DSM-5 Danger: Your Anxious Child’s Tantrums May Now Be a Disorder

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When your anxious child throws a temper tantrum because he wants candy before dinner or she wants to play on the swings instead of go home, you may take it as normal childhood behavior. The revised Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, however, suggests you may want to take that child for help.

A new addition to the revised psychiatric manual, due out in May, is that of disruptive mood dysregulation disorder, or DMDD. Doctors say condition comes into play when your anxious kid consistently throws at least three or more temper tantrums per week over a 12-month period. While the condition may be valid, its inclusion in the updated manual has critics up in arms.

The Danger

One overriding fear is that kids who are exhibiting normal kid-like behavior with a temper tantrum (or three) will now be subjected to unnecessary treatment or medication. While the DSM-5 does not offer suggestions on how to treat a condition, the simple fact that a condition is included in this psychiatric “bible” gives docs the message that, alas, something must be done!

Including DMDD in the updated manual is the result of trying to offset another danger going on in the children’s psychiatric arena: the trend toward lumping loads of kid into the bipolar disorder category.

“Something needed to be done about the mis-diagnosis and over-diagnosis of bipolar disorder in children,” according to PsychCentral.com’s John Grohol. “Clinicians, pediatricians and family doctors have simply been ignoring the official DSM-IV criteria, and making up their own to justify most of the increase of childhood bipolar diagnoses. This situation needs to end.”

Mental health professionals who support the revision say the DMDD inclusion may be the solution to the bipolar problem. But others, such as bipolar researcher Janet Wozniak, say the DMDD inclusion may actually hinder an appropriate bipolar diagnosis and delay much-needed treatment. She says it may also end smacking a disorder label on a wide range of “normal but volatile children” who are prone to tantrums and irritability.

The Symptoms

Checking out the symptoms of DMDD may give you a sense of how the disorder is different than your average temper tantrum – or it may not. Due to the fear and stress many anxious children live with daily, temper tantrums may be a common occurrence that may or may not fall into the classification.

DMDD symptoms include temper tantrums that:

  • Involve physical aggression and verbal outbursts directed at property or people
  • Are out of proportion to the situation
  • Are not consistent with the anxious child’s level of development
  • Are severe and recurrent, with an average frequency of three or more times per week over a one-year period

Additionally, anxious children suffering from DMDD will have an obvious angry and irritable mood even when not throwing a tantrum.

Only time will tell if the DMDD inclusion will end up hurting or helping anxious children. As a parent, being aware of the situation can help ensure your anxious child doesn’t get netted into a diagnosis that may not be appropriate as well as treatment that may not be beneficial.