Neuroticism: What It Is, Causes, & Ways to Cope

The History of Neuroticism Terminology

The terms neuroticism and neurotic are derived from the word neurosis, which was first used to describe abnormalities in the nervous system, and later adopted by the field of psychology. In psychology, the word neurosis took on new meaning as a way to describe psychological and emotional abnormalities. At one point, it was a clinical term used to help differentiate different kinds of psychological disorders. While it is no longer used as a diagnostic term, the word neuroticism continues to be used to describe negative emotional states and traits.¹

What Is Neuroticism?

Neuroticism is a personality trait that is included on most standardized personality tests and describes a person’s susceptibility towards stress and negative emotions like fear, anger, and sadness,⁷ There are many different personality theories and tests, but one of the most widely used and respected is The Big Five Personality Traits.⁴ The Big Five breaks personality down into a series of 5 central traits which a person can either score high or low in.

The 5 traits in the Big Five Personality test are:⁴

• Extroversion: Describes how social, outgoing, and expressive a person is
• Agreeableness: Describes how empathetic, caring, and cooperative a person is
• Conscientiousness: Describes how detailed, controlled, cautious and prepared a person is
• Neuroticism: Describes how moody, emotionally reactive, and negative a person is
• Openness: Describes how open-minded, curious, creative and imaginative a person is

High neuroticism is linked to experiencing negative emotions like fear, sadness and anger more intensely, more often, and for longer durations. Neurotic people often lack the skills to effectively regulate emotions and cope with stress, making these emotions even more overwhelming for them. Lacking effective coping skills leads neurotic people to respond in destructive, impulsive, or maladaptive ways that end up creating more problems and stress for them in the long run.³

Some of the specific signs and traits used to identify neuroticism include:^7,6

• Mood swings or feeling “up and down”
• Irritability and low frustration tolerance
• Being easily hurt or offended
• Frequently feeling nervous or anxious
• Frequently worrying
• Being uptight, tense or rigid
• Replaying upsetting or embarrassing memories
• Loneliness or feeling isolated
• Frequent feelings of guilt or shame
• Being overly critical or cynical
• Ruminating on negative thoughts
• Overreacting to stress
• Anger, hostility and resentment
• Being more insecure, self-conscious and self-critical

Is Neuroticism Bad?

Neuroticism is a personality trait that makes a person more susceptible to negative emotions but having this trait doesn’t mean a person is destined to have a bad life or always be unhappy. All people sometimes experience negative emotions, and it is possible for people without this trait to develop neurotic anxiety, neurotic depression, or anger issues. The negative effects of neuroticism are more related to the person’s response to their emotions rather than the emotions themselves.^6,9

It is possible for neurotic people to learn more effective methods of responding to their emotions and doing so can prevent many of the unwanted effects associated with this personality trait. The way a person responds internally and externally to their emotions can determine how intense they are, how long they last, and how much of an impact they have on a person’s life. Internal responses to emotions describe the way a person processes emotions and external responses describe the way emotions influence their behavior.

Some of the unhelpful responses to difficult emotions that cause many of the problems associated with neuroticism include:^1,3,9

When people respond to negative emotions in some of the unhelpful ways listed above, they are much more likely to experience these emotions more frequently, intensely, and for longer periods of time.

They are also much more likely to experience the negative effects of neuroticism, which can include:^6,8,9

• Lowered satisfaction with interpersonal relationships with partners and other supports
• Increased risk of heart problems, asthma, eczema, lowered immunity, and IBS
• Poorer response to treatment of health conditions and increased risk of mortality
• Increased risk of developing an anxiety disorder, including phobias, generalized anxiety disorder, panic disorder, or social anxiety disorder 
• Increased risk of developing a mood disorder like depressionorbipolar
• Increased risk for OCD, substance use disorder, or eating disorder
• Increased risk for schizophrenia and certain personality disorders
• Impaired performance at work and higher rates of occupational failure
• Decreased overall quality of life and lower life satisfaction
• Increased likelihood to have health anxiety and inaccurately perceive illness
• Lowered rates of marital and relationship satisfaction

Are There Advantages to Experiencing Negative Emotions?

Emotions like fear, anger, and sadness are often avoided but these emotions are not necessarily bad, and in some instances can even be helpful. All emotions, including the difficult or “negative” ones, provide information to people about things they want, need, and care about. Difficult emotions tend to arise in response to situations (real or imagined) where a person is not getting something they want or need, or when there is something of importance at stake. Even situations that seem unimportant but generate a strong emotional response tend to have hidden messages about important relationships, goals, values, or emotional needs.

When people use their emotions to become more self-aware, difficult emotions can be helpful in clarifying priorities and guiding people towards decisions that protect these priorities. When people do not use difficult emotions for healthy introspection, they are much more likely to default to ineffective responses that muddy their priorities and guide actions that are destructive. Healthy introspection does not mean ruminating on negative or self-critical thoughts, but instead means pausing to consider what really matters instead of becoming emotionally reactive.

How Neuroticism Affects Thoughts, Feelings, and Behaviors

Neuroticism involves specific patterns in the way a person thinks, feels and behaves. Neuroticism is a personality trait, but also describes an internal sequence of events in response to a perceived stressor or problem. While individual experiences can vary, the following sequence is common in people who report high levels of neuroticism:^1,3

Stressor

there is something internal (i.e. a memory or physical pain) or external (i.e. an interaction or circumstance) that serves as a trigger for stress, fear, anger, sadness or other difficult emotions.

Exaggerated Negative Perception

When positive experiences or emotions present themselves, they are downplayed or “dampened” (i.e. thinking “it probably won’t last”) while negative factors are exaggerated. This can cause a person to perceive a situation as more difficult, personal, stressful, or dangerous than it actually is

Internalization

People with high neuroticism tend to be highly self-conscious and to internalize negative stress or situations, attaching personal meaning or significance to them. They might blame or criticize themselves, fixate on their weaknesses or flaws or engage in other forms of negative self-evaluation that lead to feelings of shame, guilt or helplessness.

Rumination

The person ruminates on the negative thoughts and feelings. Excessive rumination on negative, worried, angry or upsetting thoughts will lead people to feel these negative emotions more intensely, and for longer periods of time.

Ineffective Response

When people experience stress or difficult emotions, they tend to make choices that bring short term relief but are problematic later on. They might avoid or withdraw instead of confronting a problem or they might externalize by starting conflict or blaming someone or something else. Some people turn towards destructive outlets like drugs, alcohol, or other bad habits for emotional relief.

Consequences

Ineffective responses tend to generate problems and consequences. These might include conflicts with other people, critical feedback at work, or just feeling bad or guilty afterwards and engaging in self-criticism. Without the tools to regulate their emotions, they often cycle back into negative emotions and thought processes.

Unchecked, the sequence outlined above is one that can become a self-perpetuating cycle. This happens because of the way that specific internal responses like exaggerated negative perception, internalization and rumination cause stress and difficult emotions to intensify. The more they intensify, the more likely a person is to become emotionally reactive or impulsive, acting in ways that create more problems and stress for them, triggering the cycle to repeat.

How Neuroticism Affects Relationships

Neuroticism can make it difficult for people to form close, trusting, healthy relationships with others. Neurotic people tend to have a negativity bias, and this can extend to the way they perceive their partner and their relationship. They may perceive problems when there are none, or they may exaggerate problems in ways that provoke conflicts. These patterns can cause problems in all relationships, but tend to affect close relationships the most, especially romantic relationships. Research has shown that people who score high on neuroticism tend to report being less satisfied in their marriage than people who score low.⁸

What Causes Neuroticism?

There is not one specific cause for neuroticism. Personality traits are believed to be influenced by a combination of genetic, social, and environmental factors. Genetics is believed to account for about half of a person’s personality, and research on neuroticism has identified certain genes that are closely related to this trait.^1,6

The genes that seem to predispose people to neurotic personalities are ones that affect levels of serotonin, a brain chemical that helps to regulate mood.⁶ Interestingly, this is one of the main chemicals that is deficient in people who have mood disorders like depression, which are particularly prevalent in people with neurotic traits.

People who experience trauma, stress, and adversity are also more likely to develop neurotic personality traits and behaviors, particularly when these events happen early on in life. People who experienced abuse, neglect, or who had parents who were either too involved or not involved enough are believed to be more likely to develop neurotic personalities.^1,6

Once a person begins experiencing negative emotions more intensely and frequently, they can unknowingly begin a negative feedback loop that continuously feeds into neuroticism. In this way, neuroticism can be strengthened by ineffective responses to stress and difficult emotions.³ When these patterns begin early on in life, they can persist into adulthood until a person becomes more aware and intentionally interrupts the feedback loop by responding to emotions in new, more effective ways

While personality was once believed to be fixed by adulthood and remain stable across the lifespan, researchers now believe that personality can change across the lifespan. The role of genetics in personality development is strongest early on in life but environmental factors continue to influence personality even into adulthood.⁵ Most of the time, it appears that personality changes for the better as people age. While there isn’t clear evidence that neuroticism decreases, positive traits like agreeableness and openness do appear to increase, which may help to counteract neuroticism.¹⁰

When to Seek Help for Neuroticism

Everyone encounters stress that overwhelms their current capacity to cope and when this happens, the negative impacts can begin to spill over into different areas of their lives. This can happen during times of high stress, even when people are responding effectively to their emotions.

This might lead to a worsening of their physical or mental health or an impaired ability to function at work, home, or some other area of life. When stress and negative emotions begin to have these consequences, a licensed mental health professional may be helpful.

Other indications that a person might need to seek professional help include:

• Frequent conflict in important relationships
• An inability to experience positive emotions
• Persistent negative emotions that last for weeks on end
• Intense negative emotions or mood swings that impair judgment
• Over-reliance on drugs, alcohol or other destructive forms of coping
• Thoughts of death, suicide, or urges to self-harm
• Difficulty sleeping, eating, or completing basic tasks because of negative emotions
• Inability to concentrate or focus because of persistent negative thoughts
• Frequent impulsive choices that lead to consequences or problems

How to Get Help for Neuroticism

Neuroticism responds to treatment, and can improve with therapy, medication or a combination of both. Medications that treat depression tend to affect neurotransmitters like serotonin and dopamine, which can help to improve neuroticism. You can explore options for medication by conducting a google search for a psychiatrist, by contacting your insurance company for a list of in-network providers, or by going through your primary care doctor. Some primary care doctors are willing to prescribe medication for mood-related problems and others will provide a referral.

Certain kinds of counseling can also be helpful in learning to better cope with difficult emotions and reduce neurotic tendencies. One specific type of counseling developed to help people with neuroticism is called the Unified Protocol, and draws from Cognitive Behavioral Therapy, Mindfulness, and behavioral interventions to help you learn to regulate emotions.^8,10

The Unified Protocol utilizes many elements of other Evidence-Based treatments which may also help improve neuroticism, including:

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy is a type of therapy that focuses on helping you change unhelpful thought patterns that feed into difficult emotions and drive ineffective reactions, as well as changing those reactions.

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy therapists encourage you to accept difficult emotions and be willing to experience them without getting stuck or overly involved in them. ACT also teaches you how to avoid emotion-driven responses and to instead choose value-driven responses that align with the things that matter most to you.

Exposure Therapy

Exposure therapy is often used to help people with anxiety disorders face feared situations they previously avoided, resulting in a desensitized response. Exposure therapy can be helpful for people who have relied heavily on avoidance techniques to avoid difficult emotions.

Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy (DBT) coaches people to find more moderate ways of thinking and responding to difficult thoughts and feelings by teaching mindfulness, interpersonal effectiveness (communication skills), distress tolerance (coping skills) and emotion regulation.

Finding a Therapist

People interested in seeking professional counseling can start their search online using a free counseling directory or can reach out to their insurance company for a list of in-network providers. Finding a therapist who is a good match is important, so it is a good idea to reach out to more than one therapist for a consultation prior to booking an initial appointment. Most therapists will offer these consultations at no cost. Many providers are also offering teletherapy sessions which can be conducted online, and most major insurers have extended coverage of online counseling in response to the COVID-19 pandemic.

Coping with Neuroticism: 5 Strategies for Success

Developing more effective methods of coping with difficult emotions can help to interrupt the internal processes that feed them, helping you feel more regulated and able to make good decisions.

Some effective methods of coping with neurotic thoughts and feelings include:

1. Reappraisal: Challenge Your Thinking

Reappraisal involves challenging yourself to think differently about yourself, your life, and your circumstances. Negative appraisals tend to place emphasis on things that generate feelings of sadness, anger, anxiety or stress, but positive appraisals can counteract these emotions.³

Ways to practice reappraisal include:

• In difficult situations, use reappraisal by using the sentence stem, “at least…” to identify positive aspects of the situation you may have overlooked.
• Begin a daily gratitude practice where you identify things you are grateful for each day which can help to train your mind to notice more positive aspects.
• Look for less personal explanations for problems or negative circumstances. For example, instead of assuming someone is upset with you when they don’t answer your call, identify other possible explanations.

2. Mindfulness: Pay Attention to the Present Moment

Mindfulness is a practice that involves unhooking from unhelpful thoughts and bringing your full attention to some aspect of the present moment. Mindfulness has been proven to help reduce stress, improve coping, and counteract neuroticism.^2,9

Ways to practice mindfulness include:

• Focus your full attention on your body, its sensations or your breath and track these sensations.
• Focus on your surroundings, using one or more of your 5 senses to become more present and aware.
•  Use mindfulness to pull back from unhelpful thoughts, noticing and observing them without getting overly involved or sucked into ruminating or participating in them.

3. Opposite Action: Do the Opposite of What You Feel

Sometimes, doing the opposite of what you feel is most likely to result in a positive emotional shift. Opposite actions help you understand that you are always in control of your emotions, even when they are really intense and come with strong urges.

Ways to practice opposite action include:

• When you feel sad and just want to stay in bed, push yourself to get up, be active, and follow through with your plans for the day.
• Try being kind to someone you are angry with or offering to help them
• Be open and honest with a loved one when you want to become defensive.

4. Problem-Solving: Focus on the Problem, Not the Emotion

Using a problem-solving approach means refocusing on the source or cause of a difficult emotion, rather than focusing on the emotion itself, which is something neurotic people struggle to do.⁶ Focusing on the problem is often more productive and more likely to lead to helpful actions.

Ways to practice problem solving:

• When you find yourself stressed out, overwhelmed or upset, pull back and try to identify the source of your stress.
• Once you know what the source is, try to think of actions and responses that help to address this root problem.
• If there is nothing you can do to address this problem, focus on identifying a response that is not going to make the problem worse.

5. Strengthen Relationships: Connect With Others

People with neurotic tendencies tend to have more trouble forming and maintaining close relationships with other people. Working to build and strengthen relationships is important because it is almost impossible to be happy, fulfilled, and emotionally balanced without feeling connected to other people.

Ways to strengthen relationships include:

• Practice communicating effectively, even when upset by staying focused on what you want to say rather than how you want the other person to respond.
• Become better at listening and being attentive to the feelings, needs and wants of people you care about.
• Avoid making assumptions about people’s intentions, feelings, or thoughts when doing so makes you feel defensive and instead, ask them openly.