Mood dysregulation symptoms

The core symptoms of emotional dysregulation disorder are essentially the individual's inability to flexibly adjust the intensity, duration, and form of expression of emotional responses based on the actual severity of the scene and event. Three typical manifestations often occur: "large reaction to small stimuli," "cannot get out of emotions," and "inability to recognize one's own emotions." In severe cases, it will directly damage daily social, work, and life functions.

The 17-year-old high school girl I met in the clinic last week is a typical example. Because her deskmate borrowed her a limited-edition pen and forgot to return it, she cried hysterically in the classroom for almost a whole class. The class teacher called her parents to pick her up. Her parents were still chanting in the clinic, "This child has been pampered since he was a child and has a big temper." After completing the scale and conducting in-depth interviews, it was discovered that she had experienced similar situations several times in the past six months: she missed a multiple-choice question in the last exam, stayed at home for two whole days without going to school, and did not even go to the Comic Exhibition for which she had grabbed tickets three months in advance. In fact, she had already suffered from a failure in emotional regulation, but she was always dismissed as having a "bad personality" and was not taken seriously.

Many people have biased perceptions of this issue, and the academic community itself has not completely unified its positioning on it. For example, the American Psychiatric Association's DSM-5 diagnostic system does not list "emotional dysregulation disorder" as an independent diagnostic item, but rather treats it as a core accompanying symptom of destructive mood disorder, borderline personality disorder, complex post-traumatic stress disorder and other diseases. ； The domestic clinical psychology team represented by Professor Fang Xiaoyi prefers to regard it as a core problem of transdiagnosis - that is to say, whether it is depression, anxiety or other mood disorders, more than 70% of patients will be accompanied by varying degrees of impaired emotional regulation ability. Many people even have adjustment disorders first and have not received intervention for a long time, and then gradually develop more serious psychological problems.

You can also compare it to see if there are any similar situations: it is just a small thing, such as being 10 minutes late for takeout, or a colleague casually mentioned that there are loopholes in your plan during a meeting, but you suddenly uncontrollably throw things, shed tears, or you are so depressed that you don't want to do anything. After calming down afterwards, you feel like "it doesn't matter", but you just can't stop it at the time. This overreaction, which is completely inconsistent with the severity of the event, is the easiest symptom to detect.

Some people will not explode on the spot, but the "aftertaste" of their emotions is particularly long. I had a little conflict with my friend last month, and even now I feel so angry that my chest hurts when I talk about it. ； I was criticized by my boss half a year ago. I can't help but shake my hands every time I go on stage to report. I always feel like everyone is laughing at me. Normal people's emotions are like the tide, which rises and recedes soon after. Their emotions are like a reservoir with a closed gate. You can only get in but cannot get out. It accumulates more and more, and overflows at the slightest touch.

What is even more hidden is the situation of "inability to recognize emotions". He feels panicked and restless, but when asked "Are you angry, wronged or scared now?", he is stunned for a long time and can't say anything. He only knows "I feel uncomfortable". He even clearly feels sad about being wronged, but what he says is hurtful and angry. Others think he is unreasonable, and he himself feels wronged: I don't know what happened to me at that time.

As for how to distinguish between normal mood swings and dysregulation, the academic community actually has different judgment standards: Biologically oriented researchers pay more attention to physiological indicators, such as whether symptoms are accompanied by physical reactions such as a sudden increase in heart rate, hand shaking, insomnia, etc., and whether the abnormal state lasts for more than 2 weeks.； Researchers with a social orientation pay more attention to the impact of social functions, such as whether they are absent from work and school due to emotional problems, falling out with family and friends, and being unable to complete things they could have done well. In clinical practice, I usually combine the two criteria. If I just lose control of my mood once in a while and turn around and do whatever I should do, it doesn't matter at all. Modern people are under a lot of pressure. Who hasn't collapsed yet?

As for intervention ideas, the orientations of different schools are quite different. Consultants in the cognitive behavioral school will ask you to practice "emotional clocking" first. Spend 5 minutes every day to write down when your mood fluctuates, what the triggering events are, and what you feel at the time. Slowly regain your ability to recognize emotions. ； Psychodynamic counselors will not rush you to "change your temper." Instead, they will accompany you to dig out the underlying reasons behind your emotions. For example, if you are always angry because others do not reply to messages, maybe it is the shadow left by being repeatedly ignored by your parents when you were a child. That anger is not directed at your current friends, but at yourself when no one responded when you were a child. ； Acceptance and commitment therapy, which has been popular in recent years, is more "Buddhist". It feels that the more you try to control your emotions, the easier it is to be controlled by them. Instead, it is better to accept calmly "I am very angry now" and continue to do what you should do. When you stop focusing on "Why am I in a bad mood again?", the emotions will disappear on their own.

In the clients I have contacted, these three methods are actually effective. There is no "best method", only the one that suits you best. The one who impressed me the most was a 30-year-old product manager who used to quarrel with developers during requirements review meetings. He was dismissed from three jobs because of his "low emotional intelligence". He initially followed the emotional check-in, but it didn't improve after two months of practice. Later, during a psychoanalysis interview, he discovered that when he was a child, his father always said, "It's useless if you cry." , he has been accustomed to converting grievances and fears into expressions of anger since he was a child. After finding the reason, he practiced for half a year. Now when he encounters a disagreement, he will smile and say, "I will think about it first, and we will talk in 10 minutes." In fact, it is not that he is not angry at all, but he finally knows how to get along with his emotions.

Oh, by the way, I have to say one final word, don’t label yourself casually based on the symptoms on the Internet. Many times you are just too tired recently, just have a good sleep and go out for a drink with friends. If you really feel that you can’t adjust, find a reliable counselor or go to a psychiatrist. It is not a shameful thing - the ability to regulate emotions is the same as running and swimming. You can practice it and no one is born with it.