Crisis and Distress Tolerance Skills

A crisis; a time of intense difficulty or danger. High levels of distress can lead us into a crisis and crises can be particularly frightening and dangerous. Crises can involve but may not always include;

  • Extreme emotions such as; rage, despair, intense anxiety
  • Panic Attacks
  • Suicidal/Aggressive thoughts, threats or attempts
  • Inability to communicate; incomprehensible or muffled speech, inability to articulate thoughts properly
  • Loss of touch with reality; hearing or seeing things that aren’t there, strange thoughts and beliefs (paranoia, hallucination, psychosis)

If you believe you are currently undergoing a crisis, please reach out to a crisis intervention team now. You will be put in touch with volunteers who are trained in helping people through crisis.

Call Samaritans: 116 123
Text SHOUT: 85258

Distress Tolerance

Avoiding crisis involves managing distress as we experience it. Distress is when we experience extreme anxiety, sadness or pain. This could be due to a loss, a difficult life situation or unhealed past traumas. Some short term ways we can reduce distress include:

  • Activities: This could involve engaging in hobbies, going for a walk, watching a videos, listening to music. Activities are a good way to distract us from our negative emotion and build positive emotion through pleasant, enjoyable and healthy behaviors
  • Contribute: Volunteering to do something for someone or many can help us feel more connected to the world around us and we often feel positive emotions when helping others
  • Push away: There’s nothing wrong with pushing away or walking away from a negative or distressing situation in order to gain some mental space. This can help us let the negative emotion cycle to settle and give us mental clarity on the situation later.
  • Thoughts: We can use our thoughts to focus other things while our emotions reach homeostasis again

Mindfulness for distress

Mindfulness can help us develop our sense of in-the-moment awareness of how we are physically, emotionally, mentally. It can help us see the connections between our thoughts, feeling and sensations and how they relate to the events in our lives. Importantly with regards to distress, we can use this awareness to help us to wisely navigate our experience when undergoing intense emotions.

Peaks and troughs of emotional activity

Mindfulness can help us understand this curve as it goes up and down. Things we can be aware of include the event that triggers the response, our perception of the event that took place, thoughts that arise from the emotions, the physical changes that come with the emotional and what happens as our body restores its homeostasis.

As well as helping us be aware of our emotional cycles, we can be mindful of things that may make use for vulnerable to negative emotion. Things that can effect our emotions negatively include physical illness, the quality of our eating, any medication we are taking, the amount and quality of sleep we’ve had and our level of exercise. Improving and treating these variables can give us more emotional stability.

In my experience, mindfulness is a very important part of good mental health and I will be writing more on this topic in the future

When reducing distress, we’re really wanting to reduce our negative emotions while increasing our negative emotions. To do this, we need to learn how different things effect our emotional states and then endeavor to nurture behaviours, thoughts and experiences that bring about these states. Journalling can be a great tool for this. We can record events as they have happened and examine our perspectives on them and explore ways we can remedy the negative situations or bring about more positive ones.

Positive routines to generate positive emotions

Giving ourselves good, healthy routines that bring about positive emotional experiences gives us a good foundation for keeping our distress levels down over time. While some routines will be very personal in their emotional outcomes, certain routines are generally effective for all. These include;

  • Getting the right amount of sleep – Good sleep routines improve our physical and mental health. REM (Rapid eye movement) sleep in particular has been demonstrated to help us regulate our emotional health.
  • Starting the day with good hygiene – Good hygiene in the morning makes us feel fresh and more presentable to others
  • Eating a healthy, balanced diet – Having the right amount of macro-nutrients (carbohydrates, protein and fat) keeps are body healthy and effective. Also micro-nutrients (vitamins, minerals etc.) perform a whole variety of roles that include regulating our mental health e.g. Vitamin B6 has been shown to help us regulate our moods and has been used to treat symptoms such as anxiety, depression and irritability
  • Taking time to plan your day – Planning our day can help us keep our routines together as well as make the most out of our day. For people who are more inclined to a free and open schedule, planning can still help us see what an ideal day would look like to us and we can use it as a reference for positive ventures
  • Physical exercise – Physical exercise releases endorphins that make us feel good and also promote self-esteem and cognitive functionality. Regular exercise has been shown to reduce anxiety, depression, negative mood and social withdrawal
  • Taking a moment to relax and reflect – Taking out a portion of the day to just sit with ourselves to relax and reflect with no distractions can help us check in with ourselves to see how we’re doing emotionally as well as give us a break from our activities to center ourselves and develop mindfulness
  • Spending time with loved ones – Spending quality time with those who are important to us gives us a feeling of connection that can reduce stress and improve psychological well-being. One study found that people who view their friends and families as supportive reported a greater sense of meaning in life and felt like they had a stronger sense of purpose.
  • Practicing gratitude – Taking time to be thankful for the positive things in our lives helps us develop a positive perspective and attitude. When we’re thankful, we find it easier see the positive aspects of life events and situations which is easier on us cognitively and helps us build emotional resilience
  • Helping others – Using our time to provide value to others can be very fulfilling and also leads us to social opportunities which can be beneficial to our own lives, such as creating and developing friendships. While helping others can be fulfilling, it can also be another source of distress. This is why it is important that we have healthy boundaries in place to protect our emotional well-being from being hurt.

We will all also have our own routines that provide us with positive emotion, whether that’s something relaxing, something thrilling or something that fulfills us intrinsically. What are these for you?

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