Emotion Regulation in Borderline Personality Disorder

Table of ContentsView AllTable of ContentsEmotion RegulationRegulation vs. DysregulationBPD and Emotional IssuesHow to Manage Emotions

Table of ContentsView All

View All

Table of Contents

Emotion Regulation

Regulation vs. Dysregulation

BPD and Emotional Issues

How to Manage Emotions

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Emotional regulation is what allows us to manage our emotions in different settings and situations. This includes expressing and responding to emotions in healthy ways. People who have borderline personality disorder often have a more difficult time managing their emotions, which can affect their behavior, mood, and relationships.

Many people withborderline personality disorder (BPD)experience intense emotions and have trouble regulating them. Emotionaldysregulationis a core symptom of BPD, and it may explain other characteristics of the condition, like unstable relationships, risky or impulsive behavior, and stress-related changes in thinking.Emotional instability is also part of thediagnostic criteria for BPD.

At a GlanceEmotional dysregulation is one of the hallmarks of borderline personality disorder. Emotional skills that typically develop through childhood are often impaired in people with BPD due to factors like childhood trauma, attachment issues, and differences in brain structure. This can lead to emotional issues in adulthood, including rapid mood swings, irritability, anger problems, feelings of emptiness, paranoia, and fear of abandonment. Fortunately, there are treatments that can help people strengthen their emotional regulation abilities, including dialectical behavior therapy (DBT) and self-help approaches like stress reduction, exercise, expressive writing, psychoeducation, and mindfulness meditation.

At a Glance

Emotional dysregulation is one of the hallmarks of borderline personality disorder. Emotional skills that typically develop through childhood are often impaired in people with BPD due to factors like childhood trauma, attachment issues, and differences in brain structure. This can lead to emotional issues in adulthood, including rapid mood swings, irritability, anger problems, feelings of emptiness, paranoia, and fear of abandonment. Fortunately, there are treatments that can help people strengthen their emotional regulation abilities, including dialectical behavior therapy (DBT) and self-help approaches like stress reduction, exercise, expressive writing, psychoeducation, and mindfulness meditation.

What Is Emotion Regulation?

Emotion regulationis a fairly complex combination of ways in which a person relates to and acts on emotional experiences. This includes the ability to:

People with emotion regulation skills can control the urges to engage inimpulsive behaviorssuch as self-harm, reckless behavior, or physicalaggressionduring times of emotional stress.

Emotion regulation skills develop during childhood. As we grow, we learn strategies to help us understand what we’re feeling and self-soothe when we’re distressed. Several things can negatively impact this process, including:

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Emotion Regulation vs. Dysregulation

While emotion regulation allows us to navigate setbacks, someone experiencing emotion dysregulation will have trouble understanding their feelings and responding to them in a healthy way. This is key in BPD, as people with the condition often experience significant distress in emotional situations.

Our capacity for emotion regulation plays a major role in how we respond to events in our lives. For example, if someone with emotion regulation skills experiences a breakup, they will likely feel sad and even somewhat depressed, but they will still be able to control their emotions and carry on with their daily routines.

Borderline Personality Disorder and Your Sex Life

People with BPD may also turn to impulsive, self-destructive, or even self-harming behaviors as a way to cope with emotion dysregulation.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Rapid Mood Swings and Irritability

People with borderline personality disorder have trouble managing moods and expressing emotions, leading to anxiety andirritability.Mood swingscan be intense as well as rapid.

These feelings of anxiety and irritability may interfere with your normal activities, like working at a job or even caring for yourself. Others may have trouble being around you during these episodes for many reasons, thus harming your relationships.

Emotional sensitivity may be the driving force behind the mood swings and irritability that people with BPD experience. Someone with this condition is likely to be more emotionally sensitive in general, causing them to react quickly and intensely to the situations they encounter.

Difficulty Controlling Anger

Along with intense mood swings comesintense anger, seemingly out of nowhere. Even slight inconveniences can trigger rage in those with BPD, potentially leading to destructive or violent behaviors, including self-harm.

Emotion dysregulation appears to be closely linked with problems controlling anger. Relationship intensity and stability may play a role in this as well, as people with unstable, chaotic relationships may be more prone to aggressive behavior.

Coping Skills for Borderline Personality Disorder

Feelings of Emptiness

Those with BPD often experience a chronic feeling of emptiness. While it’s not completely clear where this feeling comes from, it may be related to an insecure self-image. Someone with BPD may struggle to retain a firm idea of their identity, and they may feel disconnected from themselves and from others.

This feeling of emptiness is very disruptive, and it can lead to impulsive behaviors, as well asself-harmandsuicide.

It can also causeloneliness, as someone experiencing chronic emptiness may feel disconnected from others and may struggle to maintain friendships. If you’re experiencing this isolation, it may also make it harder to regulate your emotions, which can begin a vicious cycle that exacerbates your feelings of distress and emptiness.

Paranoia and Fear of Abandonment

Trouble regulating emotions can exacerbate this. Intense, emotional outbursts may push others further away, and an inability to soothe feelings of paranoia or insecurity can lead to more instability in the relationship.

Managing Emotions Despite BPD

If you struggle with BPD and emotion regulation, you may want to consider seeing a therapist specializing in this condition. They will have a better understanding of the origins of your emotional struggles and, together, you can work on strategies to help you learn how to regulate your emotions and manage your mood swings.

Dialectical behavior therapy (DBT)has been found to be particularly helpful for people with BPD.This form of therapy was specifically developed to help people with BPD learn how to change their thoughts and behaviors, reducing the symptoms of the condition in the process.

In addition totherapy, there are severalself-help strategies for BPDthat can further improve your ability to manage your emotions.These can include:

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Takeaways

Emotion regulation is a beneficial skill for everyone, not just people with BPD. If you do have this condition, with time, you can learn techniques to reduce your symptoms.

Therapy often makes a big difference in this regard, and it can bring about positive changes that affect nearly every area of your life. With continued help from a mental health professional, recovery from BPD is possible.

How Accepting Difficult Emotions Can Improve Emotional Health

12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.De Prisco M, Oliva V, Fico G, et al.Emotion dysregulation in bipolar disorder compared to other mental illnesses: a systematic review and meta-analysis.Psychol Med. 2023;53(16):7484-7503. doi:10.1017/S003329172300243XAmerican Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.McQuillan ME, Kultur EC, Bates JE, et al.Dysregulation in children: Origins and implications from age 5 to age 28.Dev Psychopathol. 2018;30(2):695-713. doi:10.1017/S0954579417001572Baczkowski BM, van Zutphen L, Siep N, et al.Deficient amygdala–prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder.Eur Arch Psychiatry Clin Neurosci. 2017;267(6):551-565. doi:10.1007/s00406-016-0760-zDixon-Gordon KL, Peters JR, Fertuck EA, Yen S.Emotional processes in borderline personality disorder: An update for clinical practice.J Psychother Integr. 2017;27(4):425-438. doi:10.1037/int0000044Wolff JC, Thompson E, Thomas SA, et al.Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis.Eur Psychiatry. 2019;59:25-36. doi:10.1016/j.eurpsy.2019.03.004Wall K, Kalpakci A, Hall K, Crist N, Sharp C.An evaluation of the construct of emotional sensitivity from the perspective of emotionally sensitive people.Borderline Personal Disord Emot Dysregul. 2018;5:14. doi:10.1186/s40479-018-0091-yTerzi L, Martino F, Berardi D, Bortolotti B, Sasdelli A, Menchetti M.Aggressive behavior and self-harm in borderline personality disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients.Psychiatry Res. 2017;249:321-326. doi:10.1016/j.psychres.2017.01.011Miller CE, Townsend ML, Day NJS, Grenyer BFS.Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder.PLOS ONE. 2020;15(7):e0233970. doi:10.1371/journal.pone.0233970Palihawadana V, Broadbear JH, Rao S.Reviewing the clinical significance of ‘fear of abandonment’ in borderline personality disorder.Australas Psychiatry. 2019;27(1):60-63. doi:10.1177/1039856218810154Cristea IA, Gentili C, Cotet CD, Palomba D, Barbui C, Cuijpers P.Efficacy of psychotherapies for borderline personality disorder: A systematic review and meta-analysis.JAMA Psychiatry. 2017;74(4):319-328. doi:10.1001/jamapsychiatry.2016.4287Kramer U.The role of coping change in borderline personality disorder: A process-outcome analysis on dialectical-behaviour skills training.Clin Psychol Psychother. 2017;24(2):302-311.doi:10.1002/cpp.2017

12 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.De Prisco M, Oliva V, Fico G, et al.Emotion dysregulation in bipolar disorder compared to other mental illnesses: a systematic review and meta-analysis.Psychol Med. 2023;53(16):7484-7503. doi:10.1017/S003329172300243XAmerican Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.McQuillan ME, Kultur EC, Bates JE, et al.Dysregulation in children: Origins and implications from age 5 to age 28.Dev Psychopathol. 2018;30(2):695-713. doi:10.1017/S0954579417001572Baczkowski BM, van Zutphen L, Siep N, et al.Deficient amygdala–prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder.Eur Arch Psychiatry Clin Neurosci. 2017;267(6):551-565. doi:10.1007/s00406-016-0760-zDixon-Gordon KL, Peters JR, Fertuck EA, Yen S.Emotional processes in borderline personality disorder: An update for clinical practice.J Psychother Integr. 2017;27(4):425-438. doi:10.1037/int0000044Wolff JC, Thompson E, Thomas SA, et al.Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis.Eur Psychiatry. 2019;59:25-36. doi:10.1016/j.eurpsy.2019.03.004Wall K, Kalpakci A, Hall K, Crist N, Sharp C.An evaluation of the construct of emotional sensitivity from the perspective of emotionally sensitive people.Borderline Personal Disord Emot Dysregul. 2018;5:14. doi:10.1186/s40479-018-0091-yTerzi L, Martino F, Berardi D, Bortolotti B, Sasdelli A, Menchetti M.Aggressive behavior and self-harm in borderline personality disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients.Psychiatry Res. 2017;249:321-326. doi:10.1016/j.psychres.2017.01.011Miller CE, Townsend ML, Day NJS, Grenyer BFS.Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder.PLOS ONE. 2020;15(7):e0233970. doi:10.1371/journal.pone.0233970Palihawadana V, Broadbear JH, Rao S.Reviewing the clinical significance of ‘fear of abandonment’ in borderline personality disorder.Australas Psychiatry. 2019;27(1):60-63. doi:10.1177/1039856218810154Cristea IA, Gentili C, Cotet CD, Palomba D, Barbui C, Cuijpers P.Efficacy of psychotherapies for borderline personality disorder: A systematic review and meta-analysis.JAMA Psychiatry. 2017;74(4):319-328. doi:10.1001/jamapsychiatry.2016.4287Kramer U.The role of coping change in borderline personality disorder: A process-outcome analysis on dialectical-behaviour skills training.Clin Psychol Psychother. 2017;24(2):302-311.doi:10.1002/cpp.2017

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

De Prisco M, Oliva V, Fico G, et al.Emotion dysregulation in bipolar disorder compared to other mental illnesses: a systematic review and meta-analysis.Psychol Med. 2023;53(16):7484-7503. doi:10.1017/S003329172300243XAmerican Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.McQuillan ME, Kultur EC, Bates JE, et al.Dysregulation in children: Origins and implications from age 5 to age 28.Dev Psychopathol. 2018;30(2):695-713. doi:10.1017/S0954579417001572Baczkowski BM, van Zutphen L, Siep N, et al.Deficient amygdala–prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder.Eur Arch Psychiatry Clin Neurosci. 2017;267(6):551-565. doi:10.1007/s00406-016-0760-zDixon-Gordon KL, Peters JR, Fertuck EA, Yen S.Emotional processes in borderline personality disorder: An update for clinical practice.J Psychother Integr. 2017;27(4):425-438. doi:10.1037/int0000044Wolff JC, Thompson E, Thomas SA, et al.Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis.Eur Psychiatry. 2019;59:25-36. doi:10.1016/j.eurpsy.2019.03.004Wall K, Kalpakci A, Hall K, Crist N, Sharp C.An evaluation of the construct of emotional sensitivity from the perspective of emotionally sensitive people.Borderline Personal Disord Emot Dysregul. 2018;5:14. doi:10.1186/s40479-018-0091-yTerzi L, Martino F, Berardi D, Bortolotti B, Sasdelli A, Menchetti M.Aggressive behavior and self-harm in borderline personality disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients.Psychiatry Res. 2017;249:321-326. doi:10.1016/j.psychres.2017.01.011Miller CE, Townsend ML, Day NJS, Grenyer BFS.Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder.PLOS ONE. 2020;15(7):e0233970. doi:10.1371/journal.pone.0233970Palihawadana V, Broadbear JH, Rao S.Reviewing the clinical significance of ‘fear of abandonment’ in borderline personality disorder.Australas Psychiatry. 2019;27(1):60-63. doi:10.1177/1039856218810154Cristea IA, Gentili C, Cotet CD, Palomba D, Barbui C, Cuijpers P.Efficacy of psychotherapies for borderline personality disorder: A systematic review and meta-analysis.JAMA Psychiatry. 2017;74(4):319-328. doi:10.1001/jamapsychiatry.2016.4287Kramer U.The role of coping change in borderline personality disorder: A process-outcome analysis on dialectical-behaviour skills training.Clin Psychol Psychother. 2017;24(2):302-311.doi:10.1002/cpp.2017

De Prisco M, Oliva V, Fico G, et al.Emotion dysregulation in bipolar disorder compared to other mental illnesses: a systematic review and meta-analysis.Psychol Med. 2023;53(16):7484-7503. doi:10.1017/S003329172300243X

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

McQuillan ME, Kultur EC, Bates JE, et al.Dysregulation in children: Origins and implications from age 5 to age 28.Dev Psychopathol. 2018;30(2):695-713. doi:10.1017/S0954579417001572

Baczkowski BM, van Zutphen L, Siep N, et al.Deficient amygdala–prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder.Eur Arch Psychiatry Clin Neurosci. 2017;267(6):551-565. doi:10.1007/s00406-016-0760-z

Dixon-Gordon KL, Peters JR, Fertuck EA, Yen S.Emotional processes in borderline personality disorder: An update for clinical practice.J Psychother Integr. 2017;27(4):425-438. doi:10.1037/int0000044

Wolff JC, Thompson E, Thomas SA, et al.Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis.Eur Psychiatry. 2019;59:25-36. doi:10.1016/j.eurpsy.2019.03.004

Wall K, Kalpakci A, Hall K, Crist N, Sharp C.An evaluation of the construct of emotional sensitivity from the perspective of emotionally sensitive people.Borderline Personal Disord Emot Dysregul. 2018;5:14. doi:10.1186/s40479-018-0091-y

Terzi L, Martino F, Berardi D, Bortolotti B, Sasdelli A, Menchetti M.Aggressive behavior and self-harm in borderline personality disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients.Psychiatry Res. 2017;249:321-326. doi:10.1016/j.psychres.2017.01.011

Miller CE, Townsend ML, Day NJS, Grenyer BFS.Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder.PLOS ONE. 2020;15(7):e0233970. doi:10.1371/journal.pone.0233970

Palihawadana V, Broadbear JH, Rao S.Reviewing the clinical significance of ‘fear of abandonment’ in borderline personality disorder.Australas Psychiatry. 2019;27(1):60-63. doi:10.1177/1039856218810154

Cristea IA, Gentili C, Cotet CD, Palomba D, Barbui C, Cuijpers P.Efficacy of psychotherapies for borderline personality disorder: A systematic review and meta-analysis.JAMA Psychiatry. 2017;74(4):319-328. doi:10.1001/jamapsychiatry.2016.4287

Kramer U.The role of coping change in borderline personality disorder: A process-outcome analysis on dialectical-behaviour skills training.Clin Psychol Psychother. 2017;24(2):302-311.doi:10.1002/cpp.2017

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