Distress Tolerance Is Important for Depression
Monday, February 22 2016 Liz Smith
Distress tolerance is important for depression sufferers and depression caregivers. These skills can be vital in showing a depressed person that they are accepted even when they are suffering. Here's why distress tolerance is important for depression and why we need distress tolerance skills.
What Is Distress Tolerance?
Distress tolerance is the skill of being able to sit with, and accept, a distressed state either in yourself or another person. It means that when yourself or someone else is distressed and in a state of suffering, at that moment, you are able to accept and explore that feeling rather than immediately seeking to change it (Letting Someone With Mental Illness Be Upset).
Why Is Distress Tolerance Important for Depression?
I've been training recently to volunteer on a mental health crisis support line in my home city. The session we had on distress tolerance really struck a chord with me. Depression can be a painful, alienating and lonely experience. One of the reasons it can be so lonely is because you constantly feel that you have to hide your distress and suffering as talking to others about your mental illness is not always the socially accepted thing to do. Some people may not be comfortable discussing it because of the stigma and taboos that still exist around mental illness.
Once I got my head around the idea of distress tolerance, I realised that there have been very few people in my life who have been able to accept my distress in times of depression. Most people, thinking they are being helpful, seek to solution-ise and think of ways to fix the "unhealthy" thinking of a depressed person in a distressed state, even in such crass ways as telling the depressed person to "think more positively" (if it were that easy, nobody would be depressed in the first place). We often do not seek to listen or understand, even to ourselves. Instead, we seek to remove the distress as quickly as possible because we are socially conditioned to see it as unacceptable, particularly when a distressed mental state results in behaviours such as self-injury or self-harm.
Why Tolerating A Depressed Person's Distress Can Make A Difference
I remember in my early 20s when I was very depressed and self-harming. The reaction of others around me at the time was to want to get me out of the way, hide the behaviour from others and chastise me for being so selfish and inconsiderate as to make them have to deal with me doing something so socially inappropriate.
The reaction of some family members to my mental and emotional distress at the time was to completely distance themselves from me. I no longer have contact with the majority of my extended family because the behaviour caused by the distress of my mental illness caused such a rift. They were only able to see the unacceptable behaviour and not the real distress that lay behind it. It seemed as if nobody cared about me at all -- they only cared that they did not have to witness something that made them uncomfortable. I felt alone, unaccepted and uncared for.
Because of the way I was treated by those close to me, I know I have treated other distressed individuals in the same way in the past, seeking to fix, to solution-ise, and take the distress away so it no longer troubles me. It may seem counter-intuitive to ask a depressed person to describe or explore his or her feelings of distress -- it may seem like we are encouraging them to "wallow in it," but when we deny someone's distress and depression and instruct them to stop displaying their feelings, we are telling that person that we do not accept them as they are in that moment. Accepting the distress and gently encouraging the person to tell you how they feel as they are in that moment can make a huge difference to how they then deal with those feelings (How To Help And Support Someone With Depression).
Care for Yourself After Practicing Distress Tolerance with Depression
I am not suggesting that distress tolerance skills with depression are easy. It is hard to witness someone you care for in emotional pain; therefore, it's important to use self-care strategies to re-energise yourself and keep yourself safe after dealing with a distressed individual. Tolerating and working with a person in distress requires a lot of energy, a lot of thought and a lot of empathy and that can be tiring -- I know from my training and the constant emphasis on self-care from the wonderful team I'm working with that I will need to ensure my own wellbeing after an evening of helpline work. Good self-care is vital to everyone's mental health, including caregivers and supporters.
I'm not suggesting that it's easy or comfortable to practice tolerating another's distress, but it's something that really can make a huge difference to a depressed person experiencing what can seem like insurmountable emotional pain. That's why it's worth learning and practicing this depression distress tolerance skill for ourselves and for others.
Image Attribution: Olga Caprotti, used under Creative Commons license