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Objective: Difficulty in emotion regulation is the deficiency to regulate an individual's emotional response to a negative stimulus. Our aim is to investigate the effect of emotion regulation difficulty on the process and function of bipolar disorder (BD). Methods: 64 patients with BD, 64 patients first-degree relatives and 66 healthy controls were included in the study, which were followed in Mersin University Research and Practice Hospital Outpatient Clinic of Psychiatry. Sociodemographic Information Form and Difficulties in Emotion Regulation Scale (DERS) were filled to all participants. In addition; SCID-I, Short Form-36 (SF-36), Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale were filled to the patient group. Statistical analyses were performed with SPSS 21.0 computer program. Results: DERS scores in patients group were found to have significantly higher scores than patients relatives and healthy controls (p0.05). Another finding that who score high scores on DERS receive lower scores on SF-36. In depressed patients, there was a significant positive correlation between HDRS scores and DERS scores. Discussion: In our study, it was shown that difficulty of emotion regulation negatively affected the functioning and disease course of BD patients and there is a positive correlation between difficulty in emotion regulation and impairment in functioning in depressive episodes [Anadolu Psikiyatri Derg 2020; 21(1.000): 30-36]