Labile Emotional Control Nursing Diagnosis and Nursing Care Plan

Labile Emotional Control Nursing Care Plans Diagnosis and Interventions

Labile Emotional Control NCLEX Review and Nursing Care Plans

Emotional lability is defined as abrupt, frequently dramatic fluctuations in mood characterized by intense emotional responses including uncontrollable laughter or crying, as well as excessive irritation or anger.

These extremely strong emotions are occasionally conveyed in ways that surpass an individual’s own feelings. While the general symptoms of emotional lability appear to be psychological, they are induced by alterations in the segment of the brain that regulates emotions.

A person who suffers from emotional lability may be demotivated by emotions that arise out of nowhere. It could make them cry for no apparent justification or cause them to overreact to people or events surrounding them.

Signs and Symptoms of Labile Emotional Control / Emotional Lability

The most common manifestations of emotional lability are involuntary outbursts of crying or laughing that are frequently exaggerated or unnecessarily extreme emotional responses.

These emotions can also be entirely irrelevant to a person’s thoughts and feelings. A person who is currently upset, for instance, may begin to laugh excessively.

Among the other sign and symptoms of emotional lability are:

  • brief emotional outbursts lasting no more than just a few minutes
  • conflicting emotional outbursts, like laughing followed by sobbing
  • absence of emotional symptoms between outbursts
  • chuckling or weeping in situations that others do not find amusing or sorrowful
  • emotional reactions that are extreme for the circumstance
  • emotional episodes that contrast significantly from a person’s typical behavior

Causes of Labile Emotional Control / Emotional Lability

  • Injury. An injury usually causes emotional lability to the portion of the brain that regulates emotional awareness, control over how one’s thoughts are expressed, and extreme emotional reactions. Because brain damage can lead to the loss of emotional awareness, an affected individual may be less sensitive to the feelings of others or his or her own, making it more difficult to control behavior. Blunt force head trauma, fracture of the skull, contusion, hematoma, puncture, lacerating injury, infection, brain edema, or oxygen deprivation are all forms of traumatic brain injuries (TBIs) that can induce emotional lability.
  • Stroke. Cerebrovascular accident (CVA) or stroke can also lead to emotional lability. Emotional lability is common after a stroke, with more than half of stroke survivors experiencing symptoms. Strokes induce brain cells to die within minutes, causing damage to the memory, language, and emotional parts of the brain. Although the specific origin of emotional lability after a stroke is uncertain, the most predominant concept indicates it is linked to disruption to the brainstem and frontal lobe connections.
  • Neurological conditions. In addition to strokes and traumatic brain injuries, can also cause emotional lability. Dementia, Alzheimer’s disease, multiple sclerosis (MS), and Lou Gehrig’s disease are all neurological disorders that can cause emotional lability.

Diagnosis of Labile Emotional Control / Emotional Lability

Emotional lability is frequently confused with depression or another psychiatric disorder. A person should keep a log of their symptoms, including when they appear and how long they persist, to enable receiving a diagnosis faster.

Between outbursts, the general mood and emotional experience should be observed. If there are no emotional symptoms between episodes, it is indeed a positive sign that the person is suffering from emotional lability rather than a mental condition.

Any previous head injuries or related concerns should also be disclosed to the physician. It may also be beneficial if a person brought along a loved one who has seen the emotional outbursts.

Although there is no definitive test for emotional lability, the physician will ask a lot of questions regarding the patient’s medical history and emotions in order to validate the diagnosis.

Treatment for Labile Emotional Control / Emotional Lability

While minor cases of emotional lability may not require treatment, if it poses a severe concern, a physician may prescribe certain drugs to assist in minimizing the severity and duration of outbursts. These medications can make the disorder much more tolerable and less socially damaging.

The following treatments frequently used to treat emotional lability:

  • NMDA (N-methyl-D-aspartate) receptor antagonists. A type of drug that has been certified by the Food and Drug Administration (FDA) to manage emotional lability and has been shown in studies to decrease the incidence of emotional outbursts by roughly half.
  • Antidepressants. Low-dose antidepressants may also be used to minimize the severity and frequency of emotional outbursts. Antidepressants can help with the symptoms of emotional lability, but the FDA has not approved them for treatment.

Coping Methods for Labile Emotional Control

Dealing with emotional lability or labile emotional control can really be challenging, especially if it makes it difficult for a person to engage in different circumstances or if those nearest to him or her are unaware of the condition.

The following methods are recommended when coping with emotional lability:

  1. Recognize the triggers and strive to avoid them whenever possible.Emotional lability can usually be triggered by the following:
    • extreme weariness or exhaustion
    • anxiety, stress, or tension
    • excessive stimulation such as too demanding, too loud, or too many people
    • extreme emotions or external demands
    • occurrences that are very sad or humorous like jokes, cinemas, or stories
    • addressing some matters including driving, loss of employment, relationships, and loss of significant other/s
    • speaking over the phone, in front of a huge audience, or in situations where a person is under duress
  2. Take a short break away from the situation to allow the person to restore emotional control and let emotions subside. A simple pause of a few minutes or a long amount of time might sometimes be enough to reestablish emotional control, such as having a quick stroll or engaging in a different task.
  3. Learn to ignore the emotional lability’s behavior and symptoms as often as feasible. Help persuade others to ignore it as well so that the discussion or activity can continue. Concentrating on the problem or paying a lot of attention to the person when it occurs can exacerbate the situation. It is imperative that no one else laughs, as this will only promote and intensify the behavior.
  4. Redirect or Distract. If the subject or event is a trigger, redirection and diversion can help alleviate stimulation and discomfort. Engage the person in a different activity or exercise to distract or divert their attention.
  5. Providing knowledge and awareness. If others don’t understand, excessive sobbing or laughing might be disturbing or scary. Encourage the person to give simple explanations or details about his or her medical condition to others, and let them realize what they can do to make the situation better, such as ignoring the outburst.
  6. Prepare in advance. When a person has extreme emotional lability, one-on-one, short, and enjoyable exercises in a peaceful atmosphere are preferable. Stop placing the person in difficult circumstances or surroundings, such as those that are loud, crowded, or require a lot of effort. Plan activities that are attainable for the individual. Plan more physically challenging activities or schedule appointments after rests or when the person is most energetic. Scheduling rest periods in between activities is also highly advisable.
  7. Adopt cognitive strategies. The following are a few easy cognitive practices that can help manage emotional lability.
    • Tension and stress reduction through relaxation and breathing exercises
    • Using diversions by visualizing a tranquil thought, or counting
    • Engaging in physical activity such as going for a stroll, and sipping a refreshing beverage
    • Cognitive and behavioral interventions with the help of a Psychologist which may include thought stopping

Labile Emotional Control Nursing Diagnosis

Labile Emotional Control Nursing Care Plan 1

Anxiety Disorder / Panic Disorder

Nursing Diagnosis: Labile Emotional Control related to lack of awareness on emotional response and illness progression secondary to Anxiety Disorder as evidenced by lack of eye contact, excessive and uncontrollable outbursts.

Desired Outcome: The patient will enhance awareness about triggers, illness process, manifestations, and symptom control.

Labile Rmotional Control Nursing InterventionsRationale
Provide a comfortable, non-threatening approach when dealing with the patient.Anxiety is contagious and can be spread from a health care professional to a patient, aggravating emotional lability symptoms. In the presence of a calm staff member who can avoid provoking the patient, the patient develops a sense of security.
Listen to the patient; demonstrate compassion; respond to questions directly; offer understanding and acceptance; and respect the patient’s personal boundaries.Since an outsider nurse may create a concern for a very anxious patient and cause the symptoms of emotional lability to occur frequently, management must be focused on putting the patient at peace.
Place the patient in a calm, low-stimulus environment, such as a tiny space or a quiet area with low lighting and few individuals.External stimuli intensify symptoms of emotional lability and anxiety. In comparison to a huge space, which can make the patient feel confused and anxious, a smaller or isolated space improves a sense of security and prevents triggers.
Avoid pressuring or requiring the patient to make decisions.When a patient is asked or forced to make decisions, they may not make sound or appropriate judgments, or they may be unable to make any decisions at all. They may also have an extreme emotional response that is inappropriate for the situation when pressured.
Assist the patient to engage in relaxing activities such as breathing exercises, relaxation techniques, self -hypnosis, and meditation.Relaxation exercises are conventional treatment methods for reducing anxiety and minimizing the recurrence of excessive or inappropriate emotional responses in emotional lability.

Labile Emotional Control Nursing Care Plan 2

Post-Traumatic Stress Disorder (PTSD)

Nursing Diagnosis: Labile Emotional Control related to a trauma response to a possibly life-threatening incident secondary to Post-Traumatic Stress Disorder (PTSD) as evidenced by alterations in emotional responses, erratic mood and behavior, irritability, and avoidance.

Desired Outcome: The patient will exhibit effective coping strategies and successfully avoid aggravating factors of the condition.

Labile Rmotional Control Nursing InterventionRationale
Compassionately communicate with the patient and listen with empathy.It fosters a supportive atmosphere that encourages coping when the patient’s emotions are recognized and comprehended.
Evaluate the patient’s perception of the circumstance and also his or her self-esteem and capabilities.The patient has a tendency to assume that the risk is bigger than their ability to handle it. Understanding the patient’s perspective on the problem aids in recognizing problem areas.
Ascertain that the patient is comfortable in his or her surroundings and provide moments of rest/space while remaining calm.Familiarizing the patient with their environment promotes comfort and relaxation, minimizing involuntary and unnecessary emotional responses. Giving the patient a moment of rest and observing the pace of their activity, on the other hand, generates relaxation, increases well-being, and allows the patient to conserve energy.
Help ease the patient’s concerns by explaining that his or her involuntary outbursts are an acceptable manifestation of having PTSD. Maintain empathy for the patient while avoiding false promises.Being honest provides reassurance, which reduces the likelihood of emotional lability symptoms resurfacing while empathizing with the patient fosters positivity and confidence.
Allow the patient to reflect on the process and present condition while assisting him or her in distinguishing facts from perceived concerns to health.Emotional lability can cause a lack of emotional awareness, making the patient less receptive to other people’s feelings and making it more challenging to regulate behavior. Educating the patient on the ailment process and current state can help the patient feel more at ease

Labile Emotional Control Nursing Care Plan 3

Multiple Sclerosis

Nursing Diagnosis: Labile Emotional Control related to physiological changes in the brain secondary to Multiple Sclerosis as evidenced by a change in self and others’ perception of physical capacity, inappropriate emotional response, and confusion.

Desired Outcome: The patient will understand the correlation between the disease process, emotional reactions, and cognitive or behavioral changes.

Labile Rmotional Control Nursing InterventionRationale
Evaluate the patient’s current functional capabilities and limitations; check for distorted thought patterns, labile emotions, and emotional conflict. Take note of how these factors influence the patient’s ability to cope.Biological or psychological impacts may lead the patient to become easily distracted, have trouble concentrating, problem-solving, dealing with what is going on, or being competent over their own care.
Assess the patient’s comprehension of the present condition and past approaches to dealing with problems in life.Provides insight into how a patient might respond to the current situation and aids in the identification of particular resources and needs for support.
Maintain an open and honest connection with the patient.Reduces disorientation and the frustrating struggles that come with adjusting to a new situation or way of life, which can cause the patient to have frequent, out-of-control emotional responses.
Pay attention to nonverbal communication such as stance, eye contact, actions, gestures, and touch. Compare to spoken content and, if necessary, confirm meaning with the patient.Because a patient’s emotional responses may be completely unrelated to their thoughts and feelings, comparing nonverbal communication to verbal content may reveal important information about what the patient with emotional lability is actually experiencing. However, verification is necessary to ensure that information is accurate, as discrepancies between emotions and what is communicated might hinder the patient’s coping ability.
Support the patient in determining which aspects are within his or her control. Make a list of items that may be controlled or avoided to reduce provoking excessive emotional responses.Recognizing and having to accept what is beyond the patient’s control can help them feel less overwhelmed or act out, and concentrate on things they can manage.
Accept the reality of the circumstance while also expressing positivity for the patient.Even though the prognosis may be poor, relapses are possible, and because the future cannot be anticipated, faith in a better quality of life should be promoted.

Labile Emotional Control Nursing Care Plan 4

Personality Disorder

Nursing Diagnosis: Labile Emotional Control related to an extreme emotional state secondary to Personality disorder as evidenced by intense dysregulation of emotions and inability to establish optimal control.

Desired Outcome: The patient will display an improved way of emotional control and focus on the problem-solving process.

Labile Rmotional Control Nursing InterventionsRationale
Handle the patient in the same way in all encounters as much as possible.Exceptions foster manipulative conduct while consistency in handling the patient increases feelings of security and provides structure to the patient. A sense of security might also help the patient avoid resurfacing labile emotions.
Avoid questioning about recent changes in the patient’s life, such as the loss of a significant other or a job.Addressing issues that cause the patient to feel stressed and pressured can frequently cause emotional lability.
Make an effort to understand the underlying feelings that are causing the patient’s improper behavior when appropriate.Acting out behaviors are often the result of underlying emotions of anger, anxiety, embarrassment, uncertainty, sadness, and so on; talking about these feelings can help the patient solve problems and improve. In the case of emotional lability, the apparent behaviors or emotions are also very likely to be irrelevant to their actual feelings.
Educate the patient with coping strategies to help alleviate stress and unpleasant feelings when he or she is ready and motivated.Developing effective coping mechanisms allows the patient to use better methods to relieve stress and meet demands.
When the patient’s behaviors and emotional responses are suitable and appropriate for the situation, give them positive attention. Avoid paying attention when the patient’s extreme emotions are improper.Positive reinforcement may enhance the possibility of repetition, whereas ignoring excessive and inappropriate emotional reactions when possible deprives the patient of even more negative attention, which might exacerbate symptoms.
Be considerate and compassionate when the patient is sharing his or her feelings, views, or concerns.These patients are terrified of rejection, and helping them feel at ease might help them avoid having inappropriate and overwhelming emotional reactions.

Labile Emotional Control Nursing Care Plan 5

Attention Deficit Hyperactivity Disorder (ADHD)

Nursing Diagnosis: Labile Emotional Control related to alterations in brain development and activity secondary to Attention Deficit Hyperactivity Disorder (ADHD) as evidenced by extreme mood swings, short attention span, and intense uncontrolled emotions.

Desired Outcome: The patient’s attention will be refocused on areas of control and progress and demonstrate the use of effective management techniques.

Labile Rmotional Control Nursing InterventionRationale
Avoid putting the patient in situations that are stimulating or distracting.To avoid becoming easily distracted and hyperactive, make sure the patient is completing his everyday activities in a peaceful and non-stimulating environment. Too loud or overcrowded space can also trigger excessive emotional responses in the patient.
Allow time for the patient to express their intense emotions as well as time for relaxation and tranquility.Although it is necessary for ADHD patient to express their intense emotions, it is also necessary to set aside time to remain calm. In both circumstances, scheduling the activities will assist the patient in adhering to the treatment plan.
Strive on redirecting the patient’s focus by learning ways to help the problem go away faster.After accepting their emotional impulses, the patient can learn to focus on getting through the emotional changes rather than on why they occurred. Teach the patient to redirect their attention to a new and helpful task when their mood shifts, and to remind themselves that the symptoms will pass and that it is preferable to wait it out rather than try to figure out what’s wrong.
Always prepare ahead of time by keeping some useful distractions accessible.An exciting or pleasurable event might have a depressive aftereffect for many patients with ADHD. People with ADHD can ignore the conflict and shift to the opposite emotional extremes once the stimulation has passed and the challenge has ended.
Encourage the patient to participate in appropriate exercises or activities on a regular basis.Patients who stay active maintain their balance. Although strenuous exercises and competitive sports should be avoided because they can increase aggression and energy. Several therapies can relieve stress, burn away aggravation, and restore attentiveness as effectively as regular exercise, which helps to prevent uncontrollable severe emotional reactions.
Encourage the patient to embrace the flaws and mishaps that come with the condition rather than being hard on themselves for having it.When a person can accept their situation, they are less likely to be frustrated and worried. Learning to humor their ADHD missteps and make light of them is a significant step toward improved relationships and a calmer life. The symptoms can be aggravating, but with acceptance, they can also be disregarded. Certainly, not every error should or should be taken lightly, but when a person can delightfully point out their own flaws, the people around them become much more understanding and accepting.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon


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Anna Curran. RN, BSN, PHN

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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