What is emotional dysregulation disorder

What It Is and How You Can Cope

Written by WebMD Editorial Contributors

Medically Reviewed by Poonam Sachdev on June 22, 2021

When someone is experiencing emotional dysregulation, they may have angry outbursts, anxiety, depression, substance abuse, suicidal thoughts, self-harm, and other self-damaging behaviors. Over time, this condition may interfere with your quality of life, social interactions, and relationships at home, work, or school.

Symptoms of Emotional Dysregulation

Signs of emotional dysregulation include:

Severe depression
Anxiety
High levels of shame and anger
Self-harm
Excessive substance use
High-risk sexual behaviors
Extreme perfectionism
Conflict in interpersonal relationships
Eating disorder
Suicidal thoughts or attempts

Causes of Emotional Dysregulation

There are a few different reasons why someone may develop emotional dysregulation:

Early childhood trauma. These are traumatic events experienced during the early years of a person's life. This is deemed the most critical developmental period in human life.

Child neglect. A form of abuse from caregivers that results in a deprivation of a child’s basic needs, including the failure to provide adequate supervision, health care, clothing, or housing as well as other physical, emotional, social, educational, and safety needs.

Traumatic brain injury. A brain dysfunction caused by an outside force, usually a violent blow to the head.‌

Chronic low levels of invalidation. This occurs when a person's thoughts and feelings are rejected, ignored, or judged.

Experts suspect that when you experience emotional dysregulation, there is a reduction in certain neurotransmitters' ability to function as "emotional brakes,'' causing you to remain in a prolonged “fight or flight” response. When this happens, the pre-frontal cortex — the part of the brain responsible for emotional regulation — is essentially turned off during times of heightened stress.

Disorders Related to Emotional Dysregulation

PTSD. Post-traumatic stress disorder is a mental health condition caused by experiencing or witnessing a life-threatening traumatic event. It’s often characterized by severe emotional dysregulation. Symptoms may include flashbacks, nightmares, anxiety, uncontrollable negative thoughts, dissociation, and emotional numbing.

Borderline personality disorder. This is a mental health disorder that affects the way you think and feel about yourself and others, causing problems with functioning in everyday life. It includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships.

People with a borderline personality disorder often experience emotional dysregulation and have greater emotional sensitivity, emotional reactivity, and difficulty returning to a baseline emotional level that feels stable.

Frontal lobe disorders. When the brain's frontal lobes are damaged — usually due to injury — it can cause emotional dysregulation, impulsivity, lack of impulse control, attention deficit disorder, impaired decision-making, and lack of motivation.

Typically frontal lobe disorders result from explosive violence, often experienced during combat in war zones. However, it can also be experienced by people who have a brain infection, cancer, stroke, or a neurodegenerative disease.

Obsessive-compulsive disorder. Obsessive-compulsive disorder (OCD) is a mental illness that causes repeated unwanted thoughts, obsessions, or the urge to do something over and over again. This disruption of the thinking (prefrontal) part of the brain can cause significant emotional dysregulation.

Treatments for Emotional Dysregulation

Treatment for emotional dysregulation may include one or more of the following:

Counseling. Typically this will include cognitive-behavioral therapy that combines strategies like mindfulness, acceptance, and emotional regulation.

Antidepressant medications. There are several antidepressants available that work in slightly different ways with various side effects. When prescribing an antidepressant, your doctor can help you find one that works well for you.

Diet and exercise. Coupling counseling and medication with a healthy diet and exercise can be beneficial. This can help you ensure you get enough vitamins and nutrients so you can support your physical health while supporting a healthy mood and self-care routines.

Emotional regulation. To achieve better emotional regulation, a mental health professional can help you reduce extreme reactions to emotional stimulants by teaching you better control and expression of your feelings. This is usually done through a combination of skill-building and interventions that are especially helpful in developing more consistent emotional stability.

Underlying conditions. Sometimes emotional dysregulation is brought on by an underlying physical illness. Your doctor can help diagnose and treat any underlying medical conditions that may be causing mood-altering behavior.‌

New Psychological Tools. A professional mental health care provider can help you learn and practice practical psychological tools that can promote positive self-esteem so you can experience a greater sense of control over your emotions. This could include things like taking a new course, completing school, or getting meaningful on-the-job training.‌

All of these skills and tools can be learned and mastered at any age, most effectively with the help of a skilled counselor who can act as a guide and coach during this process.

When to See a Doctor

You're not alone. If you're concerned that you may have a mood disorder, make an appointment to see your doctor or a mental health professional as soon as you can.

Emotional Dysregulation Facts | Rogers Behavioral Health

We want to helpCall 800-767-4411 for a screening or click here. Refer a patient

What is emotional dysregulation?

Individuals with emotional reactivity experience intense emotions more frequently and for longer durations. They have significant skills deficits in emotion regulation. Individuals who experience emotion dysregulation have difficulty accepting their emotional response which can lead to behavioral dysregulation including, non-suicidal self-injurious behavior, suicidal ideation and attempts, excessive substance use and impulsivity. These behaviors serve to immediately decrease the current level of emotional distress. Individuals with severe emotion dysregulation are often misdiagnosed with rapid-cycling bipolar disorder due to the extreme mood lability, sometimes even within a given day.

Emotional dysregulation symptoms

Signs of emotional dysregulation include:

Severe depression
Anxiety
High levels of shame and anger
Self-harm
Excessive substance use
High-risk sexual behaviors
Extreme perfectionism
Highly conflictual interpersonal relationships
Disordered eating
Suicidal thoughts or attempts

If you are feeling unsafe or in crisis, please call, text, or chat the 988 Suicide and Crisis Lifeline to communicate with a trained professional.

What causes emotional dysregulation and who’s at risk?

Some causes can be early childhood trauma, child neglect, and traumatic brain injury. Individuals can have biological predispositions for emotional reactivity that can be exasperated by chronic low levels of invalidation in their environments resulting in emotional dysregulation. Emotional dysregulation can easily be missed as a concern in individuals diagnosed with depression and anxiety disorders. Women are more than likely to have emotional dysregulation than males due to more intense experience of emotions, rumination, and more frequent environmental invalidation.

How common is emotional dysregulation?

Chronic emotional dysregulation lies at the core of borderline personality disorder, which is present in over 50% of those who are psychiatrically hospitalized and 4 to 6% of the general population.
Emotional dysregulation is more prevalent in female teens than their male peers.
In substance use disorders, borderline personality disorder is more prevalent in males than females.

Emotional dysregulation treatment

The empirically based treatment for emotional dysregulation is Dialectical Behavior Therapy (DBT). This can be accessed in a traditional outpatient setting but is also available in high levels of care such as inpatient care, residential care, and specialized outpatient treatment, such as intensive outpatient treatment (IOP) and partial hospitalization programs (PHP).

Rogers uses an evidence-based treatment model for all patients with methods that have been proven to provide relief for a patient’s symptoms.

We want to help

Call 800-767-4411

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Wondering if you might have an anxiety disorder?

Take a short quiz to find out.

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What is emotional dysregulation - PREOCENTER

Published: 06/14/2018 in sections: Psychology as a profession

Confused by a diagnosis and don't know what emotional regulation is? This is a difficult term to describe a person, which means that you are more emotional than most.

What are the features?

Think of a singer who can play more octaves than other people. He can't stop spontaneously entering into song when the "muse" strikes, and when he sings, he is completely absorbed in the music. Now replace the singing with emotion.

Also called "emotional hyperactivity", meaning that you are more emotionally responsive than the average person. Your emotions will work faster and have a larger scale. You also have more trouble controlling your feelings than others. Your psycho-emotional state captures you.

For example:

angry outbursts (you go from calm to furious in a few seconds)
often burst into tears
"worried" all the time and "too dramatic",
you blame others before you get the facts
break things when you're upset
you feel not just sad, but suicidal
pounce on others before you can stop yourself
constant feeling of abandonment
others always say that you are overreacting
you feel that others do not understand you
your moods change quickly, confusing other people.

Of course, most articles about emotional dysregulation focus on how this disorder makes life difficult, that is, on the "negative" side of things. But on the other hand, you may also be more sensitive to art and music and have the ability to experience deep joy. Over time, as you get to know yourself better, you will also find that you have a talent for empathy.

Is something wrong with me?

It is important to keep in mind that definitions of mental health disorders are not "diseases". You can't see them under a microscope. They are simply ways of expressing ourselves that deviate from the norm of the society in which we live.

People in some countries are more emotional. For example, an Italian will flare up or cry more often than an American.

At the same time, emotional dysregulation is a very big problem if it complicates your everyday life.

It looks like this:

dramatic and exhausting romantic relationship
inability to maintain friendship
difficulties with work performance, concentration on study
low self-esteem
loneliness
money problems
criminal charges or imprisonment
suicidal ideation
self harm.

So instead of focusing on what is wrong with you. Think about how you can work on yourself so that your emotional sensitivity does not sabotage vital moments.

Reasons?

Please note that for some people, emotional dysregulation is simply a medical problem caused by a head injury.

In other cases, as in most psychological deviations, there is no exact answer about the causes. They vary by individual and are typically a combination of biological and environmental factors.

Some babies are more likely to be emotionally dysregulated. Infants may show signs of hyperactivity for several months, with some resulting in subsequent behavioral and psychological problems.

But ED can be the result of how you were raised and brought up. In order for our emotional system to develop in a healthy way, we must have a caregiver you can trust, who will love and care for you, regardless of your behavior. Of course, we also need a parent to give us freedom when we learn to go out and try things for ourselves.

If our primary caregiver instead ignores our needs, is it unreliable, unpredictable, or suffocating? Our healthy emotional development is disrupted. We don't learn how to properly regulate ourselves.

Childhood trauma as well as recent trauma can also cause problems with emotion regulation. Trauma affects the brain, reducing its ability to deal with stress.

ED is often associated with these mental health disorders:

Borderline personality disorder is the condition most associated with emotional dysregulation. In fact, it is sometimes referred to as "unstable personality disorder" or even "emotional dysregulation disorder."

Attention deficit hyperactivity disorder (ADHD) causes mood flare-ups and swings. And impulsive behavior causes drama and irritability.

Traumatic stress disorder - makes people very nervous and stuck in stress, which means they tend to overreact.

Emotion regulation problems tend to go hand in hand with several psychological difficulties:

Addictions – including smoking, alcoholism, drugs and overeating. Addiction is used as a coping mechanism to control and suppress the difficult emotions you feel.
Self-harm - this can be the same as a form of addiction.

Other disorders associated with emotional dysregulation:

bipolar disorder
depression
eating disorders
narcissistic personality disorder
sleep problems.

What to do?

It is best to seek an evaluation from a professional to determine the cause and possible associated conditions, as self-diagnosis can cause unnecessary stress.

A psychologist or psychiatrist can help you determine if your difficulties are emotional dysregulation or not. If so, they will discuss with you which treatment is best for you. There is not always a need for medication, most often in order to cope enough talking therapy.

Book a consultation via Skype, phone or in person.

Anna Bobkova

Psychologist, sexologist

Specialist in Gestalt Therapy. Certified psychologist (KNU named after Shevchenko). Gestalt Therapist (MGI). Associate Trainer (VOPPGP). Accredited Supervisor of the All-Ukrainian Society of Practical Psychologists (VOPPPP), Member of the Ukrainian Union of Psychotherapists (USP). A body-oriented therapist working with psychic trauma and psychosomatic disorders. Leading the training program "Theory and Practice in Gestalt Therapy" (1 and 2 stages), the Author's project "Psychosomatics - Life or Illness", Supervisory and Therapeutic groups.

Private practice since 2005

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👉 How to treat an emotional disorder?

Emotional disorder

Emotional outbursts, outbursts of aggression, impulsive actions create discomfort in communication with the family and other people. It is worth seeking advice from leading specialists and getting highly qualified assistance in the fight against psycho-emotional disorder.

Have you become prone to outbursts of aggression or impulsive acts? Do emotional outbursts scare you and cause your professional activity or family to suffer because of them? To correct the situation, the help of professionals is needed. Contacting the Brain Stimulation Center will help you get an answer to the question of how to treat an emotional disorder and conduct an effective course of therapy using modern methods of evidence-based medicine.

Emotional disorder is one of the personality disorders, which is characterized by imbalance, impulsiveness of actions without considering the consequences and reduced control of actions. Common symptoms of disorders are manifested by a lack of self-control, inability and unwillingness to obey generally accepted rules and norms due to insufficient self-control and impulsivity, difficulties in creating and maintaining contacts with other people.

Emotional disorders can be treated psychotherapeutically, and people suffering from these disorders can learn the necessary rules for interacting with society.

Classification of emotional disorders

There are two types of emotional disorders:

Emotionally unstable personality disorder.
Divided into impulsive and borderline types. Impulsive disturbance is manifested by a lack of self-control and increased emotional lability. For the borderline type, aggression towards others is less characteristic and is characterized by impaired self-perception, a chronic feeling of inner emptiness, unstable and tense interpersonal relationships, a tendency to self-destruction (including suicidal attempts or gestures).
Dissocial personality disorder.
Violations are manifested by indifference to others and disregard for social norms and duties. Behavior is difficult to correct and does not change even after punishment. People easily succumb to aggression and show violence.

The etiology of emotional disorders

The causes of emotional disorders are associated with disorders of the central nervous system and most often occur against the background of the following factors:

traumatic situation;
prolonged stress;
CNS injury;
vascular diseases;
neurological pathologies;
endocrine disorders;
mental disorders;
hereditary predisposition.

The first manifestations of emotional instability may occur in childhood or appear after exposure to the causes of the disorder.

Pathogenesis of emotional disorders

An emotional disorder develops when there is an imbalance between the processes of excitation and inhibition of the central nervous system. Due to the acceleration of neural transmission of impulses, purposefulness decreases and the emotional response becomes inadequate in relation to the strength of the stimulus.

Clinical manifestations of emotional disorders

The nature of the signs of an emotional disorder depends on the type of disorder.

In the impulsive variety of emotionally unstable personality disorder, there is:

frequent and unreasonable mood swings;
predisposition to outbursts of aggression and anger;
impulsive and uncontrollable actions;
hypersensitivity to criticism.

The symptoms of an emotional disorder of the impulsive type are often accompanied by a predisposition to manipulation, excessive suspicion and unreasonable jealousy.

With the borderline type, aggression towards others is less pronounced. Patients are prone to the following manifestations:

increased anxiety and suspiciousness;
loneliness and feeling of chronic inner emptiness;
complex relationships with the opposite sex from boundless adoration to complete rejection;
tendency to self-harm (up to suicidal gestures or attempts).

In case of dissocial personality disorder, the following is observed:

disregard for social norms and duties;
no change in behavior even after punishment;
slight susceptibility to aggression;
committing acts of violence;
tendency to blame others;
plausibility of justifications for their inadequate actions.

Specialists also identify general symptoms of emotional disorders:

disorders create difficulties in professional activities, communication with strangers and close people;
onset of first signs in early childhood or adolescence;
self-centeredness;
there are no obvious phases of exacerbations and remissions;
low empathy.

Features of the course of emotional disorders during pregnancy

Against the background of gestation, the hormonal background changes significantly and the manifestations of emotional dysregulation are aggravated. The unstable psycho-emotional state of a pregnant woman can negatively affect the state of the fetus and the health of the unborn baby.

Complications of emotional disorders

Lack of qualified help leads to various negative consequences of emotional disorders:

constant conflicts in the family and with other people;
development and exacerbation of somatic diseases;
professional unfulfillment;
mental strain;
isolation from society;
chronic fatigue;
depression;
suicide attempts.

With emotional disorders, patients often experience a decrease in motivation to improve their well-being and relationships with society, and they need help from relatives to organize treatment.

Diagnosis of emotional disorders

If an emotional disorder is suspected, a consultation with a psychiatrist and a neurologist is recommended.

To diagnose emotional disorders, the doctor conducts a conversation with the patient, examines the history of his illness and life, and asks additional questions. Identification of violations is confirmed by the results of the test for emotional disorder. To exclude errors, an EEG is performed, differential diagnostics is performed for patients with epilepsy, borderline and hysterical personality disorder.

Treatment of emotional disorders

The tactics of treating emotional disorders are determined by the psychotherapist personally after a comprehensive examination. Medication is not always prescribed, and medication is usually required when the disorder is combined with depression or other mental disorders. The main methods of treatment are cognitive-behavioral and dialectical therapy. Individual and group classes are conducted by a psychotherapist and psychologist. They teach patients self-control and help them understand their thoughts and psycho-emotional reactions.

Various physiotherapy procedures can effectively complement psychotherapy and drug treatment:

Hyperbaric oxygen therapy.
During HBO sessions, tissue oxygenation improves psychological and cognitive functions, tones and eliminates chronic fatigue syndrome. SPECT scans show that low blood flow is usually associated with mental health problems. Therefore, the HBO procedure activates the vital process of blood flow to the brain, which directly positively affects the mental state.
Bioacoustic correction.
BAC procedures stabilize the psycho-emotional state, reduce reactive and personal anxiety, improve well-being and mood.
Transcranial micropolarization.
TCMP sessions help to strengthen the connections in the tissues and improve the meaningfulness of actions in response to the incoming signal. The patient stabilizes the processes of excitation and inhibition, normalizes sleep.
Hypoxic therapy.
The procedure consists in inhaling air with a reduced oxygen content, which activates the body's own forces, normalizes the functioning of the immune system. At the same time, a new capillary network is formed in the brain, which increases its blood supply. And this directly affects the improvement of the mental state.
Physiotherapy.
The use of exercise therapy, massage and other physiotherapy helps improve cerebral circulation, eliminates emotional stress and fatigue, improves cognitive function and physiological response to stress factors. The use of physiotherapy in the treatment of mental illness is included in the WHO recommendations and adapted by the International Organization for Physical Therapy in Mental Health.

The treatment can also be supplemented with music therapy and art therapy.

Prevention of emotional disorders

To prevent the development of psycho-emotional disorders, it is necessary to follow a number of rules:

correctly plan the regime of work and rest;
prevent stressful situations and increase stress resistance;
timely detect and treat mental disorders, vascular, neurological and endocrine diseases.
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