6 Things Your Child Needs to Navigate the Trauma of a Sibling's DMDD- from Surviving to Thriving
Updated: Jul 28
Written by Jami Kirkbride. Jami is a counselor, author, parenting coach, and
her favorite role — is a mom of seven blessings. Powered by creamy coffee,
quiet times, and quick naps, she helps parents struggling through stresses
of highly emotional or highly sensitive children discover calm by
understanding personalities, sensory needs, and mental health issues.
Parents often struggle with how to help their child when diagnosed with Disruptive Mood
Dysregulation Disorder (DMDD), but they also feel the tremendous burden to help
his/her siblings cope with the constant upheaval in the home due to the emotional
dysregulation. This article provides practical advice for helping siblings navigate the
challenge and trauma of living with a sibling who has DMDD, so they can thrive and not
Fresh on the heels of a DMDD diagnosis and the weight of figuring out what your newly
diagnosed child needs, an equally great burden surfaces. You realize the huge concern
of helping your other children through the challenges of growing up in a home with an
emotionally dysregulated, raging, unpredictable, highly sensitive, or out of control
If you are living this, you are painfully aware of the stress, toll, and trauma this
brings to a child’s life and to the entire family. You may feel helpless as how to help,
guilty for prioritizing your diagnosed child’s needs first, unsure of methods to protect
them, and/or overwhelmed, realizing you do not know where to even start in giving this
child some peace or security in their environment. You might even fear that this
environment will ruin them or question how or if they can survive the experience. Then
you realize that to protect and meet the needs of your DMDD child’s sibling(s) while
living in the chaos would feel overwhelming to any parent.
Before I give you some specific tools to help you move siblings from barely surviving to
fully thriving, it might help to understand what they may be feeling. Some of what I share
comes from professional experience, yet the greatest lessons have come from
experiences in our own family, with our own child, and his siblings. Please know, you
are not alone in this journey. I truly get it. Now, let’s dive in.
DMDD-- A Family Issue
Let’s acknowledge it, DMDD affects the whole family, not just your diagnosed child.
Siblings are greatly affected yet often overlooked. Through legislation and programs,
society appears to be becoming more accommodating and sensitive to families of
individuals with disabilities. There are more services, education, and support than in the
past (though still lacking in many ways). But Dr. Avidan Milevsky says it accurately,
“There is one member of the overall family system who has been neglected as part of
the effort to attend to disability issues: namely, the sibling of those with
disabilities…Sibling issues, in general, is an area that has been neglected in research,
application, and the law despite the fact that siblings play an integral role in the lives of
people throughout life.”
If you’ve lived this in your home, you know all too well, how it unfolds. Your child with
DMDD begins to act agitated, the whole family sees it, feels it, hears it, and knows it.
And at this point, you are already aware that his sibling has picked up on it. Everyone
knows what has the potential to erupt, but no predictability if for sure it will, or the
degree to which it will. Your attention at this point, and understandably, shifts to the child
in greatest need. How can you calm him, help him, reduce the response (noise, sights,
sounds, emotions, or eruption), and limit the damage and destruction?
The Sibling Experience During Emotional Dysregulation
The sibling may attempt a number of coping mechanisms to try and diffuse the
uncomfortable or scary situation. They may become sullen or withdrawn, begin acting
out, try to engage the child or parent to interrupt the process they see unfolding, get
more verbal and emotional, start crying, and even try to distract with humor or other
loud behavior. Generally, these attempts are unsuccessful, and the emotionally
dysregulated child escalates out of control.
Unfortunately, from the very point of agitation, and before things even get bad, a sibling
has already fallen off the radar. They may be feeling many of the same things you are --
fear, sadness, overwhelm, uncertainty, anger, confusion, shame, and embarrassment.
They, however, are working with an immature brain, less able to problem solve,
understand, and navigate the unpredictable journey. And they may feel very alone. No
parent intends to leave their child feeling this way. Only out of necessity do we step
aside to handle issues of safety and greatest needs, but we can also provide tools to
help our child (children). When done effectively through intention and purposeful
conversation you can help your child plan, prepare, process, and power through these
times that feel so out of control.
The Overarching Sibling Experience
The greater experience of life with a sibling who has a mental health issue has its own
impact on kids, apart from the emotionally charged situations. Siblings may feel unsure
about what the diagnosis means and left in the dark about how it will affect the
diagnosed child. Attempts to shield them from the doctors visits or discussions about the
issue can make them feel as though they are not included. Likewise, the amount of time
parents must take to address the medical treatments, counseling, medications, and
management of a child with disabilities can leave a sibling feeling a bit neglected or
unimportant. And often what a parent has left to give can feel like left-overs to the child.
In addition, a sibling can bear great responsibility to keep things together, be
responsible, and not further stress their parents.
It becomes easy to understand why research indicates that siblings of those with
disabilities can actually be at increased risk to develop emotional issues, anxiety,
depression, and stress. Children can easily direct these feelings inward and appear as
though all is well, when the feelings are bearing a greater toll on them than one might
expect. It might be their attempt to normalize a situation or try to hide problems from
How to Minimize the Impact of DMDD Diagnosis on Siblings
This may leave you feeling a bit hopeless or overwhelmed, but that is not the intention.
Instead, I want to normalize some of the feeling you may be having and help you see
that with some purposeful and intentional intervention, you can help both of your
children. While you may feel that you are spread thin and question if you can handle the
burden, I assure you…you can do this.
I want to give you six things your child needs to successfully navigate life with a sibling
who has DMDD. You will be key in providing and fostering these things for them.
The most essential thing your child needs is calm. And yes, it seems like a lot to ask
when it feels like things are falling apart around you. I get that. But it will be key to both
of your children (the dysregulated child and the sibling) that you manage you own
emotions and keep yourself as calm as you are able. It is impossible to help a child
regulate their emotions when you have not regulated your own. We refer to this as co-
regulation. So, model for your child how to stay calm. It may mean talking yourself
through it or taking deep breaths. It may be reframing the situation. Or it might be
removing yourself from the room for a brief time.
You may be thinking, easier said than done! I understand. It’s important to take
whatever measures you need to improve your own ability to stay calm. Some parents
find support groups, parent coaching, counseling, medication, or self-care as effective
measures in improving their own ability to handle these highly charged emotional
situations. Seeking help does not mean you are weak. It can be a sign of strength and
willingness to do all you can to help your children and yourself.
A child who is growing up around this kind of stress and emotional upheaval can feel
like they are constantly on guard. They begin to dread what may unfold and live with the
idea that even when things are currently calm, that could quickly change. They have
seen things erupt rapidly, drastically, and with no warning. Others are likely, not talking
about incidents like the ones they experience, and so they have no idea that there might be others going through anything similar. These children can suffer in silence, wishing
that someone just understood what it feels like to be in their shoes.
Your child needs you to take time to acknowledge, express, and affirm that you
understand the stress of this in their life. Let them know that you see them, and you
understand that so much of this feels unfair, unkind, and sometimes unbearable. Let
them know that you sometimes struggle with the feelings it brings up, but that you are
always there for them and can talk about it anytime. Many parents think if they avoid
labeling these feelings or situations that feel so unfair, that the child just won’t notice. It’s
not true, this child is already very aware. Your ability to understand them is using
empathy to validate their struggle. And that is what makes compassion and care
different. Compassion is care motivate by empathy. Don’t be afraid to put yourself in
your child’s shoes and address those things that they deal with in an honest way.
Talking about the emotions your child feels and acknowledging how they are affected in
these situations is one part of this process. You are communicating with empathy to
show them that you understand. But the communication cannot stop there. It will be vital
for your child to feel that the door to discuss things is always open. They need the
freedom to communicate the hard things and not fear making you upset. Building this
kind of trust in your communication is valuable.
I can tell you this, that even when you feel like you have communicated enough, they
may need even more. Check in with them. Process situations afterwards. Take time to
walk through what happened and what can be done differently next time. Listen to their
feelings and don’t get caught up in fixing things. Remember, listen to understand and
address what they feel are the genuine issues or problems. It might be different than
After an emotionally dysregulated incident with our son one morning, I went to school
and took two of his siblings out of class to talk about it. We sat at a picnic table outside
the school and just talked, hugged, cried a few tears, and then went back to our day. I
checked in that night and things seemed to be okay. I thought that was ample
discussion. I thought things were processed and understood. Only four months later did
it surface that our youngest was very upset with something from that morning. I had
stated in another room that if we couldn’t calm things down with our child, we might
need to call the police to help us.
His knowledge of police involvement was limited, so he thought they would come to
arrest someone. I had no idea he carried that fear from that morning. Only through
careful communication (much later than if I’d checked in randomly about this topic) did I
come to find out that every time his brother became dysregulated, he feared that
someone would get arrested. That’s a big fear for a small child. Once I knew this, I was
able to explain that calling the police to help us did not mean “arrest someone.” Instead,
it meant for the officers to assist us with calming down his brother or getting him to a
doctor or hospital so he can be helped. I further explained that if the police were to ever
come to our home, that we would explain to the officers his brothers special needs and
that we all need careful care and help. This conversation needed to take place much
sooner, and I had no idea. Remember to communicate, communicate, and then follow
up and communicate. Keep those doors open and check in often. I learned this the hard
So much of this child’s life will feel unpredictable. And as he has experienced, even
those things that are planned and routine can change at the last moment. So, bring to
their life a resemblance of what they can expect and try hard to be consistent with that.
One of the best ways you can do this is to have an approach that you usually follow
both in times of need, like when the emotionally dysregulated child begins getting
agitated, as well as in daily routines. When your child grows to trust how you will
respond, it helps them relax a bit and know what to expect from you.
One of the best ways you can do this is to know what your parenting approach looks
like. How do you handle the agitation stage? What do you say, do, or avoid when the
dysregulation begins? What methods do you use to calm your child or other children?
How do you address the siblings’ needs even in the heat of the moment? What do you
do in public when things arise? How do you handle difficult mealtimes? What tools are
helpful for your child to use? These are all important things to consider. I have found it
helpful to walk through a process I’ve termed the Calm Care Plan. It allowed us to sit at
a calm time and figure out what both the emotionally dysregulated child and the siblings
might need. The plan included what helped them to feel calm, where they would go, and
even who they could call if they needed someone to talk to while you are busy with the
dysregulated child. It also develops the plan for how the family comes back together to
reconnect after an incident. This is vital too.
This plan your family develops will be useful for many reasons. It allows you to plan,
prepare, and process the needs of each child and brings to the situation a sense of
control. Everyone in the family constantly flexes to the needs of the child who has
emotional dysregulation or mental health issues and what they can reasonably handle.
While so much feels out of their control, it is important for you as a parent to give your
child appropriate control in those areas that you can. It will help empower this child, and
aid in them feeling heard and understood. It will also teach them the skills to speak up
about their needs and feelings.
You might find that your child with DMDD or his sibling(s) may talk more freely without
the other present. Because of this, you might choose to do an initial one-on-one
discussion as you work to figure out your plan. One key thing that I encourage you to
include in your plan is a code word that you or the child can speak when they need to
leave the situation and just get to a quiet place while you work with the emotionally
dysregulated child. You can say the “code word” that tells them to go somewhere quiet
until you come and get them, or they can initiate using the word to tell you that is what
they are doing to get some space and quiet. Even this small plan will give your child a
sense of calm control when things begin to feel like they are spiraling. And remember,
empowering them is a very essential step in the process.
The last thing your child needs is connection. They need to know that no matter what,
you are there for them. They need to know that you can handle hearing their difficult
struggles and emotions. They need to know that they don’t have to have mountain size
problems to make your radar. They need to know that they can consistently count on
your presence, your interaction, and your compassion. One of the best things we
recommend in counseling is to devote 10-15 minutes daily for one-on-one time with
your child. Building in this time to connect and interact will encourage those discussions,
the checking in, and the building trust and rapport to get through tough things.
They may also really benefit from connecting with others who are experiencing
something similar. I off-handedly mentioned that I’d love to connect one of our little guys
with someone who had a sibling with similar issues as his. He stopped dead in his
tracks, and in all seriousness said, “Wait, you mean other people are going through this
too!” It broke my heart to think how much harder his journey likely felt to think we were
just broken, alone, or struggling through something so foreign. I took the opportunity to
scroll through the support group, listing family after family of those who are experiencing
the same. It was an eye-opening moment for him and me.
Making sure your child feels connected to a support system is key. You may choose to
utilize friends, extended family, community, church, counseling, or even a combination
of these. Your child will benefit from having others who also instill feelings of hope, trust,
and love in their lives. They can draw on the strength of those around them who are like
minded through beliefs, faith, positive thoughts, prayer, or healthy problem solving.
Connection can help your child find hope beyond this situation and change the game for
them in ways you may have never imagined.
Transformation From Surviving To Thriving
Building connection with your child is invaluable. They grow a trust and respect for you,
as well as a confidence in your relationship with them. They begin to trust that you can
handle the situation, their sibling, and them. This confidence you reflect to them will be
one they draw on for their own strength and resilience. Along with connection it will
power them through the difficult challenges they face and serve as a reminder that they
can do hard things. They, as well as you, will begin to see and believe that they are not
only surviving but thriving. You will begin to see the character that is being built through
the tough stuff, and you can remind and assure them that through these difficult
situations they face, they are developing skills, strength, resilience, and character that
will be a gift to them throughout their life. Help nurture this process and watch them
grow and thrive.