R is for Routines
Routines help simplify our coping strategies. They are unique to each individual, and filled with micro-actions or habits (if you are neurotypical) that help cue us that our life is on track. They are usually more than one coping strategy and predictable. They sound like, "I always take my shower at night," "I listen to this podcast or morning show on the way to work" or "I wake up early, so I can drink my coffee on the porch and watch the birds" or "Tuesday is leg day at the gym." They can be even simpler like waking up around the same time every day or going to bed around the same time.
This is one of the HARDEST things about being 12 and waking up with anxiety or depression. Kids have almost no routines to help them cope and don't know which skills might work. This means they can't stack a routine. This is also what is hard about 18. Parents often co-regulate and set up some of these routines for their kids. When we do them correctly as neurotypicals they can feel like breathing. We take them for granted. This can be good and at times bad. College students often struggle with the transition to a 9 to 5 job mainly due to the routine shift. It is difficult to completely change how you function. Your brain and body have to get used to a new structure.
This starts with identifying what you need more of in your life. If you have anxiety you may need more stability, simplicity, lack of choices, or peace. If you fall into periods of depression you may need more sparks of joy or energy to keep you going. You may need to force yourself to move or meet with friends.
The next piece is to look at your current routines. Do you have any predictable times of day when you experience spikes of sadness, anxiety, or mood dips? This is a clue you need to add a routine. Ask yourself how can I do a favor for my future self?
Note for Neurodivergence:
If you are neurodivergent habits are high effort, and don't become integrated in the way they do for neurotypicals. Habits continue to take mental energy. Decision fatigue can be reduced by creating a procedure to do a set of actions and hacks to help cue your brain to do the routine. This can be simplified with time blocks. Creating healthy systems can provide some structure to thrive in. These work best with natural functional consequences. Hacks might include: not taking your shoes off, not sitting down between tasks, visual cues like bracelets, post-it's, or magnets. You can reduce energy expenditure by paying attention to what would make tasks easier in the environment to complete. The structure itself is unique. It might be more spontaneous or more flexible depending on your personality.
KC Davis who wrote How to Keep House While Drowning and is neurodivergent recommends closing duties where she gets her kitchen to functional every night by using a timer and sometimes several simplifying tools to help her. If you are neurodivergent her book and TikTok would be excellent resources. She also uses specific tools to help her with her own routines that may be helpful to you.
Honorable mentions: R is for Read & R is for Rest & Recreation
R is for Reading
Reading is such a great way to keep your mind healthy. For my people who love to numb out, it provides an escape without being too disconnected. It is hard to read compulsively. I'm sure it can be done, but it doesn't lend itself to numbing. This makes a fiction book a relatively easy way to get to another world, and safely relax your brain for a while before re-engaging.
R is for Rest & Recreation
Rest is productive. Incorporating a balance of weekly rest and recreation (especially if that recreation has a social component) is a shortcut to creating fulfillment in your life. The tricky part is everyone is built a little differently. There is a range of rest and recreation that is healthy based on personality, stressors in your life, and even life stage. Romantic partners may have completely different rest needs. Regardless rest is key when you are sick, burnt out, overstimulated, or just over-scheduled.
Become acquainted with what it feels like to take a small pause in your week that makes you feel recharged rather than drained. As an example, I have observed that I typically do well with 2 weekends with more activities and 2 with more flexibility at home. Rest can look like watching a favorite movie, a comfort show, or even doing some reset chores like picking up a room. We want to be careful that this doesn't turn into numbing. If you feel gross after then it was probably a binge, and be mindful of how you consume that media in the future to actually get your needs met.
S is for Self-compassion
Dr. Kristin Neff on www.self-compassion.org describes self-compassion by first looking at how we experience compassion towards others.
"To have compassion for others you must notice that they are suffering...Second, compassion involves feeling moved by others’ suffering so that your heart responds to their pain (the word compassion means to “suffer with”). When this occurs, you feel warmth, caring, and the desire to help the suffering person in some way. Having compassion also means that you offer understanding and kindness to others when they fail or make mistakes, rather than judging them harshly. Finally, when you feel compassion for another (rather than mere pity), it means that you realize that suffering, failure, and imperfection are part of the shared human experience.”
Then Dr. Neff encourages us to act the same way towards ourselves when we are having a hard time rather than ignoring it or pushing the experience down embracing the human condition. In the moment she encourages us to try to use self-compassion to ask:
"How can I comfort and care for myself in this moment?"
The three components of self-compassion are self-kindness, common humanity, and mindfulness. Self-kindness can often be found by casting aside our judgment and instead embracing warmth in the messiness of our lives. We can treat ourselves how we would treat a friend. Common humanity is when we remember someone else has stood where we currently stand. We are not alone in our pain. We are a part of a larger club. Many people fear opening up to their feelings because they feel as if they may not be able to put themselves back together. The problem might grow if you over-identify with your emotions. This is where mindfulness comes in.
Dr. Neff's website has several guided exercises to get started.
If you have ever sat in bed thinking about something you did or said several years ago, this practice might be for you. It also works if you struggle with perfectionism or if others have described you as judgmental.
Honorable mention: S is for Self Talk
Self-talk is a cognitive skill connected to self-compassion. How we talk to ourselves matters and can change how we feel about ourselves. The first step here is creating some boundaries on how you are allowed to talk to you. A good rule of thumb is if you wouldn't say it to a friend then you shouldn't say it to yourself.
The truth is self-talk is an all-encompassing coping skill. For many people, they have a narrator who is nearly always in the background talking, and what that narrator says about the situation is extremely important. The narrator was often developed by a critical family member in childhood or the child's limited perception of criticisms even if the adult might say they had a very supportive family.
The narrator can become extremely judgmental around sadness, anger, perceived failure, or other major life events calling some people dramatic or attention-seeking within their own heads. Becoming an observer of this self talk can help change how the narrator talks especially by looking at if the narrator is in line with your actual values. Then we want to start applying some self-compassion.
T is for Therapy
Therapy is a coping skill. It is a way for people to verbally process their problems and feelings with someone else. For external processors, this is an essential component. They don't know exactly what they feel or how they think until they are saying it out loud and often need set aside time to process without the pressure of editing themselves. Internal processors, may spend a great deal of time in self-exploration outside of the session and continue therapy in order to have the counselor take that exploration in a specific direction. Sometimes all that is needed for this to be effective is active listening or empathy. Sometimes it's deeper.
Most adults use therapy when their typical coping skills have been overwhelmed. They come to therapy in times of extremely high emotions like trauma or grief, high-stress times like life transitions, high conflict relationships, or in the middle of mental health issues like depression. They end therapy when these issues have resolved at some level going back to more every day resources.
Keep this in mind when exploring therapy for adolescents or kids.
U is for Up and Down-Regulation Strategies
There are a few different definitions for up and down regulation, so to clarify I am talking about how to stay within a window of tolerance in your nervous system (Dr. Daniel Siegel) where we function best. I also describe this as baseline. When you think of your normal day tinted positively this is great way to find your personal baseline.
Everyone has times where they are overwhelmed or have normal emotional dips, and finding ways to return to baseline can be very helpful. This is another skill that requires observation. When we experience hypoarousal we may be in our amygdala freeze response. This may look like disassociation, shutting down, auto-pilot, numbness, feeling depressed, or flat emotions to name a few.
Once you have noticed you are in a hypoaroused state you can use up regulation strategies like opposite action (DBT) to engage socially or in activities you typically would enjoy, exercise, grounding to remind your body you are safe, drink caffeine, get in the sun, or use your voice to gently hum or sing upbeat songs to calm down your nervous system.
Hyperarousal is a response to a threat and experienced as a fight or flight response. One quick way to try to find out if you are in a hyperaroused state is to try to do a non-memorized math problem. If you can't, the more advanced thinking part of your brain may be offline. If it is more chronic you might feel tired but wired. You are tired all day, but lay down restless and can't sleep.
You can down regulate this through skills like: guided imagery, positive distraction (TV show, TikTok, video game), swimming, breaking down boxes, driving if safe, a calming playlist, walking or running, meditation, yoga, or sitting in a hot tub. You can also help address this by looking at triggers to the state itself, and facing your fears while remaining calm. This takes several repetitions. You could also take the fear and make it ridiculous. For instance yelling can be a trigger for lots of people, but going to a sporting event or concert or playing a silly game involving yelling could remind your brain that you are safe now. If you are too activated giving your flight an outlet can also work. Have a short phrase to help you tell your loved ones helps this.
V is for Values
Values help us make decisions, prioritize, stay out of shame, address negative behaviors, learn from mistakes, take responsibility, apologize, forgive, add meaning to our lives, and help navigate existential crisis. When we don't have values OR we don't LIVE by these values we can fall into using people through manipulation to get short term gratification as a way to meet our emotional needs. Our values are the unconscious measuring stick for ourselves, and when we don't live by them we experience anxiety. Ultimately this behavior alienates others and can in general cause pain as people set responsive boundaries. It can lead to entitlement, poor or flexible self image, feeling stuck or caught in the wind, and depression.
When we don't know what we stand for, we can't stand for anything.
Select your top 3 values you want to define you in the world. These 3 values will become a compass on how you act within conflict, how you treat yourself, what you buy, and how you organize your life. In times when you are not sure what to do or how to act within a relational conflict look back at these values, pause, and engage in internal struggle to stay within those values rather than completing the current behavioral or relational dance. (Dr. Jacob Porter)
W is for Widen your view
Widening our view is ultimately about actively engaging in perspective shifting. This could be through reframing the event, assessing problem size, or using a few questions to see if we can't get to a more helpful perspective.
There is a saying in research that applies here - "correlation does not equal causation". In research this means a pattern of data does not mean we know for sure what is going on. We have to approach it with curiosity. One quoted statistic used is that in car accidents today more people are wearing seat belts than not wearing seat belts. An inaccurate conclusion someone could come to is: car accidents are caused by seat belts. We know that is not true. In fact people are wearing seat belts because they prevent injury in car accidents and it can be a law to wear seat belts. However, we use this same thought process in our own lives to our detriment. We can pick up a true pattern in our lives or the lives of others, but our conclusions may be way off. There is more than one way to interpret a situation. Try to find another way to interpret that pattern. If you get stuck ask a friend to help you explore the pattern.
You can also use "interpreting the data in the most positive way" which would be giving people the benefit of the doubt or assuming the best intention. This works best for situations with low emotional consequences for misinterpreting intention such as a restaurant, coffee shop, driving, and even co-workers or SOMETIMES family members. However, this strategy can be dangerous if you are in an abusive context or need to assess an emotional situation accurately to set boundaries.
I have noticed people who are depressed along with several other mental health diagnoses are often hyper-focused on what is going on with them alone and their internal experience. Although the goal to fixating on our problems is to solve them, it can sometimes make those problems seem bigger and more out of control. Self exploration is good thing, but sometimes we need a break from trying to find the deeper reason for what caused our behaviors or how it is all connected. Pausing to assess problem size can help here. If we ask ourselves to rate how big a problem actually is versus how big we feel it is we may be able to see it slightly more accurately. Telling yourself something is an inconvenience that you can handle versus a catastrophe is a great thought trick.
The more pervasive negative feedback loop that can be worked through by widening your view and generating empathy for others. Helping others through volunteering can sometimes have the added benefit of improving our mood because it helps us see from other people's perspectives and shift from navel gazing.
Questions to ask yourself about a negative thought pattern or rumination:
Is this thought helpful?
Is it accurate or factual?
Am I looking for certainty or trying to control something that isn't controllable? What can I control
What do I need to feel 10% better?
Will this matter in a year? 5 years?
Questions after difficult feedback from a family member, friend, boss, or co-worker?
Can I take responsibility for some piece of the interaction or situation?
Is there a kernel of truth from the feedback that was given?
What can I take and what can I leave from this feedback?
X is for X out negative thoughts
Around 80% of people experience intrusive thoughts or random thoughts that pop into your head that have some kind of disturbing content. These thoughts can make you feel anxious because they don't align with your values. This is your brain being a backseat driver and trying to remind you about a danger near by. These thoughts might begin with "What if..."
"What if I went over to that person with the big stack of books, and knocked them out of their hands like an 80s movie villain"
"What if I ate that leaf"
"What if I knocked my car into the side of this concrete barrier"
"What if I forgot to lock the door"
These kinds of thoughts have no specific meaning. They are like weeds that have popped up in our brain and show that we are feeling anxious.
We might shake our head and internally say weird thought, silly brain.
Some people thank their brain. Thank you brain for noticing the concrete barrier. Regardless thoughts are not intentions or true.
Just because we think it - doesn't mean anything about what WILL happen or about what we WILL do. We also don't HAVE to do something we think. I'm not forced to knock the books out of someone's hand just because I have a thought of what that might be like.
In this case we want to return to our current activity like driving or walking in the above examples using a skill called thought stopping. This is a choice not to keep following the intrusive thought further and further. It means accepting we make mistakes and that there is uncertainty. It is possible that we forgot to lock the door, and that it will probably be fine or if not we can deal with it then. Rehearsing the tragedy won't make it easier to go through a real tragedy, so we need to return to the present.
Thought stopping can also work for ruminations or a thought loop. We keep thinking about a situation or series of tasks that is making us anxious. People seem more likely to ruminate as they are falling asleep which makes sense. Our mind is trying to explore social emotional scenarios, so we can grow in our emotional skills and integrate what we have learned with creative solutions. This is related to what we know about the function of dreams and how our mind wandering has similarities to dreaming. I like replacing these times with a guided imagery or sleep story to replace my mind's tendency to review the day or tasks for tomorrow. If fully awake you might write down our list that pops into our head to X out the thought or say something to yourself like "no more, I've thought this into a circle, I need a break from this."
Y is for Yoga
Gentle and joyful movement is a great way to keep our mind clear and help keep anxiety at bay by staying present and practicing being momentarily uncomfortable. Pilates, yoga, and swimming all have a component of mindfulness as there is a real focus on moving your body a specific way, holding certain positions, and breathing. This combines several of our other coping skills above. With yoga or Pilates we often get the added benefit of being in a class format for a social component, but it is flexible and accessible enough to do alone or with low prep at many stages in life.
Z is for Zones of regulation
Zones of regulation is often a classroom skill where elementary school aged children learn to recognize what they are feeling and then categorize it by color to help them decide what they are going to do with the feeling and self assess readiness for learning. This is a baseline skill for everyone. It is not enough as an adult to know what we are feeling, but also how to take responsibility for that feeling in a wide range of relationships and environments. Even if we become very upset or angry it is not reasonable to expect another person to regulate us. We must know how to do this for ourselves.
I like to think of this in terms of a thermometer and with colors. The zones will be yellow, green, and red, and will give us clues on what to do with each feeling. In the yellow zone we want to be cautious. Red zone we will need to use coping skills to help us calm down before continuing. Green zone we are ready to do the task at hand - emotional, physical, or mental. Below I use the emotion of anger, but we could also do this with fear or sadness.
Anger: Zones of Regulation
Yellow Zone: The lowest level for this example will be annoyed. Annoyed is uncomfortable, but an emotion that we can down regulate for ourselves. Meaning we can actively be cautious in this zone to not start a conflict, and actively calm ourselves down. Annoyed while an important indicator is often not big enough to require a conversation with someone else because the conflict itself is often worse than the original feeling and feels silly once the conflict has occurred. People describe it as an escalation or a fight about nothing. Annoyed can also be an indicator of grumpiness or that another state needs to be met like tired or hungry. It should be forgotten by the time we are doing the next task as long as we are using good self care or routines.
Green Zone: The next level in the thermometer is angry or frustrated. Frustrated is something that continues to bother you over several hours. It may be only a little more than annoyed at first, but because it lingers it can lead to resentment if a boundary is not set or a resolution achieved. This often requires a conversation to resolve, but can be done in a calm manner. Frustrated doesn't feel urgent. It is a low simmer that can sit for a long time without boiling over, but does need to be addressed at some point. Angry may feel more urgent or hot, but can still be addressed constructively. Because this is a green zone emotion we are ready to be at work, but we are also ready to have a productive conversation to resolve the conflict.
Red Zone: For the highest level of the thermometer the feeling is rage. There are several other shades of anger in between annoyed and rage, but the thermometer is a guide to help demystify the zones of regulation and how to function within them. Rage is at the top of the scale, and unfortunately it is very difficult to have a productive solution finding conversation. It needs to be down regulated to the middle zone in order to be productive. Depending on the environment calming down may be different. Calming down from road rage (music, windows down when reasonable, breathing) may look quite a bit different than calming down at work (taking a walk and listening to a podcast) or with a partner (timeout to use positive distraction). The big take away is the conflict cannot happen while in the red zone or it won't go well.
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