Emotion Lability: Navigating the Rollercoaster of Emotions

Emotions connect us to our surrounding environments of others. They create a window into our souls. However, some conditions disrupt normal healthy communication provided through emotions. Emotions instead of providing a predictable resource for understanding ourselves and others become volatile, rapidly shifting between emotional states, inappropriately matched with the circumstances. In psychology, this is referred to as emotion lability.

In psychology, rapidly shifting, exaggerated states of emotion, mismatching the context of the situation is referred to as emotional lability. The word lability comes from the Latin word labilis which means “transient, fleeting, or slippery.” Emotional lability in psychology is used to describe a condition of constantly fluctuating emotions. Several brain conditions and psychiatric disorders often incur emotional disturbances of transient emotions that dramatically and unpredictably shift.

A person with high emotional lability may express warm sentimental companionship one moment and the next quickly fly into a frightening rage. The unpredictable emotional shifts disrupts security. Those close to a person suffering from an ailment that induces emotional lability constantly walks on eggshells uncertain to when the next explosive fit of aggression will erupt.

​Two Types of Emotion Lability

There are two lines of research of emotional lability. They share similar symptoms of volatile, shifting emotions; but are unique in cause and expression.

Pseudobulbar Affect

Pseudobulbar affect is a psychological condition that may occur from diseases or physical trauma that damages the brain. It is also known as “pathological laughing or crying, emotionalism, emotional incontinence, and a host of other descriptors” (Ghaffar et al., 2008).

We define pseudobulbar as involuntary crying, laughing, or both that are not congruent with mood or circumstances. “The presence of tears without sadness and laughter without mirth” is the common characteristics of pseudobulbar affect. Significantly, pseudobulbar affect is found in “diverse neurological conditions, including multiple sclerosis (MS), amyotrophic lateral sclerosis, stroke, traumatic brain injury, Alzheimer’s disease, and cerebral tumors” (Ghaffar et al., 2008).

An early theory of the cause to these involuntary displays of emotion was attributed to damage to the bulbar nuclei in the brain, interfering with top down cortical control that keeps mood and affect congruent (Ghaffar et al., 2008). With enhanced technology, brain examinations were unable to locate any structural or functional brain imaging that clearly identify a specific region for the disfunction.

Jeffrey Cummings identified the following criteria for diagnosing pseudobulbar affect:

• Episodes of emotional expression representing a change from a person’s usual emotional reactivity.
• Emotional reactivity is inconsistent with the person’s mood or the corresponding mood state.
• The emotional response is more than any provoking stimulus.
• Repetitive episodic emotional disturbances cause significant distress or social or occupational impairment.
• Sudden emotional occurrences of expression are not accounted for by another psychiatric or neurological disorder.
• The symptoms are not a result of the direct effect of a drug or medication use (Kazi & Anwar, 2022).

Mood and Psychiatric Disorders

Many mood and psychiatric disorders also include an element of emotional lability. While the pseudobulbar affect may unpredictably laugh and cry incongruent with mood and situation, the mood and psychiatric disorders the emotional valence is in congruence but the state of arousal is not, with outbursts far exceeding the appropriate reaction for the situation.

Kazi and Anwar explain that, “The difference between mood disorders and PBA (pseudobulbar affect) is the duration. Depression symptoms, including depressed mood, typically lasts weeks to months and years, while PBA episodes last seconds to minutes.” They add “Crying, as a symptom of PBA, may be unrelated to mood, while crying is consistent with emotional state in depression” (Kazi & Anwar, 2022).

Inappropriate expressions of emotion that are context appropriate (frustrated at a perceived frustrating event) but arousal inappropriate (throwing furniture because dinner is ten minutes late) may be caused by a combination of heightened sensitivity (emotional reactivity) and weakened executive controls (emotional regulatory skills). Overall, “emotional lability…can be thought of as an individual’s reactivity, while emotional regulation can be thought of as management of said emotional reaction” (Oattes et al., 2018).

​Emotion Lability Symptoms

The main symptom of emotional lability is uncontrollable outbursts, typically of laughing or crying. These outbursts are often exaggerated and inappropriate to the circumstances. We divide Emotional lability symptoms into three categories:

Extreme and Sudden Shifts of Emotions

Emotional lability is easily identified by the rapid and dramatic shifts of emotional states. In mathematical terms, people suffering from emotional lability have a greater standard deviation from a balanced emotional state (homeostatic balance). They deviate further and more often from a balanced emotional state. They experience extreme highs and lows, and frequently shift from one emotional state to another, within short intervals of time. Emotionally labile people may shift through several extreme emotional states within a single day. Sometimes an external event may ignite a shift or sometimes, there may be no apparent reason for the dramatic emotional change.

My friend suffers from a psychological disorder with emotional lability. She is constantly thrown by life’s small challenges. One morning she was bouncing with excitement over a promotion (legitimate positive arousal). An hour later, she was in a tirade over part of her lunch being eaten from the company refrigerator (legitimate frustration).

However, her shift from one emotion (a large positive) to the next (a small negative) in a short period of time, completely abandoning the greater overall benefit of a promotion and raise in salary to the lousy loss of a bag of chips and a small sense of violation exhibits a lack of synchrony with the overall balance of life experiences.

Inappropriate Emotions

We cry at funerals and laugh at comedies. Culture generally sets emotional norms for emotional expression. When a disease, brain injury, or other condition intrudes, creating emotional lability, the individual loses appropriateness in emotional expressions. The individual may burst into uncontrollable fits of laughter at a funeral, or cry during a hilarious skit on Saturday Night Live.

It appears that the body experiences emotion but doesn’t know how to correctly translate the emotion to fit the situation. Zamfira Parincu remarks: “These behaviors can be confusing or embarrassing” (Parincu, 2022).

Difficulty with Regulating Emotions

Experience of emotion and regulating of emotion go hand in hand. We often experience emotion and then invoke cognitive executive functions to appropriately regulate expressions to fit the situation.

​People who experience emotional lability have limited or no control over the intensity of their feelings. As a result, the emotional reactivity reigns, dominating any self-control of expression. Explicitly, Arlin Cuncic emphasizes that, “They can’t ‘snap out’ of negative moods quickly even when they want to which can make it harder to maintain friendships and relationships” (Cuncic, 2021).

​Other Common Names Used to Describe Emotion Lability

Throughout research literature emotional lability has been referred to by a variety of other names:

• emotion dysregulation
• deficient emotional self-regulation
• severe mood dysregulation
• mood instability
• disruptive mood dysregulation

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Markedly “all these terms have in common descriptions of inappropriate levels of low frustration tolerance, negative mood, chronic irritability, and temper outbursts” (Overgaard et al., 2018).

​What Causes Emotion Lability?

Emotional lability may be a reaction to a medication, neurological disorder, or a psychological disorder.

Medication and Addiction

Scientist often design medications to intervene in neuronal communications. Occasionally, the medication includes an unwanted side affects, causing emotional lability. Emotional lability is occasionally a side affect of some antidepressants (SSRIs), or a reaction to discontinuing a medication or chemical substance (The Brown University Psychopharmacology Update, 2012).

In addition, consumption of substances such as alcohol, marijuana, ecstasy, and PCP may lead to emotional lability. Chemical substances, prescribed or not, may lead to side affects resembling the pseudobulbar affect, psychiatric disorders, or both.

There is also the possibility that the medication, or cessation of medication, creates a heightened demand on cognitive functions, leaving less energy for normal regulation of emotion. We refer to this in psychology as ego depletion. Have you ever upset a person who is two days into a nicotine detox?

Neurological Disorders

Neuroglial disorders often cause emotional lability—the pseudobulbar affect.

Diseases:

• Alzheimer’s disease
• dementia
• multiple sclerosis (MS)
• ALS (Lou Gehrig’s disease)
• Parkinson’s Disease

Brain Injury (TBI):

• blunt force head trauma
• skull fracture
• coup-contrecoup injury
• contusion
• hematoma
• laceration
• penetrating injury
• infection
• brain swelling
• oxygen deprivation (Parincu, 2022).

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Brain diseases or injuries can impact affect arousal, the ability to regulate, or both.

Psychological Disorders

Psychological literature and research ties emotional lability to several psychological disorders. DSM-5 defines emotional lability as “unstable emotional experiences and frequent mood changes; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.”

​Disorders that List Emotion Lability as a Symptom

In the DSM-5, APA listed emotional lability as a symptom in several disorders:

• Borderline personality disorder (BPD),
• Bipolar disorder (BP)
• Substance use disorder (SUD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Post-traumatic stress disorder (PTSD)

​Does Emotion Lability Have a Biological or Environmental Cause?

Because emotion lability is a symptom of a variety of diseases, injuries and disorders, the cause differs between cases. When emotional lability is a symptom of  the pseudobulbar affect, most likely the lability has stronger biological causes.

When emotion lability is a symptom of a psychological disorder, the cause may be biology, environment, or both. The diathesis stress model, which theorizes that, “Disorders develop as a result of interactions between pre-dispositional vulnerabilities (the diathesis), and stress caused by life experiences” (Murphy, 2021) may also be involved in developing disorders that include emotional lability as a symptoms. Accordingly, we may treat problematic emotional lability in a number of ways by addressing both behavioral and biological correlates.

Reciprocal Determinism

Another applicable theory is Albert Bandura’s reciprocal determination that theorizes an interactive relationship between behavior and environmental responses. “Bandura’s model is more representative of the dynamic impact of the different forces involved in behavior” (Murphy, 2021a).

​For example, a young child, perhaps diagnosed with ADHD, and is extremely emotional lability, regularly throwing tantrums in anger. Subsequently, the child’s behaviors impact his parents and caregivers response to the child, contributing to the development of the child.

Research confirms this interactive relationship with children exhibiting volatile emotional lability. “Children’s intense negative emotions and concordant behavioral outbursts increase parental demands, which exacerbate global parenting stress.” This heightened stress bouncing between parent and child is “associated with poor child and parent outcomes” (Walerius et al., 2016).

Treatments for Emotion Lability

Fortunately, there are treatments available that may offer some relief for those struggling with emotion lability. It is important to note that the effectiveness of these treatments can depend on the underlying cause of the lability. Therefore, seeking professional guidance is essential for a tailored approach.

Medications can be prescribed to help regulate and stabilize emotions, especially in cases where chemical imbalances are identified as contributing factors. These medications work by targeting specific neurotransmitters in the brain, which play a key role in mood regulation.

Therapies, both individual and group, can also be beneficial in managing emotion lability. Talk therapy, such as cognitive-behavioral therapy (CBT), can assist individuals in understanding and modifying thought patterns that trigger intense emotional responses. Additionally, dialectical behavior therapy (DBT) focuses on developing skills to manage intense emotions effectively. Engaging in such therapies can provide valuable tools for coping and achieving emotional stability.

In addition to traditional treatments, incorporating mindfulness practices can also contribute to mitigating the symptoms of emotional lability. Mindfulness techniques, such as meditation and deep breathing exercises, can aid in grounding oneself during moments of intense emotional upheaval. By practicing mindfulness regularly, individuals can learn to observe their emotions without judgment and respond to them in a more adaptive and composed manner. Research has shown that mindfulness practices, and other body based therapies can be effective treatments.

Associated Concepts

• Disruptive Mood Dysregulation Disorder: This is a condition diagnosed in children and adolescents characterized by severe and recurrent temper outbursts that are out of proportion to the situation and developmentally inappropriate.
• Emotional Triggers: these are anything from our inner environment or outer environment that elicit an emotional response. A feeling, a smell, a person all can set in motion a reaction that knocks us off a planned course.
• Emotional Outbursts: These are highly emotional and explosive episodes, commonly referred to as a temper tantrum.
• Irritability: This refers to an emotional state of low-grade anger and aggressiveness typically triggered by an object or event interfering with goal attainment.
• Frustration-Aggression Hypothesis: This hypothesis posits that frustration often leads to aggressive behavior. When individuals are blocked from achieving a goal or fulfilling a need, it can generate a state of frustration, which in turn increases the likelihood of aggressive responses.
• Intermittent Explosive Disorder: This is a mental health condition characterized by recurrent, sudden outbursts of aggressive or violent behavior that are disproportionate to the situation. Individuals with IED may experience intense anger, leading to verbal arguments, physical fights, and property damage.
• Frustration Tolerance: This refers to an individual’s ability to withstand and cope with frustrating or challenging situations without becoming overwhelmed or distressed. It is the capacity to remain composed, patient, and emotionally stable in the face of obstacles, setbacks, or delays.
• Bipolar Disorder: This disorder is a mental health condition characterized by extreme shifts in mood, energy, and activity levels. These mood swings can range from depressive lows to manic highs. It can impact the ability to carry out day-to-day tasks and maintain relationships.

​​A Few Words by Psychology Fanatic

In conclusion, emotion lability can have a detrimental impact on various aspects of one’s life, such as opportunities, relationships, and even overall health. It is a condition that can disrupt the harmony of daily living and possibly hinder personal growth.

Overall, while emotional lability can indeed be disruptive, there are various strategies and treatments available to help individuals regain control over their emotional experiences. By embracing a multidimensional approach that combines medications, therapies, and mindfulness, it is possible to alleviate the challenges posed by emotion lability and foster greater well-being and resilience.

Last Update: January 28, 2026

References:

Banaschewski, T., Jennen‐Steinmetz, C., Brandeis, D., Buitelaar, J., Kuntsi, J., Poustka, L., Sergeant, J., Sonuga‐Barke, E., Frazier‐Wood, A., Albrecht, B., Chen, W., Uebel, H., Schlotz, W., van der Meere, J., Gill, M., Manor, I., Miranda, A., Mulas, F., Oades, R., Roeyers, H., Rothenberger, A., Steinhausen, H., Faraone, S., & Asherson, P. (2012). Neuropsychological correlates of emotional lability in children with ADHD. The Journal of Child Psychology and Psychiatry, 53(11). DOI: 10.1111/j.1469-7610.2012.02596.x
(Return to Main Text)

Cuncic, Arlin (2021). What is Emotional Lability. Verywellmind. Published: 9-26-2021; Accessed: 9-13-2022. Website: https://www.verywellmind.com/what-is-emotional-lability-
(Return to Main Text)

Ghaffar, O., Chamelian, L., & Feinstein, A. (2008). Neuroanatomy of pseudobulbar affect. Journal of Neurology, 255(3), 406-412. DOI: 10.1007/s00415-008-0685-1
(Return to Main Text)

Hill, C., & Updegraff, J. (2012). Mindfulness and Its Relationship to Emotional Regulation. Emotion, 12(1), 81-90. DOI: 10.1037/a0026355
(Return to Main Text)

Kazi, S., & Anwar, A. (2022). Pseudobulbar Affect Presenting as Aggressive Behavior. Cureus, 14(2). DOI: 10.7759/cureus.21978
(Return to Main Text)

Murphy, T. Franklin (2021a) Reciprocal Determinism. Psychology Fanatic. Published: 12-4-2021; Accessed: 9-15-2022. Website: https://psychologyfanatic.com/reciprocal-determinism/
(Return to Main Text)

Oattes, N., Kosmerly, S., & Rogers, M. (2018). Parent Emotional Well-being and Emotion Lability in Young Children. Journal of Child and Family Studies, 27(11), 3658-3671. DOI: 10.1007/s10826-018-1188-z
(Return to Main Text)

​Overgaard, K., Oerbeck, B., Aase, H., Torgersen, S., Reichborn-Kjennerud, T., & Zeiner, P. (2018). Emotional Lability in Preschoolers With Symptoms of ADHD. Journal of Attention Disorders, 22(8), 787-795.​ DOI: 10.1177/1087054715576342
(Return to Main Text)

Parincu, Zamfira  (2022). Emotional Lability: Definition, Symptoms, & Causes. Berkley Well-Being Institute. Accessed: 9-13-2022. Website: https://www.berkeleywellbeing.com/emotional-lability.html
(Return to Main Text)

Schoenleber, M., Berghoff, C., Tull, M., DiLillo, D., Messman-Moore, T., & Gratz, K. (2016). Emotional Lability and Affective Synchrony in Borderline Personality Disorder. Personality Disorders: Theory, Research, and Treatment, 7(3), 211-220. DOI: 10.1037/per0000145
(Return to Main Text)

Walerius, D., Fogleman, N., & Rosen, P. (2016). The Role of ADHD and Negative Emotional Lability in Predicting Changes in Parenting Daily Hassles. Journal of Child and Family Studies, 25(7), 2279-2291. DOI: 10.1007/s10826-016-0381-1
(Return to Main Text)

(2012). Your medication information. The Brown University Psychopharmacology Update, 23(S4), I-II. DOI: 10.1002/pu.20162
(Return to Main Text)

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