Emotional dysregulation

Emotion regulation is the set of abilities that help us notice, understand and influence our emotions, so they fit the situation and we can act in line with our goals. Everyone struggles with this sometimes, especially when tired, stressed or unwell.

In emotional dysregulation, these abilities are under strain more often. A person might feel overwhelmed by emotions, react more strongly than they'd like, or find it hard to calm down afterward. They may also struggle to identify what they're feeling, or try to avoid or numb emotions in ways that cause problems.

Emotional dysregulation can show up as sudden anger, anxiety, sadness, shame or panic. For some people, it looks like intense emotional outbursts; for others, it's more internal, such as rumination, shutting down or feeling numb. It's not a sign of weakness or a lack of character. It reflects a mix of temperament, life experience and the skills available to manage emotions.

Common signs of emotional dysregulation include:

• Feeling like you can't control emotions once they start
• Emotional outbursts, such as yelling, crying or slamming doors
• Rapid mood swings in response to events
• Feeling overwhelmed by emotions, even in everyday situations
• Taking a long time to return to a calm state
• Difficulty naming or understanding your feelings
• Acting impulsively when upset, such as saying hurtful things, overspending or using substances
• Ruminating or replaying upsetting events for hours
• Shutting down, dissociating or feeling empty
• Self-harm as a way to cope with intense emotions

These patterns can strain relationships, affect work or school and lead to guilt and shame afterward. If you see yourself in several of these signs, it's worth exploring them with a professional.

Emotional dysregulation usually develops from a combination of factors:

• Temperament: some people are born more emotionally sensitive and reactive
• Early environment: growing up where emotions were dismissed, punished or unpredictable can make it harder to learn regulation skills
• Trauma, particularly childhood trauma or ongoing stress
• Neurodevelopmental differences, such as ADHD or autism
• Mental health conditions, including borderline personality disorder, depression, anxiety, bipolar disorder and PTSD
• Substance use, sleep deprivation and chronic stress, which reduce the capacity to cope

Emotional dysregulation is a core feature of borderline personality disorder and commonly occurs in adult ADHD. It is also involved in anger problems and self-harm. Because it's linked to many conditions, a licensed psychologist or psychiatrist can help clarify what's contributing in your case. Some mood swings, especially if they last days or weeks, may point to conditions such as bipolar disorder, which require specific assessment and treatment.

Several evidence-based therapies help people strengthen emotional regulation skills.

Dialectical behavior therapy (DBT) was developed specifically for people with intense emotions and is one of the most studied approaches. It teaches four groups of skills: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. DBT is often delivered through individual therapy combined with skills groups.

Other helpful approaches include:

• Cognitive behavioral therapy (CBT), to identify thoughts and behaviors that intensify emotions
• Acceptance and commitment therapy (ACT), to accept emotions while acting on your values
• Emotion-focused therapy, to understand and transform emotional experiences
• Mentalization-based therapy, to better understand your own and others' mental states
• Trauma-focused therapies, when trauma is a significant factor
• Anger management programs, when anger is the main concern

When emotional dysregulation is linked to conditions like ADHD, depression or bipolar disorder, treating those conditions, including with medication prescribed by a psychiatrist where appropriate, can also help.

Alongside therapy, these emotional regulation skills can help in daily life:

• Name it to tame it: labeling your emotion ("I'm feeling angry") can reduce its intensity
• Pause before reacting, even for a few breaths
• Use slow breathing, especially longer exhales, to calm your body
• Try grounding: focus on your senses, such as noticing what you can see, hear and touch
• Change your body temperature, for example with cool water on your face, which can quickly reduce intense arousal
• Take a break from a heated situation and return when calmer
• Look after the basics: sleep, food, movement and limiting alcohol
• Reflect afterward: what triggered the emotion, and what might help next time?

These skills take practice, and they work best when you use them regularly, not only in moments of crisis. Over time, many people find they feel overwhelmed by emotions less often.

A psychologist, clinical psychologist or psychotherapist trained in DBT or other emotion-focused approaches can help. At a first session, you'll talk about what triggers intense emotions, how you respond, the impact on your life and your history. Together, you'll set goals and choose skills to work on.

Seek help if emotional dysregulation is damaging relationships, affecting work or school, leading to risky behavior or causing you significant distress. Partners and family members can also benefit from learning about emotion regulation, so they can respond supportively rather than escalating conflict.

If intense emotions lead to self-harm or thoughts of suicide, please seek help right away. In the US, call or text 988. In the UK and Ireland, call Samaritans on 116 123. If you are in immediate danger, call 911 or your local emergency number.