ABSTRACT
As a transdiagnostic constellation of symptoms, mood dysregulation co-occurs with many other conditions. Borderline personality disorder, with its hallmark symptom of irritability, shares important overlap with mood dysregulation, which is defined largely by irritable dysphoria. The activation and impulsivity associated with ADHD can signal an associated mood dysregulation, but co-occurrence of bipolar and anxiety disorders with ADHD can present diagnostic complications. Eating disorders have long been associated with bipolar disorder and with dysregulation of mood. Posttraumatic stress disorder or PTSD as outlined in DSM-5, does not adequately capture the more common range of symptomatology we see in clinical practice, but a diagnosis proposed by Bessel van der Kolk, developmental trauma disorder (DTD), more fully does. The cardinal feature of DTD, as van der Kolk explains, is mood dysregulation. Anxiety and panic disorders both co-occur with mood dysregulation but the agitation and restlessness of dysphoria are often misinterpreted as anxiety. Substance use/abuse disorders intersect with mood dysregulation in complex ways, both because there is often confusion between cause and effect and because each substance has different physiologic effects on the body. The newest DSM-5 diagnostic addition to the category of depressive disorders, disruptive mood dysregulation disorder (DMDD), in some ironic way, gives mood dysregulation a footprint in the DSM as this diagnosis shares much in common with mood dysregulation, including its hallmark symptoms of irritability and angry mood and its transdiagnostic nature.
