may have a link to parental depression. However, the study size was small, so further research is necessary to confirm this association.

BD is a form of mood disorder that causes a person to experience unusual changes in their mood, energy, or focus. A person who has BD may have episodes of elation or irritability, as well as bots of depression and sadness.

Mood episodes resulting from BD can last a week or two, or possibly longer. A person can also experience a mixed episode, during which they experience both manic and depressive symptoms.

The cause of BD is not yet known. However, researchers believe that it might be the result of several different factors occurring together, such as:

  • family history of BD
  • differences in brain structure or function
  • stress

Although there can be some overlap in how BD and DMDD present, the conditions have different symptoms and diagnostic criteria.

DMDD

The symptoms of DMDD can include:

  • Frequent irritable or angry moods
  • severe temper outbursts due to minor issues three or more times a week that are unusual for the child’s age
  • difficulty functioning due to irritability in multiple settings, such as at home and at school
  • inability to control emotions

A child must have these symptoms frequently for at least a year to receive a diagnosis of DMDD.

BD

BD symptoms can depend on whether a person is experiencing a manic or a depressive episode.

The symptoms of BD during a manic episode include:

  • feeling high, elated, or very irritable and touchy
  • feeling wired and more active and energetic than usual
  • racing thoughts
  • decreased need for sleep
  • talking quickly about different subjects at once
  • Excessive desire for food, sex, alcohol, or other pleasurable activities
  • thinking they can do many activities together without feeling tired
  • feeling unusually important, powerful, or talented

Depressive symptoms of BD can include:

  • feeling very low, sad, or anxious
  • feeling slow or restless
  • difficulty concentrating or making decisions
  • sleep issues, such as trouble sleeping or waking up too early
  • forgetfulness
  • Feeling as though they are not saying anything important
  • talking very slowly
  • no interest in most activities
  • inability to do simple tasks
  • feeling hopeless or worthless
  • thinking about death or suicide

Although it can occur at any age, BD generally develops during late adolescence or early adulthood, and it is a lifelong condition. On the other hand, doctors only diagnose DMDD in children aged 6–18 years.

Both DMDD and BD can cause extreme irritation that leads to difficulty functioning. However, irritability in BD only occurs during manic episodes. In between manic episodes, a person returns to feeling a regular level of emotion. In contrast, a child with DMDD experiences irritation and anger most of the time.

A person who has BD may experience episodes of elation or depression, whereas a child with DMDD feels mainly angry or irritated.

DMDD and BD can be difficult to diagnose as their symptoms can also be indicators of other conditions.

There are no lab tests for BD or DMDD, so a doctor must use their expertise to diagnose these conditions. The doctor might ask a person, or their parent or caregiver, about the symptoms and their family history when diagnosing either of these disorders.

DMDD is a relatively new diagnosis, meaning that not all doctors may be familiar with its symptoms. This lack of knowledge may result in a misdiagnosis of BD instead of DMDD. It is also possible that a child with BD may receive the incorrect diagnosis of DMDD.

Both DMDD and BD can occur alongside anxiety disorders, which can make them harder to diagnose. The person may have other symptoms in addition to those that BD or DMDD can cause.

It is important that people speak with a qualified mental health professional when seeking a diagnosis of BD or DMDD. Doing so should reduce the likelihood of misdiagnosis and mean that a person can receive treatment quickly.

If a person thinks that they or their child might have DMDD, they should speak with a doctor. DMDD can cause issues with a person’s relationships, education, and quality of life.

The treatment options for DMDD include:

  • Medication: Medications, such as antidepressants, stimulants, and antipsychotics, can treat DMDD. Anyone taking these medications for DMDD should look out for possible side effects, such as weight gain or suicidal thoughts.
  • Psychotherapy: Therapy can help a child regulate their mood and build a tolerance to frustration. It can also teach children how to deal with anger and how to reevaluate their response to minor issues.
  • Parent training: This type of training can help a parent or caregiver learn how to interact in ways that reduce aggression. It can also help improve parent-child relationships.
  • Computer-based training: Children with DMDD can have trouble with perceiving ambiguous facial expressions as angry. Computer-based training can help these children understand facial expressions better.

BD treatments can include medication, therapy, or a combination of different treatments.

  • Medication: Medication for BD includes antidepressants and antipsychotics. A doctor may also prescribe mood stabilizers, such as lithium.
  • Psychotherapy: Therapy for BD involves a person identifying troubling emotions and behavior and working to change them.
  • Other treatments: Additional treatments for BD include exercising and meditation. Doctors may use electroconvulsive therapy, which sends electrical impulses through the brain, if the condition does not respond to other treatments.

DMDD is a condition that only occurs in childhood. However, having DMDD increases A person’s chances of developing depression or anxiety disorders as an adult.

Proper treatment can help manage DMDD symptoms, but it is important to follow the doctor’s treatment instructions. If DMDD medication causes side effects, the person or their parent or caregiver should speak with the prescribing doctor.

It is also possible to treat BD symptoms effectively. However, there is no cure for BD, so a person will need to ensure that they continue to follow their treatment plan correctly.

DMDD and BD are mental health conditions that can affect a person’s mood and behavior. Despite being similar, these conditions have certain notable differences.

Doctors only diagnose DMDD in children aged 6–18 years, whereas BD can occur at any age. Additionally, DMDD results in a child feeling angry or irritated most of the time. A person with BD may have periods of irritation before returning to a regular level of emotion.

DMDD and BD have symptoms that overlap with those of various conditions, which can make them difficult to diagnose. However, once a doctor has made the correct diagnosis, effective treatment options are available for both conditions.

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