BPD and Emotional Dysregulation: Part Two.

A month ago I wrote this post, and I called it “part one”, and then I forgot about it. Standard Natalie. But here we are!

I wanted to talk about ways of managing emotional dysregulation (ED).

There are so many different approaches, methods and techniques to manage ED, and while some work amazingly well for some people, they do not work at all for others. It is also VERY easy to disregard ideas because of assumptions we make; I hear about things like meditation, yoga and taking a long hot bath and my automatic reaction is to roll my eyes. Why would I want to sit quietly while struggling? I would rather go for a run, hit the gym or clean the house. Anything but sit still. But I am learning to open my mind to things; try guided meditations, for example. While not everything will work for you, you might be surprised that some things you do not even want to try, might work wonders.

The way I see it is, we have found ourselves in a rubbish situation, and we desperately want to learn how to manage better, and it seems like a pretty sensible thing to try every option no matter how silly it might seem. We have nothing to lose, and a lot to gain.

So first of all we have all of the things I think are airy fairy and I do not want to try, but which I do and will try; mindfulness, grounding techniques, yoga, arts and crafts. I am not going to go into detail on anything in this post as I have a lot to cover, but check out the links. (I wrote a post on this airy fairy stuff once!)

While in a day programme I absolutely hated art therapy, which they called “creative”, but towards the end I started writing rather than doing “typical” art, because the title of creative gave a lot more flexibility. Since then I have had a few periods of time where I have bought scrapbooks. I’ve had a “positive” scrapbook, and then a not so positive one, which I have yet to find a name for (I do not think “negative” is a good word for it). In the positive one it is simply lots of positive quotes or things I have read, with illustrations and things. I am not artistic. I am the least artistic person I know, but it is not about being an artist, it is about expressing yourself and creating something positive to look back at. In the other one I did the same but with quotes or poems that I could relate to in a different way; in a sad kind of way, but it was helpful because it allowed me to express some of my difficult feelings and find things I could relate to. Towards the end I also often just grabbed a sharpie and scribbled whatever was in my head onto the paper; messy and freely.

Here are some art journal prompts and writing prompts. If you really feel unsure about creating your own art, colouring in for adults is a huge thing now, as well as adult dot-to-dots!

Then there is exercise. Exercise is a complicated one. Sometimes I genuinely believe exercise is the last thing we need, especially if we are really low. There is a massive emphasis on exercise in mental health treatment, and while it is obviously backed by a lot of research, and often it is really helpful, what is not helpful is to feel like you SHOULD be exercising, but be unable to manage it, and then feel bad about it. But exercise can mean anything. Just because you do not like one thing, does not mean you will not like something else. Also, if you are really struggling you might not feel up to being in a busy gym, or intense exercise like running; but a 15 minute walk down a quiet footpath surrounded by nature, a swim, or a bike ride might be perfect for you; with this one you need to find what works for you, and this could be different things at different times. (If you struggle with, or have struggled with exercise addiction, an eating disorder, or any other addiction, be extremely careful about using exercise to manage your mood).

Medication can also be helpful in managing severe emotional dysregulation. While it is definitely not a “fix”, it can help when things are very unmanageable. This is something you will need to discuss with a medical professional, and is not something that will necessarily be an option for you. Different medications work for different people and therefore my experiences are limited in their usefulness for you as an individual, but I have found two medications particularly helpful; quetiapine and clomipramine, and while I did not think they were helping me, when I have been off them I have realised that they do. Like I said, they are not going to solve the problem to a seriously noticeable extent, but they can help ease things.

This next,and final one is a biggie! Acceptance. Acceptance of your emotions is key. Do not feel guilty or bad for feeling sad, or angry, or whatever it is you are feeling. It is ok to feel; a feeling cannot hurt you. Read more about radical acceptance, which is a key component of a famous treatment for Borderline Personality Disorder (DBT). Radical acceptance involves taking a non-judgemental stance about yourself, and the situations and people around you, and accepting them as they are. It is not about agreeing with something or someone, but simply accepting things you cannot change.

There are other things that can be helpful when experiencing emotional dysregulation:

  • Identifying your emotion(s) – if you struggle with this you can use an emotion wheel. An emotion is something that I believe is trying to tell you something. Ignoring your feelings will not help, but recognising how you are feeling and saying to yourself “right now I feel really sad” can often be helpful if you can be accepting of that, and aware that it will not last forever.
  • Distraction techniques – note that distracting yourself is not the same as ignoring your emotions; after distracting, your mood or emotions will at some point return to a more tolerable level, at which point you can address what you were feeling.
  • Longer-term you can keep a diary of triggers. It can be helpful to do an ‘ABC’, that is A (antecedent), B (behaviour) and C (consequence). For more information go here and use their blank template to record yours. This can allow you to identify frequent triggers and work on managing them. This was something I learnt from a mental health professional I used to see, and while I did not find it helpful at the time as she used it as the basis of my treatment (aka we spent all of our time doing it), it can be helpful as an aid.
  • Wise mind. This concept is also from DBT. Your ‘wise mind’ is the middle ground. The two extremes are reasonable mind and emotional mind, where wise mind is in the middle.

 

 

 

 

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