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How to Regulate in Times of Distress
Natalie DeRose • August 11, 2020

Have you ever felt overwhelmed? Have you ever felt so anxious that it became difficult to control your thoughts? Or so overly stimulated that you felt trapped and powerless?


Dysregulation, a term used to describe when we are not in control, can impact us on both a behavioural and emotional level. Dysregulation can appear in different ways and can feel differently depending on each unique person. A previous article What's Your Body Telling You?, goes into this further. However, some symptoms of dysregulation can include irritability, depression, anger, anxiety, and increased substance use.


But how can we manage high volumes of distress?


Through the use of distress tolerance skills it is possible to alleviate significant amounts of stress and cope effectively in moments of crisis. However, much like anything we engage with, it is important to adopt the proper mindset. In this, before distress tolerance can begin it is important to understand the importance of radical acceptance. At its core, radical acceptance asks us to change our attitude about a situation by inviting us to acknowledge our current circumstances without judgment or self-criticism. Instead, radical acceptance allows us to recognize that our current circumstances are a result of events that started far in the past that we cannot change, which seeks to remove blame, shame, and anger.


Once we have adopted the right mindset, we can begin to use distress tolerance skills to help us cope. The type of distress tolerance skills that is employed is highly dependent on the situation and what each individual person finds to be effective for them. I invite you to read the list of healthy distress tolerance skills below. If you find a skill that you believe will benefit you in times of distress, write it down in a note to act as a gentle reminder that you have something to come back to in times of uncertainty.


While there are various types of distress tolerance skills, here are a few basic skills that can help in times of emotional difficulty or distress:


Use Distraction 

Distraction skills allow us to distract our upsetting thoughts until they have reached a state of neutrality. Some distraction skills consist of:

  • Write a letter to someone that has hurt you. Do not send the letter but express how you are feeling and how they have hurt you. Rip up the letter when you are done or throw it away.
  • Throw rolled up socks against a bare wall.
  • Scream into a pillow. 
  • Hold an ice cube in your hand and squeeze it. This will allow your hand to feel numb and act as a distraction from harmful emotions.
  • Cry. Crying releases hormones that help to regulate us.
  • Snap a rubber band against your wrist if you have negative thoughts or feel like hurting yourself.
  • Distract yourself by leaving. If you’re in a difficult or stressful situation, and know that your emotions are going to overwhelm you, put some distance between you and the situation until you feel ready to return and address the concerns.
  • Talk to a friend. This can mean venting to your friend about your experiences, or even listening mindfully to them as a distraction from your own distress.


Be in the Moment

Although it can be very difficult, try your best to focus not on the past or future, but on the present moment using the following methods:

  • Imagery - Imagine a relaxing scene or imagine a secret room within yourself, seeing how it is decorated. Go into the room or to the scene whenever you feel threatened. Additionally, try imagining  hurtful emotions draining out of you like water.
  • Create Meaning - Try your best to focus any positive aspects of the pain that you can think of. If there aren't any positives that you can think of, remind yourself that this feeling will pass with time.
  • Relaxation - Try muscle relaxing by tensing and relaxing each large muscle group, starting with your hands and arms, going to the top of your head, and then working down. Additionally, go for a walk, take a warm bath, practice yoga, or engage in other activities that relax your muscles.
  • Focus Your Attention - Focus your entire attention on just what you are doing right now. Keep yourself in the very moment you are in; putting your mind in the present. Look for all the green objects in your room or count the number of steps from your room to the living room. This focus will allow your brain to calm itself and stay focused on the present rather than the pain of the past or the uncertainty of the future.
  • Vacation - Give yourself a small vacation by going to the park for the afternoon, unplugging your phone for the day, or getting into bed and pulling up the covers.
  • Encourage Yourself - Find a mantra to repeat to yourself such as "It won't last forever", "I'm doing the best I can", or "I will be ok".


Practice Self-Soothing

Sometimes when we are feeling high levels of stress it can be extremely helpful to focus on our external environment in order to help us feel more safe and in control. Thus, we can use our five senses in as a way to soothe anxiety, panic, uncertainty, or other distressing feelings.

  • Smell - Different scents such as lavender, chamomile, or lemon have been found to help individuals feel calm.
  • Safely burn scented candles
  • Wear scented oils that make you happy
  • Go somewhere that you find the scent to be pleasing
  • Sight - Find images that have a soothing effect on you.
  • Create a collage of pictures that you like
  • Find scenery that you like to look at
  • Draw/paint a picture
  • Taste - Taste can sometimes trigger us to recall positive memories.
  • Eat your favourite meal
  • Carry gum with you to chew on in times of distress
  • Suck on an ice cube or popsicle if you are feeling warm and let it melt in your mouth
  • Touch - Certain sensations like touching soft objects or feeling warm can be pleasing and soothing to us.
  • Pet an animal, like a cat or a dog
  • Take a warm bath
  • Lay on or under a warm and fuzzy blanket
  • Hear - Certain sounds can soothe us, making us feel happy or calm.
  • Listen to your favourite music
  • Open your window and listen to the sounds outside
  • Listen to a sound recording of nature like chirping birds or a waterfall


Lastly, if at any time you begin to feel extremely overwhelmed with distress, depression, or anxiety, or are having feelings of hurting yourself please consider reaching out to the following crisis resources:


Let us know in the comments which distress tolerance skills you found to be helpful!


Written By: Natalie DeRose, M. Psy. Candidate, B.A. (Hons)

Edited/Reviewed byChantal Legere, M. Psy. Candidate, B.A. (Hons)


References


Bray, S. (2013, January 17). Distress Tolerance in Dialectical Behavior Therapy. In Good Therapy . Retrieved from https://www.goodtherapy.org/blog/distress-tolerance-dialectical-behavior-therapy-0117134


Mckay, M., Wood, J. C., Brantley, J., & Marra, T. (2007). The Dialectical Behavior Therapy Skills Workbook: Practical Dbt Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, & Distress Tolerance (pp. 10-29). N.p.: New Harbinger Publications.


Roberts, E. (2017, October 23). How to IMPROVE the Moment – Using DBT Skills to Manage Challenging Situations. Retrieved from https://www.hartsteinpsychological.com/how-to-improve-the-moment


Photo by David  Garrison from Pexels

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The problem with blue light specifically is that it has shown to stimulate the brain in areas that are active during alert day hours, disorienting the body’s natural preparation for sleep. Furthermore, blue light suppresses melatonin production (the hormone that makes you sleepy) and elevates cortisol (the hormone associated with stress ). Mariana Figueiro, PhD., found that two hours of screen time before bed displayed a suppression in melatonin levels in the brain (Figeuiro et. al., 2011). In fact, even when our eyes are closed, we have photo-receptors all over our skin that absorb light just as our retinas in our eyes would. Thus, having screens on anywhere around our sleeping areas is problematic. Tips to manage blue light exposure: Setting a screen time curfew Wearing blue light protective glasses Turn on blue light blockers on devices, i.e. phones and computers (f.lux and Nightshift are recommended for iOS users and Twilight for android users) Instead of watching TV, movies, or YouTube before bed, listen to a podcast or audiobook with the screen off or on sleep mode. Ensure your room is completely pitch black at night, with no lights on, curtains closed, and any technology still on should be covered. For those of you who sleep with a light on, it’s recommended to buy a red light for your bedroom. Not only do these look cool but red light on the visible light spectrum has been shown to have little to no effect on both melatonin and cortisol levels. This is hypothesized to be due to the fact that humans have evolved sleeping by fire throughout human history (Stevenson, 2016). Caffeine Consumption Before getting into what you can do to manage your caffeine consumption, let’s take a simplistic look at what caffeine actually does to the brain that impacts our sleep. During normal functioning hours, the brain slowly accumulates a chemical called adenosine that binds to receptors to slow down brain activity and make you feel tired. The longer you are awake, the more tired you feel. Where caffeine comes into play is that it is shaped very similarly to adenosine and it binds to brain receptors. When these receptors are blocked by caffeine instead of adenosine, this tricks the brain into thinking it's not tired. Caffeine has a half-life of about 6-8 hours. A standard cup of coffee has roughly 150g of caffeine in it. What this means is that after about 6-8 hours there is still about 75g of caffeine in your system. Therefore, the timing of your caffeine consumption is just as important as the quantity. With this being said, the best strategy involves setting a caffeine curfew in order to reduce the amount of caffeine in your system by bedtime. It is recommended to cut out all sources of caffeine approximately 8 hours before bed. This includes coffee, caffeinated teas, espresso, or any other source of caffeine. Change Your Mindset in Regards to Sleep Although the other two points mentioned will probably apply to most readers, this one was the most influential point towards improving my sleep. I associated sleep with a negative outlook, specifically with loss of time. I knew through research and extensive thought that if I was going to improve my quality of sleep I was going to have to change my mindset. That isn’t the easiest task, especially when you spend years of your life thinking you dislike something. Some things that I did that helped me with this was reinforcing my why . The more I thought about why I was addressing my sleep, the easier it became to desire wanting sleep. 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This is just the beginning when it comes to ways to improve your sleep, as solutions often depend on one’s specific sleep challenges. However, trying any of these tips can be beneficial as improving our sleep is crucial to improving our physical and psychological well-being. Best of luck on your sleep journey and sweet dreams. Written By: Erik Michalik, M. Psy Candidate, BASc, Edited/Reviewed by : Chantal Legere, M. Psy References Figueiro MG, Wood B, Plitnick B, Rea MS. (2011) The impact of light from computer monitors on melatonin levels in college students. Neuro Endocrinol Lett .; 32(2):158-63. PMID: 21552190. Stevenson, S. (2016). Sleep smarter: 21 essential strategies to sleep your way to a better body, better health, and bigger success . New York, NY: Rodale Books. Photo by Andrea Piacquadio from Pexels
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Cognitive Behavioural Therapy (CBT) is a widely used approach in mental health care that focuses on the connection between thoughts, feelings, and behaviours. It may offer individuals valuable tools for managing stress and anxiety. By exploring how these elements interact, CBT aims to help people understand and modify patterns that contribute to their distress. The importance of managing stress and anxiety cannot be overstated, as these conditions can significantly impact overall well-being and quality of life. CBT addresses these issues by helping individuals recognize and change negative thought patterns and behaviours. Through cognitive restructuring and behavioural activation, patients can work on altering unhelpful thinking and engaging in positive behaviours. Cognitive restructuring involves identifying and challenging distorted thoughts, while behavioural activation encourages participation in rewarding activities to counteract depression and anxiety. These methods may empower individuals to handle challenges better and improve their mental health. Understanding how CBT can be integrated into personal care routines may benefit those seeking to enhance their psychological well-being. How CBT Addresses Stress and Anxiety Cognitive behavioral therapy (CBT) offers valuable strategies for addressing stress and anxiety. By identifying and challenging negative thought patterns related to stress, CBT helps individuals recognize how these thoughts can contribute to their stress levels. Techniques such as cognitive restructuring aim to change these stress-inducing thoughts, while behavioural interventions work to modify the behaviors that often accompany stress. For instance, someone overwhelmed at work might learn to break tasks into manageable steps and develop healthier work habits through CBT. When managing anxiety, CBT can be particularly effective in reframing anxious thoughts. Through techniques like exposure therapy, individuals gradually face their fears in a controlled manner, which can reduce anxiety over time. CBT sessions often teach coping strategies and skills that help individuals manage their stress in various situations, such as deep breathing exercises or structured problem-solving. The benefits of CBT for stress and anxiety include a better understanding of personal thought patterns and the development of effective coping strategies. This approach may offer long-term relief from stress and anxiety by equipping individuals with the tools to handle their challenges more effectively. Consulting with psychologists in Toronto can provide further insights into how CBT may support personal mental health goals. Consulting with a Psychologist Consulting with a psychologist for cognitive behavioural therapy (CBT) can provide valuable support in managing stress and anxiety. During your first CBT session, you may discuss your concerns and goals with the psychologist, who will work with you to develop a treatment plan. This plan may include strategies to address negative thought patterns and behaviours contributing to your stress and anxiety. Finding a qualified psychologist in Toronto, such as those at Toronto Psychologists, can be a crucial step in accessing effective CBT. In summary, CBT may offer significant benefits for managing stress and anxiety by providing a structured approach to understanding and changing unhelpful thought patterns and behaviours. If you are considering CBT, consulting with a psychologist may be a helpful next step in finding personalized support and exploring how this therapy can work for you.
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When an individual expects something to happen, many processes go on in our brains and bodies to meet these expectations.
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Let’s put something into perspective here: each day consists of 24 hours. Of those, it is recommended that each person sleep approximately eight hours per night. According to these numbers, we spend one third of our entire lives asleep, yet for some reason the majority of us are choosing to ignore the importance of this inevitability. Sleep alone can improve our stress , memory functioning, alertness, mood, immune system, hormone functioning, and weight, to name a few. There are no quick fixes or super pills anyone can take for instant success but sleep is truly one of the closest natural aspects we can improve on in order to benefit almost EVERY aspect of our lives. So what can we do to improve our sleep? Define Your Why A recurring theme when deciding to make changes in our lives is defining our ‘why’. Any meaningful action requires meaning or purpose for it to be achieved. No matter how complex or simple it is, when you have a reason to do something, you are more likely to actually follow through with it. Remember to remind yourself why you want to focus on this area of your life. This will be particularly important when the going gets tough or if you fall victim of your previous routine way of functioning. Remember, meaningful change (in this case, sleep) does not happen overnight. Limit Blue Light Exposure Cutting out screen time before bed is one of the most effective ways to improve sleep quality. However, I’m fairly confident that most of you reading this will end the last moments of your night on a screen, whether it's a phone, computer, iPad, or the television. Throughout human evolution, humans evolved to be awake when the sun was up and to fall asleep when the sun went down. The problem with blue light specifically is that it has shown to stimulate the brain in areas that are active during alert day hours, disorienting the body’s natural preparation for sleep. Furthermore, blue light suppresses melatonin production (the hormone that makes you sleepy) and elevates cortisol (the hormone associated with stress ). Mariana Figueiro, PhD., found that two hours of screen time before bed displayed a suppression in melatonin levels in the brain (Figeuiro et. al., 2011). In fact, even when our eyes are closed, we have photo-receptors all over our skin that absorb light just as our retinas in our eyes would. Thus, having screens on anywhere around our sleeping areas is problematic. Tips to manage blue light exposure: Setting a screen time curfew Wearing blue light protective glasses Turn on blue light blockers on devices, i.e. phones and computers (f.lux and Nightshift are recommended for iOS users and Twilight for android users) Instead of watching TV, movies, or YouTube before bed, listen to a podcast or audiobook with the screen off or on sleep mode. Ensure your room is completely pitch black at night, with no lights on, curtains closed, and any technology still on should be covered. For those of you who sleep with a light on, it’s recommended to buy a red light for your bedroom. Not only do these look cool but red light on the visible light spectrum has been shown to have little to no effect on both melatonin and cortisol levels. This is hypothesized to be due to the fact that humans have evolved sleeping by fire throughout human history (Stevenson, 2016). Caffeine Consumption Before getting into what you can do to manage your caffeine consumption, let’s take a simplistic look at what caffeine actually does to the brain that impacts our sleep. During normal functioning hours, the brain slowly accumulates a chemical called adenosine that binds to receptors to slow down brain activity and make you feel tired. The longer you are awake, the more tired you feel. Where caffeine comes into play is that it is shaped very similarly to adenosine and it binds to brain receptors. When these receptors are blocked by caffeine instead of adenosine, this tricks the brain into thinking it's not tired. Caffeine has a half-life of about 6-8 hours. A standard cup of coffee has roughly 150g of caffeine in it. What this means is that after about 6-8 hours there is still about 75g of caffeine in your system. Therefore, the timing of your caffeine consumption is just as important as the quantity. With this being said, the best strategy involves setting a caffeine curfew in order to reduce the amount of caffeine in your system by bedtime. It is recommended to cut out all sources of caffeine approximately 8 hours before bed. This includes coffee, caffeinated teas, espresso, or any other source of caffeine. Change Your Mindset in Regards to Sleep Although the other two points mentioned will probably apply to most readers, this one was the most influential point towards improving my sleep. I associated sleep with a negative outlook, specifically with loss of time. I knew through research and extensive thought that if I was going to improve my quality of sleep I was going to have to change my mindset. That isn’t the easiest task, especially when you spend years of your life thinking you dislike something. Some things that I did that helped me with this was reinforcing my why . The more I thought about why I was addressing my sleep, the easier it became to desire wanting sleep. Once I slowly worked towards this, I found that my anxiety associated with loss of time began to reduce and I was able to associate sleep with a positive mindset. Meditate Mindfulness is the act of becoming aware in the present moment, without judgement. The practice of mindfulness through mindful meditation can provide an opportunity to create mental space at bedtime and to help you feel more relaxed. Mindfulness can also help you to cope with negative thoughts surrounding sleep and to help you shift your focus to your body and to be present. This technique is easily accessible by downloading free apps or using beginner guided sleep meditation videos on YouTube. Other Minor Tips to Improve Your Sleep Journaling is an excellent release before bedtime, especially if you are an over thinker. Letting out the thoughts on paper and getting them out of your head will allow you to focus more on sleep and less on what’s on your mind. Invest in a good mattress. As mentioned earlier, we are going to spend about one third of our lives sleeping so why not ensure that we get the best sleep possible? If you are not in an ideal financial situation at the moment, perhaps investing in a proper mattress isn’t realistic. For you, I suggest buying a memory foam topper or just a mattress topper. This is an inexpensive way to improve sleep quality. Sleep and wake at consistent hours. Our super complex yet lazy brain loves to work off of routines so do your brain a favour and go to bed and wake up around the same time. This will make the process easier on yourself and will make you less likely to give up from frustrations of not being able to accomplish what you set out to. Do not, and I repeat do not, do any work or eating or anything in your bed besides sleep. The brain works off of associations so don’t confuse your brain into thinking your mattress is an office, movie theater, or a kitchen table. This is just the beginning when it comes to ways to improve your sleep, as solutions often depend on one’s specific sleep challenges. However, trying any of these tips can be beneficial as improving our sleep is crucial to improving our physical and psychological well-being. Best of luck on your sleep journey and sweet dreams. Written By: Erik Michalik, M. Psy Candidate, BASc, Edited/Reviewed by : Chantal Legere, M. Psy References Figueiro MG, Wood B, Plitnick B, Rea MS. (2011) The impact of light from computer monitors on melatonin levels in college students. Neuro Endocrinol Lett .; 32(2):158-63. PMID: 21552190. Stevenson, S. (2016). Sleep smarter: 21 essential strategies to sleep your way to a better body, better health, and bigger success . New York, NY: Rodale Books. Photo by Andrea Piacquadio from Pexels
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