Disciplining a child with disruptive mood dysregulation disorder (DMDD) requires a different approach than traditional discipline methods. Children and adolescents with DMDD have difficulties regulating their emotions, making regular disciplinary approaches less effective. This guide provides other compassionate ways to teach kids to manage their emotions and maintain positive behavior.
What is DMDD?
Disruptive mood dysregulation disorder (DMDD) is a condition that causes extreme emotional reactions in children. Unlike typical mood swings, children and teens with DMDD may experience frequent and intense outbursts that are far beyond what is expected for their age.¹ These outbursts are not occasional tantrums but occur several times a week and last for a year or more.
How DMDD affects a child’s behavior
DMDD can make everyday situations more challenging for both children and their families. These difficulties often include:
- Persistent irritability: Many children with disruptive mood dysregulation disorder are in a constant bad mood, appearing angry or annoyed even when nothing upsetting has happened.
- Difficulty following rules: Because they struggle with impulse control, they may refuse to follow directions or react aggressively when disciplined.
- Challenges in school and social settings: Their intense emotions can make it difficult to get along with classmates, follow classroom rules, or manage frustration during schoolwork.
- Struggles with frustration and disappointment: Small setbacks, like losing a game or being told “no,” can trigger intense meltdowns that last much longer than expected.
How to discipline a child with DMDD
Disciplining a child with disruptive mood dysregulation disorder (DMDD) requires a different approach than traditional discipline methods.²,³ Instead of focusing on punishment, parents and caregivers should use emotionally supportive methods to guide their children toward good and positive behavior. These disciplinary approaches include:
Using proactive discipline methods
Since children with DMDD struggle with emotional dysregulation, setting up a structured environment can help prevent outbursts before they begin. To do this:
- Create consistent routines: A predictable schedule gives children a sense of stability, helping them know what to expect and reducing anxiety about what comes next. For example, setting a regular bedtime and meal schedule can reduce unexpected stress.³
- Set clear expectations: Avoid vague rules; state exactly what behavior is expected in specific situations.
- Prepare for transitions: Sudden changes can trigger frustration, so give your child advance notice before moving on to a new activity (e.g., “In five minutes, we will clean up”).
Responding calmly to emotional outbursts
When a child with DMDD has a meltdown, traditional punishments like timeouts or taking away privileges may escalate the situation. Instead, use de-escalation techniques to help them regain control:²
- Stay calm and use a neutral tone: Yelling or showing frustration can worsen the child’s irritable mood.
- Give them space: If safe, allow the child time to calm down without engaging in power struggles.
- Validate their feelings: Acknowledge their frustration while reinforcing appropriate behavior (e.g., “I see you’re upset. Let’s take deep breaths together”).
- Use distraction and redirection: Encouraging a different activity, like drawing or listening to music, can help break the cycle of overwhelming emotions in a natural and calming way.
Using positive reinforcement and reward systems
Positive reinforcement helps children with DMDD learn appropriate behaviors by boosting confidence, reducing frustration, and encouraging the repetition of good actions in a supportive way. To do this:
- Praise specific behaviors: Instead of general praise, say, “I like how you stayed calm when your toy was taken.”
- Implement a reward chart: Offer small rewards for meeting behavioral goals, like using words instead of yelling.
- Encourage effort over perfection: Acknowledge progress, even if it’s small, to build confidence and motivation.
Teaching coping skills and emotional regulation
Children with DMDD need step-by-step guidance and regular practice to learn how to manage their emotions effectively. Parents can help by:
- Modeling self-regulation: Demonstrate healthy ways to cope with frustration, such as taking deep breaths or counting to ten.
- Helping kids handle conflicts calmly: Guide them through resolving conflicts with words instead of aggression. For example, if a sibling takes their toy, help them practice saying, “I was playing with that; can I have it back when you’re done?” instead of grabbing or yelling.
- Practicing relaxation methods: Introduce activities like mindfulness, squeezing a stress ball, or listening to calming music.
Setting logical consequences
While harsh punishments don’t work well for children with DMDD, logical consequences can help your child learn how to be responsible:
- Use natural consequences: If a child refuses to wear a coat, they will feel cold and learn why it’s necessary.
- Apply time-limited consequences: Shorter consequences (e.g., losing tablet time for 15 minutes) are more effective than long-term restrictions.
- Avoid punitive measures: Spanking, yelling, or shaming can increase anger and defiance rather than improve behavior.
Therapy for adolescents with DMDD
Parenting a child with DMDD can feel exhausting and frustrating, especially when discipline doesn’t seem to help. In these moments, therapy can provide a structured approach to help children regulate emotions and develop self-control. Avery’s House offers therapy and parent training to help your child manage their emotions in a supportive environment. Support is available for your child. Contact Avery’s House today.
Recognizing temper tantrums vs. DMDD outbursts
All children push boundaries at times, and while some disruptive behavior is normal, excessive defiance could be a sign of disruptive mood dysregulation disorder (DMDD) rather than typical childhood behavior. Understanding the difference helps parents respond appropriately and seek the necessary support.
Signs of typical child defiance
Typical defiance often looks like this:
- Occasional refusal to follow directions: Kids may resist chores or homework but eventually comply.
- Frustration with rules: They may complain about rules but can adjust when given explanations.
- Mild tantrums when upset: These outbursts are short-lived and occur less frequently as they grow.
- Negotiating or arguing: Children might push back against authority but remain open to discussion.
Signs of DMDD-related defiance
Signs that point to DMDD include:
- Frequent, intense emotional outbursts: Tantrums that happen three or more times a week and last far longer than typical.
- Chronic irritability: The child seems constantly angry without a clear trigger.
- Extreme reactions to small frustrations: Minor issues, like a denied request, result in yelling, aggression, or destruction, resembling the severe temper outbursts common in mood disorders.
- Difficulty calming down: Once upset, the child struggles to regain control, even with guidance.
- Persistent behavior across settings: The outbursts and mood issues happen at home, school, and with peers—not just in one environment.⁴
Key differences between typical defiance and DMDD
To determine whether your child is experiencing DMDD symptoms or typical defiance, consider the following:
- Intensity: DMDD-related outbursts are much stronger and more challenging to manage than typical tantrums.
- Frequency: Typical defiance happens occasionally, while DMDD symptoms occur almost daily.
- Duration: DMDD-related meltdowns last longer and don’t resolve with typical discipline.
- Impact on daily life: If behavior issues interfere with school, friendships, and home life, it may indicate DMDD.
Professional support for disciplining a child with DMDD
Disciplining children with disruptive mood dysregulation disorder (DMDD) can be overwhelming, especially since its symptoms often resemble those of bipolar disorder, depressive disorder, or ADHD. Parents don’t have to handle it alone.
When to get professional help
While some children with DMDD respond well to structured discipline at home, a child psychologist’s help may be needed if:
- Outbursts are severe and frequent: If meltdowns happen almost daily and affect daily life, a mental health specialist can help create a personalized plan to help you.
- The child struggles at school and with peers: Social difficulties, academic challenges, or conflicts with teachers may indicate the need for additional support.
- Parents feel exhausted or helpless: Managing DMDD can be emotionally draining, and professional support can provide tools and reassurance.
Final thoughts
Parenting children struggling with mood disorders requires patience and a compassionate approach to guiding their behavior toward positive change.
Discipline is not about punishment but about teaching self-control and emotional regulation in a way that builds trust. If you need support, Avery’s House offers therapy programs to help your child regulate their emotions and develop positive behaviors.
Call us to speak with our counselors and learn how we can help.
(480) 360-4989
Speak To A Representative
Sources
1. Roy AK, Lopes V, Klein RG. Disruptive mood dysregulation disorder: A new diagnostic approach to chronic irritability in youth. Am J Psychiatry. 2014;171(9):918–24. DOI:10.1176/appi.ajp.2014.13101301
2. Boudjerida A, Guilé J-M, Breton J-J, Benarous X, Cohen D, Labelle R. A Delphi consensus among experts on assessment and treatment of disruptive mood dysregulation disorder. Front Psychiatry. 2024;14:1166228. DOI:10.3389/fpsyt.2023.1166228
3. Hatchett GT. Treatment planning strategies for youth with disruptive mood dysregulation disorder [Internet]. ERIC; 2022. Available from: https://files.eric.ed.gov/fulltext/EJ1334298.pdf
4. Coldevin M, Brænden A, Zeiner P, Øyen A-S, Melinder A, Stubberud JE. Disruptive mood dysregulation disorder, parental stress, and attachment styles. Front Child Adolesc Psychiatry. 2024;3:1430850. DOI:10.3389/frcha.2024.1430850
Explore more helpful guides by categories
Mental health treatment for adolescents in Arizona
Is your teen struggling with their mental health? We’re here to help. Our specialized programs for teens, available across several Arizona locations, provide the care and support they need. Let’s work together to find the best path forward for your family.
Phoenix
Chandler
Author: Editorial Staff
FEBRUARY 13, 2025