The clinical reference used by mental health professionals gets revised periodically by scholars and researchers in the field of psychology. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a text that helps standardize the language used by mental health providers. For instance, when a therapist calls a psychiatrist about a client with Bipolar Disorder, that psychiatrist will already have a rough idea about the symptoms the client may be experiencing. The standardization of the DSM helps everyone speak the same language.
However, in May 2013, the DSM went through its most recent version, adding two new mood disorders that may apply to children and teens. These disorders didn’t exist before, but that doesn’t mean teens didn’t experience their symptoms. The new illnesses were added to help refine the way teens are being diagnosed and to help mental health professionals be more precise. A more accurate diagnosis leads to more accurate treatment.
Certain mental illnesses that have to do with emotions and moods are sometimes called Mood Disorders. These illnesses can include various experiences of mood, such as having a very low mood, such as with depression, or a very high mood, such as mania. Mood disorders can range in their symptoms, experience, and length. For instance, a hypomania is less severe than mania but still considered a high energy mood that can be dangerous.
Mood disorders include:
- Major Depressive Disorder
- Catatonic Depression
- Melancholic Depression
- Bipolar Disorder I and II
- Seasonal Affective Disorder
- Cyclothymic Disorder
The two new mood disorders added to the most recent version of the DSM include:
- Disruptive Mood Dysregulation Disorder (DMDD)
- Persistent Depressive Disorder (PDD)
Disruptive Mood Dysregulation Disorder (DMDD)
This illness was born out of teens being inaccurately diagnosed. Initially, when children and teens exhibited irritability, severe temper tantrums, and anger, mental health professionals believed that these were symptoms of an early phase of bipolar disorder. However, as these children and teens developed, they did not exhibit symptoms of bipolar disorder. Instead, they tended to experience depression or anxiety as adults. To more accurately diagnose teens, the new revision of the DSM provides mental health providers with the diagnosis of Disruptive Mood Dysregulation Disorder or DMDD for short.
The following is a list of symptoms that teens with DMDD might exhibit:
- recurrent temper outbursts
- verbal rages
- physical aggression toward people and property
- aggression is often out of proportion to the situation
- temper outbursts often does not reflect a teen’s developmental level
- temper outbursts tend to occur three or more times per week
- between outbursts, a teen typically remains irritable and/or angry
- teens typically experience these symptoms for months at a time
It’s important to note that teens with the above symptoms and who simultaneously experience manic or hypo-manic episodes do not fit the description of DMDD. In these cases, bipolar disorder or another mood disorder might be a more accurate diagnosis. Along these lines, DMDD would not be given to a teen who also has oppositional defiant disorder or intermittent explosive disorder. DMDD can co-exist with major depressive disorder, attention deficit/hyperactivity disorder, and conduct disorder, and addiction.
Also, researchers have found that girls are more likely to experience the symptoms of adolescent bipolar disorder, while boys are more likely to experience DMDD.
Persistent Disruptive Disorder (PDD)
This illness was formerly known as Dysthmia, which is a chronic but less severe form of major depression. The most significant feature of this illness is that a teen experiences a depressed mood for most of the day and for most days of the year, for at least one year.
The following are typical symptoms of PDD:
- poor appetite or overeating
- insomnia or hypersomnia
- low energy or fatigue
- low self-esteem
- poor concentration
- difficulty making decisions
- feelings of hopelessness
A teen might be more at risk for developing PDD if a relative also has the disorder. Two other risk factors include:
- a teen’s temperament
- a recent trauma or loss (such as losing a loved one)
Teens with PDD might also be diagnosed with Major Depressive Disorder. One diagnosis does not exclude the other. In fact, a teen might at first experience Major Depressive Disorder and then PDD with periods of more intense depression. However, teens who experience Major Depressive Disorder for a period of at least one year also quality for a PDD diagnosis. In other words, teens can have both Major Depressive Disorder and PDD.
However, teens who experience depression along with a manic or hypo-manic episode might be better described as having Bipolar Disorder. The same is true with teens who experience depression along with psychosis. Although disorders of psychosis (such as schizophrenia) often come with low moods and little energy, an experience of psychosis is better described by a different disorder. A teen who experiences psychosis would not have PDD.
Seeking Professional Help
If you are a parent or caregiver of a teen who is expressing any of the above symptoms for DMDD or PDD, seeking a mental health professional may be useful. Loved ones of teens with these disorders should be aware that there are various forms of treatment that may help ease symptoms, such as the following:
- cognitive behavioral therapy
- behavior modification
- family therapy
- inpatient treatment
- medication (antidepressants or stimulants)
- cognitive behavioral therapy
- interpersonal therapy
- medication (antidepressants)
With both illnesses, research has found that a combination of psychotherapy and medication can be the most effective for teens. It should also be noted that teens who begin to take antidepressants should be closely monitored by their health care provider and families, especially if taking antidepressants for the first time.
Finally, research has found that when an illness in teens go untreated they are more likely to experience more severe symptoms. Also, when untreated an illness can progress throughout adolescence and into adulthood. However, treatment can assist a teen with overcoming their symptoms and return to living a normal life.