"Emotion dysregulation" is everywhere these days: in therapy sessions, in articles, all over social media. Most of the time it gets used to mean "big feelings" or "being too emotional." In the research, it means something more specific, and honestly, more hopeful. Because once you understand what emotion dysregulation actually is, you can also see why it's treatable.
This guide is a little different from most of what you'll find online. It's based on a peer-reviewed review of emotion dysregulation that our Clinical Director published in Canadian Psychology, a journal of the Canadian Psychological Association (Agako et al., 2022). Here, we've translated what the science says into a plain-language guide.
Emotion Dysregulation Is Two Problems, Not One
The most useful thing the research tells us is that emotion dysregulation is an umbrella term for two different kinds of difficulty: problems with emotional reactivity and problems with emotion regulation (Gross & Barrett, 2011; Gross & Jazaieri, 2014).
Put simply, reactivity is about how emotions arrive: how quickly they come on, how intense they get, how long they stay. Regulation is about what happens after they arrive: what you do with them, on purpose or on autopilot. Someone can struggle with one, the other, or both. The difference matters, because each calls for somewhat different work in therapy.
Part One: When Emotions Arrive Differently
When an emotion fires, it arrives as a package: the felt experience, the body's response, and an urge to act. With fear, for example, that package is the feeling of being afraid, the surge of adrenaline through your system, and the pull to fight or run (Gross & Jazaieri, 2014).
People differ on several dials in how that package arrives: how easily an emotion gets triggered, how intense it peaks, how fast it rises, and how long it takes to settle (Cole et al., 2004). Problems can show up on any of them (Gross & Jazaieri, 2014). Some people go from calm to overwhelmed in seconds over something others would shrug off. Some find that a wave of shame or anger sticks around for hours or days. And reactivity problems also include under-responding: feeling numb or shut down when you'd expect to feel something. Emotion dysregulation is not only "too much." Numbness counts too.
One more piece of the research worth holding onto: differences in emotional reactivity show up very early in life (Thompson, 1994). If your emotions have always arrived hot, fast, or muted, it's easy to perceive this as a character flaw or a failure of willpower. That's not accurate. Our reactivity is a starting point, shaped by temperament and then by experience.
Part Two: When Managing Emotions Goes Wrong
Emotion regulation is everything we do, deliberately or automatically, to influence which emotions we have, how strong they get, and how long they last (Cole et al., 2004; Gross & Jazaieri, 2014). Research maps five points in the life of an emotion where we can step in (Gross & Jazaieri, 2014; Sheppes et al., 2015). Each one is a place where things can go the way we want them to, or not.
- Choosing what you step into. Researchers call this situation selection. Declining a gathering you know will drain you can be wise; declining every gathering for a year because feelings might happen is avoidance running the show.
- Changing the situation itself. Asking to move a hard conversation to a calmer moment is skillful. Building your whole life around never having a hard conversation maintains anxiety in the long run.
- Where you point your attention. Distracting yourself through a turbulent flight can help. Replaying the argument for the fortieth time tonight (researchers call this rumination) keeps the emotion firing.
- The story you tell yourself. This is what researchers call reappraisal. "My boss was short with me because I'm failing" lands very differently than "my boss was short with everyone today."
- What you do once the feeling hits. Working with the emotion after it's already underway: slowing your breathing, expressing it, pushing it down, or reaching for something (a drink, a purchase, a screen) to switch it off.
The research points to two ways this system breaks down (Gross & Jazaieri, 2014). The first is not using any strategy when one would help, so the emotion just runs the show. The second is a mismatch between the strategy and the situation. That second one matters, because it means no strategy is good or bad on its own. Holding back your frustration in a job interview is adaptive; holding back your grief with your partner for twenty years quietly costs you the relationship. If you've read our post on overcorrection after trauma, this will sound familiar: the problem is rarely the strategy itself. It's the rigidity.
Why This Distinction Matters for Your Therapy
Here's where the science becomes practical. If the main difficulty is reactivity, especially reactivity heightened by trauma, where the alarm system learned from real danger to fire hard and fast, then therapy often needs to include work on the experiences driving the alarm. This is what trauma-focused treatments like EMDR or Prolonged Exposure target: reprocessing the memories so your system stops responding to the present as though it were the past. If the main difficulty is regulation, therapy leans toward building a wider, more flexible set of strategies and knowing when to use which.
Most people who come to us with longstanding emotional difficulties, particularly those with histories of complex trauma, need some of both. Part of a good assessment is figuring out the proportions, so treatment targets the actual problem rather than a guess at it.
One Process, Many Diagnoses
If you've collected more than one diagnosis over the years, this section is for you. A landmark study followed people for twenty years, from adolescence to midlife, looking at how mental health conditions overlap, persist, and co-occur. The researchers found that psychopathology was best explained by a single underlying dimension, which they named the p-factor (Caspi et al., 2014). In plain terms: many conditions we treat as separate seem to share common ground.
Emotion dysregulation is one of the strongest candidates for that common ground, because pieces of it show up in most mental health conditions (Agako et al., 2022). For example, anxiety can be understood as an alarm system that over-responds to threat and can't be dialed back down. Depression can involve a muting of positive emotions alongside heightened negative emotions, without being able to shift either. Borderline personality disorder involves strong reactivity across emotions together with real difficulty regulating them (Linehan, 1993). Seen this way, carrying several labels doesn't mean several separate things. It often means one underlying process is showing up in different ways, and it explains why therapy that targets emotion dysregulation itself can improve more than one problem at a time.
How Clinicians Measure It
Research uses five families of tools to capture emotion dysregulation: self-report questionnaires, cognitive tasks, physiological measures, brain activity measures, and behavioral measures (Agako et al., 2022). In everyday clinical practice, our review concluded that self-report questionnaires are currently the most practical approach, with the Difficulties in Emotion Regulation Scale being the most widely used measure in the field, cited thousands of times since its publication (Gratz & Roemer, 2004; Agako et al., 2022). These questionnaires have honest limits, which is exactly why we pair them with a thorough clinical interview. But they give you and your therapist a shared, trackable picture of what's happening. If you've ever wondered why we ask you to fill out forms, this is why. They might be annoying to fill out but they help us measure what's actually going on and whether therapy is working.
A Moment to Reflect
Take a pause and ask yourself: when emotions cause trouble in your life, is the difficulty more in how they arrive (too fast, too big, too flat, too long)? Or in what happens next (the avoiding, the ruminating, the pushing down, the reaching for something to switch them off)? Of the five points where we can step in, which one feels like your sticking point?
There are no wrong answers here. Noticing the shape of the pattern is the first piece of information therapy works with.
Frequently Asked Questions
Is emotion dysregulation a diagnosis?
No. Emotion dysregulation is not a standalone diagnosis; it's a process that cuts across many conditions, which is part of what makes it such an important treatment target (Agako et al., 2022; Caspi et al., 2014). You don't need any particular diagnosis for it to be worth addressing.
Is emotion dysregulation the same as being "too sensitive"?
No. High sensitivity describes only one dial: how easily emotions get triggered. Emotion dysregulation also includes emotions that are too muted, too brief, too persistent, or mismatched to the situation, along with difficulties in the strategies used to manage them (Gross & Jazaieri, 2014). And because reactivity differences show up early in life (Thompson, 1994), none of this reflects a moral failing.
Can lifelong patterns actually change?
Yes, on both fronts. Regulation is built from strategies, and strategies can be learned, widened, and better matched to situations (Sheppes et al., 2015). Reactivity can shift too, particularly when it's being driven by unprocessed experiences: as trauma is treated, the alarm system has less reason to fire. This is the logic behind combining skills-focused work with trauma-focused approaches in PTSD treatment.
Where does trauma fit into all of this?
Trauma and chronically invalidating environments shape both halves of the picture: they can tune the alarm system toward threat, and they teach strategies (pushing feelings down, avoiding, controlling) that made sense then but misfire now (Linehan, 1993). Our posts on complex trauma and on overcorrection after trauma explore that second half in depth.
The Bottom Line
Emotion dysregulation is two problems wearing one name: emotions that arrive in ways that don't fit the moment, and ways of managing them that fail or misfire (Gross & Jazaieri, 2014). Both halves are understandable, both are measurable, and both respond to treatment.
At Trauma Care Psychology, assessment and treatment of emotion dysregulation runs through much of what we do, from PTSD treatment and complex trauma therapy to EMDR, emotion-focused and somatic approaches. If what you've read here sounds like your inner life, we invite you to book a free consultation. You don't have to navigate this alone.
This blog post is for informational purposes and does not constitute clinical advice. If you are experiencing emotional difficulties, please reach out to a qualified mental health professional.
References
- Agako, A., Ballester, P., Stead, V., McCabe, R. E., & Green, S. M. (2022). Measures of emotion dysregulation: A narrative review. Canadian Psychology / Psychologie canadienne, 63(3), 376–391. https://doi.org/10.1037/cap0000307
- Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., Meier, M. H., Ramrakha, S., Shalev, I., Poulton, R., & Moffitt, T. E. (2014). The p factor: One general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2(2), 119–137. https://doi.org/10.1177/2167702613497473
- Cole, P. M., Martin, S. E., & Dennis, T. A. (2004). Emotion regulation as a scientific construct: Methodological challenges and directions for child development research. Child Development, 75(2), 317–333. https://doi.org/10.1111/j.1467-8624.2004.00673.x
- Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94
- Gross, J. J., & Barrett, L. F. (2011). Emotion generation and emotion regulation: One or two depends on your point of view. Emotion Review, 3(1), 8–16. https://doi.org/10.1177/1754073910380974
- Gross, J. J., & Jazaieri, H. (2014). Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science, 2(4), 387–401. https://doi.org/10.1177/2167702614536164
- Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
- Sheppes, G., Suri, G., & Gross, J. J. (2015). Emotion regulation and psychopathology. Annual Review of Clinical Psychology, 11(1), 379–405. https://doi.org/10.1146/annurev-clinpsy-032814-112739
- Thompson, R. A. (1994). Emotion regulation: A theme in search of definition. Monographs of the Society for Research in Child Development, 59(2–3), 25–52. https://doi.org/10.1111/j.1540-5834.1994.tb01276.x