Creating a Distress Tolerance Kit

As anyone who struggles with anxiety, overwhelming thoughts, and overwhelming emotions, and panic attacks knows, there are many times when it feels like the mind has gone bye-bye and has taken logical, helpful thinking with it. In moments of distress, regardless of what triggered them, it can feel like torture. It can feel like the whole world is falling apart, that nothing is safe, and it’s very possible that you might die.

These feelings and thoughts can be paralyzing. I have a very hard time thinking clearly and being able to cope, self-soothe, or distract, can be challenging.

There are some days where I can use “Cope Ahead” from DBT to try and reduce the anxiety by preparing ahead of certain situations where my anxiety or a panic attack can be triggered. Some days though, coping ahead isn’t as effective as I would like it to be, or I didn’t think the anxiety would be so bad so I didn’t cope ahead at all. And some days the anxiety or panic attack hits with no reason or warning at all.

In order to try and reduce my anxiety, no matter where I am, I created a portable distress tolerance kit. It’s small enough I can carry it in my bag so I have it with me pretty much all of the time. At any given time I know where it is. In fact, I have even created a second kit with most of the same items to put in the other bag I use, just in case I forget to take the first one when I switch using bags.

I highly recommend creating a distress tolerance kit for yourself for when anxiety hits, and keeping it somewhere that you can easily get to it when needed, even carrying it with you for when anxiety hits while on the go. Create several kits if you need them and keep them any- and everywhere you may need to use it. Create one for at home, in your car, at work, in your bag, and even at a family or friends place. If you trust them to tell them what it is and what it’s for, of course.

Creating yourself a kit is super easy and can be low-cost too. I created mine by going to the dollar store and altogether I spent less than $20. There are tons of options that can be used for a distress tolerance kit.

Starting with the pouch, which can be any size and basically anything that can hold your little toys or puzzles or whatever. I found my little red pouch in the craft section of the dollar store. Really anything purse or pouch-like can be used. It all depends on how portable you need it to be and how many items you want to carry. You could use a little purse, a coin/change purse, a pencil case, even a sealable sandwich bag could work. If you keep a kit at home, find a pretty box or container you can use to hold your items. Be creative and check toy stores, dollar stores, clearance sections, housewares, crafts and stationary sections too.

As for the items to go into the kit, it is entirely up to you and your needs. Be creative and whenever you find something that helps you, no matter what it is, add it to the kit. Toy sections are an incredibly rich source for little toys and gadgets you can fidget or play with. Even the baby section can have a great selection of items that you can use to soothe or distract you when feeling anxious. Google ideas, too.

This is my distress tolerance kit, and what is included:
– small drawstring pouch
– mini slinky toy
– two small pointy toys
– squishy ball
– silly putty
– small soft mitten

This is the small drawstring pouch

This is the squishy ball (it’s rubber with water inside, and please ignore the fuzzy stuff that got stuck to it, it’s from the inside of the bag)

This is my mini slinky

These are my two pointy toys that I like to fidget with

This is my silly putty (store inside its egg to keep soft)

This is my mitten (it was, of course, a pair of baby mittens, I like to fidget with them because they are so soft)

This is a mini wooden puzzle. (I got this from a Toy Store called Masterminds. I like to fidget with this when I need something more challenging for my mind than just a pointy toy. But apparently, my skill level does not allow me to figure this stupid thing out so I don’t use it a lot.)

This is a mini Rubik’s cube

This is a mini Word Search book

I got all of these items, except for the wooden puzzle, at a dollar store. The wooden puzzle I got from a toy store called Masterminds. And like I said above, the whole kit, including the toy from the toy store, cost me about $20.

These are just some examples that you can use but whatever you find helps distract you and cope could be totally different. I recommend keeping the items small so you can carry them with you, if needed. Sometimes when I’m going out and I’m not carrying a bag I’ll just take the silly putty with me so if I need to fidget I have it on me.

Just remember whatever items you use are what will help you when you need it. It doesn’t matter if they don’t make sense or are not things that right off the bat seem like they will help. If fidgeting with a pencil helps you, then carry a pencil. If you like the way a fluffy little toy feels and helps to soothe you, then get the toy. If fidgeting with a bottle cap helps, then keep a bottle cap on you. It’s you and your needs you’re looking after.

I also have a rock that I like to fidget with and helps me do observe and describe, so yes, I have a rock in my pocket too.

Remember that whatever you decide to use, whether on their own, or collectively as a kit, should be accessible for when you need them. This means keeping them where you can find them and being able to use them because if you’re experiencing high anxiety or panic attack, you most likely won’t be thinking very clearly, so seeing and accessing the items should be easy and fast.

I add and take away items as needed too, so feel free to explore what helps you and rotate or replace items as you need it. You may be in a panic attack when you discover something that didn’t work, try and think to that moment and how you can have something else on hand to help you the next time. I thought a word search book would work for me but one day it didn’t I preferred something I could just fidget with, and so I discovered the silly putty helped.

Having a distress tolerance kit has helped me on many occasions. I do still have anxiety and panic attacks, and a few times I forgot I had the stuff, so it’s not foolproof nor will it totally take the anxiety away. I wish. It does help though. A lot. My anxiety has been reduced by having toys to fidget with, and I have avoided several panic attacks because of them too. Having several items can also help for days when your never know what can help. Sometimes I’m positive the slinky will help but it doesn’t, the toy helps, and other times the toy doesn’t help but the silly putty does.

Sometimes just knowing I have stuff with me can help.

I highly recommend taking the time, as much as needed, and creating your own distress tolerance (anxiety/panic attack) kit. And when you can, don’t leave home without it!

Good luck!

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A Meds Dilemma

One of the meds I just started a few weeks ago is really helping to bring my mood back up. Not in a dazzling, ray of sunshine, bring on the day kind of way, more like okay maybe today won’t completely suck kind of way. I’ve taken it in the past and it was helpful to me then as well. So I know my track record with this med is relatively successful. And by successful I mean it doesn’t give me suicidal thoughts or tendencies, I usually don’t have any headaches or stomach issues as side effects, and it actually does more good than harm.

The problem is, it does affect my anxiety. A lot. It raises the baseline of my anxiety to a high moderate level so that I’m constantly feeling pretty anxious, and feeling a bit on the edge. Not a jittery, pace the room kind of anxious. More like a can’t relax enough to relax kind of anxious. As tense as my neck and shoulders are normally, they are even more so with this med.

And my susceptibility to panic attack increases. Whereas before I may have had a shot at managing the anxiety before it becomes a panic attack, now I’m lucky enough if I get a warning with enough time to intervene before the panic attack hits. If I’m already in the panic attack, it lasts longer and feels way more intense.

Just yesterday I had high anxiety for most of the morning, and it crept higher and higher until an hour or so later I had a panic attack, having to abandon my lunch and make my way home. And it lasted all the way home. It was awful. And it is the third panic attack in just the last several days.

Lately I’ve been better able to cope ahead and manage my anxiety to a level that allowed me to get some things done and go out every now and then. Of course, my mood was low enough that getting things done was low on the list of things to do, and going out was even lower but when I would the anxiety was mostly manageable.

Enter my dilemma. Do I continue to take the med so that I can continue to have an elevated mood, and just endure the anxiety as best as I can? Or do I stop the med altogether, significantly reducing my anxiety and bringing my mood back down?

It’s kind of a tough call. Because this anxiety is brutal. It is near constant and so intense it startles me. And then there’s the thing that the med actually does help me. As anyone struggling with illness and going through different treatments knows, the quest to find a med that works can be long and tiring, and can often lead nowhere. It is nice to want to get out of bed in the morning. Well, maybe want is a strong word. More like, I’ll get up and we’ll see how it goes. Which is more motivation than I’ve had in a while so…

My psychiatrist is thankfully working on this with me, letting me see if the benefit does outweigh the downside. She’s kindly offered to help me work on managing the anxiety so that I can continue on the med to see if the elevated mood is enough. Plus she was kind of enough to give me a script for an anti-anxiety med for when the panic attacks are really beating me down.

So is the anxiety worth the slight mood elevation that I get with this med? I mean if it gave me real pep and a get up and go kind of benefit that might be a little more persuasive in staying on it. I’d be much less depressed and maybe even productive. With this med, I’m not there so I’m not sure if it is worth it.

I’m thankful that I have a doctor willing to work with me on this instead of just writing off scripts and leaving it at that. Hopefully the anxiety can be contained and I can keep the elevated mood. We’ll see…

When Thoughts Become the Enemy

I have always been a thinker. Not in a philosophical, “let-me-contemplate-life” kind of way but more in a “I-don’t-want-to-sound-like-an-idiot-and-what-is-wrong-with-me” kind of way. At times this has been a blessing; fueling fantastic ideas, helping me better understand situations or emotions by thinking before I speak, and giving me better perspectives and patience for others as well as for myself. But sometimes it can be a curse. Sometimes it can be a life-threatening, violent curse.

And thinking is the last thing I should be doing. Thinking is the first step for me towards things spiraling out of control. Because sometimes my thoughts have turned against me, and have now become my enemy.

I understand that thoughts don’t necessarily mean anything. I understand that thoughts are usually not factual, and are most often influenced by the mood of the moment and/or the current environment I’m in. I understand that thoughts are not made of cement and are subject to change at a moment’s notice. I understand that just because a thought pops into my head doesn’t mean I have to entertain it, or believe it, and the thoughts don’t have to turn bad. I understand that I am not my thoughts.

I understand all of that, logically. But emotionally… emotionally, I’m not so on board with this theory. And as much as I know logically that my thoughts can be harmless and don’t have to make or break who I am, sometimes they do. Sometimes they really, really do.

In DBT, one of the things that is taught (I really should get back to my weekly progress on that here too by the way) is that our thoughts are not who we are. They are just thoughts. They don’t need to take over everything, and they don’t need to even be entertained for a moment. Because they are just thoughts.

A practice to help realize this is to think of our thoughts like they are leaves on a river. Each leaf on the river is one thought, and they just float on down the river as leaves, doing nothing, going wherever. They don’t have to be addressed or picked up. They don’t have to be noted or talked about. They just float down the river and away.

Now, I am actually a fan of this idea. I really like the leaf and river theory because first of all, I like watching leaves on a river and leaving them to just float, but the bigger reason I like this idea is because it allows me to see the thoughts as something separate from myself. It helps me to see that the thoughts are just thoughts, and don’t have to have any power. They kind of lose their power when they are made into something harmless and benign like a leaf can be.

There have been times where I am successful at doing this, but unfortunately not as often as I’d like, and not nearly as often as it would help me. A lot of the time my thoughts take me over and take me down so fast that I feel like I don’t even get the chance to turn them into something else, let alone to turn them into leaves on a river and just watch them float by.

A thought comes into my head and before I realize that my thinking has turned to a dark place, I am already caught up in the race of thoughts now taking place in my mind. Like a speeding roller coaster with a broken control lever, I am taken for a ride that picks me up and pulls me down, throws me all over the place, and is getting very close to making me feel sick.

My thoughts can determine whether I end up having a bad day or a good day. They can start out so innocent and passive and within moments they can keep me paralyzed to going anywhere or doing anything. My thoughts can come pretty close to killing me.

My thoughts can go from compassionate and kind to degrading and insulting in a heartbeat. I’ll think that I am okay, I’ll believe that I’m okay, and that I can handle things without resorting to more negative thinking and destructive coping methods. I’ll think that my thoughts are manageable and won’t hurt my feelings or leave me feeling suicidal. And then BOOM! just like that, I am thinking that I am the worst person in the world. I am a horrible person who no one likes and that I will always be hopeless and worthless. I am useless and don’t deserve to be alive. My thoughts will become harsh, mean, degrading, and abusive.

I’ll try to stop the negative thinking by challenging if the negative thoughts are true (another thing I learned from DBT and “Checking the Facts”). And I’ll ask myself if it’s really true that I am a horrible person, and if so, then where is the proof? I’ll challenge if I should really be dead, or if that’s just my thinking being a bully. And depending on whether I am able to divert the thoughts back to something positive, or at the very least, less negative and abusive, and change the thoughts, I will again fall prey to all the bad stuff I think of myself. This may or may not lead to anxiety, depression, and/or suicide, or all of the above. Sometimes I am able to change the tide and save myself from spinning into darkness. But a lot of the time, I can’t. A lot of the time the thoughts are more powerful than I am. A lot of the time I am able to find all the proof I need to show how horrible I am. I can find all the proof I need to prove that I should be dead. And I can prove with the best of them my worthlessness and the millions of reasons that no one likes me. And no one ever will.

I used to fall prey to these bad thoughts so easily that it could take weeks or months for me to come back from how much I would hurt and insult myself. And even then, it would take almost constant reinforcement from others for me to believe that what I think of myself is not true. It would take almost constant reassurance from others (because there’s no point in me saying it because it’s only true if others say it), that I am not worthless, that I am not hopeless, and that I am not unlikeable, and that I shouldn’t be dead.

If I have hurt myself deeply enough I may not even believe what others say. If I have insulted myself enough into a deep, dark, desperate, weeping puddle on the ground, then there are few people who could make things better, and even fewer people that I would believe if they try to make me feel better. If they try to tell me that I am worthwhile and likeable I would scoff and tell them that they have obviously missed the memo that I am a horrible, unlikeable person. They obviously are lying to me and to themselves, and they are wasting their time with me. And because people have jobs and families and lives, it is very rare for me to get the constant reassurance I need in order to turn the tide of negative thoughts in my mind. This a fraction of how powerful my thoughts can be.

I am working as hard as I can to challenge all of this, and keep my thoughts from taking me over. It’s hard. It’s not always successful. It’s a work in progress.

The power of our thoughts can be debilitating and hold enough force that we believe them to be true. Why would I think it, if it wasn’t true? How can it not be true, it’s such a frequent and powerful thought? All of my thoughts are telling me this, so why wouldn’t it be true? Would my thoughts lie to me? Why would my own thoughts lie to me?

Our thinking can lead us to personal beliefs, of ourselves, and others, that may or not be true. They can lead us to behaviours that can reinforce our thoughts and strengthen our beliefs. To the point that everywhere we look we find proof that what we thought was true. What we thought was a fact. Even when it isn’t.

Our thinking can spawn any number of scripts that run through our minds at any given moment, particularly when we need it the least, and despite knowledge that contradicts the information, can leave us a complete and total mess. Our self-esteem a puddle on the floor, and our beliefs stronger than ever of things that aren’t true.

The scripts tell us how everything we are is wrong, and everything we do is wrong. It tells us how much we deserve all of our flaws and tribulations because we are that awful. It tells us that we will never change and shouldn’t even try. It tells us that we will only have bad things happen to us, and proves it by providing the thoughts of all the bad things we have endured so far, conveniently omitting any of the positive things, because the script knows how to break us. The script knows what to say and what not to say. The script will run so often and so loud we feel we are forever stuck with it.

The scripts may change over the years, growing or shrinking as we add new thoughts and take away old ones, but the lies will remain the same. The lies become bigger and brighter with each run of the script. Until finally it is so ingrained in us that we lose sight that we even have the script, and we could possibly think any differently. We feel it becomes us because its automatic for us now. We barely need the prompt before the thoughts are up and running. It’s as close to automatic as breathing, and just as difficult to change. So we resign ourselves to our thoughts and the script it plays, and hope that maybe this time will be different.

For many, many years I have hated my thoughts. I have hated thinking and was convinced that it could only, ever be bad and mean. I was convinced that my thoughts would never be able to change and one day they would definitely kill me. I was convinced my thoughts were me. My thoughts were absolutely who I was. I was convinced that everyone and everything else outside me, contradicting or challenging my thoughts, were the ones who were wrong. All my thoughts were true and factual. Everyone and everything else was false. I was convinced that my thoughts would never lie to me. That they couldn’t.

The scripts that I run have been hard and I hate that, until recently, I have believed them so fiercely for so long. My scripts have reinforced my anxiety, depression, and several disorders. I considered them as gospel, to me and to my life. I considered them as everything I was.

It is only recently that I have finally realized that my thoughts are not me. And A LOT of the time, they are in fact, untrue and misleading. My scripts are not written in stone, and not only can they be changed, they can be removed. And they should be. I still sometimes forget that my thoughts are not me, and they don’t have to be my enemy. They might not necessarily be my friend either, and that’s okay. Thoughts are just thoughts. That’s all. Not bad. Not good. Just thoughts. If they are anything, they are either useful or not. They don’t have to be followed, entertained, believed, repeated, hated, liked, ignored, or accepted. They are just thoughts.

I hope of all the thoughts I have, that’s the one I remember.

What a Difference a Year Makes

It occurred to me yesterday that it had been exactly one year since I had been hospitalized. One year since I had felt the bottom drop out and sought help. And it got me thinking of how far I had come, how far I still had to go, and the journey thus far.

At first, I thought I haven’t come far enough. I’m still struggling. I still have some very bad days, and I still have some emotions and thoughts that overwhelm me.

And then I realized that I was being really unfair to myself, and negating what progress I have made. When I actually compare where I was and how I felt last year this time to where I am and how I feel this year, I couldn’t ignore that I had made way more progress than I gave myself credit for.

Last year I was teetering on the edge, and was thisclose to standing on a ledge. I was inconsolable and suicidal. I was self-harming and doing anything I could think of to ignore and suppress all the pain. I was sleeping fewer than four hours a night and eating everything in sight. My dreams were killing me, with images and ideas that left me disturbed and scared so bad that they would wake me almost every night. I was afraid, hopeless, helpless, and I felt more alone than ever. I couldn’t even imagine seeing the next day, let alone a year later.

So I asked for help. I took myself, in my pj’s, crying my eyes out, down to CAMH 24-hour emergency down at College, and I asked them for help. I told them that I was afraid for myself and that I wouldn’t make it if I was left alone any longer. And just like that, they took me in. They said they could help and they wanted to. That floored me. They wanted to help me?! Why? Well I still don’t know why, and frankly I don’t need to know anymore. All I know is they did.

I spent six weeks in their care, and the team that was built around me, saved my life.

To be clear, they had saved my life, but I still wasn’t totally sure that life was worth living. And I was pretty sure that I would end up right back where I had started. It was only a matter of time.

I had very few illusions about my prognosis. I had been low before and somehow managed to claw my way back. Several times. Granted it wasn’t really ever a recovery so to speak, it was more just getting to a point where I could function. Enough to work and pay bills and keep a home, but just enough.

My relationships were stressed, at best, my health was on a downward spiral that I’m still working to manage, my work was a joke with no purpose or enjoyment on any level, and my thoughts were slowly deteriorating my will and my sanity. I wholly assumed that this time would be no different.

But…it was.

I don’t know exactly why this time turned out differently. I just know that it did. Maybe it was the team I had behind me, maybe it was the medication, maybe it was me, or maybe all of the above. Whatever it was I had somehow found a path towards living a life worth living. I was able to get into, not one, but three different programs that would help me work through my destructive coping methods, address my overwhelming thoughts and emotions, and teach me how to build a life worth living.

Every day poses an obstacle that can still stump me, and there are days where I am filled with uncertainty and anxiety, but I am learning, and despite the uncertainty and anxiety, I am making changes that are positive. I am learning better ways to cope that are not destructive.

It is by no means, an easy journey, and there are no guarantees that everything will turn out okay, but it’s farther than I’ve ever come before. It’s far more progress than I’ve ever made before. And the changes, so far, have stuck around. I can only hope that this is a turn towards a better life that will last.

And hopefully, this time next year, things will have improved from today, and I can tell of all the latest progress I will have made. At least, that’s the hope.

Until next time… 🙂

The Unsettling Feeling of Calm

I wanted to share this because I’m curious to know if anyone else has experienced this. Or if it’s just me and I’m losing it. 

Today on my way to an appointment, I was on the bus and it was about halfway through my trip when I realized that I felt calm. It hit me quite suddenly as I was just looking out the window and thinking. Was I…calm? Was my body…calm? Wait a second, was calm? Really? Are you sure? Me? Calm? That can’t be right. Okay, what’s going on? 

So I scanned my body to look for anything that might be there, a flutter, some tension, anything to tell me that my body was in a state that wasn’t even close to calm. And as I reached my toes and still had not found anything, it started to sink in that I wasn’t really feeling anything at that moment. Say what? I wasn’t feeling anything? 

I thought maybe I was numb then. That made sense. I wasn’t feeling anything in my body because I was numb. But the body scan told me it wasn’t numbness because even when I’m numb I physically feel a certain way. There are still physical sensations that tell me I’m feeling numb. And this time there was nothing. Just…nothing. No anxiety. No tension. Nothing. My breathing was normal and my body was calm. 

What the crap was this?

I scanned my body again, looking for the slightest twinge or tension, thinking I needed to double-check this out because I couldn’t be just calm, could I? And again the scan told me there was nothing. My body was not in a state of anything. Was this what riding the bus with no anxiety looked like? Was this what an anxiety-less body felt like? Was this simply riding the bus? Was this what just taking a bus looks like? Was this what just taking a bus feels like? 

Well I don’t like it. 

Now don’t get me wrong, when I say I was calm I don’t mean that my mind was blank or quiet because it was neither. I don’t mean that by being calm I was not having a swarm of thoughts going through my mind because I did. In fact I was thinking about my life and my emotions when I realized how calm I was. I was not really relaxed, meditative, or even happy because I wasn’t. It was just…calm. 

For whatever reason, I was not tense or anxious or feeling like I would pass out or freak out. I was not worried that I might die or anything. The absence of the chaos I usually carry within me was very unsettling. It wasn’t long before I wondered if I should be freaking out. I mean this was not my usual feeling. This was not my usual state. This was not the way I normally take a bus. This was new, and weird, but suprisingly even when I thought of freaking out my body just stayed calm. For a moment I was unable to even stir myself into feeling anxious. I have no idea how. And I have no idea why. I just was. So this was calm? This was just sitting with myself? This was just being?

Interesting. 

I actually managed to stay calm for the next hour or so, and frankly I’m just stunned. I don’t know how it happened. I don’t know why it happened. I have no idea how I managed to stay calm in my body as my mind pondered life’s questions. But there it was. Me. Calm. 

Alrighty then. Good to know. 

I’ve decided not to analyze this to death because I have a feeling it will never be explained. I have a feeling that it actually doesn’t  matter why it happened. So I am going to accept it for what it was, a feeling of calm while going to an appointment. 

I’d like to say that I was able to stay there, in the calmness, but unfortunately my anxiety about not having anxiety managed to build my anxiety level, and within a couple of hours I was back up to a 7 or 8 on the anxiety level scale, and also had a slight panic attack on my way home from the appointment. 

On the plus side, I was super pleased that I had at least caught a glimpse of what a zero on the anxiety level looks like. It’s nice to know that it can happen, that it is possible, and that I can get there. I’d like to know why or how it had happened so I could harness it for the future but I know that is probably not possible. Some things can’t be harnessed like that. At least, not yet. 

As unsettling as it was to just be calm and not have anxiety and all the baggage that goes with me wherever I go, I’m really glad it happened because maybe it will happen again. And maybe it might even last longer. Or maybe I’ll never see it again. Who knows.  But at least knowing it’s possible is good. 

Has anyone else experienced this? I really hope it’s not just me.