10 Coping Strategies for Distress Tolerance

10 Coping Strategies for Distress Tolerance

Distress is so uncomfortable that people understandably want to make it go away as soon as possible. At the moment of intense emotions, it feels like it may never end. Extreme emotions distort thinking and sometimes people make choices that cause more harm (self-injury, suicide attempt, telling off your boss, ending a relationship, etc…). These choices are an attempt at coping strategies and calming the distress, but ultimately they don’t support recovery. Learning distress tolerance skills to manage emotion in ways that aren’t harmful will help you remain on the path of recovery and mental wellness.

Intense Emotions: Riding the wave of distress

The Oxford Dictionary defines distress as: Extreme anxiety, sorrow, or pain.

Distress is often brief and passes after minutes or hours. It can be thought of like a wave that will peak and then fall as the emotion rolls by. During this time of intense emotion, one of the goals is to ride it out to the other side.

Distress Tolerance Skills

Distress tolerance skills help people get through the painful waves of emotion unharmed and without relationships in need of urgent repair. Effective skills and coping strategies are simple, easy, and prepared ahead of time. They help to ground and distract in order to shift the focus away from the emotion and let it pass.

10 Coping Strategies to ground and distract from extreme emotions

  • Deep breathing: Use an app like Breathe2Relax or  Stress Free Now. These mindfulness apps that can walk a person through a breathing relaxation exercise. Find one you like and have it ready on your phone.

  • Guided meditation apps: Find a list of options on my resource page.

  • Aromatherapy: Pick a scent you like and carry it with you. I don’t believe aromatherapy cures all things (like some claims out there) but I do think it smells good! An enjoyable scent can be grounding (and I suppose an aversive scent could be distracting!).

  • Aromatherapy: Pick a scent you like and carry it with you. I don’t believe aromatherapy cures all things (like some claims out there) but I do think it smells good! An enjoyable scent can be grounding (and I suppose an aversive scent could be distracting!).

  • Exercise: I particularly like high-intensity bursts of exercise that can match the intensity of the extreme emotion. Exhaust yourself by doing rapid jumping jacks, pushups, running quicker than is comfortable, burpees, a punching bag…there are many options available. If this level of exercise is not possible, find other exercises that work such as going for a walk.

  • Take a warm bath.

  • Music: Crank it up or play it softly. Music can be a great distraction.

  • Pet: There is nothing more grounding than spending some time petting or playing with your animal. Animals are always in the moment and can help guide you back to the here-and-now.

  • Nature: Being out in nature is calming and grounding. It sometimes helps us to see the world is bigger than this moment. The world doesn’t end when there is a storm but finds a way to recover and adjust.

  • Distract yourself with a word game or puzzle.

  • Any other distraction you can think of!

Distress Tolerance Success

It is much harder to come up with coping strategies during a powerful surge of emotion. Get prepared ahead of time when cognitive abilities aren’t distorted by emotions. Come up with your own list and keep it handy if the need arises to use it. Don’t wait for distress to hit to practice these skills and self-care.

A version of this article first appeared here

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  • Stephanie Hollis

    I feel much better, thank you

  • Kyle Swann

    Good stuff !!

  • Daniel Askew

    Very helpful !!!

  • Connor Hayes

    Chasing meaning is better than avoiding discomfort.

  • Jordan Watson

    Nailed it

  • Valerie Spanjevic

    I totally agree with what you said

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Melissa (Wheelock) Welby, MD

Healthcare Expert

Dr. Melissa Welby is a psychiatrist that participates in people’s process of discovery, empowerment, and search for satisfaction and happiness. She treats a variety of illnesses including depression, anxiety & panic attacks, adult ADHD (Attention Deficit / Hyperactivity Disorders), bipolar disorder, OCD (Obsessive-Compulsive Disorder) and borderline personality disorder. She is also the current president of the Connecticut Psychiatric Association.She completed her Internship & Residency at Cambridge Hospital, affiliate of Harvard Medical School, 2000 to 2004. Dr. Melissa Welby is Board Certified in General Psychiatry by the American Board of Psychiatry and Neurology, 2005 to present. 


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