Understanding Emotional Dysregulation In Autism

Emotional dysregulation in autistic individuals refers to difficulties in effectively managing emotional responses.

This can manifest as challenges in managing the intensity, duration, and expression of emotions, often resulting in prolonged emotional episodes, rapid mood shifts, or intense reactions to seemingly minor triggers.

Autistic individuals may struggle with identifying and communicating their emotions (alexithymia), leading to heightened frustration.

Emotional dysregulation can be influenced by autism-related characteristics such as sensory sensitivities, social communication challenges, and difficulties with cognitive flexibility.

It’s important to note that these experiences can vary widely among autistic individuals and may be context-dependent.

Emotional dysregulation is not exclusive to autism and can be observed in various other neurodevelopmental and mental health conditions.

It’s a prominent feature in Attention Deficit Hyperactivity Disorder (ADHD), where individuals often struggle with regulating their emotions, leading to impulsivity and mood swings.

Similarly, emotional dysregulation is also seen in conditions such as Borderline Personality Disorder, Bipolar Disorder, and even in some cases of anxiety and depression.

Signs of emotional dysregulation in autism

Autistic individuals may display several signs of emotional dysregulation (ED). While ED is not a universal experience for all autistic people, it is a common challenge, often stemming from the interplay of core autistic characteristics and external factors.

Below are some of the signs of emotional regulation differences in autistic individuals.

It’s important to note that these signs are not exhaustive and might vary depending on individual experiences and developmental stages.

Intense and Frequent Negative Emotions

Autistic individuals experiencing ED might exhibit heightened negative emotions like sadness, anger, anxiety, or frustration more frequently and intensely compared to their neurotypical peers.

Chris describes his emotional dysregulation as feeling an “immense combination of emotions and feelings” that make him feel nauseous.

Intense and frequent negative emotions can manifest as:

• Explosive Outbursts: These might involve sudden and disproportionate reactions to seemingly minor events. The individual may struggle to control their anger, leading to verbal or physical aggression.
• Prolonged Emotional Episodes: Difficulty recovering from emotional upset can lead to extended periods of intense emotional expression. This may include crying, shouting, or engaging in self-soothing behaviors that persist longer than might be expected given the triggering situation.
• Sustained Negative Responses: Even after the triggering event has passed, individuals with ED might hold onto negative emotions, impacting their ability to engage in subsequent activities or interactions.
• Elevated Irritability: Increased sensitivity to frustration can lead to a lower threshold for annoyance and anger. The individual might appear easily agitated or quick to anger in various situations.

For example, an autistic individual may experience intense frustration when their carefully planned schedule is disrupted by an unexpected work meeting. This frustration might persist long after the meeting has ended, affecting their productivity and interactions with colleagues for the rest of the day.

Rapid Emotional Shifts

ED can also involve significant fluctuations in emotional states, sometimes referred to as emotional lability.

Megan, a neurodivergent life coach characterizes emotional dysregulation as experiencing rapid and intense emotional shifts, describing it as “emotional whiplash.”

Rapid emotional shifts can look like:

• Abrupt Mood Swings: The individual might switch between different emotions quickly and unexpectedly. For example, they may go from laughing to crying within a short span, seemingly without a clear external trigger.
• Difficulty Regulating Emotional Intensity: Individuals might experience emotions in a magnified way, making it challenging to find a comfortable emotional middle ground.

For example, an autistic individual may be deeply engrossed in a philosophical discussion, feeling intellectually stimulated and happy. However, when the conversation shifts to a topic they find less engaging, they might suddenly experience a drop in mood and energy, struggling to maintain their previous level of enthusiasm.

Challenges with Emotional Awareness and Expression

Difficulties identifying, understanding, and communicating emotions effectively can significantly contribute to ED in autism.

Chris highlights that his difficulties in describing his emotions are not due to a lack of feeling, but rather an overwhelming intensity of emotions. This intense experience leaves him feeling “frozen” and unable to express himself.

He notes that this can be particularly challenging during a meltdown, a state where forcing communication can be counterproductive.

Challenges can manifest as:

• Alexithymia: This refers to difficulty recognizing and verbalizing one’s own emotions. Individuals with alexithymia might struggle to label their feelings accurately, hindering their ability to seek support or engage in self-regulation.
• Misinterpretation of Social Cues: Challenges with social communication, a core aspect of autism, can lead to misunderstandings and misinterpretations of emotional expressions in others. This can result in anxiety, frustration, and difficulty navigating social situations appropriately.
• Difficulty Expressing Emotions Effectively: Individuals might struggle to communicate their emotional needs and experiences to others, potentially leading to internalizing emotions or resorting to maladaptive behaviors to gain attention or regulate their emotional state.

For example, an autistic individual may feel physically unwell during a social gathering but be unable to identify that they're experiencing social anxiety. They might struggle to communicate their need for a break, instead becoming increasingly withdrawn or irritable, which could be misinterpreted by others.

Meltdowns and Shutdowns

Autistic individuals experiencing emotional dysregulation may exhibit meltdowns or shutdowns, which are intense responses to overwhelming emotional or sensory stimuli.

These reactions can be more severe and frequent compared to typical stress responses in neurotypical individuals.

Meltdowns and shutdowns can manifest as:

• Loss of Behavioral Control: During a meltdown, the individual may lose control over their behavior, resulting in crying, shouting, or physical actions like throwing objects or self-injury. These behaviors are not intentional but rather a result of being overwhelmed.
• Withdrawal and Non-responsiveness: Shutdowns involve a retreat from the overwhelming situation. The person may become non-verbal, avoid eye contact, or appear unresponsive to external stimuli.
• Physical Symptoms: Both meltdowns and shutdowns can involve physical manifestations such as increased heart rate, sweating, trembling, or feeling physically ill.
• Difficulty Recovering: After a meltdown or shutdown, the individual may need significant time to recover and return to their baseline state. This recovery period can last hours or even days in some cases.

For example, an autistic individual might experience a meltdown in a crowded public space due to sensory overload from the noise, lights, and crowds. This could result in crying, covering their ears, and the need to immediately leave the environment. Afterward, they might require several hours in a calm, familiar setting to fully recover from the experience.

Coping Mechanisms and Regulatory Behaviors

Autistic individuals with emotional dysregulation may develop various strategies to manage challenging emotions.

While some of these can be helpful, others can be detrimental or pose challenges in certain contexts:

• Repetitive Behaviors: A core feature of autism, repetitive behaviors can serve an important regulatory function in response to emotional distress. For many, these behaviors (such as stimming or engaging in specific routines) can be calming, grounding, and help manage anxiety or sensory overload. It’s important to recognize that while these behaviors may sometimes interfere with daily activities, they often serve a vital purpose in emotional regulation and self-soothing.
• Social Withdrawl or Avoidance: Difficulty regulating emotions in social settings can lead some individuals to limit their social interactions or be selective about the situations they engage in. While this might be perceived as withdrawal, it can also be a form of self-care and boundary-setting.
• Intense Focus on Interests: Engaging deeply with special interests can serve as a powerful emotional regulation tool for many autistic individuals. This focus can provide comfort, reduce anxiety, and offer a sense of control. While it’s important to maintain a balance with other life activities, recognizing the regulatory function of these interests is crucial.
• Self-Harm or Suicidal Ideation: In severe cases, ED can contribute to self-harming behaviors or suicidal thoughts as a way to cope with overwhelming emotional pain. It’s crucial to seek professional help if any of these behaviors are observed.

For example, an autistic individual might develop strategies to avoid supermarkets due to the overwhelming sensory input and social demands these environments often present. They may opt for online grocery shopping, schedule visits during off-peak hours, or rely on a support person to handle shopping tasks.

What can trigger emotional dysregulation in autism?

Some common triggers for emotional dysregulation (ED) in autistic individuals include:

Frustrating Situations

Autistic individuals may struggle with regulating their emotions in frustrating situations, exhibiting heightened negative affectivity, venting, and avoidance behaviors compared to their non-autistic peers.

For example, consider an autistic person attempting to complete an online job application form. They encounter several challenges:

1. The website repeatedly times out, forcing them to start over.
2. Questions are ambiguously worded, causing confusion.
3. The form doesn’t allow progress to be saved.

While these issues might be merely annoying for a neurotypical person, they could trigger an autistic individual to experience intense anger, upset, repetitive self-talk, or complete abandonment of the task.

Sensory Sensitivities

Sensory sensitivities, a common characteristic of autism, could contribute to emotional overload and subsequent dysregulation.

This is because autistic individuals may experience heightened or altered sensory responses to stimuli like sounds, textures, and lights.

For example, an autistic person may become agitated and upset when they experience hot weather, itchy clothing, and the feel of hair on their neck at the same time.

It’s essential to recognize that sensory overload can be overwhelming and potentially lead to emotional distress and dysregulation.

Social Communication Challenges

Differences in social communication, a core feature of autism, can also trigger ED. Misinterpreting social cues or struggling to express oneself effectively can lead to frustration, anxiety, and emotional outbursts.

Imagine receiving a message from your friend that says: “Hey, can we talk?”

For an autistic individual, this vague message could be challenging to interpret. They might not know if they are supposed to phone their friend to talk or whether the friend is suggesting to meet in person or carry on texting. They might not know what their friend wants to talk about or what to expect.

This ambiguity can lead to anxiety about how to respond appropriately, potentially triggering emotional dysregulation.

Likewise, if an autistic person struggles to identify and verbalize how themselves or others are feeling, this can result in misunderstandings and frustration.

Similarly, struggles with theory of mind, or understanding others’ perspectives, can further complicate social interactions and heighten emotional vulnerability.

Transitions and Changes in Routine

Many autistic individuals thrive on predictability and routine, and unexpected changes can be highly upsetting.

This can lead to emotional distress and behavioral difficulties, as the familiar structure that provides a sense of security is disrupted.

Imagine having a specific bedtime routine that lasts about 20 minutes before getting into bed. However, one night you get a phone call at the start of your routine which delays you getting to bed on time.

An autistic person may become irritable and snappy with the person who has interrupted their routine, causing confusion, tension, and possibly a falling out.

Difficulties with Cognitive Flexibility

Cognitive inflexibility, often observed in autism, can contribute to ED. This inflexibility refers to challenges with shifting attention, problem-solving, and adapting to new situations.

When confronted with unexpected events or demands, individuals with cognitive inflexibility may struggle to adjust, leading to frustration and emotional outbursts.

For instance, an autistic person is out at a restaurant and is served food that they did not order. While non-autistic people might be able to point out this mistake to the server straight away, an autistic person may take this unexpected event negatively.

They may also take longer to process what happened and also take longer to work out how to solve the problem.

Intolerance of Uncertainty

Intolerance of uncertainty (IU), the inability to manage the distress caused by uncertain situations, is frequently observed in autistic individuals.

This intolerance can significantly impact emotional regulation, as the unknown can be highly anxiety-provoking.

IU can lead to attempts to control situations rigidly, and when these attempts are unsuccessful, emotional dysregulation may occur.

For instance, an autistic person is planning to attend a party but feels intense anxiety because they are not sure when the party starts, what specific activities are planned, and when it is all likely to finish. Everyone else seems happy to ‘go with the flow,’ but all the uncertainty makes the autistic person feel reluctant to attend.

Impact on Daily Life and Relationships

Below are some ways that emotional dysregulation (ED) can impact daily life and relationships. It is important to note that this is not an exhaustive list, and the impact of ED can vary from person to person.

• Relationships: ED can lead to difficulty maintaining relationships because effectively managing and expressing emotions is crucial for building trust and fostering intimacy. When someone struggles to regulate their emotions, it can cause misunderstandings, conflicts, and strained interactions, which affect the quality of the relationship.
• Mental Health: ED is a trans-diagnostic risk factor for mental health conditions. It is associated with a range of negative mental health outcomes like depression, anxiety, and self-harm. Research suggests that ED in autistic adolescents and young adults plays a role in co-occurring psychopathology.
• Daily Functioning: ED can make it hard to get things done as emotional instability can affect focus. The inability to manage emotions can hinder an individual’s ability to complete tasks and achieve goals.
• Sense of Self: ED can negatively impact self-image and make it challenging for individuals to maintain a stable sense of self. The unpredictable nature of emotional experiences can lead to feelings of self-loathing and difficulty in self-acceptance.

How to manage emotional dysregulation

Managing emotional dysregulation in autism depends on what specifically an individual may find challenging. Below are some general tips which may be helpful:

Practice Describing Feelings

Regularly practicing the identification and description of feelings can be beneficial. This can be through using a feelings wheel or journalling for instance.

While this might be challenging, especially during periods of heightened emotions, perseverance with this practice can be helpful.

Cultivate Awareness through Mindfulness

Mindfulness-based interventions can be helpful in managing emotional dysregulation. It can be difficult to control emotions without first being aware of them.

Developing a consistent language to communicate about emotions, combined with practicing mindfulness, can be a beneficial approach.

Implement structured problem-solving techniques

To address difficulties with cognitive flexibility and intolerance of uncertainty, develop a structured problem-solving approach:

1. Create a visual flowchart or decision tree for common challenging situations
2. Break down complex problems into smaller, manageable steps
3. List potential solutions and their pros/cons
4. Practice applying this method to hypothetical scenarios during calm periods

When faced with unexpected changes or problems, refer to this structured approach. This can help reduce anxiety by providing a clear, logical path forward, even in uncertain situations. Over time, this technique can improve cognitive flexibility and build confidence in handling unpredictable events.

Develop a personalized emotional regulation scale

Create a visual scale representing your emotional states, tailored to your specific experiences. This can help address challenges with emotional awareness and expression:

1. Identify your typical emotional states, from calm to highly dysregulated
2. Assign each state a number (e.g., 1-10) and a color
3. For each level, list associated feelings, physical sensations, and helpful coping strategies
4. Create a visual representation of this scale (e.g., a thermometer or ladder)

Use this scale regularly to check in with yourself and communicate your emotional state to others. When you notice yourself moving up the scale, implement the corresponding coping strategies early. Share this scale with trusted individuals to help them understand and support you better. This tool can improve self-awareness, facilitate communication about emotions, and promote proactive regulation.

Utilize special interests

Engaging with special interests can serve as a powerful self-regulation tool for autistic individuals during stressful times.

To implement this strategy:

1. Keep easily accessible items related to your special interest nearby (e.g., books, images, or small objects).
2. Set aside dedicated time to immerse yourself in your interest when feeling overwhelmed.
3. Use your special interest as a mental ‘safe space’ by visualizing or thinking about it during stressful situations.
4. Create a playlist of videos or podcasts about your interest to listen to when needing to calm down.
5. Incorporate your special interest into relaxation techniques, such as imagining sorting or organizing related items during deep breathing exercises.
6. Share aspects of your interest with supportive people as a way to redirect focus and reduce anxiety in social situations.

Develop a “safe space” protocol

Designate a quiet, low-sensory area in your home or workplace as your safe space. Equip it with comfortable seating, soft lighting, and calming items like weighted blankets or noise-cancelling headphones.

Establish clear guidelines with others about respecting this space, such as using a “do not disturb” sign when you need uninterrupted time.

Agree on how long you might need and how others should communicate with you while you’re using it. Regularly use this space, even when not overwhelmed, to make it a familiar and effective retreat for managing emotional dysregulation.

References

Barnes, G. L., Ozsivadjian, A., Baird, G., Absoud, M., & Hollocks, M. J. (2024). Investigating the Effects of Transdiagnostic Processes on Anxiety and Depression Symptoms in Autistic Young People: the Mediating Role of Emotion Dysregulation. Journal of Autism and Developmental Disorders, 1-12. https://doi.org/10.1007/s10803-024-06246-0

Cai, R. Y., Richdale, A. L., Uljarević, M., Dissanayake, C., & Samson, A. C. (2018). Emotion regulation in autism spectrum disorder: Where we are and where we need to go. Autism Research, 11(7), 962-978. https://doi.org/10.1002/aur.1968

Dell’Osso, L., Massoni, L., Battaglini, S., De Felice, C., Nardi, B., Amatori, G., … & Carpita, B. (2023). Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood. Frontiers in Psychiatry, 14, 1234518. https://doi.org/10.3389/fpsyt.2023.1234518

Mills, A. S., Tablon-Modica, P., Mazefksy, C. A., & Weiss, J. A. (2022). Emotion dysregulation in children with autism: A multimethod investigation of the role of child and parent factors. Research in Autism Spectrum Disorders, 91, 101911. https://doi.org/10.1016/j.rasd.2021.101911