Emotional instability: what are the main signs in adults?

Written by: Dr Sylvia Tang
Published:
Edited by: Laura Burgess

If you live with emotionally unstable personality disorder (EUPD) your mood swings can be intense as your emotions fluctuate. You could go from euphoric happiness to crushing feelings of sadness all within the same day and it can be exhausting. We spoke to one of our expert psychiatrists Dr Sylvia Tang about the personality disorder and the signs to pay attention to if you think either you or your loved one may have the condition.

What is emotional instability?

Emotional instability presents with a changeable mood. You could be feeling happy and energetic one minute, but then small things like a comment made by someone or something not going as planned can result in a sudden, and sometimes quite catastrophic, drop in mood. Everything can suddenly feel pointless.

This can be associated with thoughts of suicide, a hollow crashing feeling that everything is awful and hopeless. This can present with tearfulness, demonstrations of anger, agitation, throwing, things, self-harm, screaming and suicidal thoughts and sometimes actions.
 

What are some causes of emotional instability?

These sorts of extreme feelings are common in teenagers and normally one has developed better coping strategies and abilities to regulate one’s emotions by the time one reaches one’s twenties. However, this development can be interrupted by life events, like illness, trauma, loss, abuse.

When persistent, this is known as an emotionally unstable personality disorder, which will have repeated episodes as above. Sometimes, however, this can be precipitated in someone who has apparently been coping well with things and a life event or an episode of depression or severe anxiety can manifest itself with these symptoms.
 

What are the main signs in adults?

The feelings above can also be associated with low mood, anxiety attacks, flashbacks, poor sleep, loss of appetite and weight loss.
 

When should someone see a specialist?

It is important to seek help if the feelings are overwhelming and result in repeated self-harm, suicidal thoughts and acts, or if it is accompanied by other things such as a very low mood. If you experience overwhelming anxiety, hopelessness, very poor eating and weight loss, you are not sleeping, have poor self-care, and struggle to work or function on a day to day basis, then you should seek help.
 

Does this always need to be treated by a specialist?

It is helpful for a diagnosis and medication can be used to treat low mood and anxiety. Some medications can also help to regulate mood changes in some instances.
 

What type of treatments can you offer?

Diagnosis, medication, coping strategies and referral of therapies that can help. These can range from dialectical behaviour therapy (DBT), metallisation therapy (MBT), cognitive behavioural therapy (CBT) or trauma therapy depending on what is appropriate.


Dr Tang specialises in treating depression, anxiety, emotional control and eating disorders. If you would like to work with her, you can make an appointment via her Top Doctor’s profile here.

By Dr Sylvia Tang
Psychiatry

Dr Sylvia Tang is a highly-trained consultant adult psychiatrist based in London with over 29 years of experience treating patients with a wide range of mental health symptoms. Her areas of expertise include depression, anxiety, emotional instability, eating disorders, OCD and PTSD.

Dr Tang graduated with an MBBS degree from The Royal London Medical School in 1992. She later completed her specialist training at various London hospitals, including the Royal Free Hospital, and then becoming a member of the Royal College of Psychiatrists in 1997 and finally, a fellow of the Royal College of Psychiatrists. Her first consultant post was in 2001 at Camden and Islington NHS Foundation Trust. Whilst practising here, she also became the Medical Director in 2006 and then the Deputy Chief Executive in 2012.

Dr Tang joined the Priory Group in 2014 as the Group Medical Director. She later became the Chief Executive of Priory Healthcare in 2016 until she left in 2019. During both periods, she was also part of several committees which included the NHS England London Clinical Senate Council, where she was one of the 11 clinical experts reviewing evidence for service reconfiguration in London, the NHSE National Mental Health Payment Steering Group and London Mental Health Strategic Clinical Network.

In regards to her approach to treatment, she believes in working closely with her patients to deliver an individualised care plan that they believe in. She has always received exceptional feedback from her patients and has even been thanked by many individuals and their families for saving their lives. She works particularly with people when they are at their most desperate to ensure they get the right care and support that they need.

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