Tips for Choosing Coping Skills

Disclaimer: I am not a licensed (or unlicensed) health care professional. I have suffered from chronic suicidal ideations, major depression disorder, major bipolar disorder, general anxiety disorder, chronic perfectionism, and other mental problems for several years. The following tips are from a perspective of experience and are not meant to be a substitute for licensed medical care. If you are not safe or are not feeling safe, please seek care.

National Suicide Prevention Hotline: 1-800-273-8255
National Suicide Prevention Website (With online chat): https://suicidepreventionlifeline.org/

I keep a list of coping mechanisms that I cycle through using, but I have favorites. If you take anything away from this, take this: Choose three healthy, effective coping skills you can use at any time, in any place, near anyone. 

1. Choose Coping Skills that are healthier than your undesired behavior, until they're not. 
- e.g., if your undesired is having panic attacks, choosing to have a glass of wine to ground yourself is fine in moderation (and if you're following legal precedents.) If your undesired behavior is alcoholism, choosing to have a bubble bath would be a healthier alternative.
-  Always try to opt for the healthiest option, but if you need to pick the lesser of two evils, do so.

2. Choose a set of coping skills you can do over different periods of time. Something you can do in the moment, something you can do in the meanwhile, something you can do long term.
- e.g., you won't always be able to draw a bubble bath in the middle of a subway station.
- Your best coping skills, the ones that consistently bring you back from the edge, may not be feasible in some or even most situations, so having backups you can use any time is reassuring. For me, these are mindfulness techniques (breathing exercises) or thought exercises (going to my happy places. Yes, I have many happy places.)
For example,

• Short-Term: I like a cyclic breathing exercise where you breathe in for 5 seconds, hold your breath for 5 seconds, breathe out for 5 seconds, and then hold for another 5 seconds before repeating. 
• Mid-Term: These vary, but I tend to keep these between 2- 20 minutes. Short walks, Watching a comedy skit, playing a quick game of hackeysack (that I keep in my backpack so I always have it), etc.
• Long-Term: Telling my therapist about this, Talking with family and friends, Planning ways to prevent this from happening and acting on those plans. 

3. Choose coping skills specific to what brings about your undesired behaviors. Whatever triggers the panic attacks, the suicidal thoughts, the kleptomania, have coping skills that directly intervene against those triggers. 

- e.g. if loud noises trigger flashbacks, Short Term: plug your ears, Mid Term: Go to a quiet place and listen to music, Long-term: talk to your therapist to devise a treatment plan.

- e.g. if being given more responsibilities than you think can handle trigger panic attacks, Short:Term: breathing exercises, Mid-Term: 5-4-3-2-1 method (notice 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, and 1 thing you can taste.) to ground yourself, Long-Term: Plan out your capabilities with those giving you responsibilities. Consider options for lessening the load on yourself. 

4. Incorporate your social network. As part of the long-term strategies for recovery, you can start by at least including your health team. Tell your doctor about what's going on. You can rely on people you know and trust if you let them know about what's going on.
- e.g., trust appropriately, carefully, and set boundaries, but the most important thing here (for me at least) was letting people who were in my vicinity know the signs of symptoms of me getting worse so that they could call me out and I'd know it was time to seek medical help. 

That's it. I hope this helps. 

In Sanity and In Insanity,
Stephen.