Emotion Regulation in Borderline Personality Disorder

A middle-aged man holds his hands in front of his face, clearly upset

Maskot / Getty Images

Many people with borderline personality disorder (BPD) experience intense emotions and have trouble regulating them. Emotional dysregulation is a core symptom of BPD, and it may explain other characteristics of the condition, like unstable relationships, risky or impulsive behavior, and stress-related changes in thinking. Emotional instability is also part of the diagnostic criteria for BPD.

What Is Emotion Regulation?

Emotion regulation is a fairly complex combination of ways in which a person relates to and acts on emotional experiences. This includes the ability to:

  • Behave appropriately when distressed
  • Identify, understand, and accept emotional experiences
  • Use healthy strategies to manage uncomfortable emotions

People with emotion regulation skills are able to control the urges to engage in impulsive behaviors such as self-harm, reckless behavior, or physical aggression during times of emotional stress.

Emotion regulation skills develop during childhood. As we grow, we learn strategies to help us understand what we're feeling and self-soothe when we're distressed. Several things can negatively impact this process, including:

  • Childhood stress or trauma
  • Punitive or controlling parents
  • Differences in brain structure
  • A lack of secure attachment to parents

Emotion Regulation vs. Dysregulation

While emotion regulation allows us to navigate setbacks, someone experiencing emotion dysregulation will have trouble understanding their feelings and responding to them in a healthy way. This is key in BPD, as people with the condition often experience significant distress in emotional situations.

Our capacity for emotion regulation plays a major role in the way we respond to events in our lives. For example, if someone with emotion regulation skills goes through a breakup, they will likely feel sad and even somewhat depressed, but they will still be able to control their emotions and carry on with their daily routines.

However, if someone with BPD goes through the same situation, they may become depressed to the point of not functioning. They may cope by engaging in destructive or violent behaviors, or in impulsive activities like promiscuity.

BPD and Emotional Issues

People with BPD experience a number of symptoms related to their ability to regulate their emotions. Each of these can lead to significant problems in daily life by generating anxiety and depression, making it difficult to maintain stable relationships or causing issues at work.

People with BPD may also turn to impulsive, self-destructive, or even self-harming behaviors as a way to cope with emotion dysregulation.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Rapid Mood Swings and Irritability

People with borderline personality disorder have trouble managing moods and expressing emotions, leading to anxiety and irritability. Mood swings can be intense as well as rapid.

These feelings of anxiety and irritability may interfere with your normal activities like working at a job or even caring for yourself. Others may have trouble being around you during these episodes for a number of reasons, thus harming your relationships.

Emotional sensitivity may be the driving force behind the mood swings and irritability that people with BPD experience. Someone with this condition is likely to be more emotionally sensitive in general, causing them to react quickly and intensely to the situations they encounter.

Difficulty Controlling Anger

Along with intense mood swings comes intense anger, seemingly out of nowhere. Even slight inconveniences can trigger rage in those with BPD, potentially leading to destructive or violent behaviors, including self-harm.

Emotion dysregulation appears to be closely linked with problems controlling anger. Relationship intensity and stability may play a role in this as well, as people with unstable, chaotic relationships may be more prone to aggressive behavior.

Feelings of Emptiness

Those with BPD often experience a chronic feeling of emptiness. While it's not completely clear where this feeling comes from, it may be related to an insecure self-image. Someone with BPD may struggle to retain a firm idea of their identity, and they may feel disconnected from themselves and from others.

This feeling of emptiness is very disruptive, and it can lead to impulsive behaviors, as well as self-harm and suicide.

It can also cause loneliness, as someone experiencing chronic emptiness may feel disconnected from others and may struggle to maintain friendships. If you're experiencing this isolation, it may also make it harder to regulate your emotions, which can begin a vicious cycle that exacerbates your feelings of distress and emptiness.

Paranoia and Fear of Abandonment

People with BPD often are afraid of being alone, rejected, or abandoned by those closest to them, which can cause intense paranoia. That may lead them to act obsessively and constantly seek reassurance, or even to push others away to avoid feeling hurt by a future rejection. Unfortunately, many of these behaviors can lead to a lack of stable relationships.

Trouble regulating emotions can exacerbate this. Intense, emotional outbursts may push others further away, and an inability to soothe feelings of paranoia or insecurity can lead to more instability in the relationship.

Managing Emotions Despite BPD

If you struggle with BPD and emotion regulation, you may want to consider seeing a therapist specializing in this condition. They will have a better understanding of the origins of your emotional struggles and, together, you can work on strategies to help you learn how to regulate your emotions and manage your mood swings.

Dialectical behavior therapy (DBT) has been found to be particularly helpful for people with BPD. This form of therapy was specifically developed to help people with BPD learn how to change their thoughts and behaviors, reducing the symptoms of the condition in the process.

In addition to therapy, there are several self-help strategies for BPD that can further improve your ability to manage your emotions. These can include:

Get Advice From the The Verywell Mind Podcast

Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares how you can learn to tolerate uncomfortable emotions.

Follow Now: Apple Podcasts / Spotify / Google Podcasts

A Word From Verywell

Emotion regulation is a beneficial skill for everyone, not just people with BPD. If you do have this condition, with time, you can learn techniques to reduce your symptoms.

Therapy often makes a big difference in this regard, and it can bring about positive changes that affect nearly every area of your life. With continued help from a mental health professional, recovery from BPD is possible.

9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Carpenter, RW, Trull, TJ. Components of emotion dysregulation in borderline personality disorder: A review. Curr Psychiatry Rep. 2013;15(1):335. doi:10.1007/s11920-012-0335-2

  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013. doi:10.1176/appi.books.9780890425596

  3. McQuillan ME, Kultur EC, Bates JE, et al. Dysregulation in children: Origins and implications from age 5 to age 28Dev Psychopathol. 2018;30(2):695-713. doi:10.1017/S0954579417001572

  4. Baczkowski BM, van Zutphen L, Siep N, et al. Deficient amygdala–prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorderEur Arch Psychiatry Clin Neurosci. 2017;267(6):551-565. doi:10.1007/s00406-016-0760-z

  5. Terzi L, Martino F, Berardi D, Bortolotti B, Sasdelli A, Menchetti M. Aggressive behavior and self-harm in borderline personality disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients. Psychiatry Res. 2017;249:321-326. doi:10.1016/j.psychres.2017.01.011

  6. Miller CE, Townsend ML, Day NJS, Grenyer BFS. Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorderPLOS ONE. 2020;15(7):e0233970. doi:10.1371/journal.pone.0233970

  7. Palihawadana V, Broadbear JH, Rao S. Reviewing the clinical significance of 'fear of abandonment' in borderline personality disorder. Australas Psychiatry. 2019;27(1):60-63. doi:10.1177/1039856218810154

  8. Cristea IA, Gentili C, Cotet CD, Palomba D, Barbui C, Cuijpers P. Efficacy of psychotherapies for borderline personality disorder: A systematic review and meta-analysis. JAMA Psychiatry. 2017;74(4):319-328. doi:10.1001/jamapsychiatry.2016.4287

  9. Kramer U. The role of coping change in borderline personality disorder: A process-outcome analysis on dialectical-behaviour skills training. Clin Psychol Psychother. 2017;24(2):302-311.doi:10.1002/cpp.2017

By Kristalyn Salters-Pedneault, PhD
 Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University.