DBT Distress Tolerance Skills

What is DBT?

Dialectical Behavior Therapy’s (DBT) premise is that two seemingly opposite things can be true at the same time. For example, my parents did the best they knew how when raising me and they negatively affected my emotional development.  

DBT trains the mind to think with a good balance between reason and emotion, calling this the “wise mind.” It also can keep you out of all or nothing or black and white thinking. There are many shades of grey with everything in life. 

There are four main tenets of DBT. They are Distress Tolerance, Mindfulness, Emotional Regulation, and Interpersonal Skills. 

Distress Tolerance and Radical Acceptance

Distress Tolerance includes an idea called “Radical Acceptance” where you fully acknowledge the present moment reality. This does not equal condonement. Radical acceptance places you in a position of being able to make a plan to elicit changes in your life because you cannot change anything if you aren’t fully engaged in the acceptance of what currently is. 

Distress Tolerance skills include distraction and self-soothing. Distract by engaging in pleasurable, non-destructive activities, focusing on helping others, doing chores, counting breaths or anything you can see, or distract by removing yourself from the situation.

Self-soothe any of your senses: smell, sight, sound, taste and touch. Use any input that makes you feel good that is non-destructive and not harmful to you or anyone else. 

R.E.S.T.

Above all, make sure to use the “Rest” technique in any situation that is upsetting to you at the start. Relax (R), Evaluate the facts (E), Set an intention (S), Take action (T).  The intention and take action steps could include some ideas from the distress tolerance skills.

More to come on DBT skills…

Comorbidities in People with Mental Illness

Comorbidities in people with mental illness means they have another disorder in addition to their mental illness. This is quite common. I, for example, have bipolar disorder and chronic migraine.

Comorbidities do not have to be a mental disorder paired with a physical disorder. They can also be two or more mental disorders or two or more physical disorders.

Having more than one disorder has its challenges. For example, a person with both multiple sclerosis and depression would be treated for both conditions, but it would be important to take into consideration the overlap between medications that would be prescribed by different doctors.

For this reason, people with comorbid disorders should take good notes of their symptoms, medications and their side effects, and anything they and their doctors discuss at each appointment so that unwanted interactions are avoided. It is also important to have excellent communication with all providers so that everyone knows what everyone else is doing.

If you have comorbidities, you must be a persistent advocate for yourself to get the proper treatment plan in place to treat all of your disorders so that you can reach and maintain optimal health, both physically and mentally. By following the aforementioned suggestions you can be on your way to better health no matter how many comorbidities you have.

Should You Take Medication to Treat Your Mental Illness?

To take medication for a mental illness is a very personal choice. For me, medication has allowed me to live a life with some stability in my moods and has helped me to be a better wife, mom, and friend. 

I have severe symptoms that do not subside without medication because I believe my brain is imbalanced with regards to certain neurotransmitters, such as Serotonin, Dopamine, and Norepinephrine.  There are side effects, such as drowsiness and weight gain, but these need to be weighed against the benefits to decide if the medicine is worth taking or not. 

Some people can manage their symptoms with non-medication interventions such as counseling, lifestyle changes, diet, prayer and meditation, exercise, and journaling/keeping mood charts to stay on top of their mental health status.

It is up to the individual whether or not to treat their mental illness with medication and it is none of everyone else’s business to criticize what they decide to do. 

Any thoughts? Join the conversation and leave a comment.

Let’s Talk About Stress

Today is National Stress Awareness Day.

Stress is physical, emotional, or psychological tension felt as a result of an event or thought that causes feelings of frustration, anger, or anxiety.  In short bursts, stress can be helpful, like in getting you out of a dangerous situation or helping you meet a deadline. When chronic, however, it can be harmful to your health and contribute to the development of conditions such as 

  • High blood pressure
  • Heart disease
  • Diabetes
  • Obesity
  • Depression or anxiety
  • Skin problems, such as acne or eczema
  • Menstrual problems

Common causes of stress include

  • Getting married or divorced
  • Starting a new job
  • The death of a spouse or close family member
  • Getting laid off
  • Retiring
  • Having a baby
  • Money problems
  • Moving
  • Having a serious illness
  • Problems at work
  • Problems at home

Signs of chronic stress include

  • Diarrhea or constipation
  • Forgetfulness
  • Frequent aches and pains
  • Headaches
  • Lack of energy or focus
  • Sexual problems
  • Stiff jaw or neck
  • Tiredness
  • Trouble sleeping or sleeping too much
  • Upset stomach
  • Use of alcohol or drugs to relax
  • Weight loss or gain

Sometimes stress can be managed by getting the right amount of sleep, talking problems over with a trusted friend, getting regular exercise and proper nutrition, and generally taking good care of yourself. Other times if you find yourself having panic attacks, feeling overwhelmed for weeks on end, or unable to function at work or home, you should probably contact your doctor or mental health professional for some help. 

Source: https://medlineplus.gov/ency/article/003211.htm

How do you cope with stress in your life?

How to Deal with the Mental Health Provider Shortage

With mental health providers already in limited supply the increase in the need for services due to the stresses caused by the pandemic has made finding help extra difficult as of late.  If you are just starting out with problems, your primary doctor or ob-gyn might be a good place to start. In addition to doing an initial assessment, taking a history and prescribing medication, they can refer you to the appropriate mental health professional, if needed.

The obvious way to find providers is to check your health plan provider list. Consider those outside your area who offer teleheath services via the phone or computer. This could widen your options quite a bit. 

Seeing providers out of network or paying out of pocket may be other options to facilitate access to providers, which unfortunately are more costly and not possible for many people.  Although, some providers may offer a sliding-fee scale for those who are self pay that allows them to pay based on their personal income and what they can afford.

If you or your spouse are employed, you can check to see if your employer offers an Employee Assistance Plan (EAP) which is separate from the medical plan. Typically you can access counseling at no cost on a short-term basis. Check with your HR department. 

If you are a student, take advantage of any free campus or university resources.

Your local church might offer pastoral counseling from a trained clergyman or woman which is usually free.

Some teaching colleges and universities may offer low-cost therapy provided by grad students who are supervised while they gain counseling experience. If there is such a school in your area, contact the psychology or behavioral health department and inquire.

SAMHSA is a government organization that is the go-to resource for locating affordable mental health care nationwide. Contact them at 1-800-662-4357 or online https://findtreatment.samhsa.gov

Online therapy is another option with chats with actual therapists from places like Better Help, TalkSpace or 7 Cups.com.

Theravive is a resource directory you could investigate for low cost therapists by state. 

Open Counseling is another resource for attaining accessible care. The site indicates if providers are accepting new clients and many list their rates. 

Open Path connects low-cost therapists to patients. I think you pay a lifetime membership fee and then get access to discounted rates on therapy sessions in the future. 

You can also get professional help getting professional help by contacting NAMI support services. Call their helpline, 1-800-950-NAMI (6264) to find a chapter or services in your area. 

If your mental health puts you in an immediate crisis, help is always available by going straight to the hospital emergency room. All emergency rooms have access to psychiatric care. 

Are you having trouble accessing mental health services?  What are you doing about it?

Looking Back at Ten Years of Blogging at Write into the Light

Ten years ago today I posted my first blog here at Write into the Light. Ten years!  I feel like that is such a long time.  

I started off writing daily meditations because I couldn’t find any meditation books specifically written for people with mental illness or mental health issues. Over the years my writing has evolved from those meditations to journal-type entries and poems, to essays and opinion pieces, and finally, reports on mental health research articles. 

Regardless of the type of writing I post, all of it helps me process and cope with my own mental health symptoms and I hope helps others with the same. Writing has been one of my biggest coping skills when it comes to my mental illnesses, hence the name of this site. 

There were many months I was inactive and even full years where I only wrote a few blogs at most depending on my health status. Several times I almost closed the site down but I never did because even though I would go periods without writing, the stats showed that people were still viewing my posts on a daily basis.  And I thought, if the blog was helping someone by just being there then it was worth leaving up even if I wasn’t adding anything new to it at the time. 

Over the last 10 years I’ve written over 360 posts and have had over 44,000 visitors and 65,000 views. I have close to 900 readers on WordPress, a tad over 300 Twitter followers, 1200 and something Facebook fans, and 25 email subscribers. Definitely not a big outfit by any stretch of the imagination, but a small little part of the mental health community that I hope is contributing enough in a way that is making a difference in someone’s morning, afternoon, or evening every once in a while. 

I wonder who is out there who has been blogging for ten years or more. I am in contact with no one from my early days of blogging because their blogs have been dead for years and I miss some of them so much.  

I am happy to have found new bloggers throughout the years, however, and thank every one of you for taking the time to follow, read, like and comment on my posts. I appreciate you and always enjoy connecting with you. 

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Election Stress

What a long exhausting week it has been. I’ve been sleeping like crazy and been generally unmotivated to do anything. I hate the feeling of being in limbo with no where to go.

I feel like a balloon that is a few days old, lost most of it’s helium and is just kind of suspended a few feet off the ground, barely floating around, pathetically living out the last few days of its existence.

I need a big wind to come along and boost me high in the air, twirling me up and around, giving me life and energy. I think most of my malaise has to do with the general state of the country due to the election and that I will feel much better and more grounded after it is decided. How about you?

In the meantime, I have downloaded a goal tracker app and have created some simple daily tasks for me to do so that I keep myself moving and feeling accomplished, while still allowing myself downtime to nap and indulge in my unmotivated moods.

What do you do when you’re feeling unmotivated and stressed out?

Back to Bipolar Basics

Bipolar is a mood disorder that is subdivided into two categories: bipolar I and bipolar II.

Bipolar I

Bipolar I is characterized by at least one manic episode often resulting in a hospitalization. “A manic episode is a period of abnormally elevated or irritable mood and high energy, accompanied by abnormal behavior that disrupts life.” (WebMD.com)

People with bipolar I also experience depression and often cycle between manic and depressive episodes.

Bipolar II

Bipolar type II is similar to bipolar I in the cyclical nature of moods, however, full mania is not reached but rather hypomanic moods are more common. Hypomania often feels good with increased energy and mood and productivity, but can include distractibility and irritability as well.

Unlike in full mania, hypomanic behaviors are not out of control. Overall, depression typically dominates bipolar type II moods.

Do you have bipolar I or bipolar II disorder? What is your experience with it?

Study Reports Active Social Connection is Protective Factor for Depression

Source: https://neurosciencenews.com/social-connection-depression-16834/

When Mental Illness Takes Away Your People Skills

Part of combating a mental illness is making sure that you have meaningful activity to participate in on a regular basis. Even those without mental health conditions need to have meaningful, purposeful tasks in their life to make life worthwhile.

There are very few tasks that don’t involve interacting with other people. Even something as solitary as writing a book eventually involves submitting it to editors and publishers and dealing with them, as well as critics and readers.

As a result of my bipolar disorder, ADHD, borderline personality disorder, and severe social anxiety disorder, I have the most difficult time interacting with people. This limits my range of productive activities that I can do outside of the home. I cannot hold any job that involves interacting with others for any length of time outside of my immediate family. I do short stints of volunteer work, an hour here and there, and that is it.

It makes me sad to think my life will be void of being of sustained service to other people for the rest of my life due to my mental health conditions. However, I can do nothing else but accept this reality and move on.

I do take satisfaction in the fact that I can at least blog here and write about my experiences and provide information and encouragement to those who may be in the same situation as myself.