What is Emotional Intensity?
You are being offered an intervention for Emotional Intensity because you have identified you experience several of the following problems that are disrupting your life.
- Difficulty being aware of your own emotions, thoughts and urges in the moment - this might mean that you might not be aware of what is upsetting you before reacting and you might experience waves of emotions and be unsure how you go there so quickly or intensely.
- Difficulty staying focused and fully participating in the moment - you might find yourself worrying about the past and the future a lot.
- Not knowing what your goals are - you might feel unsure about who you are, what your values are and what's important to you.
- Emotional dysregulation - fast intense mood changes with little control - you might feel fine one minute and then experience a wave of anxiety, followed by shame, then move into anger very quickly or you might experience a steady negative emotional state.
- Impulsivity - you might act on urges without thinking of the consequences at the time, especially in times when emotions are heightened.
- Difficulties in your relationships with others - you might struggle to maintain friendships, have frequent fall-outs with others and experience intense shifts in how you feel about people (one day they are amazing, another day you feel betrayed and angry and want to leave the relationship).
For some young people emotional dysregulation can lead to self-harm or suicidal thinking. You may experience thoughts about wanting to harm yourself or end your life, particularly when you are feeling overwhelmed or experiencing an emotion you find uncomfortable. Suicidal thoughts and feelings can occur suddenly and without much warning or they can build up over time. You might it hard to talk about this but seeking help from someone you trust or reaching out to mental health services could support you and prevent you from reaching 'crisis' point.
Why am I struggling with emotional dysregulation?
Emotional dysregulation is entirely normal, especially in adolescence, from time to time however when it starts really disrupting your life, you may need additional support.
There are a number of biological reasons why you might be more vulnerable to emotional dysregulation:
- Natural brain development - the teenage brain is still developing, especially the parts responsible for emotion regulation.
- Hormonal changes - hormonal fluctuations can make people more vulnerable to changes in their emotions.
- Biological vulnerability/difference in emotion experience and processing - some people are more sensitive to emotions, they may experience them quicker and more strongly than others, and it can take longer for the emotion to become manageable.
- Trauma - past experiences of trauma or neglect can impact the way the brain experiences and manages emotions.
- Neurodivergence - there are differences in the way people with ASC and/or ADHD take in and process information which can impact on emotional regulation.
When someone struggles with emotional dysregulation, the person and those around them can start to interact with each other in ways that keep the problems "stuck". This can happen for many reasons - there is no blame around this - the important thing is that learning emotion regulation and validation skills have been found to be helpful in improving emotional dysregulation.
What is self-harm?
Self-harm involves the act of doing something to cause harm or omitting to do something which in turn may cause harm (such as not taking prescribed medications).
There are many forms of self-harm.
There are many reasons why you may engage in self-harm and each individual episode of self-harm may have a different trigger or reason. The most important thing to know about self-harm is that it is purposeful and meaningful; it serves a need or function.
Self-harm can be a very secretive behaviour as it is often associated with feelings such as guilt and shame which can make it hard for you to share how you are feeling and what you are doing.
West Sussex Mind - What to do if you feel like self harming: a guide for young people
A video explaining reasons why some young people self harm and ways to cope when you feel like self harming. This video is 7 minutes 19 seconds.
Here are some signs to look out for:
- Unexplained cuts, bruises or burns on the body. These marks could be anywhere on a child or young person's body.
- Unexplained blood stains on tissues, sheets or clothing
- Keeping themselves fully covered at all times, even in hot weather
- Self-loathing and low self-esteem; blaming themselves, thinking they’re not good enough or expressing a wish to punish themselves; making statements of worthlessness or hopelessness
- Becoming very withdrawn and not speaking to others
- Unusual weight loss or weight gain, or changes in eating habits. A young person may try to hide this by wearing loose clothing or being secretive about eating
- Evidence of vomiting in toilets, wash basins, showers or baths (drains may become blocked)
West Sussex Mind - Self Harm: support for parents and carers
A video explaining how parents and carers can support their child or young person who is self harming. This video is 7 minutes 18 seconds.
Suicide
Suicide is the act of intentionally and purposefully ending one’s life.
You may experience thoughts about wanting to harm yourself or end your life, particularly when in crisis or experiencing a distressing life event. This can be very secretive and can be hard for you to talk about how you are feeling.
As a parent or carer, it can be difficult to know what to do. Talking to your child about their thoughts of wanting to harm themselves or end their life will not make it worse, if you are worried about suicide, it is okay to ask them directly. This can be a safety factor for young people experiencing these thoughts and feelings.
Please visit Papyrus website for more information about talking to your child about suicide
It can be difficult to notice if your child or young person is experiencing thoughts and urges or even making plans to end their life, particularly as suicidal thoughts and urges can occur suddenly, unexpectedly and impulsively, especially among children and adolescents.
Some signs to look out for but are not limited to:
- Withdrawing from friends, family, responsibilities, commitments and previously enjoyed activities
- Uncharacteristic low mood and or irritability
- Uncharacteristically reckless behaviour
- Disinterest in maintaining personal hygiene or appearance
- Poor diet changes, rapid weight changes
- Appearing distracted or agitated
- Poor sleep
- Alcohol or drug misuse
- Expressing or appearing hopeless; failing to see a future or appearing to give up or be disinterested in their hopes, dreams, goals or ambitions
- Believing they are a burden to others
- Saying they feel worthless or alone
- Talking about death or wanting to die
Crisis
Experiencing a mental health/emotional crisis means you feel unable to cope with overwhelming or upsetting thoughts and feelings.
Crisis is different for every child or young person; there may be different triggers and different ways crisis is experienced. There is no right or wrong way to think or feel when in crisis.
You may not engage in self-harm behaviour is in crisis and not everyone who engages in self-harm is suicidal.
Not everyone who experiences suicidal thoughts or urges engages in self-harm may appear to be in crisis.
Situations that might trigger or contribute towards your child or young person experiencing a mental health or emotional crisis:
- Relationship difficulties or conflict and arguments with friends, family or partners
- Bullying, teasing, harassment (verbal, physical, emotional, financial, sexual); direct or indirect
- Abuse (verbal, physical, emotional, financial, sexual, neglect); direct or indirect
- Being in or worrying about being in trouble
- Having multiple demands/having too many things to process, manage or do
- Stressful or traumatic life events which can be sudden, unexpected or expected such as accidents, injury or illness, bereavement, family breakdown or change in living circumstances
- Physical health illness or pain (to self or others)
- Change or transition (e.g. school, moving house)
- Perceived or real failure/ not meeting expectations or hopes
- Build-up of difficulties over a long time
- Extreme fatigue
- Drug and alcohol misuse
Emotional Intensity and neurodivergence
All children and young people regulate their emotions differently; this can be a particular challenge for neurodivergent children and young people.
Some neurodivergent children and young people find it difficult to name the emotions they are feeling, you may see this referred to as Alexithymia. They might find it easier to identify the physical feelings in their bodies, rather than their emotions. Please visit the National Autistic Society's webpages on self-harm and suicide for more information.
You may find it helpful to use the emotion wheels and body map to help yourself identify their emotions and body feelings.
We encourage you or your parents and carers to talk to your clinician about adjustments you may need. We will make adaptations to support you to engage with the treatment we offer.
Below are some example of adjustments you could ask for.
- Movement breaks during sessions
- Turning bright lights off
- Using visuals or writing your thoughts down
- Session plans sent before and after sessions
How can I help myself?
If you have to wait for therapy or you can't access it for any reason, or if you just want to try things to help yourself here are some things you can do to manage anxiety.
- Talk to someone you trust about how you are feeling - you could use an emotion wheel and body map to help you identify and explain your feelings.
- Moving – walking, running or doing any form of exercise - especially if it is outside, you could listen to music or a podcast at the same time.
- Breathing – taking control of/slowing down your breathing can help you feel calmer. Try taking a slow deep breath in through your nose for 5 seconds, hold this breathe for 5 seconds, then slowly breathe out through your mouth for 5 seconds. You may find the West Sussex Mind video below helpful.
- Personal Coping Plan - you might find it helpful to do this with someone you trust, there is more information on this here.
- Self-soothe box - you might it helpful to make this, there is more information on this here.
- Distraction and grounding techniques - you might like to use the 5-4-3-2-1 technique. Name 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell and 1 thing you can taste
- Relaxation and mindfulness - you can find guided relaxation and mindfulness videos on YouTube or there are some apps below.
Mind: 30 second breathing exercise
This video guides you through a short breathing exercise. The video is 31 seconds.
How can I support my child?
As a parent/carer, your job is to be the calm in the storm for your child or young person. Your job is to be regulated and show your child you can manage their emotions. We recognise this is a hard task, especially at times of stress, so the first step is to think about how you are looking after yourself.
- What can you do to increase your own ability to cope with things and what support might you need to access to do this?
- How can you increase the chances of staying calm and being able to show your child you can cope with whatever they might want to share?
West Sussex Mind - Emotional and Self Regulation (a guide to supporting children and young people)
A video explaining what emotional and self regulation is, why it matters and ways to help your child or young person. This video is 5 minutes 7 seconds.
Talking to your child, in a calm way is the next step. You want to let your child know that you are there for them, whatever comes up. Try and take a curious approach, and at the same time be accepting if your child cannot tell you why they are feeling like this, or even how they are feeling at all. Try and spend time together, doing other things, and gently create the opportunities for conversations about what is happening in their life, the worries they may have, and reassure them you are there to support them. You do not need to have the answers. Take the approach that you want to understand and support.
It can help just to spend time in each other's company without any expectations of talking or discussing the problems, so look out for opportunities to create that connection where you can. That could be as simple as watching their favourite TV show together, eating together, or doing chores together at home. This can help when your child seems to be pulling away from you or withdrawing- a low pressure way to be together.
You may be able to support your child or young person to recognise what triggers their emotional dysregulation, self-harm and suicidal thoughts and urges and what signs you and them can look out for. You may find the Personal Coping Plan helpful to support this conversation.
You might find it helpful to talk to their school or college to discuss reasonable adjustments that could be made to support them to attend school, if that is one of the problems.
You might find it helpful to involve family (including siblings) in discussions about what emotional dysregulation is and how to support your child or young person.
Modelling and demonstrating ways that you look after yourself can help set that expectation in the family. For example, saying that you are feeling very upset and you are going to talk to your partner or a friend for support, or that you need some time alone to do some thinking so are going to have a quiet bath, can be helpful in normalising the fact that we all need to tune into our emotions and do proactive things to help us. Do these things as a day to day thing, rather than just when things are very challenging.
This can also help reassure your child that you can cope with what they may share with you, as sometimes children worry that they will cause lots of problems that their parents will not be able to cope with, and that increases feelings of guilt and may exacerbate withdrawal and isolation.
West Sussex Mind - Self-soothing for children and young people
A video explaining how you can support your child or young person to self-soothe. This video is 23 minutes 45 seconds.
Support while I am waiting
We know that it can be difficult waiting for therapy to start.
There are a number of different places that can offer some support whilst you wait, and there are places that you can go to learn more about emotional intensity. Some of these support services and resources are outlined below.
Please note that none of these support services are a replacement for treatment, but they can be a good way to connect with others with common experiences and continue working towards your goals. They are also may not be able to provide urgent help.
If your life is in immediate danger, please call 999 or go to A&E.
- Text the word SUSSEX to 85258 (free NHS 24/7 mental health text-messaging support service)
- Call NHS 111 and select the mental health option (free 24/7 advice service for anyone concerned about their own, or someone else’s, mental health)
- Call Samaritans on 116 123 (free 24/7 listening service providing support and advice for anyone having thoughts of suicide). You can also email: jo@samaritans.org
- Call Hopeline247 on 0800 068 4141 (free 24/7 listening service offering support and advice for young people having thoughts of suicide). You can also email: pat@papyrus-uk.org or text: 88247
- Call Childline on 0800 1111 (free 24/7 support and advice for young people who want to talk about how they are feeling). You can also speak to a trained professional via web chat: https://
www. childline.org.uk/ get-support/ 1-2-1-counsellor-chat/
If you do not current have a lead practitioner within CAMHS and you are waiting for treatment, you can contact the CAMHS duty team if your mental health gets worse and you need some support. The duty team is not an emergency service, and you can expect to get a response within 2 to 14 working days, if you require more urgent help, you should call 111/999/attend A&E.
More information about Emotional Intensity
Below are some links to additional information about emotional intensity.
Please note: This is a collection of resources that children and young people often find helpful, and they are not authored by or owned by Sussex Partnership NHS Foundation Trust. We will attempt to keep these resources as up to date as possible, but you may find changes with the links and information given.
Websites
YoungMinds
The links below explain what self harm and suicidal thoughts are and how you can get support.
Self-harm | Advice for young people | Get help | YoungMinds
Suicidal thoughts and feelings | Help For Young People | YoungMinds
Papyrus is a UK charity working to prevent suicide in young people. You can find more information about suicide and what support you can access.
Samaritans is a charity that is working to prevent suicide. You can find more information about suicide and what support you can access.
SIFT (previously known as Self Injury Support) is a UK organisation working to support people who self harm and their family and friends. You can find more information about self harm and support you can access.
Anna Freud Supporting Children and Young People
The links below provide information on supporting children and young people who self harm. They give an overview of the self harm, signs to look out for and how to support them.
Supporting children and young people who self-harm | Anna Freud
Websites
YoungMinds
The links below explain what self harm and suicidal thoughts are and how you can get support.
Self-Harm & Mental Health | Guide For Parents | YoungMinds
Suicidal Thoughts | Suicidal Ideation Signs & Symptoms | YoungMinds
Papyrus is a UK charity working to prevent suicide in young people. You can find more information about suicide and what support your child or young person can access.
Samaritans is a charity that is working to prevent suicide. You can find more information about suicide and what support your child or young person can access.
SIFT (previously known as Self Injury Support) is a UK organisation working to support people who self harm and their family and friends. You can find more information about self harm and how to support your child or young person.
Webinars
Sussex Partnership NHS Foundation Trust - Self harm and suicidal thoughts: A parent and carer workshop
This webinar is 44 minutes, it provides more detailed information about what self harm and suicidal thoughts are and how can you help as a parent or carer.
West Sussex Mind - Support for parents and carers with children and young people that are self harming
This webinar is 44 minutes, it provides more detailed information about what self harm is, reasons for self harm, looking after yourself and how can you help as a parent or carer.
Please note some of these app may require payment or paid subscriptions to access certain features of the apps.
For distraction and coping
The Virtual Hope Box is an app that contains simple tools to help with coping, relaxation, distraction and positive thinking. The content can be personalised based on your specific needs.
Features include:
- Distract me - sudoku puzzles, photo puzzles, word searches and mahjong solitaire
- Inspire me - inspiring quotes that can be fully personalised and added to with your own
- Relax me - controlled breathing, muscle relaxation and guided meditations
- Coping tools - create your own personalised coping cards to remind you of coping strategies you find helpful
For suicide
This app is a pocket suicide prevention resource packed full of useful information and tools to help you stay safe in crisis. You can use it if you are having thoughts of suicide or if you are concerned about someone else who may be considering suicide.
Features include:
- Local support contacts
- Stay alive tools - life box, safety plan, wellness plan, breathing exercises and reasons for living
- Advice to cope with suicide thoughts
Advice for how to help someone struggling with suicide thoughts
For self-harm
Calm Harm is an app to help manage the urge to self-harm developed by a Clinical Psychologist.
Features include:
- Ride the wave - learn to surf the wave of the urge by choosing a 5-minute or 15-minute activity
- Breathe activity
- Self-monitoring - record, streaks, journal, safety net, usage and activity log
This app enables people who self-harm and may feel suicidal - and those close to them - to find useful information, self-care tips and links to support all in one place.
Features include:
- Information about self-harm
- Self-help - tips, advice and distractions
- Support - information, help and concerns
- Calm zone
- Emergency contacts
For understanding and tracking your emotions
Animi is a free app that helps you learn about your emotions, understand their causes, and manage them effectively. The app is designed to improve alexithymia, emotional awareness and emotional intelligence, and over time help you build emotional vocabulary and understand the nuances of hundreds of feelings and emotions.
This app can help you identify emotions by allowing you to delve into different categories on the feeling wheel and to find which emotion resonates the most.
Features include:
- Interactive emotion wheel
- Emotion tracker
How We Feel is a free journal for your well-being created by scientists, designers, engineers, and psychologists. Over time, you will learn precise words to describe how you feel, spot trends and patterns, and practice simple strategies to regulate your emotions in healthy ways.
For parents and carers
Combined Minds helps families and friends to find ways to provide the right environment to help the individuals they support affect their own change. This provides support to families and friends to help them understand and manage their loved one's difficulties including anxiety, depression, self-harm, eating disorders, digital addiction and safety planning.
For mindfulness and relaxation
Free mobile app with virtual “bells” to time and support your meditations, and access to lots of guided meditations by many different meditation teachers.
Chill Panda is a game-style app that incorporates breathing exercises and coping strategies to help manage anxiety in an interactive way. You can engage in the app by playing the full game mode or use the "Quick Chill" function to access skills quickly.
You may find other helpful apps on the Sussex Health and Wellbeing app library.
For younger children
Ideal for children aged 7 to 11 years old
A picture book to support children to understand 12 emotions and normalise their experiences of these. It also provides what to do when they feel an emotion.
Ideal for children aged 5 to 12 years old
A book to support which uses mindfulness techniques to understand and cope with their emotions.
Ideal for children aged 7 to 11 years old
A book to help children to understand their thoughts and feelings and develop skills to have good mental health.
For older children and teenagers
Ideal for children aged 12 years and above
This book helps young people to understand their emotions and relationships and communication they have with friends and family. It includes stories from young people who have had similar difficulties and ways to cope with these difficulties.
Ideal for children aged 13 years and above
This book uses Dialectical behaviour Therapy techniques to help young people to understand and accept their experience of emotions and develop coping skills to become in control of their emotions.
Ideal for children aged 11 years and above
This book helps young people and their parents and carers to understand what self harm is, why people self harm and how to get help.
For parents and carers
This book helps young people and their parents and carers to understand what self harm is, why people self harm and how to get help.