Instead of self-medicating or suppressing intense emotions, try emotion regulation skills for bipolar disorder.
Key Takeaways
- People living with bipolar disorder often experience emotions more intensely, which can make reactions feel urgent or hard to control.
- Dialectical behavior therapy (DBT) teaches practical skills to help you ride out big feelings and respond more intentionally.
- You can also reduce vulnerability with ABC: add pleasant moments, build mastery through small wins, and practice coping skills in advance.
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Many people would prefer to avoid emotions that make them uncomfortable. Some attempt to numb their feelings through the use of alcohol or drugs. Others avoid or detach from situations that may bring about unpleasant emotions.
Those strategies may provide short-term relief, but they rarely support long-term mental wellness. Instead, it’s worth exploring skills that help you regulate emotions more effectively.
Emotion regulation has proven especially helpful for people living with bipolar disorder, who often have a sense that their emotions are out of control. Rather than trying to simply not feel an emotion, the goal is to reduce the negative impact of feeling it too intensely, in the wrong context or situation, or in a prolonged or distressing way.
Let’s be clear: You’re allowed to feel any emotion you feel. The goal is not to get rid of an emotion or smother it, but to gain more control over how it affects you.
What Can Help Me Handle Overly Intense Emotions?
Here are two techniques taught in dialectical behavior therapy (DBT), an evidence-based treatment that can support emotion regulation for people living with bipolar disorder.
Technique 1. Opposite Action
Intense emotions often activate an urge to act in ways that are not always in your best interest. Opposite action skills can help you resist biologically triggered impulses that would only make the situation worse.
For example, anger may make you want to shove or hit someone who is pushing your buttons. Instead, do the opposite: show kindness, offer a hug, or walk away. Fear may create an urge to run or avoid. Instead, do the opposite: move toward what matters, stay engaged, and build courage in small steps.
Technique 2. Mindfulness Practices
Learning to be more aware of distressing emotions helps lessen their intensity and helps you respond with more choice.Â
One way to do this is to imagine the emotion as a wave. Picture it rising and building, coming to a peak, and then receding, just like a wave on the shore. Acknowledge emotions as they come, remind yourself it’s okay to feel them, and recognize that they will ebb just as waves do.
Can I Reduce My Vulnerability in the First Place?
Think of the acronym ABC — courtesy of psychologist Marsha M. Linehan, PhD, who developed DBT:
A: Accumulate Pleasant Emotions
Each day, try to engage in at least one pleasurable activity — even if you’re feeling unpleasant emotions or are experiencing a depressed mood. Often, once you start an activity you usually enjoy, some pleasurable emotions may creep through. If not, remind yourself that the more you manage to do, the better you will feel in the long run.
It can also be helpful to write a list of pleasurable things that have improved your mood in the past, especially things you can do immediately or in the short term. For example: watch your favorite movie, spend time with someone you care about, sit in the sunshine, play with your pet, or go for a walk.
B: Build Mastery
Decide on a goal-directed activity and practice it until you feel competent. This is less about what you do and more about the feeling you get when you do it. What makes you feel accomplished? Sometimes, that might be as basic as taking your medications on time or washing the dishes. Other times, it might be a larger goal, such as learning a language or making plans with an acquaintance to strengthen your friendship.
C: Coping Ahead
This means practicing emotion regulation techniques such as opposite action and mindfulness until you feel confident you can deploy them when needed in the future.
As with anything new, you can’t try a technique once and decide whether or not it works. Practice in many different settings and scenarios. When gripped by intense emotion, the ability to problem-solve and recall skills is usually diminished. Frequent practice at other times makes it easier to access and implement skills during emotional dysregulation.
Where to Learn More DBT Skills
If you’d like more options for emotion regulation, consider working with a therapist who is trained in DBT. If that isn’t practical, written resources can be a strong starting point. I often recommend The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder, by Sheri Van Dijk.
UPDATED: Originally posted January 2023
