Double exhalations. Place one hand on your belly, and one on your chest. Breathe deeply with your exhalation twice as long as the inhalation. Breathe in for a count of 2, out for count of 4; in for count of 3, out for 6; breathe in for 4 and breathe out for count of 8. This shifts your nervous system to a calmer state.

Pressure & Hard Tapping. With an open palm, using hard pressure, quickly and firmly pat one arm from top to bottom, then the other, then both legs. Make the pressure harder than your thoughts are loud. Try wrapping yourself in a weighted blanket if you have one.

Relaxing bilateral music. By listening to music that has alternating left-right beats, you can desensitize and calm anxiety or other emotional distress. Go to youtube.com and search for bilateral music. Listen with earphones for the bilateral effect, and lie down with your eyes closed, and breathe slowly as you focus on the bilateral sounds.

5-4-3-2-1. Name 5 things you can see, 4 things you can hear, 3 things you can feel, 2 things you can smell, and 1 thing you can taste. This helps to ground you in the present moment.

Slow tapping. Cross your arms across your chest, placing each hand on the front of each opposite shoulder. At a beat of about one tap per 1-2 seconds, alternate tapping each open hand on your shoulders, right, left, right, left. Close your eyes. Breathe in slowly, and then push the air out of your lungs in a slow, steady stream, like you are blowing out candles. See how long you can exhale before taking the next inhalation. The physical tapping on alternate sides of the body helps to calm the nervous system, and grounds you to focus on your breath and your body as well, instead of anxious or distressing thoughts. Combine with imagery of safe place.

Use temperature sensations to change your nervous system. Cold: Go to the kitchen and take a piece of ice, and some napkins. Hold the ice in your hand, and use the napkins to absorb the melting water. Focus on the intense cold sensation of ice in your hand. There is a nerve called the vagus nerve that runs down the center of your body, and sends signals of nervousness or calmness into your body. This nerve is sensitive to temperature, and if you place an ice pack or a cold washcloth on your chest or head, it can literally change your nervous system from a flight-or-flight mode into a calm, restorative mode. Heat: If you are sensitive to cold and prefer warmth, take a hot bath with epsom salts for additional magnesium to relax your nervous system. Drink hot tea and hold the warm cup in your hands and focus on the warm sensation calming and soothing you.

Physical exertion. If you have high intensity anxiety or anger, go for a quick run, a hard hike in nature, or do some kind of exercise to get rid of some of that excessive agitation.

Self-Soothe. Get yourself a hot tea, coffee, soda water, natural juice or ice water. Drink your beverage slowly focusing on the sensations of taste, smell and temperature.

Distract yourself. Pick up a magazine and focus your attention on the pictures or an interesting article. Bring your mind to whatever you are reading or looking at, redirecting it from upsetting thoughts and feelings.

Use relaxation. Give yourself a little neck and shoulder massage - you can rapidly tap your fingers on your neck and shoulders or rub your neck and shoulders. Focus on different muscles in your body from your head to your feet telling yourself to let go of tightness and tension.

Watch a video on relaxation techniques. Search on youtube.com for distress tolerance or mindfulness techniques. Focus on the skills presented in the video and choose one to practice right now.

Talk back to the intrusive thoughts with reasonable thoughts and facts. “This is a medical condition and can be treated with medicines and therapy.” “I am a good person and this is an illness that can go away. It does not define who I am. This can get better.” “My life has a purpose even if I don’t always feel like it does.”

Thought-stopping. Tell yourself “Stop.” Visualize a stop sign. Visualize an exit sign on a freeway and imagine you are exiting the freeway of your thoughts and coming to a stop.

Use imagery. Imagine a wall between yourself and the situation. Or imagine a peaceful, happy, secure place. It can be someplace you have been or someplace that you create in your mind. Imagine in detail what your place looks like, any soothing smells, if there are any comforting people or animals with you, what it feels like, what sounds you can hear. This is your safe space. Assign a word to this space, such as Peace, Serenity, Safety, etc., and say this word to yourself if you feel emotionally upset.

Keep perspective. Put things in a healthier perspective by thinking about problems that you no longer have, or all of the things you have overcome so far. Consider the ways in which you have grown over time, what you have learned, and remember that we are all a work in progress, and there is always hope for improvement.

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