Emotions are a huge part of the human experience. They help us to understand and react to situations quickly, before we have time to logically process what’s happening. They pull us towards certain things and push us away from others.
Some of the emotions that we experience are moderate and feel easy to handle and bear. At other times, emotions can be very intense. They may feel overwhelming or unbearable. Intense emotions can also push us towards actions that we know aren’t good for us.
As we grow up, we develop strategies to handle our emotions so that we are able to continue doing the things we want or need to do. These skills and strategies are called emotional regulation. Emotional regulation involves managing the intensity and duration of our emotional responses, while having an awareness, understanding, and acceptance of our emotions.
The process of learning to regulate emotions starts as soon as a child is born. Usually, babies and infants learn from interactions with their caregivers to distinguish between different emotions, such as fear, sadness, or anger. They also learn that emotions can vary in intensity and duration.
As they grow older, children develop different strategies for managing emotions, such as help-seeking, avoidance, distraction, suppressing impulses, and problem-solving. This learning process requires trusting connections with caregivers, family members, or friends, as well as other thinking skills. Language also influences the way emotional regulation develops.
How Does Emotional Dysregulation Develop?
Sometimes, this developmental process is disrupted. Aspects of the environment they grow up in, personality traits, and personal experiences can prevent young people from understanding their emotions and developing a range of healthy strategies for managing them. This is known as emotional dysregulation.
Experts think that emotional dysregulation develops when children experience intense emotions in an environment where they’re unable to learn how to manage them. This might be because they lack stable relationships with caregivers or a stable home environment. It may be because of interpersonal difficulties in other relationships, such as bullying or a lack of trusting friendships. It can happen when a young person’s emotions have been minimised, denied, or punished.
How Does Emotional Dysregulation Affect Our Mental Health?
Unsurprisingly, the ability to regulate our emotions plays a big role in our mental health. Emotional dysregulation can lead to the experience of intense and enduring negative emotions such as sadness, anger, and emotional pain. Without effective emotion regulation strategies, young people may turn to harmful coping mechanisms, such as self-injury or disordered eating behaviours, that can have detrimental consequences.
Emotional dysregulation in children and adolescents influences many mental health disorders, including eating disorders, depression, bipolar disorder, borderline personality disorder, and psychological trauma. For example, young people with emotional dysregulation are more likely to develop mental health symptoms after a traumatic event. Emotional regulation may predict the start of depressive symptoms.
How Does Emotional Dysregulation Contribute to Eating Disorders and Borderline Personality Disorder Among Adolescents?
Eating disorders and borderline personality disorder are serious mental health disorders that usually develop during adolescence. Research suggests that 5.5 to 17.9% of young women may have experienced an eating disorder by early adulthood. Around 3% of adolescents may have borderline personality disorder.
Both eating disorders and borderline personality disorder are closely related to emotional dysregulation.
Eating Disorders and Emotional Dysregulation
Disordered eating behaviours are intertwined with emotional experiences. Research shows that feelings of depression and negative emotions lead to disordered eating and bulimic symptoms. Difficult emotions and stress are the most common triggers of binge-eating episodes.
For some young people, eating disorders may function as a way of regulating difficult emotions, especially if they are unable to effectively use other coping mechanisms. In reality, however, this only leads to further mental and physical distress.
A study among adolescent girls found that girls with high levels of disordered eating expressed:
- more frequent negative moods
- more difficulty identifying emotions
- fewer ways to cope with negative emotions
- poor emotional awareness
Other research has found that all aspects of emotional dysregulation make it more likely that women will develop binge-eating or purging behaviours in the future. A recent review concluded that emotional regulation is associated with eating disorder symptoms and diagnoses for both adolescents and adults.
Addressing Emotional Dysregulation in Eating Disorder Treatment for Adolescents
Effective treatment for eating disorders involves addressing the underlying psychological and social causes of disordered eating behaviours, including emotional dysregulation. By supporting young people to understand and manage their emotions in healthy ways, adolescents can move away from harmful behaviours like diet restriction, purging, or binge-eating.
Treatment approaches that address emotional dysregulation have been shown to effectively treat eating disorders. These include dialectical behavioural therapy, mindfulness-based therapies, and emotional regulation skills training. Dialectical behavioural therapy is a type of talking therapy that teaches radical acceptance of emotions, alongside skills learning, such as finding new ways to cope with distress.
These modalities may be combined with other eating disorder treatment approaches to provide a whole-person approach to recovery that addresses the various psycho-social factors underpinning eating disorders. They may also be useful in early intervention and prevention programs, helping to prevent the development of eating disorders among young people, especially those vulnerable to the disorders.
Borderline Personality Disorder and Emotional Dysregulation
Intense emotional responses are a core trait of borderline personality disorder. Young people often engage in impulsive behaviours, another core trait, as a way to cope with intense and unbearable emotions. They may also experience dissociative symptoms as a response to psychological distress.
Research on the development of BPD emphasises that emotional regulation is a core, underlying feature of the disorder. Adolescents with BPD have higher levels of emotional dysregulation than those without the disorder, including those with other psychiatric conditions. Studies have found that levels of emotional dysregulation are directly associated with BPD symptoms.
Treating Emotional Dysregulation and BPD
Addressing emotional dysregulation is a core aspect of treatment for borderline personality disorder. Dialectical behavioural therapy was specifically designed for borderline personality disorder, focusing on managing emotional distress and interpersonal difficulties as the core features of the disorder.
DBT has been adapted specifically for adolescents, DBT-a. It involves four main skills learning modules:
- Mindfulness
- Distress tolerance
- Interpersonal effectiveness
- Emotional regulation
DBT sessions involve a balance of acceptance and change techniques.
The Wave Clinic: Specialist Mental Health Support for Young People
The Wave Clinic offers specialist mental health care for young people and families. We offer residential and outpatient support for borderline personality disorder from our treatment spaces in Kuala Lumpur and Dubai.
Our outpatient programs combine a diverse selection of treatment modalities for eating disorders and borderline personality disorder, including DBT-a and MANTRa. Our residential space focuses on building self-confidence, friendships, and life skills through education and enriching experiences, alongside exceptional clinical care.If you’d like to enquire about our programs, contact us today.
