Balancing the Storm: Disruptive Mood Dysregulation Disorder Treatment for Youth

Navigating a disruptive mood dysregulation disorder (DMDD) or other mood disorders in teens and adolescents can be a significant challenge, impacting their ability to maintain emotional stability and affecting their daily life and school performance.

While traditional methods like talk therapy and stimulant medications prescribed by a qualified mental health professional can be effective for some, Trails Carolina wilderness therapy programs offer a unique and effective alternative approach to address the complexities of mood disorders, like disruptive mood dysregulation disorder, in adolescents and teens. 

By approaching DMDD treatment with a blend of emotional healing with outdoor adventure and experiential learning, Trails Carolina helps youth and teens cultivate resilience, positive behavior, communication techniques, and coping skills, providing long-lasting benefits even after the program ends.

Understanding Mood Dysregulation in Adolescents and Teens

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Mood dysregulation encompasses a range of difficulties in controlling and regulating emotional responses, resulting in significant mood swings and emotional instability.

It can manifest in various other mental health disorders such as disruptive mood dysregulation disorder (DMDD), borderline personality disorder (BPD), oppositional defiant disorder (ODD), post-traumatic stress disorder (PTSD), severe anxiety disorders, pediatric bipolar disorder, and depression.

Mood dysregulation plays a significant role in the symptoms of these conditions, leading to challenges in relationships, daily life, and school performance.

For instance, BPD is characterized by unstable emotions and impulsivity, often triggered by seemingly minor events. PTSD involves heightened emotional reactions following a traumatic event, leading to difficulties in coping with stress. Bipolar disorder involves extreme mood swings with periods of mania and depression, making emotional and mood dysregulation a defining feature. Depression, or major depressive disorder, often involves persistent feelings of sadness and hopelessness.

Disruptive mood dysregulation disorder (DMDD) is a childhood mood disorder and a relatively new diagnosis. It is typically treated with methods used to treat other mental health disorders, like those listed above, that carry similar symptoms.

DMDD symptoms may include a combination of extreme or prolonged outbursts, persistent irritability, irritable mood, or irritable behavior, angry mood, temper tantrums, and severe temper outbursts, leading to problems at school, at home, and with peers.

Trails Carolina’s Approach to Treating Children and Teens with a Mood Dysregulation Disorder

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Trails Carolina’s wilderness therapy provides a holistic approach to treating DMDD and addressing mood dysregulation as it manifests in relation to a variety of mental health conditions by focusing on the mind, body, and spirit. Using a combination of traditional, evidence-based therapies, individualized treatment plans, therapeutic adventure activities, peer group activities, comprehensive transition and aftercare planning, and parallel parent training, all within a distraction-free wilderness setting, Trails Carolina fosters the emotional healing, self-awareness, and personal growth needed to treat children and teens with disruptive mood dysregulation disorder.

Individualized Treatment Planning and Cognitive Behavioral Interventions for Disruptive Mood Dysregulation Disorder

Trails Carolina tailors treatment plans to meet the unique needs of each participant. Individualized treatment ensures that specific challenges related to mood dysregulation are effectively addressed taking into account any dual diagnoses, specific strengths, challenges, and goals of each student.

Several of our compassionate and licensed clinicians incorporate evidence-based interventions such as Cognitive-Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), which have shown success in managing mood dysregulation.

  • Cognitive-Behavioral Therapy (CBT) helps adolescents and teens manage mood dysregulation by helping them to identify and change negative thought patterns and behaviors. Students learn to address their irritable mood triggers and develop healthier coping mechanisms through wilderness and group activities like hiking, peer group discussions, and experiential learning.
  • Dialectical Behavioral Therapy (DBT), rooted in CBT principles, focuses on developing mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness skills. Integrating both CBT and DBT techniques empowers our students to manage mood dysregulation effectively, leading to lasting emotional growth and resilience.

Adventure Activities, Group Therapy, and Peer Support

At Trails Carolina, students coexist in segmented peer groups based on age and gender. In these groups, students share their journeys with others facing similar mood dysregulation and mental health challenges. Group therapy sessions provide a safe space for participants to share their experiences with others who face similar mood dysregulation challenges.

Within their peer groups, students engage in adventure activities in the wilderness, such as hiking, backpacking, camping, and team-building activities which serve as catalysts for personal growth and self-discovery.

Benefits of Group Therapy and Peer Support:

  • This collaborative environment fosters empathy, understanding of each other’s struggles, and a sense of connectedness, enabling individuals to reflect on their emotions and address underlying issues.
  • The group environment allows individuals to reflect on their emotions and explore underlying issues that contribute to mood dysregulation.

Parallel Family Programming and Parent Training

Family dynamics play a critical role in supporting a child or teen with disruptive mood dysregulation disorder, as well as other mental health disorders, which is why Trails Carolina incorporates parallel family programming that encourages parent involvement throughout the program. Parallel family programming at Trails means involving the family in the child’s therapeutic process and providing them with the tools and knowledge to support their child’s emotional growth.

This programming includes weekly updates for parents on their child’s progress, the parent’s own therapeutic process, and educative family workshops. For parents whose child is learning to manage a disruptive mood dysregulation disorder, this parallel programming may include parent management training.

Parent training teaches effective strategies to support their child’s emotional regulation and overall well-being. This includes learning effective communication techniques to use when the child’s behavior is aggressive or disruptive, as well as encouraging rewarding positive behavior instead of focusing on negative behavior, which can help decrease irritability in the child.

Intentional Transition Practice and Aftercare Planning

Teens with mood dysregulation disorder face unique challenges that require ongoing support and guidance beyond the wilderness therapy program. Trails Carolina recognizes the importance of intentional transition practice and aftercare planning, specifically tailored to meet the needs of these individuals. Here’s why teens with mood dysregulation disorder benefit significantly from such comprehensive planning:

  1. Sustaining Positive Mood Management and Coping Skills:
    • Teens with mood dysregulation disorder often struggle with managing their emotions and coping with stressors effectively.
    • Wilderness therapy equips them with valuable mood management and coping skills that are instrumental in their emotional healing and growth.
    • Through intentional transition practice and aftercare planning, teens can continue practicing and reinforcing these skills as they reintegrate into their daily lives.
  2. Building Lasting Habits and Routines:
    • Transitioning from a structured wilderness setting to their regular environment can be overwhelming for teens with mood dysregulation disorder.
    • Intentional transition practice involves gradually reintroducing them to their daily routines, responsibilities, and challenges, ensuring a smoother reintegration process.
    • Aftercare planning includes support in establishing healthy habits and routines, which are essential for maintaining emotional stability and overall well-being.
  3. Supporting Family Dynamics:
    • The impact of mood dysregulation disorder extends beyond the individual teen and often affects family dynamics.
    • Aftercare planning involves working with the family to ensure they are equipped with the tools and knowledge to continue supporting their teen’s emotional growth.
    • Families learn how to communicate effectively, set boundaries, and create a supportive environment at home, fostering an atmosphere conducive to the teen’s ongoing recovery.
  4. Addressing Relapse Prevention:
    • Teens with mood dysregulation disorder may be vulnerable to relapse, especially during times of stress or change.
    • Intentional transition practice and aftercare planning focus on identifying potential triggers and developing strategies to prevent relapse.
    • By creating a relapse prevention plan, teens gain confidence in their ability to navigate difficult situations and maintain progress in the face of challenges.
  5. Providing Continued Therapeutic Support:
    • Emotional healing is an ongoing process that requires continuous therapeutic support beyond the wilderness program.
    • Aftercare planning may involve connecting teens with local therapists or support groups that specialize in mood dysregulation and related issues.
    • Ongoing therapeutic support ensures that teens have a consistent source of guidance and understanding as they navigate post-wilderness life.
  6. Promoting Long-Term Success:
    • The ultimate goal of Trails Carolina’s approach is to promote long-term success and sustainable emotional growth for teens with mood dysregulation disorder.
    • Intentional transition practice and aftercare planning contribute to a smoother and more successful transition, increasing the likelihood of continued progress and improved overall well-being.

By combining intentional transition practice and aftercare planning, Trails Carolina strives to provide teens with mood dysregulation disorder the support, tools, and resources they need to thrive beyond the wilderness therapy program and lead fulfilling lives as emotionally resilient individuals.

How Does Wilderness Setting Help in Treating DMDD?

Trails student works with a counselor practicing emotional regulation techniques and trigger identification.

One of the core elements of the wilderness therapy approach used to treat DMDD is direct exposure to natural environments. This immersion in nature allows adolescents and teens to confront stressors and challenges, leading to a better understanding of personal strengths and resilience, crucial factors needed to treat irritability and achieve emotional balance.

Emotion Regulation Skills for Mood Problems and Chronic Irritability

In the unique wilderness environment of Trails Carolina’s programs, kids and teens with Disruptive Mood Dysregulation Disorder (DMDD) gain invaluable emotion regulation skills. The natural surroundings and adventure-based approach offer specific benefits:

  • Nature’s Therapeutic Influence: Interacting with nature has a calming effect on the nervous system, reducing stress, anxiety, and irritable behavior. This setting helps children and teens with DMDD feel more relaxed and receptive to learning emotion regulation skills.
  • Reduced Distractions and Focus: The distraction-free wilderness environment allows students to focus solely on their emotional experiences and growth. Without the usual external distractions, they can concentrate on understanding and managing their emotions effectively.
  • Immediate Feedback Loop: The immediacy of the wilderness environment provides immediate feedback for emotional regulation efforts. Students can witness how their newly acquired skills influence their emotional responses, reinforcing positive changes.
  • Real-Life Applications: The wilderness setting offers real-life scenarios for practicing emotion regulation skills. Students face challenges and uncertainties that mirror their everyday lives, allowing for practical application and generalization of the learned skills.

Goal Setting, Personal Development and Rewarding Positive Behavior

In Trails Carolina’s wilderness programs, kids and teens with DMDD embark on goal-oriented journeys designed for their specific emotional growth. The wilderness environment contributes to their success in various ways:

  • Empowerment through Achievement: Overcoming challenges in the wilderness setting fosters a sense of empowerment and confidence in participants. This newfound self-assurance spills over into their emotional regulation journey, encouraging positive behavioral changes.
  • Connection to Intrinsic Motivation: The wilderness adventure itself becomes an intrinsic motivator for participants to set and achieve emotional growth goals. The desire to succeed in the outdoors translates into determination to succeed emotionally.
  • Immediate Rewards and Natural Consequences: The wilderness setting provides natural rewards for positive behavior and consequences for negative behavior. This direct cause-and-effect relationship helps kids and teens with DMDD grasp the impact of their actions and choices.
  • Holistic Approach to Personal Development: The wilderness environment supports holistic personal development. Participants engage in activities that promote self-awareness, self-reflection, and self-discovery, nurturing emotional growth alongside physical and mental well-being.

Mindfulness, Acceptance, and Meditation in Wilderness Therapy

Trails Carolina integrates mindfulness, acceptance, and meditation into its wilderness therapy programs to further enhance emotional regulation and mental well-being. Mindfulness allows kids and teens to observe their thoughts and emotions without judgment, leading to better recognition of mood shifts and triggers, ultimately fostering emotional resilience.

  • Enhanced Sensory Experience: The wilderness environment heightens the sensory experience, facilitating mindful awareness of the present moment. Engaging with nature’s sights, sounds, and textures deepens the mindfulness practice.
  • Safe Space for Self-Acceptance: In the supportive and non-judgmental wilderness setting, participants can embrace self-acceptance. They learn to validate their emotions and experiences without harsh self-criticism, fostering emotional healing.
  • Connection to Nature’s Rhythms: Engaging in meditation and mindfulness practices in the wilderness allows participants to align with nature’s rhythms. This harmony with nature promotes a sense of inner peace and emotional balance.
  • Embracing Change and Uncertainty: The ever-changing wilderness environment teaches participants to accept and adapt to uncertainties, supporting them in dealing with the unpredictability of emotions and mood shifts.

Physical Interventions: Exercise, Yoga, and Deep Breathing

Trails Carolina recognizes the importance of physical interventions like exercise, yoga, and deep breathing techniques in managing mood dysregulation through wilderness therapy.

  • Nature’s Therapeutic Influence: Engaging in physical activities like hiking and outdoor exercises amidst nature enhances the therapeutic benefits. The natural environment complements the physical interventions, reinforcing emotional well-being.
  • Grounding Techniques: Yoga and deep breathing exercises in the wilderness setting promote grounding, helping participants stay centered during moments of disruptive mood dysregulation.
  • Stress Reduction in Nature: The combination of physical interventions and the tranquil wilderness setting effectively reduces stress and anxiety levels, improving mood regulation.
  • Connection to the Body: Physical interventions in the wilderness encourage participants to connect with their bodies. This somatic awareness aids in recognizing and managing physical sensations associated with emotional states.

Frequently Asked Questions

Q1: What is the success rate of wilderness therapy for mood dysregulation treatment?

While specific success rate percentages may vary, wilderness therapy has shown to be effective in helping individuals develop coping strategies and a positive sense of self and hope for the future.

Q2: How does wilderness therapy compare to traditional therapy for managing mood disorders?

Wilderness therapy combines outdoor experiences with therapy sessions, offering a unique and encouraging environment for self-discovery. Both approaches have strengths, and the effectiveness may depend on an individual’s symptoms and preferences.

Q3: What activities are typically involved in wilderness therapy programs?

Activities in wilderness therapy programs vary and may include adventure-based experiences, group therapy sessions, and individual counseling, all geared towards personal growth and learning new coping strategies.

Q4: How do families participate in the therapeutic process during wilderness therapy?

Family involvement is essential, and programs may include regular check-ins, family therapy sessions, workshops, or on-site visits, strengthening the support system for the individual in treatment.

Avatar of Jeremy Whitworth

Jeremy Whitworth

As Executive Director at Trails Carolina, a leading wilderness therapy program for youth and teens, I oversee operations and collaborate with our leadership team. Since 2022, I've also hosted the Common Ground Podcast for parents: With a background in Wilderness Leadership and Experiential Education, I've managed adventure-based therapeutic programs across the US and Canada. My experiences in competitive athletics and adventure sports have honed my leadership, risk assessment, and decision-making skills, which I apply to running a successful business like Trails Carolina.

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Trails saved my daughter’s life. Amanda is an amazing human and a brilliant therapist. I am so grateful to her, Science Steve, and the other wonderful people who could reach my daughter at a time when I could not.

Margot Lowman August 2022

Great life changing experience for our son. After becoming addicted to gaming during covid he was very depressed. At Trails he experienced the wilderness, Science Steve, learning survival skills and top notch therapy and support etc… I highly recommend! This gave our son and our family a renewed family bond full of love and excitement about his bright future.

Winnifred Wilson July 2022


Outstanding clinical work and superb staff! There’s a great culture at this company and it shows with how they engage with families/clients.

Kristin Brace June 2022


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