Editing Borderline personality disorder (section)

===Mood and affect===
{{Further|Emotional dysregulation}}
Individuals with BPD exhibit emotional dysregulation.<!-- This is actually a Transclusion of the first paragraph of the lede of [[Emotional dysregulation]] --> Emotional dysregulation is characterized by an inability to flexibly respond to and manage [[emotional state]]s, resulting in intense and prolonged emotional reactions that deviate from [[social norms]], given the nature of the environmental stimuli encountered. Such reactions not only deviate from accepted social norms but also surpass what is informally deemed appropriate or proportional to the encountered stimuli.<ref>{{Cite book|last1=Austin|first1=Marie-Paule|title=Mental Health Care in the Perinatal Period|last2=Highet|first2=Nicole|last3=Expert Working Group|publisher=Centre of Perinatal Excellence|year=2017|location=Melbourne}}</ref><ref>{{harvnb|Linehan|1993|page=43}}</ref><ref name="Manning_364">{{harvnb|Manning|2011|page=36}}</ref><ref name="CE">{{Cite journal|last1=Carpenter|first1=Ryan W.|last2=Trull|first2=Timothy J.|date=January 2013|title=Components of Emotion Dysregulation in Borderline Personality Disorder: A Review|journal=Current Psychiatry Reports|volume=15|issue=1|page=335|doi=10.1007/s11920-012-0335-2|pmid=23250816|pmc=3973423|issn=1523-3812}}</ref>

A core characteristic of BPD is ''affective instability'', which manifests as rapid and frequent shifts in [[Mood (psychology)|mood]] of high [[Affect (psychology)|affect]] intensity and rapid onset of [[emotion]]s, triggered by environmental stimuli. The return to a stable emotional state is notably delayed, exacerbating the challenge of achieving emotional equilibrium. This instability is further intensified by an acute sensitivity to [[Social cue|psychosocial cues]], leading to significant challenges in managing emotions effectively.<ref>{{cite book|title=Abnormal Psychology|vauthors=Hooley J, Butcher JM, Nock MK|date=2017|publisher=[[Pearson Education]]|isbn=978-0-13-385205-9|edition=17th|location=London, England|page=359}}</ref><ref name="Linehan_45">{{harvnb|Linehan|1993|page=45}}</ref><ref>{{Cite journal|last1=Dick|first1=Alexandra M.|last2=Suvak|first2=Michael K.|date=July 2018|title=Borderline personality disorder affective instability: What you know impacts how you feel.|journal=Personality Disorders: Theory, Research, and Treatment|volume=9|issue=4|pages=369–378|doi=10.1037/per0000280|issn=1949-2723|pmc=6033624|pmid=29461071}}</ref>

As the first component of emotional dysregulation, individuals with BPD are shown to have increased [[emotional sensitivity]], especially towards negative mood states such as fear, anger, sadness, rejection, criticism, isolation, and perceived failure.<ref name="CE" /><ref>{{cite journal|vauthors=Stiglmayr CE, Grathwol T, Linehan MM, Ihorst G, Fahrenberg J, Bohus M|date=May 2005|title=Aversive tension in patients with borderline personality disorder: a computer-based controlled field study|journal=Acta Psychiatrica Scandinavica|volume=111|issue=5|pages=372–9|doi=10.1111/j.1600-0447.2004.00466.x|pmid=15819731|s2cid=30951552}}</ref> This increased sensitivity results in an intensified response to environmental cues, including the emotions of others.<ref name="CE" /> Studies have identified a [[negativity bias]] in those with BPD, showing a predisposition towards recognizing and reacting more strongly to negative emotions in others, along with an [[attentional bias]] towards processing negatively-[[Valence (psychology)|valenced]] stimuli.<ref name="CE" /> Without effective [[coping mechanisms]], individuals might resort to self-harm, or suicidal behaviors to manage or escape from these intense negative emotions.<ref name = reasons_NSSI /><ref name="CE" /> While conscious of the exaggerated nature of their emotional responses, individuals with BPD face challenges in regulating these emotions. To mitigate further distress, there may be an unconscious suppression of emotional awareness, which paradoxically hinders the recognition of situations requiring intervention.<ref name=Linehan_45 />

A second component of emotional dysregulation in BPD is high levels of [[negative affectivity]], stemming directly from the individual's emotional sensitivity to negative emotions.<ref name="EP" /> This negative affectivity causes emotional reactions that diverge from [[Social norm|socially accepted norms]], in ways that are disproportionate to the environmental stimuli presented.<ref name="CE" /> Those with BPD find it difficult to tolerate the distress that is encountered in daily life, and they are prone to engage in maladaptive strategies to try to reduce the distress experienced. Maladaptive coping strategies include [[Rumination (psychology)|rumination]], [[thought suppression]], [[experiential avoidance]], [[emotional isolation]], as well as impulsive and self-injurious behaviours.<ref name="CE" />

American psychologist [[Marsha Linehan]] highlights that while the sensitivity, intensity, and duration of emotional experiences in individuals with BPD can have positive outcomes, such as exceptional enthusiasm, idealism, and capacity for joy and love, it also predisposes them to be overwhelmed by negative emotions.<ref name="Linehan_45" /><ref name="Linehan_44">{{harvnb|Linehan|1993|page=44}}</ref> This includes experiencing profound [[grief]] instead of mere sadness, intense shame instead of mild embarrassment, rage rather than annoyance, and panic over nervousness.<ref name="Linehan_44" /> Research indicates that individuals with BPD endure chronic and substantial emotional suffering.<ref name="DSM-5 Task Force_2013" />

Emotional dysregulation is a significant feature of BPD, yet Fitzpatrick et al. (2022) suggest that such dysregulation may also be observed in other disorders, like [[generalized anxiety disorder]] (GAD). Nonetheless, their findings imply that individuals with BPD particularly struggle with disengaging from negative emotions and achieving emotional equilibrium.<ref>{{cite journal|vauthors=Fitzpatrick S, Varma S, Kuo JR|date=September 2022|title=Is borderline personality disorder really an emotion dysregulation disorder and, if so, how? A comprehensive experimental paradigm|journal=Psychological Medicine|volume=52|issue=12|pages=2319–2331|doi=10.1017/S0033291720004225|pmid=33198829|s2cid=226988308}}</ref>

[[Euphoria]], or transient intense joy, can occur in those with BPD, but they are more commonly afflicted by [[dysphoria]] (a profound state of unease or dissatisfaction), depression, and pervasive distress. Zanarini et al. identified four types of dysphoria characteristic of BPD: intense emotional states, destructiveness or self-destructiveness, feelings of fragmentation or identity loss, and perceptions of [[victimization]].<ref name="dysphoria">{{cite journal|vauthors=Zanarini MC, Frankenburg FR, DeLuca CJ, Hennen J, Khera GS, Gunderson JG|year=1998|title=The pain of being borderline: dysphoric states specific to borderline personality disorder|journal=Harvard Review of Psychiatry|volume=6|issue=4|pages=201–7|doi=10.3109/10673229809000330|pmid=10370445|s2cid=10093822}}</ref> A diagnosis of BPD is closely linked with experiencing feelings of betrayal, lack of control, and self-harm.<ref name="dysphoria" />

Moreover, [[emotional lability]], indicating variability or fluctuations in emotional states, is frequent among those with BPD. Although emotional lability may imply rapid alternations between depression and elation, [[mood swing]]s in BPD are more commonly between anger and anxiety or depression and anxiety.<ref>{{cite journal|vauthors=Koenigsberg HW, Harvey PD, Mitropoulou V, Schmeidler J, New AS, Goodman M, Silverman JM, Serby M, Schopick F, Siever LJ|date=May 2002|title=Characterizing affective instability in borderline personality disorder|journal=The American Journal of Psychiatry|volume=159|issue=5|pages=784–8|doi=10.1176/appi.ajp.159.5.784|pmid=11986132}}</ref>