Disruptive mood dysregulation disorder is characterized by severe recurrent temper outbursts expressed verbally and/or behaviorally. A person with this disorder will show physical aggression toward people or property that is grossly out of proportion in intensity or duration to the situation or provocation. The temper outbursts occur, on average, three or more times per week and are inconsistent with the individual’s developmental level. Moreover, the individual’s mood between temper outbursts is persistently irritable or angry most of the day, nearly every day.

A diagnosis for this condition may occur when:

• Symptoms and behavior described above have been present for 12 or more months, including a lapse of symptoms for no more than 3 months.
• Behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder, such as autism, posttraumatic stress disorder, separation anxiety disorder, or dysthymia.
• Symptoms are not attributable to the physiological effects of a substance or to another medical or neurological condition.

A diagnosis of disruptive mood dysregulation disorder cannot coexist with a diagnosis of the oppositional defiant disorder, intermittent explosive disorder, or bipolar disorder. However, it can coexist with major depressive disorder, attention deficit hyperactivity disorder (ADHD), conduct disorder, and substance abuse disorders.

What is Premenstrual Dysphoric Disorder?

Premenstrual dysphoric disorder is a condition similar to Premenstrual Syndrome (PMS), but it is more serious. This type of depression is diagnosed when at least five symptoms are experienced in the final week before the onset of a woman’s menstrual period. The symptoms improve within a few days after a woman’s period begins and become minimal or absent in the week after her period ends. Among the symptoms listed below, at least one symptom must be present from symptoms 1-4, and at least one from symptoms 5-11:

1. Mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection
2. Irritability, anger, or increased interpersonal conflicts
3. Depressed mood, feelings of hopelessness, or self-deprecating thoughts
4. Anxiety, tension, or feelings of being on-edge
5. Decreased interest in usual activities (work, school, friends, hobbies)
6. Difficulty concentrating
7. Lethargy or lack of energy
8. Change in appetite, overeating, or specific food cravings
9. Insomnia or sleeping too much
10. Feeling overwhelmed or out of control
11. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, feeling bloated, or weight gain

What is Substance-Induced or Medication-Induced Depressive Disorder?

Substance/medication-induced depressive disorder occurs when a person experiences a depressed mood, or greatly diminished interest or pleasure in activities, during or after substance intoxication or withdrawal, or after taking a medication. Substances that can cause depression include alcohol, cocaine, opioids, sedatives, amphetamines, inhalants, phencyclidine, or other substances.

How is a depressive disorder due to another medical condition diagnosed?

A person can be diagnosed with depressive disorder due to another medical condition when there is evidence from the history, physical examination, or laboratory findings that the depression is the direct consequence of another medical condition. Requirements for this diagnosis also include:

• A prominent and persistent period of depressed mood in all, or almost all, activities.
• Depression is not better explained by another mental disorder, such as adjustment disorder, in which the stressor is a serious medical condition.
• The depression does not occur exclusively during the course of a delirium.
• The individual experiences significant distress or impairment in social, occupational, or other important areas of functioning.