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…

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. 

There Is Nothing Wrong With Having Mental Health Issues

This past weekend brought up the conversation of mental health issues in a number of ways for me; from hearing about Toronto Blue Jays pitcher Roberto Osuna speaking publicly about struggling with anxiety, and not feeling himself, to conversations I’ve had with family and friends. I feel like it needs to be said again, and again, that there is nothing wrong with having mental health issues. I’m going to be repeating this often throughout this post, THERE IS NOTHING WRONG WITH HAVING MENTAL HEALTH ISSUES.

I think Roberto Osuna’s decision for opening up about what he is struggling with, which is no doubt much more common in baseball, and sports in general, than is reported, was exceptionally brave. It isn’t easy to open up about something so personal and something that can be subject to judgement, criticism, and misinterpretation.

Mental health is absolutely vital to our well-being. Without it, we are open to literally falling apart. Mental health is just as important to our being able to function and cope as physical health is. In fact, there are a number of situations where mental health may be even more important than physical health.

The dozens of disorders and diagnosis that encompass mental health are never something to be taken lightly, no matter how, where, when, or why, a person finds themselves struggling with them. Whether it’s a disorder that has been a part of your life since childhood, or whether it’s something that pops into your life in later years, it is always, repeat always, something to be taken seriously. And at no time is it ever a reflection on what kind of person you are, nor does it ever mean that something is wrong with you.

Admittedly, you may need treatment, you may even need medication, but that does not mean you are broken, or flawed, or weak, or a bad person. It doesn’t mean you should be treated differently nor does it mean you should be shunned, judged, ostracized, or criticized. It means that you need help and support, encouragement and compassion, and understanding and patience for a difficult situation or period in your life. That’s really all it means, that you need help. And there is nothing, NOTHING, wrong with that.

I can understand that there are people who have not struggled with mental health issues and may not be able to fully grasp what it means but that is no excuse to treat someone with mental health issues any differently than had they been struggling with something physical that can be seen or quantified. People struggling with mental health issues are still people.

You don’t have to have mental health issues to be compassionate.

I think it’s great that the conversation of mental health is fast becoming more mainstream, and less a “closeted” discussion, saved only for professionals. With places like CAMH (Centre for Addiction and Mental Health), here in Canada, CMHA (Canadian Mental Health Association), also here in Canada, the annual Bell Let’s Talk campaign, and several sports and television personalities opening up about their own mental health struggles has made a HUGE impact in people starting to realize and understand that mental health is something that can affect anyone, in any capacity, or social standing, and that it is NOT something to be ashamed of.

I firmly believe that places like CAMH and CMHA are leading the fight in bringing awareness to mental health, bringing the discussion to the masses, and especially with bringing help to those in need. Addressing mental health openly has come a long way in starting to lose the stigma that has been attached to it for so long. But there is still more work to do. And it starts with us, talking to someone when we need help, and not feeling ashamed about what we are going through.

I’m not saying that you need to speak about what you might be struggling with to everyone you know and everyone you meet. It may mean only sharing it with one person, it may mean sharing it with a group of strangers at a support group, it may mean sharing it only with a professional. It isn’t about who you choose to share it with, it’s about owning that you are struggling right now with mental health issues, and that is nothing to hide or be ashamed of. I’m going to repeat that, “struggling with mental health issues is NOTHING to be ashamed of.

Life is hard. Very hard. This is not new information for anyone. Sometimes trying to handle all that life throws at us, and coping with difficult situations, emotions, and difficult people can be more than just a challenge at times. It can be something that permeates your whole being, and for some, it may also mean using more destructive than constructive methods to cope. It can be something that filters down into your relationships, your work, your interests, your family and friends, and even your ability to function at a basic level. Mental illness can grip you like a vise and twist itself around you so that you feel like you can’t breathe. It doesn’t care if you have the time, or the space, or whether you’re ready or not, it can come on without warning and take you over, or take you down. Regardless of who you are, where you’re from, what you do, where you work etc, you could be someone who finds themselves struggling with mental health issues just as easily as anyone else.

Mental health isn’t selective in who it affects. No exemptions or discrimination here. Mental health is an equal opportunity assailant.

I don’t want to compare mental health to physical health because I don’t think they really can be compared. The each have their own struggles, symptoms, treatments, and perspectives. But I will say that with as many differences that lie between physical/medical issues and mental health issues, there are also a number of similarities between them too. There a lot of physical illnesses or disorders that can often strike at will to whomever, whenever, without warning or cause, and mental health issues can be just as arbitrary and random in who becomes affected too. There are a number of physical/medical issues that cannot be seen just by looking at someone, and that cannot be measured with a blood test or x-ray, just like not being able to tell just by looking that someone is struggling with mental health issues.

Someone struggling with a physical/medical issue is as important to address as someone struggling with a mental health issue. One issue is not necessarily any more urgent to address than the other. Of course I understand that there are some serious medical issues that can be life-threatening and are important to treat as soon as possible, and that there are some mental health issues that are not as urgent in the moment to treat, but they are still important enough to treat, regardless.

Someone struggling with mental health issues may be able to wait a few more days for help than someone requiring urgent medical assistance, but it doesn’t mean that the person struggling with mental health issues should be dismissed or indefinitely delayed in getting treatment.

All issues that can befall us, whether physical, emotional, or mental, each have their own urgencies or not, in how and when they are addressed, but the important thing to remember is that they ALL deserve addressing.

Repeat: THEY ALL DESERVE TO BE ADDRESSED.

I would like to close this by saying to all those struggling with mental health issues, please seek help if you need it, don’t wait. And please don’t be ashamed or feel less than because you need help. Talk to someone. Share with those you trust in your own time. You don’t have anything to be ashamed of, nor do you owe anyone an explanation. You are struggling and you need help. Please remember that. You are struggling and you need help.

For those who have a loved one struggling with mental health issues I would encourage and hope that you give as much time and space to your loved one as you can for them to deal with things as they need. Be compassionate and patient. You don’t need to understand someone to be kind to them. You don’t need to have experienced it to have patience for it.

Your loved one may be struggling to live at some point, and this is NOT a weakness, nor is this something to be taken lightly. Anyone feeling like life isn’t worth living anymore should ALWAYS be taken seriously and at their word. They need help. Please do what you can to help them get help.

Most importantly, for all, please remember that there is nothing wrong with having mental health issues.

 

Everyday People

When I have to go outside it takes me some time and effort to make my way out. Some days are easy, where I don’t have to prepare myself. I don’t have to work up to anything. I can pretty much just go. And some days are hard, where I need a lot of time to work through the anxiety. When I need to somehow ease the anxious feeling in my stomach and chest. I need to ease my urge to hide and avoid, and often either slow down or soothe a panic attack. Those are the days I may not make it out but I still try because sometimes the tips work.

When I am outside the anxious feeling doesn’t really go away. It stays in varying degrees of intensity from when I leave my home and it doesn’t ease until I’m back home, and even then it doesn’t totally disappear. The time that I am out I am hyper-aware of my surroundings and how long things are taking. I am aware of the people around me and I am aware of the length of time I will be in any given place because I am almost counting the minutes until I can finally go home again.

I have to be very careful about this state though because if it gets pushed too far, and the anxiety overwhelms me, it can push me into a numb, dissociative state. Where I am on automatic pilot and I am sort of aware of my surroundings but it’s a blur and most of the time I can’t recall where I was or how I got there.

When I’m on the bus I watch the people around me. In part I do it to be aware of who is where, what they are doing, and are they posing any threat to me in any way? But sometimes I find myself almost mesmerized by them. I’m mesmerized by their mundane ways of sitting or standing on the bus. I watch them play on their phones, or read a book, or talk to someone they are travelling with, or just staring out the window, and I find myself feeling envious of them.

These people, just normal people, they get on the bus and choose their place to sit or stand and they settle in for their ride. Without a second thought they are just taking the bus and doing whatever they need to do to pass the time on the ride. And they look normal. They look calm. They look bored. They look complacent. And I envy that.

I envy that these people can just walk onto a bus without sizing up the world they’re entering. I envy that they sit down or stand like they own the place and they aren’t thinking of anyone or anything around them let alone if they’re wondering if something is a threat. They aren’t surveying the scene from moment-to-moment. They don’t look like they’re counting anything at all. They look and act so normal. And then I briefly think of how many thoughts I have had in the short time I’ve been on this bus and how many worries and fears I’ve had and I feel jealous that they sit there like normal, everyday people.

I’ve wondered if anyone has looked at me and thought of me as weird, or thought of me as unworthy to take up space on the bus, or any other kind of thought. I’ve wondered if they are judging me or making assumptions about me. Are they thinking I don’t belong here? Are they thinking I shouldn’t be here? Are they thinking I’m a fraud? Are they thinking I look like a bitch? Are they thinking that they hate me?

It makes me feel like a freak. It makes me feel like I’m a nutcase. And it makes me feel alone.

These people go about their day, seemingly without a care, and they work, and live, and function. They go out. They do things. They talk to people. They interact. And I think of my own day that has been filled with anxiety, panic attacks, fear, worry, and shame, and all that races through my mind from the moment I step outside my door to when I step back inside my door and I can’t help but wonder, “how do they do it?”

How do these people leave their homes so easily? How do these people just walk to their bus stops and subway stations like it’s nothing? How do they get on the transit and they’re only concern is if a seat is available and making sure they catch their stop? How do they manage to just take the bus? How do they manage to be around other people as if it’s nothing? How do they sit there and wait for their stop like it’s no big deal? How do they not worry, and wonder if this will be okay? How do they not worry what others are thinking? How do they not care? How do they not feel anxious if they will be okay? How do they not work to hold themselves up enough so that they don’t pass out? How are they able to sit there so complacent and not have a panic attack? How?

My excursions are plagued by any number of worries, thoughts, anxieties, and emotions, and sometimes it’s bad enough that I can’t even leave the house. But these everyday people, they seem to have none of that. They live and function normally. But how? How are they able to function without a thought? How do they function without anxiety? How do they get up and go about their day without worrying about everything?

I wish I could be an everyday person. I wish I could just go about my day and that’s it.

Sudden Panic Attack

I realize this is actually an oxymoron or whatever they’re called because panic attacks rarely give much warning.

I was minding my own business, writing up my next post, when suddenly I felt the need to run. Run far. Run fast. Now. I felt like everyone in the library was watching me and judging me. That they knew what I was thinking and they thought I was an idiot. I felt like everyone was judging me. Watching my thoughts and thinking “my god this girl is awful”. When I looked around people’s eyes were lowered or distracted by computers or books but it felt like they only just averted their gaze and the minute I looked away they would stare at me again.

I felt my heart pounding and I wondered for a moment if I stood up right now would I pass out. Oh god no. Please don’t let that happen. I couldn’t handle people seeing me hit the floor. And then the librarians will probably call an ambulance. And I’ll have to be taken to the nearest hospital to be checked and I know they will find nothing. Because that’s how this goes. That’s how this will play out. I know it. I’ve been there. And I will feel like an ass having taken up people’s time and the city’s resources. And for what?

I look around me to see if I can leave with the minimal amount of people seeing me but no. I can’t. Because where I am and where the exit is, is right in front of everyone.

Oh god. Everyone…

I know this is a panic attack. And I need to remember that.

Remember that. 

Oh, and breathe. 

I seem to forget how to breathe when this happens. I don’t know what I’m holding my breath for but I feel the need to hold it. Like it will protect me from harm. If I hold my breath then the world will not move until I say so and let my breath out. I know this is nonsense but I believe it nonetheless. The worst part is the holding of my breath makes me far more susceptible to actually passing out than a panic attack would. But I hold it anyway.

I want to go hide in a hole with cakes and donuts to sustain me.

Time to go.

Residual Effects of a Panic Attack

I’d like to say that whenever I am struck by a panic attack that once it subsides I am good to go but I would be lying if I said that.

I don’t know if it’s just me but whenever I have a panic attack, particularly a big one, it may be over in minutes but the after effects last hours and even sometimes a day or two. At first when this happened I thought maybe I was having panic attacks all day, over and over again, and a couple of times when it was bad that was probably true, but in actuality I discovered it was the residual effects of the original panic attack.

The slight edginess in my body that left me feeling like I could be knocked over by a feather, I was that anxious. My breaths periodically speeding up or the holding of my breath, just keeping me wondering enough if another attack was coming. And the headache. I feel tired and somewhat numb after a panic attack.

I’m not sure if this is some kind of defence mechanism by my body but I find it highly intrusive. It’s bad enough that I suffered the attack in the first place but now I have to deal with the residual crap too?

Is it just me? Do others experience this too?

It feels a little bit like I’ve been wounded and the following day the bandages have been taken off. So I’m good to keep going but things remain tender, exposed, and vulnerable.

All day today I just felt slightly on the brink of something, most likely bad, and exposed. Thankfully I didn’t have another panic attack but I definitely feel like I could crash.

I hope it’s not just me.