How Neurotic Are You?

How Neurotic Are You?

What does Neuroticism look like, and what makes some people more neurotic than others?

Neuroticism is the personality trait of tending to frequently experience intense negative emotions (Barlow et al., 2014). In addition, these feelings are usually accompanied by the thought that one will not be able to control or handle the situation in which the negative emotions are occurring.

Since neuroticism is defined as a personality trait, this means that each of us demonstrates a particular degree of neuroticism in our own lives. In fact, people vary enormously in how neurotic they are, ranging from having intense reactions to very minor challenges to showing little negative emotion in even the most challenging situations (Lahey, 2009).

Neuroticism Characteristics

People high in neuroticism are more likely to engage in certain behaviors as a response to their emotions and the sense of lack of control that accompanies those emotions (Barlow et al., 2014). They may worry more, spend more time ruminating on their fear or sadness, or try to avoid their emotions. Each of these behaviors can actually make things worse, by reinforcing the negative emotions and increasing the likelihood that those emotions will happen again (Barlow et al., 2014).

Research shows again and again that the trait of neuroticism is higher on average among people with many psychiatric and physical illnesses (Lahey, 2009). In the realm of mental health, these disorders range from depression and anxiety to schizophrenia to eating disorders to substance use (Malouff et al., 2005), while in the realm of physical issues, heart problems, irritable bowel syndrome, skin conditions, and asthma are all related to one’s neuroticism levels (Widiger, 2017). In fact, mental and physical health challenges are so strongly correlated with neuroticism that measures of neuroticism can be thought of as predicting how long and healthy our lives will be (Lahey, 2009; Malouff et al., 2005).

“It’s ironic to think that behaviors we consider neurotic are actually holding the word in place – but sooner or later whatever protection they offer decays.And it’s so much work. So damn much work.”
― Stephen King

Causes of Neuroticism

Dr. David Barlow, a clinical psychologist and one of the foremost experts on anxiety, says that our levels of neuroticism are caused by three different inputs (Barlow, 2000). In what he calls the triple vulnerability theory, he outlines how the following three factors interact to cause neurotic responses in us:

1. Biological vulnerability. Simply put, some of us are born with a more reactive system – some people are just programmed to react more strongly to events than others are. This vulnerability is inherited – it results from the unique combination of genes we inherited from our parents.

2. General psychological vulnerability. Thanks to the experiences we have growing up, we may develop a perspective on the world that increases our neuroticism. If we come to see the world as out of our control, unpredictable, and dangerous, we will over time grow to respond more neurotically to the world.

3. Specific psychological vulnerability. While our overall experience can make us more neurotic, the precise flavor of our neuroticism will depend on specific experiences we have. For example, some people may learn to cope with negative emotions by self-medicating, such as through drugs or alcohol, while others may cope by developing obsessive-compulsive rituals.

Examples of Neuroticism

The following are a few examples of neuroticism in action. Keep in mind that people high in neuroticism may have multiple of these reactions at once (Weiss & Costa, 2005). Suppose your housemate walks into the kitchen, makes themselves a sandwich, and leaves without saying hi to you or making eye contact. If you are high in neuroticism, you may…

1. become very anxious. You obsess over what you must have done to upset them and have trouble getting back to the task you were working on.

2. say something passive-aggressive under your breath as they leave. You can’t believe they acted like you don’t even exist. You refuse to acknowledge their existence for the next two days.

3. spiral into a funk of sadness. This is the final confirmation you were afraid of that they’re not interested at all in being your friend.

Dealing With Neuroticism

People high in neuroticism are generally not very effective in dealing with their stress – after all, this is what perpetuates their elevated neuroticism levels (Barlow, 2000). For example, they report interpreting situations in their lives with more distress and more negativity than less neurotic individuals, and perhaps because of these reactions, they are more likely to use less effective coping strategies (Gunthert et al., 1999).

Interventions that help people deal with their neuroticism target their negative emotions and thoughts (Sauer-Zavala et al., 2017). Another technique is to help people change their environments to reduce the frequency and intensity of the events that trigger their neurotic reactions. A key step is to help them directly address their emotions, rather than avoid them, as this can help break the neurotic cycle of strong negative reactions creating the expectation of future strong negative reactions (Armstrong & Rimes, 2016).

A classic example of this is exposure therapy for people with obsessive-compulsive disorder, who usually score high on neuroticism measures (Samuels et al., 2000). Exposure therapy consists of having people encounter exactly the situations that cause them to feel distress and want to use compulsive coping strategies. By enduring those situations without using coping strategies, people learn that the situations do not have to be as stressful as they were before. Eventually, their responses become less neurotic.

In Sum

Our baseline levels of neuroticism are not really in our control. We can’t control the genes we inherited, nor did we have much influence over the environments that we lived in growing up. Unfortunately, parents who are neurotic themselves often both pass on biological vulnerability and create psychological vulnerability through their parenting (Ellenbogen et al., 2010).

So if you have read this article and are thinking you might be high in neuroticism, please don’t blame yourself. Many psychotherapies are effective in changing neurotic patterns of emotions and thoughts (Barlow et al., 2014) – there are many places you can find help changing your ways or the ways of somebody close to you.


● Armstrong, L., & Rimes, K. A. (2016). Mindfulness-based cognitive therapy for neuroticism (stress vulnerability): A pilot randomized study. Behavior Therapy, 47(3), 287-298.

● Barlow, D. H. (2000). Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. American Psychologist, 55(11), 1247.

● Barlow, D. H., Ellard, K. K., Sauer-Zavala, S., Bullis, J. R., & Carl, J. R. (2014). The origins of neuroticism. Perspectives on Psychological Science, 9(5), 481-496.

● Ellenbogen, M. A., Ostiguy, C. S., & Hodgins, S. (2010). Intergenerational effects of high neuroticism in parents and their public health significance. American Psychologist, 65(2), 135–136.

● Gunthert, K. C., Cohen, L. H., & Armeli, S. (1999). The role of neuroticism in daily stress and coping. Journal of Personality and Social Psychology, 77(5), 1087-1100.

● Lahey, B. B. (2009). Public health significance of neuroticism. American Psychologist, 64(4), 241-256.

● Malouff, J. M., Thorsteinsson, E. B., & Schutte, N. S. (2005). The relationship between the five-factor model of personality and symptoms of clinical disorders: A meta-analysis. Journal of Psychopathology and Behavioral Assessment, 27, 101–114.

● Samuels, J., Nestadt, G., Bienvenu, O. J., Costa, P. T., Riddle, M. A., Liang, K. Y., … & Cullen, B. A. (2000). Personality disorders and normal personality dimensions in obsessive-compulsive disorder. The British Journal of Psychiatry, 177(5), 457-462.

● Sauer-Zavala, S., Wilner, J. G., & Barlow, D. H. (2017). Addressing neuroticism in psychological treatment. Personality Disorders: Theory, Research, and Treatment, 8(3), 191-198.

● Weiss, A., & Costa, P. T. (2005). Domain and facet personality predictors of all-cause mortality among medicare patients aged 65 to 100. Psychosomatic Medicine, 67, 724–733.

● Widiger, T. A. (Ed.). (2017). The Oxford handbook of the five factor model. Oxford University Press