How to Manage Acute Distress

Tips to Manage When You’re ‘Freaking Out,’ ‘Losing It,’ ‘Having a Meltdown,’ or Panicking

Life’s tough moments are unavoidable. Pain and distress are part of being human – they can’t be eliminated, and fighting that truth often makes things worse. This series is about building skills to tolerate distress and bear pain more skillfully.

Distress tolerance is about learning to accept, without judgment, both ourselves and the situations we find ourselves in. It’s about seeing reality without demanding it be different, feeling emotions without scrambling to numb them out, and observing your thoughts without wrestling for control.

That said, acceptance doesn’t mean approval. Tolerating reality as it is doesn’t mean agreeing with it. It’s about building the skills to get through those moments when emotions feel intense without adding fuel to the fire.

Getting Through Tough Moments

When you’re overwhelmed, it’s easy to react in ways that make things worse. That’s where these skills come in. They’re not a fix-all, but they can make the moment more manageable, giving you the clarity to approach things differently later. While their effects might be temporary, even brief relief is a win.

This episode will cover two tools. They might not resonate with everyone, but maybe one will click for you – or even just part of one. That said, don’t write them off too quickly. Give them a go – especially if what you’ve been trying so far hasn’t been working.

TIP Skills

TIP skills are designed to quickly change your body chemistry by activating the parasympathetic nervous system, which calms emotional arousal (as opposed to the sympathetic nervous system, which triggers fight-or-flight responses). These skills are especially helpful when emotions feel overwhelming and immediate relief is needed. While there are two “P” skills, the mnemonic remains “TIP.”

• Temperature: Use cold water or ice packs on your face while holding your breath (30–60 seconds) to trigger the human dive reflex. This reflex activates the parasympathetic system, reducing physiological and emotional arousal rapidly. A cold shower or splash of cold water can also help calm your system instantly.
• Intense Exercise: Engage in intense aerobic activity for at least 20 minutes. This quickly shifts your mood, decreasing negative emotions and ruminative thoughts while increasing positive feelings.
• Paced Breathing: Breathe slowly and steadily to regulate emotions. Inhale for three seconds, hold for three seconds, and exhale for four seconds (slightly slower than inhaling). Aim for five to six breath cycles per minute to achieve a calming effect.
• Paired Muscle Relaxation: Pair muscle relaxation with your out breath. Tense muscle groups tightly (almost to the point of discomfort) while inhaling, then release the tension as you exhale slowly. Focus on the sensation of relaxation as the tension fades, and say a calming word like “relax” to reinforce the effect.

When to Use These Skills

• When pain feels unbearable: Use these skills to reduce intense pain to a level where you can manage it and avoid destructive actions.
• When acting on emotion would make things worse: If you feel the urge to do something impulsive that might backfire, these skills can help you pause and regain control.
• When emotional distress feels overwhelming: Sometimes it’s more effective to ease strong emotions quickly than to let them take over completely.
• When you’re overwhelmed but still have responsibilities: High stress can make it hard to think clearly, leading to emotional breakdowns that create new problems. These skills help you stay grounded and functional.
• When timing isn’t right to solve a problem: If you can’t address an issue immediately, these skills help you step back and approach it later with a clearer head.

The STOP Skill

The STOP skill is a quick and powerful way to pause and avoid impulsive actions – like snapping in anger, making a rash decision, or turning to unhealthy coping mechanisms. STOP is a mnemonic for:

• Stop:
  When you feel your emotions surging and taking over, stop immediately. Visualise a big, bright STOP sign if you need to – it’s a cue to freeze. Don’t react. Don’t move a muscle. Just stop.
• Take a Step Back:
  Step away – either physically or mentally – from the situation. This might mean walking out of the room, turning your focus inward, or simply taking a deep breath. Deep, steady breaths can help your nervous system calm down and reduce the intensity of your emotions.
• Observe:
  Notice what’s happening – both around you and within you.
  • What’s going on in the situation?
  • Who’s involved?
  • What are people saying or doing?
  • What are you feeling?
  • What are your physical sensations?

Gathering this information helps you better understand what’s happening so you can respond rather than react.

• Proceed Mindfully:
  Ask yourself:
  • “What do I want to get out of this situation?”
  • “What’s my ultimate goal here?”
  • “What action will help, and what will make things worse?”
  • Mindfulness means choosing actions thoughtfully and intentionally instead of letting thoughts and feelings drive you impulsively – acting on impulse is the opposite of being mindful.

By practising these two tools – STOP and TIP – you’ll have practical strategies to get through those moments when emotions feel intense without making things worse. These skills might take a bit of practice, but with time, they can be incredibly effective for managing distress.