Emotional regulation is the ability to manage and respond to emotional experiences in a healthy way. For adults with extreme mental health conditions such as Borderline Personality Disorder (BPD), Post-Traumatic Stress Disorder (PTSD), Bipolar Disorder, Schizophrenia, and Severe Anxiety or Depression, emotional regulation can be a significant challenge. Without proper support, difficulties in regulating emotions can impact daily functioning, relationships, work performance, and overall quality of life.
Occupational Therapy (OT) plays a vital role in helping adults develop emotional regulation skills by using individualized, evidence-based strategies. OTs help clients identify triggers, practice coping mechanisms, and engage in meaningful activities that foster emotional stability. This blog explores how occupational therapy can support emotional regulation in adults with extreme mental health conditions and promote a balanced, fulfilling life.
Table of Contents
Understanding Emotional Dysregulation in Extreme Mental Health Conditions
Emotional dysregulation refers to difficulties in managing emotions effectively, often leading to impulsive behaviours, intense mood swings, and difficulty coping with stress. Here’s how it manifests in different mental health conditions:
Borderline Personality Disorder (BPD)
- Individuals experience intense emotional shifts, fear of abandonment, and difficulty maintaining stable relationships.
- Emotional dysregulation can lead to impulsive behaviours, such as self-harm, substance abuse, or suicidal thoughts.
Post-Traumatic Stress Disorder (PTSD)
- Strong emotional responses triggered by trauma reminders, including panic attacks, dissociation, and emotional numbness.
- Flashbacks or intrusive thoughts can lead to difficulty in managing day-to-day responsibilities.
Bipolar Disorder
- Extreme mood swings between mania (high energy, impulsivity) and depression (low motivation, sadness, withdrawal).
- Emotional dysregulation makes it challenging to maintain employment, relationships, and personal well-being.
Schizophrenia
- Emotional blunting (reduced emotional expression) or intense emotional reactions that don’t match the situation.
- Difficulty distinguishing reality from delusions, leading to emotional instability.
Severe Anxiety & Depression
- Anxiety disorders cause excessive worry, restlessness, and difficulty controlling fear responses.
- Depression leads to emotional numbness, sadness, and lack of motivation to engage in daily activities.
How Occupational Therapy Helps with Emotional Regulation
Occupational Therapists use holistic, person-centred approaches to help adults develop the skills needed to regulate emotions and improve daily functioning. Below are some key ways OTs support emotional regulation:
Identifying Emotional Triggers
- OTs help individuals recognize specific triggers that lead to emotional distress.
- This is done through mindfulness techniques, journaling, and structured self-reflection exercises.
- Example: A person with PTSD may identify loud noises as a trigger for panic attacks. The OT will then work on coping strategies to reduce distress when exposed to sudden sounds.
Developing Coping Strategies
- Breathing Techniques: Deep breathing exercises like 4-7-8 breathing (inhale for 4 seconds, hold for 7, exhale for 8) help manage panic attacks.
- Progressive Muscle Relaxation (PMR): Reduces physical tension related to emotional stress.
- Cognitive Behavioral Strategies: OTs teach positive self-talk and reframing negative thoughts to change emotional responses.
- Grounding Techniques: Using the 5-4-3-2-1 method (naming five things you see, four you can touch, etc.) helps bring a person back to the present moment.
Sensory Modulation Techniques
- Many individuals with mental health conditions struggle with sensory overload or under-responsiveness.
- OTs use sensory integration techniques, such as:
- Weighted blankets for calming effects.
- Fidget tools to reduce anxiety-driven restlessness.
- Aromatherapy with lavender or peppermint to regulate emotions.
- Sensory diets are personalized activity plans that help maintain emotional balance.
Establishing Healthy Routines
- OTs help create structured daily routines that promote emotional stability, including:
- Morning routines: Reducing stress by planning the day in advance.
- Meal planning: Encouraging proper nutrition, which impacts emotional health.
- Exercise schedules: Engaging in movement-based activities like yoga, swimming, or walking, which naturally regulate emotions.
- OTs help create structured daily routines that promote emotional stability, including:
Engaging in Meaningful Activities
- Participation in hobbies and productive tasks helps improve mood and provides a sense of purpose.
- OTs encourage engagement in:
- Creative outlets like painting, journaling, or playing music.
- Community involvement, such as volunteering or social groups.
- Mindfulness activities like gardening or tai chi.
Social Skills Training & Communication Strategies
- Many individuals with extreme mental health conditions struggle with maintaining relationships due to emotional dysregulation.
- OTs use role-playing exercises and group therapy to teach:
- Assertiveness and boundary-setting.
- Conflict resolution skills.
- Non-verbal communication awareness (body language, tone of voice).
Sleep Hygiene & Relaxation Strategies
- Sleep is crucial for emotional regulation. OTs help clients develop bedtime routines that promote restful sleep, such as:
- Limiting screen time before bed.
- Practicing deep breathing or meditation before sleeping.
- Using white noise or weighted blankets to improve sleep quality.
- Sleep is crucial for emotional regulation. OTs help clients develop bedtime routines that promote restful sleep, such as:
Vocational & Workplace Support
- Emotional regulation difficulties can impact job performance and workplace interactions.
- OTs assist with:
- Workplace accommodations (e.g., flexible schedules, quiet spaces).
- Job coaching to improve stress management and communication skills.
- Time management strategies to increase productivity without emotional burnout.
Psychoeducation for Clients & Families
- Many individuals benefit from learning about their condition and emotional responses.
- OTs provide education on:
- How emotions influence behaviors.
- Recognizing early signs of emotional dysregulation.
- Strategies for self-advocacy and asking for support when needed.
- Family education helps improve understanding and reduce stigma, enabling loved ones to offer better support.
Case Study: Occupational Therapy in Action
Client Profile: Sarah, 28, diagnosed with BPD & PTSD.
Challenges:
- Intense emotional reactions to stress.
- Self-harm tendencies when overwhelmed.
- Difficulty maintaining relationships and employment.
OT Intervention Plan:
✅ Identifying Triggers: Journaling to track emotional responses.
✅ Coping Skills: Practicing deep breathing and grounding techniques.
✅ Sensory Modulation: Using a weighted blanket and fidget tools.
✅ Social Skills Training: Learning assertive communication in therapy sessions.
✅ Routine Development: Structuring her day with scheduled self-care and mindfulness activities.
Outcome:
- Sarah reported fewer emotional breakdowns and improved her self-awareness.
- She maintained employment for the first time in two years.
Family relationships improved due to better communication strategies
Summary
For adults living with extreme mental health conditions, emotional regulation can be one of the most challenging yet crucial aspects of daily life. Occupational Therapy provides a holistic, individualised approach to help clients build essential emotional regulation skills.
Through coping strategies, sensory modulation, structured routines, meaningful activities, and social training, OTs empower individuals to navigate life with greater stability and resilience.
By addressing emotional dysregulation in a supportive, therapeutic environment, Occupational Therapy helps adults gain confidence, build independence, and lead fulfilling lives despite their mental health challenges.
Next Steps: If you or someone you know is struggling with emotional regulation, it can be beneficial to reach out and consult with one of our Occupational Therapists for a formal evaluation and intervention support.
Transform Life is a NDIS registered organisation that provide support for you and your family.
Book your consult with an experienced Therapist at Transform Life to explore how Occupational Therapy , Positive Behavioural Support and Speech Therapy can support you and your family.
