It is generally accepted that children and teens have mood swings, and sometimes those mood swings can be intense. However, when a child consistently responds inappropriately in emotional situations, or has trouble controlling the duration and intensity of his emotions, that child could suffer from Emotional Dysregulation. Emotional Dysregulation is also known as Borderline Personality Disorder, and it is believed that approximately 1-3% of the population suffers from this mental illness.
Like many mental health issues, it is hard to specifically define and diagnose Emotional Dysregulation, and mental health professionals have not settled on a specific Emotional Dysregulation definition.
Defining Emotional Dysregulation Disorder
One of the reasons Emotional Dysregulation is so hard to define is that emotions themselves are hard to define. Everyone has emotions, but emotional responses are so varied and nuanced it is hard to pinpoint what is “normal.”
Emotional Dysregulation generally refers to a condition in which the person cannot effectively modulate his or her emotions. Emotional Dysregulation in children is marked by extreme emotional instability, above and beyond the normal ups and downs of regular mood swings. Often, the child’s response to the world around him is inappropriate – for example, when a teacher disciplines a child for talking during class, the normal acceptable response would be that the child changes his behavior to avoid further discipline. A child with Emotional Dysregulation may react more negatively than would be expected. The child may scream and cry or throw things, or challenge the teacher further.
Other Signs of Emotional Dysregulation in Children
A child with Emotional Dysregulation may exhibit a high level of anger, often without provocation. The child may bully other children or lash out. Conversely, a child can develop an inappropriate level of familiarity and dependence with another person, and exhibit a high level of fear and even hysteria when he feels threatened or when a situation seems out of control.
Other features of Emotional Dysregulation include:
- Passive-aggressive behavior to manipulate others
- Creating chaotic situations, meaning the child acts out in such a way to elicit strong emotional responses from people around him.
- Threatening to harm – the child may threaten to harm himself or others.
- Isolation – avoiding other people and social situations in order to protect himself from perceived danger.
The severity of the dysregulated emotional response can vary, but in most cases it is enough to disrupt the child’s learning, playing, social and familial relationships.
What Causes Emotional Dysregulation?
The majority of experts believe that Emotional Dysregulation disorder is closely linked to an early childhood trauma. Such trauma can affect how the child perceives the world around him, which then causes him to react inappropriately to what he sees and feels. Think again of the child who is disciplined by his teacher. If his reaction is severe when his teacher disapproves of his behavior, perhaps he perceives an adult’s disapproval much more negatively than one would expect, which causes him, in turn, to have an inappropriate response to something that all kids deal with at one time or another.
Of course, chemical imbalances in the brain are also necessary to consider, and not all children with Emotional Dysregulation are victims of abuse. In many studies, including one published in Biological Psychiatry in 2003, it was shown that individuals with Emotional Dysregulation had an amygdala that overreacted to visual stimulation. Specifically, individuals were shown pictures of faces. The people with Emotional Dysregulation found neutral expressions to be threatening or hostile, and the amygdala was overly active in these people compared to those in the control group who had a normal response.
Traumatic brain injury, especially to the frontal lobe, has been shown to illicit mood disorders like Emotional Dysregulation. Veterans who have suffered traumatic brain injury may exhibit Post Traumatic Stress Disorder, a mood disorder, which has been linked to the trauma to the frontal cortex of the brain.
Family History of Mental Illness
Children who have a parent with mental illness are more likely to have mental illness themselves. Some mental illnesses have been linked to both environmental and genetic factors. Research is still being done to show how genetics plays a role in mental health.
Regardless of the source or cause, the important thing is to obtain the correct diagnoses so a treatment plan can be created and implemented.
Emotional Dysregulation Treatment
Again, mental illness is a complex subject and there is no cure-all for most mental illnesses. If your child suffers from Emotional Dysregulation, it is important to work with a psychiatrist to develop a treatment plan that is tailored to your child’s unique situation to manage the symptoms of the disease.
The most common form of treatment is a combination of Dialectical Behavioral Therapy, which boils down to talk therapy with a licensed therapist, both individually and in a group setting, and a prescription of selective serotonin reuptake inhibitors (SSRIs) to regulate the chemical imbalances and increase serotonin levels, which has been shown to elevate mood.
In Dialectical Behavioral Therapy, the patient and therapist will talk, but most importantly, the patient learns various methods and coping mechanisms to adjust his way of thinking about a situation and modulate his response. It is a long process, but the patient essentially learns to modify his entire way of thinking so as not to perceive the world around him in a skewed manner.
The level and frequency of Dialectical Behavioral Therapy and any medication should be reevaluated and adjusted frequently to get the best result. Many people, parents especially, are hesitant to put a child on SSRIs – but they are considered by many doctors to be milder than regular anti-depressants, and sometimes medicinal intervention is necessary.
What Does the Future Look Like for Someone with Emotional Dysregulation Disorder?
As I have tried to emphasize, mental illness is always complex and therefore it is difficult to predict what one person’s response to diagnoses and treatment will be. Studies have shown that people that suffer from Emotional Dysregulation Disorder, Borderline Personality Disorder, and other mood disorders have a higher risk of abusing drugs or alcohol, developing eating disorders, or engaging in other risky behaviors (like sexual promiscuity).
However, contrary to popular belief, recovery from the symptoms of Emotional Dysregulation is common and achievable, even in severe cases. Important factors to treating the symptoms of Emotional Dysregulation and creating the best possible future for your child include:
- Early Diagnoses. The sooner Emotional Dysregulation is diagnosed, the sooner treatment can begin.
- Understanding the Root Causes. If there was an early childhood trauma, therapy to deal with the issues may be effective. If there is a chemical imbalance, SSRIs may be the best choice. Understanding the underlying causes will help to better treat the problem and create a better long-term outcome.
- Support of Family, Friends and Community. People, especially children, diagnosed with a mental illness often feel alienated and embarrassed. If you are a parent or caregiver to someone with Emotional Dysregulation, it is important to educate yourself as to the causes, treatments and prognosis of the disease and support your child in his journey to recovery. If a family member is struggling with a mental illness, the best thing you can do is avoid blaming the person and offer support for what he is going through. Teachers, clergy, and other community members can aid in a child’s recovery by following the treatment advice of doctors and offering emotional support.
Unfortunately and too often, mental illness is looked at a pseudo-disease – one that the sufferer is almost at fault for. For a person who does not suffer from Emotional Dysregulation, someone whose responses seem abnormal or extreme is hard to understand. This is especially true in a parent and child relationship. The parent may see his child “acting out” and believe it to be willfulness or that the child is throwing a temper tantrum. Of course, any child can throw a temper tantrum, but the consistent display of inappropriate emotional responses may indicate a bigger problem.
A child should not be punished for having Emotional Dysregulation, nor should the parent blame themselves. Blame only inhibits the treatment process, so it may even be wise for family members of children with a mental illness to participate in therapy. Remember that mental illness is both a medical diagnoses and a social problem that should be faced with sensitivity and love.