Emotional instability: Description, Causes and Risk Factors:
Emotional instability refers to rapid, often exaggerated changes in mood, where strong emotions or feelings (uncontrollable laughing or crying, or heightened irritability or temper) occur. These very strong emotions are sometimes expressed in a way that is not related to the person’s emotional state.
When a person is emotionally labile emotions can be out of proportion to the situation or environment the person is in. For example, a person may cry, even when they are not unhappy – they may cry just in response to strong emotions or feelings, or it may happen “out of the blue” without warning.
Emotional instability can be caused by chemical imbalances in the brain, such as a decrease in serotonin (as see in depression) and also fluctuating levels of dopamine and serotonin (as seen in conditions such as bipolar disorder). Environmental causes can also create emotional instability. Causes such as grief and loss, abuse, abandonment, and detachment can cause emotional instability.
This disorder is about 5 times more common among first-degree biological relatives of those with the disorder than in the general population. There is also an increased familial risk for substance-related disorders, antisocial personality disorder, and mood disorders.
The prevalence of emotional instability is about 2% of the general population. It is seen in 10% of psychiatric outpatients, and 20% of psychiatric inpatients. This disorder is more frequent in females (about 75%) than males. Emotional instability and impulsivity are very common in adolescents, but most adolescents grow out of this behavior. Unfortunately, for some, this emotional instability and impulsivity persists and intensifies into adulthood; thus they become diagnosed with this disorder.
The course of this disorder is quite variable. The most common pattern is one of chronic instability in early adulthood. This disorder is usually worse in the young-adult years and it gradually decreases with age. During their 30s and 40s, the majority of individuals with this disorder attain greater stability in their relationships and vocational functioning. After about 10 years, about half of individuals with this disorder no longer meet the full criteria for Borderline Personality Disorder.
Related: Emotional pain
Whilst the condition is not very common, emotional instability is classed as a serious mental health problem due to the high incidence of self harming and suicidal tendencies. Most people suffering from emotional instability disorder suffer from very low self esteem, which has a knock on effect on all areas of life and many sufferers are prone to bouts of extreme depression and a chronic sense of emptiness. If left untreated, the patient can begin to withdraw from the world and give in to their internal pain, distress and emotional numbness.
Patients suffering from emotional instability are subject to mercurial mood swings, often for no apparent reason. Such changeable mood patterns can play havoc with close personal relationships, which makes living with a person suffering from emotional instability disorder very challenging.
A fear of abandonment is another common symptom of emotional instability disorder. This particular symptom is often related to the underlying cause of the disorder: a traumatic childhood characterized by parental neglect, abuse, and rejection. Abandonment issues in adulthood lead to very intense and emotional relationships where the sufferer is often insecure and likely to cling on to dysfunctional relationships with people who treat them badly.
Many patients suffering from emotional instability exhibit destructive behavioral traits. These can take on many different forms and include the likes of alcohol and drug abuse, gambling and compulsive shopping addictions, to the development of eating disorders and inappropriate or high-risk sexual behavior.
Alcohol and drug abuse often occur as a direct result of the other symptoms of Emotional instability. Frequent bouts of depression and a sense of emptiness can cause the patient to seek solace in alcohol and drugs as a way of numbing the intense pain. Unfortunately, this is never the answer and self-medicating only serves to exacerbate interpersonal relationship problems and underlying emotional issues.
Emotional instability patients are often very impulsive and likely to make rash decisions without thinking their actions through. This type of behavior pattern can include embarking on or ending relationships very quickly, or even rushing from one job to another.
In chronic cases of emotional instability disorder, patients can become delusional and suffer from paranoia, psychotic episodes and hallucinations. These can include paranoid delusions about the people around them, hearing voices in their head, and an extreme sense of disconnection from the world.
There is no specific definitive test, like a blood test, that can accurately assess that a person has emotional instability. People who are concerned that they may suffer from emotional instability might explore the possibility by taking a self-test, either an online or printable test. To determine the presence of this disorder, practitioners conduct a mental-health interview that looks for the presence of the symptoms, also called diagnostic criteria. As with any mental-health assessment, the practitioner will usually work toward ruling out other mental disorders, including mood problems like depression, anxiety disorders including anxiety attacks or generalized anxiety, types of other personality disorders like narcissistic personality disorder, dependent personality disorder or histrionic personality disorder, substance-abuse problems as well as problems being in touch with reality, like schizophrenia or delusional disorder. The professional will also likely try to ensure that the individual is not suffering from a medical problem that may cause emotional symptoms. The mental-health practitioner will therefore often inquire about when the person has most recently had a physical examination, comprehensive blood testing, and any other tests that a medical professional deems necessary to ensure that the individual is not suffering from a medical condition instead of or in addition to emotional symptoms. Due to the use of a mental-health interview in making the diagnosis and the fact that this disorder can be quite resistant to treatment, it is of great importance that the practitioner knows to conduct a thorough assessment. This is to assure that the person is not incorrectly assessed as having emotional instability when he or she does not.
Emotional instability Treatment:
Treatment includes psychotherapy which allows the patient to talk about both present difficulties and past experiences in the presence of an empathetic, accepting and non-judgemental therapist. The therapy needs to be structured, consistent and regular, with the patient encouraged to talk about his or her feelings rather than to discharge them in his or her usual self-defeating ways. Sometimes medications such as antidepressants, lithium carbonate, or antipsychotic medication are useful for certain patients or during certain times in the treatment of individual patients. Treatment of any alcohol or drug abuse problems is often mandatory if the therapy is to be able to continue. Brief hospitalization may sometimes be necessary during acutely stressful episodes or if suicide or other self-destructive behavior threatens to erupt. Hospitalization may provide a temporary removal from external stress. Outpatient treatment is usually difficult and long-term – sometimes over a number of years. The goals of treatment could include increased self-awareness with greater impulse control and increased stability of relationships. A positive result would be in one’s increased tolerance of anxiety. Therapy should help to alleviate psychotic or mood-disturbance symptoms and generally integrate the whole personality. With this increased awareness and capacity for self-observation and introspection, it is hoped the patient will be able to change the rigid patterns tragically set earlier in life and prevent the pattern from repeating itself in the next generational cycle.
There is a wide variety of strategies to help control emotions, these include relaxation and breathing techniques, learning better communication styles, meditation techniques, yoga, learning better problem-solving methods, physical exercise, journaling, prayer, and even changing one’s environment.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.