Emotional Dysregulation

Emotional dysregulation means having difficulty managing your emotions and the way you react to them. When this happens, your feelings or reactions might seem stronger or more intense than what others might expect in a given situation.

Emotional regulation, on the other hand, is the ability to understand and manage your emotions in healthy ways. Most people begin learning these skills in childhood and improve them as they grow older. Being able to regulate your emotions helps you cope with challenges, adapt to change and respond to life’s ups and downs more effectively.

It’s normal for young children to have temper tantrums as they learn to manage their emotions. These outbursts are a typical part of development while children are still learning how to express feelings in healthy ways. As they get older, most children develop better coping skills, so tantrums happen less often and eventually stop. However, if these skills don’t fully develop, emotional dysregulation can continue into teen or adult years.

While emotional regulation usually develops in childhood, emotional dysregulation isn’t only about missing early skills. It can also appear later in life after trauma or certain mental or physical health conditions. In these cases, previously learned strategies may be harder to use or break down under stress.

A healthcare provider can help you manage this symptom.

Signs and symptoms of emotional dysregulation

Emotional dysregulation can affect how you feel, speak and act. Common signs and symptoms include:

• Acting impulsively
• Emotions that get in the way of setting or reaching goals
• Feeling frustrated easily by small problems or annoyances
• Having trouble calming down once upset or feeling emotionally “out of control”
• Losing your temper often
• Mood swings
• Ongoing irritability or anger between outbursts
• Saying or doing things you later regret when upset
• Shutting down or going numb when overwhelmed (feeling “blank,” zoning out or withdrawing)

Sometimes, big feelings burst outward (like yelling or slamming doors). Other times, they turn inward (going quiet or checking out). Both are common ways your brain and body try to cope when emotions feel too strong.

You might also notice dissociation. This is feeling detached from your emotions or body. This is a short-term protection response to stress or trauma. If it happens often or gets in the way of your routine, a healthcare provider can help.

Signs of severe emotional dysregulation

Some of the more serious effects of this symptom include:

• Verbal outbursts, like shouting, yelling, screaming or crying
• Aggressive or violent behavior toward objects, animals or people
• Trouble keeping friendships, relationships or other social connections

Emotional dysregulation causes

Emotional dysregulation can happen when parts of your brain don’t talk or work together as they should. It often appears with other conditions. Many people have more than one factor that causes it.

Common causes include:

• Mental health conditions
• Neurodevelopmental differences (neurodivergence)
• Brain conditions or injuries
• Trauma

Mental health conditions that can cause emotional dysregulation

Emotional dysregulation is a symptom of many mental health conditions, including:

• Anxiety disorders
• Depression
• Bipolar disorder
• Disruptive, impulse-control and conduct disorders (like conduct disorder, disruptive mood dysregulation disorder and oppositional defiant disorder)
• Personality disorders (like borderline personality disorder)
• Post-traumatic stress disorder
• Obsessive-compulsive disorder

Neurodivergent conditions and emotional dysregulation

Emotional dysregulation can happen when your brain develops or works differently. Examples include:

• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder (ASD)

Many people with ADHD also experience rejection sensitive dysphoria (RSD). This isn’t a medical condition. But it’s very common. With RSD, you may feel intense pain or stress when someone rejects you or when you fail at something.

Brain conditions or injuries

Damage or disruptions in certain parts of your brain can cause this symptom. These include:

• Brain tumors
• Delirium
• Degenerative brain diseases (like Alzheimer’s disease or dementia)
• Epilepsy
• Head injuries (like concussions and traumatic brain injuries)
• Infections (like encephalitis or meningitis)
• Intoxication or substance use disorders
• Stroke

Trauma and environmental causes

Emotional dysregulation can also happen after harmful experiences like long-term bullying, abuse or other types of extreme stress. These experiences can change how your brain and nervous system respond to danger, keeping them on “high alert.” Over time, that can make it harder to manage emotions, even when you’re no longer in danger.

Keep in mind, these reactions aren’t your fault. They’re natural responses to chronic stress or trauma. Because your brain can adapt, treatment can help bring these systems back into balance over time.

How is emotional dysregulation treated?

There are several ways to manage emotional dysregulation. The right treatment depends on what’s causing it and may include:

• Therapy: Talking with a mental health professional can help you understand what’s contributing to symptoms. They’ll teach you healthy ways to manage these emotions and behaviors. Different types of therapy may be helpful based on your needs, like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) or family therapy.
• Medications: Your healthcare provider may prescribe medicine to treat underlying conditions. These can include antidepressants, ADHD medications, antipsychotics or mood stabilizers.
• Supportive care: If emotional dysregulation is related to another medical condition, treatment may focus on the medical issue. For example, you may need surgery to remove a brain tumor.

A healthcare provider can offer a diagnosis and guide you to the right care plan.

What are the possible complications of not treating emotional dysregulation?

This symptom isn’t something you want to ignore. Even mild cases benefit from treatment.

If you have more severe symptoms, it can disrupt many parts of your life, including:

• Friendships and relationships
• School
• Work

There are certain causes that need immediate medical care. Because of this, it’s best to talk to a healthcare provider if you notice sudden emotional changes.

Severe cases may also involve aggression, reckless behavior, self-harm or suicidal thoughts. These can increase the risk of injury or other dangerous, life-threatening outcomes.

If safety is a concern, crisis services and a personalized safety plan can help right away. In rare situations, loss of control may lead to conflicts that involve security or law enforcement. Getting support early reduces those risks and helps keep you, and others, safe.

Can emotional dysregulation be prevented?

Emotional dysregulation isn’t your fault, and it isn’t always something you can prevent. Some causes, like genetics, neurodevelopmental differences or illness/injury, are outside your control. However, you can take steps to lower your risk and build emotional resilience.

Things that may help:

• Build support. Spend time with people who are kind and dependable. If you’re experiencing bullying or abuse, reach out to someone you trust or a professional for help.
• Practice regulation skills. Try meditating, mindfulness or relaxation exercises. Keeping regular routines for sleep, meals and physical activity can also help stabilize mood.
• Set healthy boundaries. Reduce ongoing stress when possible and schedule time for rest. If it’s hard to do this alone, ask your healthcare provider about therapy options for extra support.
• Limit substances. Alcohol and addictive substances can worsen mood swings and reduce impulse control, making it harder to manage emotions.

You can also:

• Wear safety gear (helmets, seat belts) to avoid traumatic brain injuries
• Manage health conditions like high blood pressure and diabetes to prevent stroke
• Treat infections early, like ear and eye infections that could spread to your brain
• Tell your or your child’s provider if either of you experienced bullying or trauma, so you can get the right resources

When should emotional dysregulation be treated by a healthcare provider?

If emotional dysregulation is affecting your life in any way, it’s a good idea to talk to a healthcare provider.

You should also seek medical care if this symptom develops suddenly. This can be a warning sign of serious or even life-threatening conditions.

If a loved one develops emotional dysregulation gradually, encourage them to see a provider. Age-related conditions, like Alzheimer’s disease or dementia, can cause these changes over time. A healthcare provider can diagnose the cause and recommend treatment or support.

This symptom can sometimes involve self-harm or suicidal thoughts. Call 911 (or your local emergency number) or go to the ER if you feel like you may harm yourself or others.

You can also reach out for immediate help:

• Suicide and Crisis Lifeline (U.S.): Call or text 988.
• Local crisis lines: Check mental health centers or organizations in your area.

When to get help for emotional dysregulation in your child

Many parents notice signs of emotional dysregulation in their children. It’s important to remember that emotional regulation doesn’t develop automatically. Children learn it gradually as they grow.

Like any skill, some children pick it up more quickly, while others need more support. Be patient. Learning to manage emotions can be as challenging as learning to tie shoes or ride a bike. Your support can make the process easier and have a lasting impact on your child’s well-being.

Talk to your child’s healthcare provider if you’re concerned that their emotional regulation isn’t developing as expected. Their provider can check for any concerns and offer guidance or resources to help.

Is emotional dysregulation the same as ADHD?

No, ADHD and emotional dysregulation are very different. ADHD is a diagnosable medical condition. Emotional dysregulation is a symptom of many conditions.

However, ADHD and emotional dysregulation have a long history. In years past, receiving an ADHD diagnosis required that you also have emotional dysregulation. While that’s no longer required for an ADHD diagnosis, experts still know it’s a common feature of ADHD. Providers often take emotional dysregulation into account when offering treatment guidance.