Distress Tolerance: Tools for Staying Calm in Tough Times

When life feels overwhelming, distress tolerance can be a lifeline. Distress tolerance skills allow you to approach challenges thoughtfully instead of reacting on impulse. With practice, anyone can strengthen their distress tolerance and navigate even the toughest moments with greater control and confidence.

What is distress tolerance?

Distress tolerance helps you manage tough emotions like anxiety, anger, or sadness without lashing out, using substances, overeating, isolating, or relying on other unhelpful coping strategies to avoid those feelings. There are many ways to cope with distress, but mental health professionals often draw on dialectical behavior therapy (DBT), a proven approach for tempering intense emotions. Distress tolerance DBT skills include techniques like staying present in the moment (mindfulness), accepting things as they are (radical acceptance), and finding healthy ways to distract yourself when things get tough.

Types of distress tolerance

DBT distress tolerance skills fall into two main categories:

Crisis survival strategies

These DBT distress tolerance skills are quick, go-to techniques for intense situations. Think of them as emergency tools to calm down or ground yourself when emotions are at their peak to prevent you from acting on harmful impulses.

Reality acceptance skills

Reality acceptance DBT skills help you move past the “this shouldn’t be happening” mindset and focus on what you can control. It doesn’t mean you like the situation; it just means you acknowledge it as reality.

What influences distress tolerance?

Everyone’s ability to handle distress varies, shaped by factors like genetics, life experiences, and mental health. How your family dealt with emotions growing up plays a big role. Did they openly talk about feelings or was there a lot of tension and conflict? Were some emotions encouraged while others were dismissed?

Understanding these influences is the first step. The next is learning how to manage distress more effectively. This is where distress tolerance skills come in.

How do distress tolerance skills help?

Distress tolerance skills can help with everyday challenges like work stress or family disagreements, and are especially important if you experience:

• Frequent impulsiveness in conflicts like sending heated texts, yelling, or walking out of conversations instead of addressing issues
• Turning to substances or engaging in other unhealthy behaviors to escape discomfort
• Constant worry or feeling “on edge”
• Avoiding activities, people, or responsibilities because of distress
• Feeling angry, sad, or anxious a lot of the time

Building distress tolerance helps decrease these reactions and navigate intense emotions better.

Here are some key benefits of strengthening distress tolerance:

• Improved relationships – Learning to manage emotional surges can keep arguments from escalating
• Healthier lifestyle – Managing emotions better keeps you from engaging in unhealthy behaviors to cope
• Reduced stress and anxiety – Calmly handling day-to-day stressors helps keep anxiety at bay
• Better emotional agility – Pausing and responding to conflict in a way that aligns with your values means fewer regrets and more fulfilling personal and professional interactions
• Increased resilience – Managing stress effectively helps you build confidence in your ability to navigate challenges

6 ways to build distress tolerance

No matter your biology or background, anyone can strengthen their distress tolerance skills. Think of these skills as a mental toolkit—you might not need them all the time, but having them on hand can help you navigate difficult situations with greater ease. Here are some ways to build DBT distress tolerance skills:

#1 Practice

The key to better distress tolerance is practicing outside of intense situations. For example, if you find yourself in a heated argument with your partner, you’re probably not going to step back and think, “I read somewhere that breathing is good for this.” Practicing distress tolerance skills during less stressful situations helps them become second nature—like muscle memory—when times are tough.

#2 Press pause

In moments of high stress, you can use crisis survival distress tolerance skills to press pause. These are like the “hammer” of the toolbox when you just need to stop things from escalating like in an argument or impulsive urge. Here are a few ways to press pause:

• Stop and observe – Stop everything—your body, words, and reactions—and just observe things around you to break the chain of negative actions
• Get away from the stressor – Put down your phone if you’re about to send a text you’ll regret or walk away from the situation to give yourself space to cool down. If you’re tempted to reach for an unhealthy coping mechanism, like a drink, pause and step back.
• Breathe – Once you’ve stopped and gotten away from the stressor, take a deep breath to shift into a more mindful state so you can make better choices as you proceed

#3 Change the body to change the mind

Sometimes, the fastest way to dial down distress is to focus on your body. This shifts your focus from mental to physical. Here are a couple of ways to reset:

• Use cold water – Submerge your head in cold water or place ice packs on your head to activate the vagus nerve, a key part of your nervous system that helps regulate heart rate and emotional response. This technique can effectively slow your heart rate and calm your body.
• Exercise intensely – Engage in high-intensity exercise like running up and down the stairs or doing push-ups. This isn’t just your typical workout; it’s a quicker, more vigorous burst of activity. Intense exercise can help release built-up tension and trigger the release of endorphins, which can elevate your mood and provide a powerful reset for both your mind and body.

#4 Distract and do something different

If you feel an impulse—whether it’s sending a harsh text or reaching for a vice—distract yourself by doing something that grabs your attention and pulls you away from distress, like watching TV, going for a bike ride, or doing a crossword puzzle.

#5 Practice acceptance

Often in high-stress moments thoughts like, “It shouldn’t be this way” can fuel negative emotions. Practicing reality acceptance DBT skills lets you stay grounded and focused on what you can control. For example, “This is the situation right now, and I can focus on what steps I can take next.”

#6 Try therapy

You don’t have to wait for a crisis to seek therapy—distress tolerance skills can benefit anyone, no matter where you are emotionally. While you can practice these skills on your own, a therapist can provide personalized guidance and support. A therapist helps you understand your unique triggers, tailor coping strategies to your specific needs, and hold you accountable as you apply what you’ve learned.

Build a toolbox for difficult moments

Distress tolerance skills help you manage life’s toughest moments with more calm and clarity. By learning these strategies, you’re not just surviving hardship but building resilience and emotional flexibility to help navigate all of life’s challenges.