DBT - Distress Tolerance - Part 3

In my two previous posts on distress tolerance (here and here), I talked about ways to cope with uncomfortably past or present situations. Practicing distress tolerance skills is helpful for anyone who wishes to stay mentally healthy.

Think of a situation where you’ve been distressed. Maybe it’s an argument with a friend or family member. Maybe it’s a poor performance review or a disagreement with a supervisor or coworker. If you’re like me, your first inclination to deal with the problem isn’t always the most helpful. As someone who deals with anxiety, my usual go-to is worry and rumination. You’d think that I would learn by now that neither one of those things makes me feel good, not to mention that they don’t do anything to solve the problem.

In DBT, one aspect of distress tolerance is distracting oneself from worries. The acronym the distress tolerance skill of distracting is: ACCEPTS. I won’t go into a lot of details here (the DBT Self Help website has an article dealing with ACCEPTS here , but the acronym stands for: activities, contributing, comparisons, emotions, pushing away, thoughts, and sensations.

I haven’t used all of the strategies and have used some with only limited success, so I’ll share the two that have been most helpful for me.

Activities are a big one for me, and they’re easy to implement. Running is often helpful as I can concentrate on the physical exertion, but the drawback is that my mind is usually free to think about whatever it is I’m dealing with. Reading and listening to audiobooks are great ways to take my mind off of things that are worrying me. And sometimes I listen to audiobooks or podcasts while I exercise for the double bonus of exercising and distracting myself from my worries.

Watching TV shows, movies, or sports are also ways I distract myself from worries. Sometimes, when I’m feeling hypomanic, it’s hard to concentrate on reading, so watching something is an easier way to distract myself.

Contributing is another way I used to distract myself from worries. It’s easy to let stressful life situations give me a “woe is me” attitude, so contributing is a great way to help others and not worry about your own problems. I recommend scheduling some sort of volunteering so you don’t have to think about contributing when you’re feeling stressed out. Giving to a charitable organization is another way to contribute.

Distress tolerance skills are useful to have in your tool belt, but remember that they are not a solution to all your problems. They may, however, help you gain perspective and realize that some difficult situations can be ignored, or bring you to a place where you’re more emotionally stable to deal with a problem.

If you’re interested in learning more about DBT techniques, I recommend the website, DBT Self Help.

Be well.

DBT - Distress Tolerance - Part 2

Life will always deal difficult circumstances. It's part of the human experience. While some people deal with more difficult circumstances than others, everyone will have to deal with uncomfortable, if not tragic, situations. While these DBT skills can help those struggling with mental health issues or mental illness, they are also helpful to maintain mental health in general.

In my last post on distress tolerance, I wrote about dealing with difficult situations using radical acceptance. In this post I want to share in a little more detail how I use radical acceptance.

Radical acceptance means taking a look at a past event or current situation and deciding what to do about it. Rather than allowing the situation to consume you and lead to anxiety or depression, there are strategies to cope and deal with that event or situation without emotional turmoil.

As I touched on in the previous post on distress tolerance, the first part is accepting the situation for what it is. Then, it is accepting the emotions that go along with that situation. Finally, it is accepting that life will be OK, even with the painful situation.

It is hard for me to practice radical acceptance when feeling depressed. Instead of being able to accept a past mistake, I tend to ruminate and focus on that mistake with regret, which leads to more feelings of depression.

It's good to practice radical acceptance when I'm feeling balanced because then it's easier to accept a past event or mistake and realize that the only thing I can do is learn from that past event or mistake and that beating myself up or feeling depressed about it isn't going to help me. By practicing radical acceptance when I'm not experiencing bipolar symptoms, it helps me be more effective at it when I am dealing with anxiety, depression, or hypomania.

A big piece of radical acceptance is telling oneself that life can still be good despite a past painful event. Past events do not have to become self-defining. Though I had to leave two different jobs abruptly because of acute bipolar symptoms, I don't need to label myself a quitter. Instead, I can accept what happened and tell myself that even though those weren't ideal circumstances, I have a job now and am better prepared to stop or reduce bipolar symptoms that could lead me to miss work. Rather than focus on the past, I can enjoy the things that are good in my life, of which are many.

My next post will be my last post on distress tolerance.

Until next time.

DBT - Distress Tolerance - Part 1

In my last post, I wrote about how using DBT, specifically mindfulness skills, helped me through a rough patch of bipolar symptoms. The skill sets of DBT include mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. In my last post, I wrote about how I used mindfulness  skills to cope with symptoms from bipolar and how those skills can help keep one mentally healthy in general.

Distress tolerance skills were also helpful in getting me through my last rough patch of bipolar symptoms. Distress tolerance skills are similar to mindfulness skills in that many of the skills help one focus in the present rather than fretting about the future or feeling depressed about the past. I’ll spend a couple posts on distress tolerance as there are a lot of skills and several were helpful to me in getting through my last rough patch.

The main distress tolerance skills my therapist had me work on was radical acceptance. Radical acceptance means accepting the world and the moment exactly how it is in that moment. In my post on mindfulness, I wrote about using the observe and describe skills to recognize memories and emotions that may be painful. Using radical acceptance, I work on experiencing the moment, no matter how uncomfortable, and accepting that moment for how it is, without denial and without judgment.

By accepting the situation or emotion without denying it, I’m more able to effectively deal with it. Denial of a situation or an emotion does not get rid of it. By pretending a situation or emotion is not there, it merely prolongs the situation or emotion because one has no opportunity to deal with them.

Radical acceptance was helpful to me as I went through my last bout of bipolar symptoms. When I get into a cycle of symptoms, I can start to feel out of control and begin to worry that I’ll continue spiraling and end up in really bad shape, possibly landing in the hospital. By using radical acceptance, I can stay in the current moment and focus on that moment alone rather than worrying about what may happen in the future.

Using radical acceptance does not mean you have to shrug, say, “it is what it is,” and leave the situation at that. Instead, one can still radically accept something and still work to improve or learn from the situation.

In my next post I'll write more about how to get through difficult moments—both by exploring radical acceptance in more depth and by using other skills and strategies.

DBT - Mindfulness

About a month ago, I wrote about how I was using DBT (dialectical behavioral therapy) to help get me through a rough patch. I’m happy to report that since that post I’ve started to feel better, and I attribute at least part of that improvement to working on DBT skills. If one doesn’t have anxiety or depression,  DBT skills can still be useful for improving mental health in general.

The first category of skills I’ve been working on is mindfulness. Using mindfulness helps get me out of my head and focus on the current moment rather than ruminating on past mistakes or worrying about the future.

The three specific skills I’ve been working on are, “Observe: just notice,” “Describe: put into words,” and, “Nonjudgmental stance.”

When I talked to my therapist, I mentioned how my mind would often wander to past mistakes I’d made and how those thoughts led me to feelings of guilt, which in turn contributed to my depression.  Also, I was spending time worrying about future events, which was aggravating my anxiety.

So, she suggested using the observe skill and the describe skill along with the nonjudgmental stance to deal with the thoughts and emotions. 

Using the observe skill, rather than trying to counteract worry or the thought of a past mistake, I just notice it. I see that it’s there, then use my next skill, describe. I describe the thought in my head along with the feeling it elicits. In this way, I separate myself from the thought and emotion. The thought and emotion are simply there—they are not me. I then employ the nonjudgmental stance, which means I look at the thought and emotion and without judging them. In this way, I don’t let the emotion affect me further. Instead, I merely acknowledge it and not worry about when the thought and emotion will leave.

I can’t say these skills in mindfulness work every time. There are still moments were I succumb to guilt or anxiety, but putting these skills into practice definitely helps.

In a future post, I’ll write about some other skills I’ve been using that helped get me through that rough patch. 

Thanks for reading.