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Emotional Dysregulation 


Emotion dysregulation is a difficulty in effectively regulating one’s own emotions in response to a changing environment. Emotional dysregulation can impact several aspects of the autistic experience, including social communication (if overwhelmed, one may misinterpret nonverbal cues) and repetitive behaviours (called stimming; a way in which many autistic people manage emotional dysregulation[4]). In addition to being frequently experienced by neurodivergent individuals (including those with ADHD and autism), emotional dysregulation is also commonly related to a wide range of mental health conditions [1-3].

a tidal wave with a person in it.jpg

For example, emotional dysregulation is a predictor of anxiety and suicidality, and is linked to reductions in social relationships and overall quality of life in autistic individuals [9-11].

 

Jessica McCabe [5] of ‘How to ADHD’ describes emotional dysregulation well, through a tide metaphor. You are standing with your toes in a low tide. With each dysregulating event in your environment, you notice the tide begins to rise and rise and rise with successive hits to your system. If you do not have a method of getting out of the rising tide (coping strategies), very soon a tidal wave comes and takes you under. You are swept away in this overwhelming feeling, like drowning, until the tsunami of emotions runs its course, and you are left standing on the beach, drained and exhausted.

Why is emotional dysregulation so common in neurodivergent individuals?  Many individuals with ADHD and autism experience sensory differences, including increased sensitivities to noises, smells, visual input, and others [6], thus, environmental stimuli may be more triggering. Further, autistic individuals thrive on routines and predictability, and changes to schedules, interruptions, or unexpected events can trigger stress and dysregulation. Because emotional dysregulation is often triggered by environmental stimuli, the ability to cope with aversive sensory stimuli, changes to routines, and a potentially decreased understanding of ones own emotional responses may heighten the risk for emotional dysregulation in autistic (and other neurodivergent) populations [7-8].

 

One way that neurodivergent individuals manage emotional dysregulation is through stimming. NeuroClastic author Maxfield Sparrow describes stimming as “communication, celebration, and self-regulation” [16]. That is, stimming taps into the sensory system (which is often different in neurodiversity) to calm or entertain the self, as well as enjoy the world. With respect to emotional dysregulation, stimming is used to calm oneself when feeling anxious, overwhelmed, scared, too cold, too hot, too sad, and so on [16].

 

Neurodivergent individuals are more prone to become overwhelmed by environmental cues due to differences in their sensory systems (too loud, strong smells, too many people, overhead lights, tight work uniform) and internal cues (pain, hunger, increases in heart rate). As such, stimming can operate like a check and balanceto manage the incoming information [16].

 

In addition to stimming, research has identified that psychological interventions are effective for treating emotional dysregulation in neurodivergent individuals, noting improvements in anxiety, depression, coping skills, and regulation strategies [12-14]. Yet, many neurodivergent individuals are more likely to be prescribed medication for their mood and behaviour rather than psychological intervention to teach and practice coping strategies [15]. This is potentially problematic. Neurodivergent brains are different from neurotypical brains (who these medications were created for), and as such, medications can affect neurodivergent brains differently, with many individuals experiencing an increase in negative side effects [17]. Further, medications do not provide the individual with coping skills needed to manage stress, including recognizing triggers and gaining self-awareness for when the tide starts to rise before it completely takes over (as noted above).   

 

References 

  1. Gross, J.J., & Thompson, R.A. (2007). https://www.guilford.com/books/Handbook-of-Emotion-Regulation/Gross-Ford/9781462549412

  2. Eisenberg, N., et al.  (2010). https://doi.org/10.1146/annurev.clinpsy.121208.131208

  3. Uhl, K., et al. (2019). https://doi.org/10.1007/s10826-019-01474-w

  4. Samson, A. C. et al. (2014). https://doi.org/10.1007/s10803-013-2022-5

  5. McCabe, J. (2024). https://www.penguinrandomhouse.ca/books/710890/how-to-adhd-by-jessica-mccabe/9780593578940

  6. Grzadzinski, R., et al. (2013). https://doi.org/10.1186/2040-2392-4-12

  7. Mazefsky, C. A. (2015). https://doi.org/10.1007/s10803-015-2602-7

  8. Mazefsky, C. A., & White, S. W. (2014). https://doi.org/10.1016/j.chc.2013.07.002

  9. Vasa, R. A., et al. (2018). https://doi.org/10.1002/aur.1916

  10. Conner, C., et al. (2020). https://doi.org/10.1007/s10803-020-04370-1

  11. Beck, K. B., et al. (2020). https://doi.org/10.1016/j.jaac.2020.07.004

  12. Factor, R. S., et al. (2019). https://doi.org/10.1521/bumc.2019.83.3.235

  13. Scarpa, A., & Reyes, N. M. (2011). https://doi.org/10.1017/S1352465811000063

  14.  White, S. W.,  et al. (2020). https://doi.org/10.1080/23794925.2020.1796551

  15. Vasa, R. A., et al. (2022). https://doi.org/10.1007/s10803-021-05056-y

  16. Sparrow, M. (2021). https://neuroclastic.com/stimming-what-it-is-and-why-autistic-people-do-it/

  17. Sarris, M. (2018). https://www.kennedykrieger.org/stories/interactive-autism-network-ian/what-anxiety-treatments-work-people-autism

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