Leaving melancholia: disruptive mood dysregulation disorder

This chapter outlines the importance of critically reflecting on the diagnos-

tic criteria for DMDD now included in

DSM-5.

In so doing, it mounts the

argument that DMDD is a new and problematic inclusion to the ‘Depressive

Disorders’ in an extremely influential manual of psychiatric disorders. Sig-

nificantly, the inclusion of this new ‘disruptive’ and ‘energetic’ disorder as a

form of ‘depression’ has yet to meet with substantive critique. DMDD crite-

ria include ‘tantrums’, a point that has been hotly debated. For instance, as

Wakefield (2013) pointed out, ‘Children tend to outgrow these temper tantrum

problems, so treatment and stigma may be applied unnecessarily to large num-

bers of children’ (2013, p. 150). It is unknown how this new child disorder

will impact, positively or negatively or even if it will afford the clarity that it

is hoped to deliver. As Gitlin and Miklowitz (2014) concluded, ‘whether this

new category will advance diagnostic clarity and/or more appropriate treat-

ment is unknown’ (2014, p. 89). The chapter demonstrates how historically

informed analysis can be drawn upon to reflect on how interpretations and

representations of melancholia and depression are very much connected to the

political, the discursive, and, in the 21st century, to the authors of one manual

of mental disorders. For a simple summary of the implications for practice, see

Table 10.1.