Signs of emotion regulation difficulties

Strong feelings are part of being human. Feeling crushed after bad news, angry at unfair treatment or scared before surgery does not mean something is wrong with you. Emotion regulation difficulties are different. They are patterns that keep showing up, feel hard to control, and get in the way of the life you want.¹

This page walks through the six areas researchers most often measure, with examples from daily life. It also explains how these patterns differ from normal strong feelings, and when to get help. The reflection list near the end is not a test. It is a way to notice your own patterns with curiosity instead of blame.

Normal strong feelings or something more?

Everyone has hard days. Poor sleep, illness, hunger and stress can make anyone moodier. In a large review of experiments, losing sleep lowered positive feelings and raised anxiety, even in healthy people.⁹ A rough week is not the same as a regulation problem.

The key questions are how often it happens, how long it lasts, and how much it gets in the way of work, home and relationships.

The six areas, in everyday language

The Difficulties in Emotion Regulation Scale (DERS) is one of the most used questionnaires in this field. Psychologists Kim Gratz and Lizabeth Roemer published it in 2004.¹ A short form, the DERS-SF, keeps the same six areas with three questions each.² Our self-check, WhySigh MindCheck, uses the DERS-SF. Here is what each area means.

1. Not accepting your feelings

Researchers call this nonacceptance. It means reacting to your own feelings with more bad feelings, or denying that you are upset at all.² In other words, being upset about being upset.

It can look like:

• Feeling ashamed or embarrassed when you are sad or scared
• Telling yourself you are weak or silly for feeling hurt
• Feeling guilty for being angry, even when anger makes sense
• Insisting to yourself that you are fine when you are not

The extra layer of shame or guilt piles a second feeling on top of the first. That can make a hard moment feel even heavier.

2. Losing focus when upset

Researchers call this the goals area. It means having a hard time concentrating or getting things done while upset.²

• After an argument, you read the same email five times without taking it in
• Worry about a family member makes it impossible to finish a task
• When you are upset, bills and chores pile up because you cannot get started

3. Trouble controlling impulses

This is the impulse area: difficulty controlling what you do when feelings run high.²

• Snapping, yelling or slamming doors, then regretting it
• Sending an angry text you wish you could take back
• Spending, eating, drinking or driving fast to get rid of a feeling
• Hurting yourself to cope with emotional pain

Impulse difficulties are among the areas most strongly linked with self-harm and with substance use disorders.^5,6 See also Anger: signs and causes.

4. Not noticing your feelings

The awareness area is about not paying attention to your emotions.²

• Other people notice you are upset before you do
• You realize you were angry only after you exploded
• You feel tense, tired or sick to your stomach but do not link it to stress or worry

Low awareness can look calm on the outside. But feelings that go unnoticed do not simply go away. They can still shape your mood, your body and your choices.

5. Feeling you have no way to cope

The strategies area is the belief that once you are upset, there is little you can do to feel better.²

• Thinking, "Once I'm upset, the whole day is ruined"
• Feeling that a bad mood will last forever
• Not knowing anything that helps, or giving up on coping quickly

This area shows some of the strongest links with self-harm and substance use.^5,6 The good news is that it is also one of the most teachable. See Emotion regulation skills.

6. Not knowing what you feel

The clarity area means being unsure which emotion you are having.²

• Feeling "bad" or "off" without knowing if it is sadness, fear, anger, shame or loneliness
• Feeling flooded by a mix of feelings you cannot sort out
• Struggling to answer when someone asks, "How do you feel?"

Trouble with awareness and clarity is strongly linked with eating disorders.⁷

Other patterns people notice

Some signs do not fit neatly into one area, but they often go along with regulation difficulties.

• Going over and over a problem. Rumination means replaying upsetting events or worries again and again. It tends to deepen low mood and makes problem solving harder. It is linked with depression, anxiety, binge eating, binge drinking and self-harm.⁸
• Moods that shift fast and hit hard. In borderline personality disorder (BPD), intense moods can change quickly and last from a few hours to a few days. Intense or hard-to-control anger and a lasting feeling of emptiness are also common.⁴ See Borderline personality disorder.
• Using something to escape feelings. People with substance use disorders report much more trouble regulating emotions than people without. They also tend to hide their feelings more.⁶ Some people use food or binge eating in a similar way.⁷ See Substance use and Eating disorders.
• Hiding every feeling. Keeping a calm face while churning inside does not lower the feeling. It can raise your body's stress response and make it harder for others to connect with you.³

How it can look at different ages

• Young children. Tantrums are normal in toddlers. It is more of a concern when a child has frequent tantrums or is irritable much of the time.¹⁰ See Emotion regulation in children and teens.
• Teens. Strong moods are common in the teen years. Warning signs include self-harm, drinking or drug use, risky behavior and pulling away from friends and family.¹⁰
• Older adults. In Alzheimer's disease, a person may get upset, worried or angry more easily than before. Sudden changes in behavior, especially after an infection or a new medicine, should be checked by a doctor right away.¹¹ See Emotion regulation in later life.

A short reflection list (not a test)

Think about the last few times you felt very upset. Take your time with these questions. There are no right answers and no score.

• What did you tell yourself about having that feeling? Was it kind or harsh?
• Could you still do what you needed to do that day?
• Did you do or say anything you wished you could undo?
• When did you first notice the feeling: early on, or only once it was huge?
• Did you have at least one thing you could do to help yourself feel a little better?
• Could you put a name to what you felt?
• How long did it take to settle?
• Did anyone close to you get hurt by how the moment went?

If several of your answers worry you, and this happens often, it may help to talk with someone. For a structured check, try WhySigh MindCheck. You can also explore feelings with our emotions quiz.

Common questions

Is emotion dysregulation a diagnosis?

No. It describes how hard it is for a person to manage feelings. Researchers developed the DERS to measure these difficulties across many conditions, not to diagnose one.¹

Does a high score mean I have borderline personality disorder?

No. Many people with emotion regulation difficulties do not have BPD. Only a trained professional can diagnose BPD, after a careful conversation about your history. See Getting diagnosed.

Can a person be "too controlled"?

In a sense, yes. Holding every feeling in, never showing it, or not noticing it at all can also be a regulation difficulty. Hiding feelings can leave you feeling worse inside and make closeness harder.³

When to get help

Talk with a doctor, counselor or other mental health professional if:

• These patterns have lasted for weeks or months
• They cause problems at work, at school or in your relationships
• You often act on urges that put you or others at risk
• You use alcohol, drugs or food to manage feelings
• You feel numb or empty most of the time

Help can include skills training, talk therapy, or care for a related condition. See Treatment for emotion regulation difficulties and how to find a therapist.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.