How Emotional Dysregulation Feels and Affects Behavior
Medically reviewed by Elle Markman, PsyD, MPH
Emotional dysregulation involves having intense and extreme emotions that do not align in severity with a given event. The problem makes it hard for you to control or manage your emotions. It can also be difficult to return to a normal baseline after an outburst.
Emotional dysregulation is not a mental disorder though it can occur with these types of problems. It can exist alone even if its causes are not fully known. Treatment involves learning skills and techniques to help you manage emotions and handle conflict.
This article describes emotional dysregulation, its causes, symptoms, and how it affects you and others. It also explains treatment options and ways you can work to manage the problem.
Illustration by Julie Bang for Verywell Health
Defining Emotional Dysregulation
Emotional dysregulation is the inability to regulate the quality and intensity of emotions such as fear, anger, and sadness to produce an appropriate emotional response.
Many biological and environmental factors can impact emotional dysregulation. It often surfaces in childhood or adolescence, though the problem can persist into adulthood. It occurs when the methods you use to process external or internal stimuli become dysfunctional. As a result, you are left without significant skills to help regulate emotions.
Emotional dysregulation makes it difficult to do the following:
Manage feelings of excitability
Keep a stable mood
Prevent overreacting emotionally to issues others handle without incident
Return to an emotional baseline (the state after an emotional outburst), leaving you in a heightened state longer than normal
Examples in Mental Health Conditions and Disorders
Emotional dysregulation can occur with many mental health conditions and disorders. These conditions include:
Attention deficit hyperactivity disorder (ADHD): Emotional dysregulation is a key issue in children and adults with ADHD. Children with ADHD express a higher emotional affect (the experience of feeling or emotion) and have problems regulating and expressing their emotions.
Personality disorders: Emotion dysregulation is a key feature of borderline personality disorder. It may also be seen in histrionic personality disorder and narcissistic personality disorder.
Mood disorders: Mood disorders are mental disorders that impact your emotional state. They include major depressive disorder and bipolar disorder. Emotional dysregulation in these disorders can involve underreacting and overreacting to stimuli and an exaggerated fight-or-flight response to negative stimuli.
Depression: Depression, also known as major depressive disorder, is a mood disorder that causes symptoms such as extended low mood and withdrawal. Emotional dysregulation issues can precede the start of depressive symptoms. A child's capacity for emotional regulation can be overwhelmed by the symptoms of depression.
Cyclothymia: Cyclothymia is a mood disorder in which mood fluctuations are not as intense as in bipolar disorder. Emotional dysregulation is a core feature of cyclothymia, presenting with extreme mood reactivity and instability. Cyclothymia is linked with emotional and behavioral problems such as sleep anxiety, eating disorders in female children, separation sensitivity, and antisocial-aggressive behavior in male children.
Suicidality: Suicidality is the risk of suicide, usually linked with suicidal ideation (thoughts or ideas of suicide) or suicidal intent, perhaps with a well-elaborated plan. Research indicates that suicidal ideation may be a strategy to avoid the overwhelming negative emotions that occur as a result of exaggerated emotional reactions.
Other Causes and Risk Factors
Emotional dysregulation can also occur as a result of external causes, such as problems linked to environmental factors. These can include the following:
Psychological trauma: Interpersonal trauma and maltreatment, especially those involving a lack of emotional support from parents or parental figures, are linked with the formation of a reactive attachment disorder, which can lead to emotional dysregulation.
Childhood experiences that involve sexual, physical, and emotional abuse, as well as post-traumatic stress disorder, increase the risk of severe emotional dysregulation. These experiences are also associated with impaired physical, affective, behavioral, cognitive, and interpersonal functions.
Traumatic brain injury (TBI): TBI changes the way your brain works as a result of a forceful blow or jolt to your head or body. Damage to the frontotemporal systems can affect socioemotional function. People with a traumatic brain injury often have emotional dysregulation.
Genetic factors: Research indicates that a certain gene may be associated with traits linked to emotional dysregulation, such as aggression and insecure attachment.
Emotional Dysregulation Symptoms
Emotional dysregulation symptoms can vary by individual and the situation involved. People tend to not have the same type of extreme response to every triggering event.
While there is no agreement regarding the criteria that define emotional dysregulation, research indicates that the condition has five overlapping though not mutually exclusive dimensions, which are:
Decreased emotional awareness
Inadequate emotional reactivity
Intense experience and expression of emotions
Emotional rigidity
Difficulty with cognitive reappraisal (reinterpretation of stimuli to modify their emotional response)
Slow return to baseline
These aspects of emotional dysregulation involve a wide range of intense and unpredictable behaviors and emotions.
Behaviors
Behaviors consist of observable and measurable actions, responses, and patterns of activity exhibited by individuals or groups. The most common behavioral symptoms of emotional dysregulation are:
Sudden outbursts of anger
Exaggerated crying fits
Extensive grudge-holding
Wild mood swings
Severe conflict avoidance
Accusatory statements
Self-harm
Excessive substance use
High-risk sexual behaviors
Extreme perfectionism
High conflict in interpersonal relationships
Eating patterns consistent with eating disorders
Difficulty making decisions
Emotions
Emotions are short, intense feelings that result from a given event. The most common emotional symptoms of emotional dysregulation are:
Severe depression
Irritability
Frustration
High levels of shame and anger
Suicidal thoughts or attempts
Symptoms of Emotional Dysregulation in Children
While all children may have emotional outbursts, the outbursts become problematic if they increase in frequency or intensity beyond what you would expect for your child's age. In children, symptoms of emotional dysregulation can include the following:
Temper tantrums
Yelling
Cursing
Breaking items
Uncontrolled crying
Threatened or real violence to others, oneself, or property
If your child has these behaviors, consult a healthcare provider for an assessment. Supporting a child with emotional dysregulation can involve the following:
Validating their feelings
Helping them recognize and name emotions
Teaching healthy coping strategies
Showing acceptance
Avoiding the reinforcement of outbursts
Effects of Emotional Dysregulation
The effects of emotional dysregulation can impact all aspects of your life. It can interfere with your ability to perform at school or work and maintain relationships with coworkers, friends, and family. Emotional dysregulation can also harm the way you see yourself and the world.
Self
If you have emotional dysregulation, you may not easily recognize your own emotions or take time to consider your feelings. You can become confused or feel guilty about the emotions you experience or your emotional response such that you are not able to control your behavior.
Your reaction can lead to self-injurious conduct such as substance abuse, impulsivity, and suicidal ideation and attempts. These types of reactions can help immediately reduce the level of emotional distress.
Intense emotions can lead to situations in which you are unable to calm down easily. As a result, you may try to avoid difficult emotions. However, when difficult emotions do arise, your reaction can be impulsive and overly negative.
On Others
Your emotional responses affect how you relate to others around you. Emotional dysregulation can hurt those around you. It can interfere with healthy communication, trigger conflicts, and prevent trust and intimacy that are needed to build strong emotional bonds.
Those closest to you may become the targets of your impulsive emotions. Even if you lash out at others unintentionally, your actions have an impact on the other person.
Emotional dysregulation can make it hard to maintain relationships with others because you become so hyperfocused on your own feelings that you don't think about those around you. It can lead to misunderstandings and hurt feelings. Over time, your actions can contribute to the breakdown of relationships.
Getting Help for Emotional Dysregulation
Getting help for emotional dysregulation is necessary if you notice that your emotional responses are interfering with the ways you interact with others and how others respond to you. Emotional dysregulation can affect your family, social relationships, and professional relationships. It can make it difficult to function normally as your outbursts intensify.
Getting help for emotional dysregulation can lead to better management of your emotions and emotional responses. It can also identify underlying physical or mental health issues so you can get appropriate treatment.
Where to Look
If you are confused about where to look to find appropriate mental health counseling, start in the following places:
Primary care provider: Contact a healthcare provider for a consultation about your behavior. They can assess your symptoms and often provide referrals to an appropriate mental health specialist in your area.
Insurance provider: If you have health insurance, your healthcare insurance provider can give you details about what your insurance policy covers counseling services and the mental health providers.
Community resources: Contact your community mental health center for information on low-cost or sliding-scale resources for mental health care. Check the National Association for Free and Charitable Clinics for low-cost or free care in your area.
Online therapy services: If local mental health specialists are unavailable or overbooked, consider one of several online therapy services that provide confidential counseling services. If insured, check with your insurer to confirm whether the services are covered under your policy.
Help Is Available
If you or someone you know are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor.
For more mental health resources, see our National Helpline Database.
Treatments to Address Emotional Dysregulation
Research indicates that the following treatments to address emotional dysregulation can be effective in improving the condition:
Dialectical behavior therapy (DBT): DBT is a modified type of cognitive behavioral therapy (CBT). It teaches you how to live in the moment, regulate your emotions, develop healthy ways to cope with stress, and improve your relationships. Its four skill modules include mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Schema therapy: This type of psychotherapy focuses on identifying and changing your schemas, which are broad and pervasive patterns of behavior that relate to your sense of self and the world. It proposes that symptoms such as emotional dysregulation are caused by difficult childhood experiences, which led to the formation of maladaptive early schemas.
Mentalization-based treatment (MBT): MBT is a form of psychotherapy (talk therapy) that focuses on how your mental states affect your own behavior and the behavior of others. It works to enhance your ability to reflect on your feelings and behaviors as well as those of others.
Medication: Medication may be used if your emotional dysregulation is linked with a larger mental disorder such as ADHD. In these cases, appropriate medications such as antidepressants or antipsychotics may be prescribed to treat the disorder while you participate in therapy for emotional dysregulation.
Self-Regulating Exercises to Try
Self-regulating exercises can help you identify why you feel the way you do and determine the best way to deal with it. Try the following exercises to manage your emotions:
Situation selection: Think about the types of situations that lead to undesirable emotions and work to avoid them. Choose situations most likely to generate pleasant emotions.
Situation modification: When you find yourself in a situation likely to make you feel an undesirable emotion, work to change, adjust, or improve the situation's impact. This can also involve leaving the situation.
Attentional deployment: Divert or focus your attention on the neutral aspects of a potentially undesirable situation or something completely unrelated to the situation. This can allow your mind to concentrate on something less likely to trigger an outburst.
Cognitive reappraisal: Change your perception of a situation by thinking about things differently to change how you feel. Think of this as "looking on the bright side" of a bad situation.
Response modulation: When you feel an emotion, identify it and decide how to change your reaction to it to decrease the emotional impact on yourself and others.
Grounding or self-soothing techniques: Learn techniques to use in moments of acute distress. Grounding is focusing on the physical world to interrupt the focus on your internal thoughts and emotions. Self-soothing shifts focus to something you find calming, like music, thinking of a pleasant place, taking a bath, or enjoying a favorite healthy beverage.
Summary
Emotional dysregulation is being unable to manage emotions in a healthy way. While it can happen to anyone, it can be linked to a mental health problem, brain injury, or childhood trauma.
This problem can cause intense outbursts and reactions that do not align with a given event. It can damage the way you see yourself and how you deal with others. After an outburst subsides, it can take a longer than normal time to return to your baseline state.
If you have emotions that you can't control, contact a healthcare provider to pinpoint the cause of your symptoms. Treatment can address an underlying mental health problem. It can also help you learn healthy ways to manage your emotions so you can improve your life.
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