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Why some kids won’t talk

Over the years, more and more parents have walked into my office describing a similar, challenging pattern in their children—kids who don’t just get upset but explode.

They have quick tempers, intense emotional reactions, and rigid thinking. They can’t bounce back quickly once triggered, and the minor issue—a sibling touching the remote or a favourite shirt in the wash—can lead to full-blown meltdowns.

These children were once labelled everything from ADHD to early signs of bipolar disorder or intermittent explosive disorder. Dr. Ross Greene aptly called them explosive. But we now have a better understanding: Many of these children are dealing with disruptive mood dysregulation disorder (DMDD), a mood disorder characterised by severe irritability and frequent, intense temper outbursts (Goldstein, 2024).

What Is DMDD?

DMDD is a relatively new diagnosis, officially recognised in the DSM-5 in 2013. It was developed to more accurately categorise children who don’t fit cleanly into other disorders like pediatric bipolar disorder or standard ADHD. These children experience:

  • Severe recurrent temper outbursts, verbal or behavioral, that are grossly disproportionate to the situation
  • Chronic irritability or anger that is present most of the day, nearly every day
  • Difficulty regulating emotions, especially when frustrated or disappointed

These are not occasional tantrums. This persistent pattern interferes with daily life, friendships, school functioning, and family dynamics. The hardest part? These children often can’t talk about what’s going on.

Why They Won’t Talk

As therapists, we’re trained to expect that if we show up with empathy, patience, and good questions, kids will open up. We assume that once we gain their trust, they’ll tell us what’s going on so we can help them learn how to manage their anger or anxiety. That approach works for many children. But with kids who have DMDD, it often falls flat.

These kids don’t talk. Not because they’re defiant or oppositional, but because they genuinely can’t. They don’t understand what set them off. They don’t know when the next outburst is coming. And when they aren’t upset, they don’t want to go near those feelings. As one child put it:

“I never know when I will get upset or what will upset me. I never know how long I’m going to be upset. So, when I’m feeling good, I don’t want to talk about feeling bad because maybe even that will make me feel bad.”

This kind of emotional whiplash makes sense of their silence. For them, talking about outbursts feels dangerous, like a trapdoor back into chaos. Avoidance becomes a form of emotional self-protection.

A Better Way Forward

I changed my approach once I started to see this pattern more clearly. Rather than pushing these children to relive what upset them, I started focusing on what helps them feel in control. Instead of probing into the past, I shifted the conversation to the future. We discuss this model in depth in our new book, Raising Resilient Children With Disruptive Mood Dysregulation Disorder.

“What might help you feel more in control the next time something unexpected happens?” I ask.

That future-focused lens and a few more key shifts made a real difference. Here’s what I learned:

  1. When they’re upset, don’t talk. Just support them. Verbal processing is useless in the moment of a meltdown. What helps is a calming presence, gentle redirection, and clear boundaries.
  2. When they’re calm, don’t dig—build. Focus on building confidence in their self-regulation. Avoid rehashing past blowups. Instead, role-play possible future situations or devise “control plans” together.
  3. Help parents shift their expectations. These kids aren’t trying to be difficult; they’re overwhelmed. Parents need tools for prevention, not punishment—structure, routine, and patience.

One Family’s Story

I remember working with a 9-year-old boy. Let’s call him Evan. His parents were at their wits’ end. Evan had daily meltdowns over seemingly minor issues. One afternoon, he kicked a hole in the wall because his cereal bowl was the wrong color. His parents had tried everything: therapy, charts, and consequences. Nothing worked, and he wouldn’t talk during sessions.

When I met Evan, he was polite but distant. He looked at his shoes more than me. In the first few sessions, we barely spoke. I gave him a marker and let him draw. Eventually, I asked him what made him feel strong and in control, not what made him mad. That changed everything.

Over the weeks, we built a “control kit” together. It contained his own list of calming tools, a drawing of his “cool brain,” and even a superhero name he gave himself when he could stay calm in tough situations. His parents also learned new ways to respond—less focused on punishment and more on prevention.

It didn’t “fix” everything. He still had tough days. But now he had words for those days. And more importantly, he had hope that he wasn’t just broken.

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