Coping with Emotional Dysregulation in Borderline Personality Disorder

Though a BPD episode looks different for each person, there are some common experiences of emotional dysregulation.

You may have intense negative emotions that can last for hours or days. These may include:

• depression or sorrow
• anxiety
• anger or rage
• shame
• panic or terror
• chronic emptiness or loneliness

You may experience unpredictable and significant mood shifts over a short period of time. For example, you may go from feeling suicidal one moment to fairly positive a few hours later.

You may also have an unstable self-image or sense of self. Your likes and dislikes may change often, and you may sometimes feel like you don’t really know who you are.

In an effort to avoid being abandoned, you may have difficulties and instability in your relationships. You may see others or situations as “all good” or “all bad.” Inappropriate or intense anger may cause you to easily lose your temper or lead to frequent arguments or physical fights.

It’s also common for people with BPD to have recurrent suicidal thoughts, intent, or behaviors.

According to 2018 research, there’s no single cause of borderline personality disorder. A combination of factors may likely trigger a BPD episode, including:

• genetics, or family history of BPD
• environmental factors
• problems with brain development or neurotransmitters, chemicals that transmit signals between brain cells

Environmental factors can include instances such as:

• emotional, physical, or sexual abuse
• parental neglect
• growing up with someone with a serious mental health condition, such as bipolar disorder or substance misuse
• exposure to long-term fear or distress as a child

According to a 2022 research review, emotional self-regulation is the ability to modify or control your thoughts, feelings, and reactions. There are things you can try to incorporate into your everyday life to help regulate your emotional state.

• Try to reframe your situation: Start by acknowledging and accepting your feelings, andthen you can focus on what you can do about your situation. Ask, “What are my choices right now?” and “What tools or people do I have in my life that can help?”
• Practice mindfulness: Try to focus on the present moment without judgment. This keeps your attention on the now rather than ruminating on the past or worrying about the future.
• Set a consistent exercise routine: Get regular, vigorous exercise, such as 30 minutes of brisk walking or swimming most days of the week. Exercise helps increase feel-good hormones and boost your mood.
• Adjust your diet: Focus on a nutrient-rich diet of fresh fruits and vegetables, whole grains, and lean meats. Limit processed foods and sugar, which can cause spikes in blood sugar and contribute to mood swings. Try to eat at regular intervals to avoid that “hangry” (hungry and angry) feeling.
• Prioritize sleep: Get adequate sleep with good sleep hygiene, such as keeping a regular bedtime schedule and establishing a relaxing wind-down routine.
• Maintain positive social connections: Call a supportive friend who can offer words of wisdom or a much-needed laugh. Plan activities you enjoy that give you a sense of achievement. Volunteer for a cause that speaks to you, or see how you can help a neighbor in need.

Contrary to popular belief, borderline personality disorder is a treatable condition. Many people reach remission, with few or no symptoms, with the help of treatment. It’s even possible to overcome symptoms.

The best way to regulate emotion and control symptoms is by using a combination of treatments. These may include:

• Medication: to treat symptoms of depression and mania when they happen
• Identify signs: to recognize BPD episode signs and triggers
• Individual or group psychotherapy: to help you cope with depression and work on improving your relationships
• Dialectical behavioral therapy: to help create positive behavior change, using the concepts of validation and dialectics

Currently, there are no medications approved or even helpful specifically for BPD. However, medication can sometimes help with any comorbid disorders such as depression, anxiety, or bipolar disorder.

If you’re having trouble managing emotions with borderline personality disorder, talk with your primary doctor or therapist, if you have one. They may ask how your symptoms are affecting your quality of life and suggest a combination of treatments.

To find a mental health professional near you, consider using the FindCare tool. You can also visit Psych Central’s resource page to find a therapist based on your unique needs.