By Stethoscopes (Own work) [CC-BY-SA-3.0 (www.creativecommons.org/licenses/by-sa/3.0) or GFDL (www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons
Being a parent is an incredible journey filled with joy, pain, confusion, hope, stress and just a flood of emotions that most new parents never imagined they would experience.
There is nothing more frightening than to witness with grief and fear your child suffer within their own minds.
Parents want to know what is happening and how to help their child. If a child is in pain, we want to help ease their pain be it physical, psychological or spiritual any way we can.
But a diagnosis for the sake of a diagnosis is never a good idea. That said, it’s still a common problem.
Recently a new diagnosis has been proposed for children and youth, Disruptive Mood Dysregulation Disorder or DMDD.
Here is a brief outline of the proposed addition to the DSM-V:
The disorder is characterized by severe recurrent temper outbursts in response to common stressors.
- The temper outbursts are manifest verbally and/or behaviorally, such as in the form of verbal rages, or physical aggression towards people or property.
- The reaction is grossly out of proportion in intensity or duration to the situation or provocation.
- The responses are inconsistent with developmental level.
B. Frequency: The temper outbursts occur, on average, three or more times per week.
C. Mood between temper outbursts:
- Nearly every day, the mood between temper outbursts is persistently negative (irritable, angry, and/or sad).
- The negative mood is observable by others (e.g., parents, teachers, peers).
The remainder of the proposed addition can be read here at the APA website.
If there is a new diagnosis like this proposed, it suggests we have a better sense of what was going on with these children and how to collectively address the “disorder.” Right? If only.
Dr. Allen Frances is more than disappointed about the new category. In a piece recently published in Psychiatric Times (login required), he states:
“DMDD will capture a wildly heterogeneous and diagnostically meaningless grab bag of difficult to handle kids”
Caution is needed: the symptom list could be used by those who would assume that a tantrum is worse than it really is. A misdiagnosis could label a child for life or worse, put them through an unnecessary and potentially life threatening medical treatment.
Everyone involved in the child’s life must resist the urge to parcel out the child’s behavior into tiny bits of a symptom list. The ‘symptoms’ that are part of this new diagnosis could easily be taken out of context of the child’s experience in the world. Discernment is needed in order to be able to see that there is more than just anger in the room. This is a child who is part of an ecosystem: a family, a community, and ultimately society. Seeing all of those factors along with the tantrum, rage and outbursts is critical in creating a path to healing for the child and their family.
In his article published in the Journal of Humanistic Psychology, G. Kenneth Bradford offered a similar perspective on the DSM.
“…an accurate knowing of Other minds must be process based, recognizing that a human subject is not an isolated mind but a being that exists within an intersubjective field, including a diagnostic field that is co-constituted by both doctor and patient.”
It is unclear whether or not this new diagnosis will be of any real help to families. Knowing that what your child is experiencing has a name is probably the most useful aspect for some families, but will this lead to a positive long term treatment? That is a question that is surely under the research scope of the Eli Lilly, Pfizer and other pharmaceutical giants.
We will have to wait to see what comes of this proposed change to the DSM. It may not be incorporated in the new edition. If it is hopefully, it will not take over the minds of those who are working to help families and children. Hopefully, we will not lose sight of the whole child. Doing so will ensure that they will not grow to be whole adults living complete and authentic lives.
— Makenna Berry