Understanding Dysregulation

The Complex Nature of Dysregulation and Its Impact on Mental Health

Antonieta Contreras, LCSW-R, CCTP-II, BCN, Author

The Changing Narrative of Mental Health

In the past, mental health issues were often swept under the rug or sensationalized in movies and TV shows, perpetuating harmful stereotypes.Characters with mental illnesses were frequently depicted as violent or unpredictable, contributing to the stigma surrounding these conditions. However, there’s been a shift in recent years towards more authentic portrayals of mental health struggles, with individuals bravely sharing their own experiences.

While this trend has its merits, it has also led to the transformation of complex psychological concepts into everyday lexicon, minimizing their importance and confusing their meanings. For instance, do you use the word “dysregulated”? I bet you or your clients have used it to talk about heightened emotional reactions.

Decoding Dysregulation

Dysregulation, in psychological terms, refers to disruptions in our behavior caused by both psychological and physiological factors. This concept has gained traction thanks to advances in neuroscience, which have revealed the intricate connection between our behavior and the functioning of our nervous system. This is a significant shift! Do you remember that for decades psychology claimed that our behavior was purely our fault or genetic? Interventions were aiming to convince us to change it or to cope with it. Understanding dysregulation has transformed the game. But it is also one of those terms that have become part of the psycho-gossip — the practice of using psychological terms to talk about oneself or others to indicate some level of mental health dysfunction, often involving judgment, exaggerations, and misunderstandings.

Regulation vs. Dysregulation: A Closer Look

When the brain is functioning optimally, operates like a well-oiled machine when everything is in balance; the structures that play a role in how we experience or manage emotions operate within their natural rhythms and regulatory mechanisms.

Dysregulation occurs when these structures lose their natural rhythms due to, for example, extreme stress from constant or severe perceived threat. When brain structures are dysregulated, they may not function as efficiently or effectively, leading to disruptions in their specific roles, affecting other structures, and causing an overall dysregulated system that adopts a discordant pattern of operation.

The consequences of this lasting lack of harmonious coordination range from light to severe alterations in mood and cognition or physical health problems, depending on the frequency and intensity of the events that disrupt the system.

Spotting the Difference: Dysregulation vs. Overreaction

Intensely emotional moments can disrupt the harmony of several brain structures, but what many people call dysregulation may only be a momentary or partial spike in over-activation and a temporary loss of tolerance for a specific emotion. It’s important to distinguish between momentary overreactions, like getting scared by a spider or getting into a heated discussion, and genuine dysregulation, which involves persistent difficulties in emotional and cognitive stability.

Dysregulation is a chronic state that can significantly impair daily functioning and quality of life. Actually, this longstanding state is often seen in various mental health disorders, such as depression, anxiety disorders, PTSD, and borderline personality disorder. When dysregulation is associated with a mental disorder or a diagnosis like PTSD refers to a persistent inability to regain normal functioning, leading to ongoing impairment. Examples include:

• Being afraid all the time without a specific threat.

• Being hyper-vigilant to an extreme where fear is active even while sleeping, causing difficulty staying asleep.

• Experiencing intense, frequent, and uncontrollable emotional outbursts from small things.

• Struggling with chronic anxiety and panic attacks that interfere with daily activities.

• Manifesting constant states of tension or jumpiness, debilitating intrusive and distressing memories or flashbacks, and an inability to concentrate or maintain focus most of the time.

  
  

The Faces of Dysregulation

There are two main types of dysregulation commonly associated with trauma: autonomic dysregulation and emotional dysregulation.

Autonomic dysregulation affects the body’s automatic functions, leading to symptoms like irregular heartbeat or chronic fatigue. PTSD is characterized by this state and is typically explained as the loss of internal equilibrium. The loss of internal equilibrium occurs when the brain shifts its regular operation to focus on survival, resulting in the body being stuck in crisis mode and leading to a range of physiological and emotional symptoms. Autonomic dysregulation is not as apparent and is basically impossible to measure with the naked eye.

Emotional dysregulation, on the other hand, involves the pervasive difficulty in managing and responding to emotional experiences adaptively, and the inability to return to a stable state afterward. This condition is often quite visible, which creates its own challenges. When we can’t control the expression or intensity of our emotions, we feel disoriented, ashamed, vulnerable, and even ‘crazy.’

The Ripple Effect

Even when both types of dysregulation are independent, and emotional dysregulation can occur without autonomic dysregulation, autonomic dysregulation causes emotional dysregulation. Dysregulation doesn’t just affect one aspect of a person’s life; it permeates every facet, from relationships to daily tasks. The inability to regulate emotions is like being caught in a storm of emotions, unable to find solid ground.

People suffering from dysregulation feel either too much or nothing at all. For individuals having trouble managing or recovering from extreme emotional states, even love may be experienced as extreme and may cause distress. For instance, dysregulated individuals may feel irremediably in love with their abusers (trauma bond). Positive emotions easily turns into need, dependency, and grief, while negative ones such as irritation can quickly become hatred and aggression. A dysregulated person may experience both often, which fragments their concept of self, causing them to doubt who they are or the validity of their experiences.

In the case of fear, if a person has trouble regulating it, the brain can easily amplify the perception of risk in certain events and activate the survival circuits, which can cause a loss of balance in the autonomic system, resulting in autonomic dysregulation.