Managing Extremes: Do You Struggle With Emotional Dysregulation?

We all have those friends who claim they never cry, or who appear way less affected than we are by the ebbs and flows of life. Some are quicker to anger, faster to laugh, or moved easily by a commercial featuring a dog or a baby. None of those emotions are incorrect – it’s how we communicate them and get our needs met that matters.

However, when some of us are faced with the same everyday emotional prompts we can find ourselves flooded with intense, overwhelming emotions that last longer than we can tolerate, in situations that we don’t feel match our reactions. This can mean feeling crushing sadness or blinding rage in situations where we feel unheard or rejected, like when a partner does not understand our point of view. It could also mean feeling crippling shame and anxiety in neutral situations, such as receiving both positive and negative feedback at work. No matter how hard we work to calm ourselves down, these emotions feel too big to handle in the moment.

When the highs of our emotional experience are very high and the lows very low, it can feel scary and even dangerous to access or express our emotions. We may feel the need to resort to drastic measures in order to release the emotional pressure and restore a sense of balance. When this cycle begins to occur more frequently, it may be a sign that you’re experiencing emotional dysregulation. 

What is emotional dysregulation (and what is it not)? 

Generally, emotional dysregulation can be defined as having persistent difficulty accepting, moderating and diffusing our emotional responses. Managing emotional responses can be most distressing when people struggle to reduce the intensity and duration of unwanted emotions for a variety of reasons. The experience of these intense emotions can prevent us from being our best selves and moving toward our goals.

While intense emotions are a large component of emotional dysregulation, they are not inherently the problem. The problem begins when we can’t self-soothe and bring ourselves out of an intensely emotional state. As a result, we can feel forced to utilize unhealthy coping mechanisms to restore ourselves to our emotional baseline. This can appear as:

• Impulsivity
• Non-suicidal self-injury behavior
• Suicidal ideation or attempts
• Substance misuse
• Chronic emotional avoidance
• Withdrawal
• Rumination
• Aggression
• Denial

Though effective in the short-term, these strategies can become unsustainable or even dangerous as they’re used over time. Without accessible and healthy coping strategies to manage our emotions, emotional dysregulation can negatively affect our mental and physical well-being, our self-esteem and our relationships. 

Emotional dysregulation can be associated with a number of vulnerability factors including:

• Childhood trauma or neglect
• Chronic invalidation
• Traumatic brain injuries
• Post-traumatic stress disorder
• Anxiety
• Depression

There is no singular direct cause or diagnosis to address the experience of emotional dysregulation. Each person will have a nuanced understanding of how it appears for them and its consequences in their life.

What does emotional regulation look like? How do I know if I’ve achieved it?

Most people will experience some degree of emotional dysregulation from time to time. It is a fact of life that we will have moments when our emotions overwhelm us or cause us to respond in ways that don’t align with our values or best interests. Being “emotionally regulated,” like most things, is more of an ongoing process than a constant end state, but it can be recognized by how we respond to our emotions in the moment. Some of the following questions might be important to ask:

• Am I able to calm myself down in moments when my emotions feel very strong?
• Do I feel that the coping skills I use to manage my emotions are healthy and sustainable?
• Am I able to act effectively in pursuit of my goals/in service of my values when feeling strong emotions?
• Do I feel like I can be flexible and adapt to new situations?

Being emotionally regulated does not mean that we numb or disengage from negative emotions. There is nothing wrong with experiencing sadness, anger, envy or fear, because they provide information that something externally or internally needs to change. If we didn’t feel these emotions, we would do a disservice to ourselves. Being emotionally regulated means that we are able to accept and cope with the full spectrum of the human experience while taking care of ourselves and moving forward.

What can be helpful for individuals experiencing emotional dysregulation?

While many forms of therapy can be helpful to people experiencing emotional dysregulation, Dialectical Behavior Therapy (DBT) is specifically tailored to individuals struggling with intense emotions which affect their lives and interpersonal relationship. DBT aims to first help people identify the triggers that lead to intense emotional states, and then to learn coping skills to help avoid or change behaviors that are no longer serving them. 

DBT focuses on mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness. These can be practiced alone or with a therapist.

• Mindfulness – The first step in regulating our emotions is the ability to slow down and notice them when they’re occurring in the moment, utilizing our “Wise Mind.”
• Distress tolerance – Distress tolerance skills help self-soothe when emotions are particularly strong, difficult to accept or are causing strong urges to engage in unhealthy coping behaviors. One skill, “RESISTT” provides seven strategies for self-soothing or decreasing overwhelming emotions.
• Emotional regulation – Emotional regulation skills help us understand our emotions and their causes. Two such skills, “Building Mastery” and “Being Effective” use short and long-term goal setting to increase feelings of confidence and agency. 
• Interpersonal Effectiveness – Interpersonal effectiveness skills help us strengthen relationships and access support once emotions have been regulated. The “DEAR MAN” skill can be helpful for those strategizing how to best advocate for their needs.

When struggling with emotional dysregulation, finding a therapist who specializes or is trained in DBT could be an excellent place to start working to heal. 

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