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There is a concept that some of you might find helpful - "subjective units of distress".

Many years ago, I was struggling badly with my life, going through one mental breakdown after another. I asked my psychiatrist: "How can I live my life if my anxiety goes from 0 to 60 in the matter of seconds?". The psychiatrist said: "But Nina, no one, including you, goes from 0 to 60 instantly. It just feels this way."

So, he explained, human brain is silly and usually cannot tell the difference between not being distressed (SUDS 1) and quite distressed (SUDS 7). As long as we keep functioning, our internal brain state and suffering in it seems to be almost invisible for us.

If I am at SUDS 2, and accidentally spill morning coffee on my blouse, it will probably raise my distress to SUDS 4 or 5, but I will change to a new blouse and go to work.

If I am at SUDS 7 after a doctor's call, and spill coffee on myself, I'll go from being calm to a sobbing mess faster than you can say "therapy".

Keep track of your SUDS!

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I don't know, maybe this stuff is obvious to normal people. It 100% was not obvious to me. It is freaking eye-opening, to realise that most of the times I thought and felt like I was OK? In reality, I wasn't.

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@nina_kali_nina Yea

I always explain it like, emotions are building up in me, and if I don't do something to reduce pressure again, at some point I will collapse under it, but while it's rising i can still keep it together. To me this is somewhat feel-able, but that's partly bc I have extreme emotions and am very aware of them

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@nina_kali_nina I would compare it to CPU/memory load:
Even at 80% load, I can still work at my pace and handle stuff, but when an unexpected extra process starts, "frantically trying to swap memory pages in and out" immediately becomes 98% of what I do.

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@nina_kali_nina ok this hits a spot. In a group setting we used PCI, or personal crazy index. Like did you brush your teeth? Eat? "Normal things" . Higher scores were warning signs. I like this one better since it doesnt explicitly stigmatize the acrion or lack thereof. Sometimes we ritualize differently for weeks and it is objectively fine.

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@thejikz looking out for warning signs helps to change the course of action in time!

PCI sounds a bit stigmatising:)

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@wakame yes, this!!! The crazy thing is that the task manager/vmstats isn't always available in the brains...

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@nina_kali_nina really useful. Thinking I should maybe keep a SUDS diary

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@Nekoplanet if you notice that you have sudden mood changes, you might want to make multiple records a day. It can be really eye-opening!

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@nina_kali_nina wow that is seriously eye opening. No wonder it feels like I can’t self soothe when the time for it had long passed. Thanks for sharing this. I’m surprised I’ve never come across it in all my years in therapy.

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@ddl it seems like for some people this comes naturally, I have no idea! I'm glad if this knowledge can help you to live a more satisfying life!

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@nina_kali_nina Related: The concept of the "Window of Tolerance", a kind of "reserve capacity" that can grow or shrink depending on stress, relaxation etc.
And of course, if almost none of that capacity is left, one can't compensate for even minor hiccups.

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@nina_kali_nina there was a similar tool, a simple android app for people who was suffering from PTSD that you just opened it, clicked on a number (or maybe was an emoji face, don't remember well) and it recorded the time and the number.

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@Nekoplanet there are many; I used to use one that would send me notifications at random intervals to get a more precise picture of my mood changes.

It was horrifying to see that my mood could swing from 2/10 to 9/10 and back in the matter of hours. I was seriously "disregulated" :) Having this chart handy easily proved that it's not bipolar ;p

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@wakame oh, thank you! I'll research the topic, sounds helpful!

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@nina_kali_nina
Then let me quickly infodump these two things:

Vagus-nerve massage (three points in and on each ear to stimulate the vagus nerve that apparently partially controls "stress" and "relaxation" phases). Personally find this very helpful.

And of course: Removing distrations that gnaw on your mind constantly. From that annoying sound to the half-finished project on your desk that you feel vaguely guilty about. (And now that I write it: I should definitely move that electronics stuff on my desk to my workbench. Right now.)

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@nina_kali_nina

Do you have a link that explains the various acronyms in this image?

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@tine_schreibt those are all acronyms from DBT. STOP is "stop, take a step back, observe, proceed". TIPP is for "temperature, intense exercise, paired muscle relaxation, paced breathing" - skills for changing the mood with body chemistry. ACCEPTS is a skill about finding a way to tolerate the distress when it's not so acute, and IMPROVE is for when you can't escape the situation. Here is a random leaflet I found online that explains all the letters in the abbreviations. Some find these helpful, some don't - I feel DBT is a lot like "here's a bucket of tools, see if some of these work for you"

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@nina_kali_nina With animals, we'd call this "trigger stacking", and yes, it is real. You can still go from 0 to 60 instantly if something really unexpected happens; tire burst at highway could do that.
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@pavel I suppose so. But then I remember getting into real trouble a few times (one was shooting and one was traffic accident), and I remember being strangely chill about either.

I imagine that I'd go from 0 to 60 if I learn something truly terrifying and unexpected...

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@nina_kali_nina
My mind is kind of blown 🤯

Hope you don't mind but I thought your text really added value, so I edited the two together so next time I drop a piece of toast and break down crying I can find and re-read it easier 😅

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@Flyingfirepig I think the most frustrating thing about this nugget of therapy knowledge is this: I've been to therapy for 4 years before I first heard of it. Most books on mental health sort of assume that one can gauge their internal state easily and act accordingly.

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@nina_kali_nina thanks, this is really validating. For about a year between 2020-21, I was between 7 and 9 nearly all the time - but I struggled to get that across to people as I'm so practised at 'faking normal' so as not to cause concern to/inconvenience other people.

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@nina_kali_nina Interesting - never quantified my stress levels in this way. I reckon I’m about a 5-6 today. Any tips on deescalating your score?

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@nina_kali_nina

I do like this scala on the one hand, but find it overly simplified on the other.

"Functioning" is a complex matter. Someone in a fight or flight response might function in some areas, although in extreme distress.
Someone with a mix of cPTSD and ADHD might only really function under a certain amount of distress (and yes, I mean distress, not eustress).

So a linear scale doesn't work for many, I'm afraid.
Don't know a better way of visualising thisy though.

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@oxytocinated absolutely, yes, things are more complicated than this. But even this approach is more helpful than not having any model on what's happening with your distress. I'm looking forward to more research in this area!

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@nina_kali_nina Uncomfortable epiphanies: when I look at this scale I suspect I’m between 5 and 7 most of the time.

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@zakalwe pat pat. That actually can help you to get your distress down when you're still functioning!

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@nina_kali_nina@tech.lgbt I hear you. I found myself thinking about "things that are self-soothing" and 'yeah, you know, I do that a lot", and things I don't get nearly enough of...

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@zakalwe sometimes there are periods of life when getting enough of soothing things is not an option blobcatsadreach​ but hopefully that's not the case for you

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@nina_kali_nina as a previous "normal people that don't struggle with anexiety" that was promoted out of that state by recent life events, no normal people aren't aware of this kind of thing at all, in my case I just cruised along without breaking the higher thresholds all that often, and when I did I was like, "that was random and weird" and shrugged it off.

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@nina_kali_nina To me it is not obvious, so thank you. And now I need to think about why I'm oscillating between levels 4 and 7, but never below 4. And why I didn't notice.

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@sashag Things to ponder :) Hopefully it can help you to live a more satisfying life, like it did help me!

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