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This question originally appeared on Quora. Answer by Mills Baker.

The only coping mechanisms I can reliably use when I'm extremely unstable — and I think instability is the real emotional challenge here, as much as the states between which we oscillate — are the following:

Hunker down for the flu. An illness is an illness, and if you've got the flu you know you're going to feel terrible for some number of days. You plan for it: you get movies to watch, maybe, or books for bed; you stock up on the things you know you can always eat, and just wait to stop feeling horrible. Note that you don't put pressure on yourself to feel better. If you wake up with a cough at 2:30 AM, you don't weaponize the experience, turn it against yourself. You just say: "I'm awake until I'm done coughing. That's the flu!" I do the same for periods of instability. You're not well; it might last a few days, a week, maybe even more. The most important thing is to slow your life down, take it easy, keep yourself safe from stresses, judgments, tensions, and difficult things, just like you would if you had the flu.

Pack a suitcase. When I'm unstable, I have a hard time remembering lessons I've already learned and distinguishing valid thoughts from invalid thoughts. You don't have much bandwidth, memory, or cognitive capacity left over after tons of frenetic interiorized suffering! But some things you must remember:

  • No self-harm
  • Seek help when you need it
  • This too shall pass
  • Anything mental is survivable
  • Progress is possible

I visualize "packing" these ideas into a tiny suitcase, and I bring them with me into the smallest, deepest, darkest places that way. I am never without this suitcase; even when I suffer so much I cannot remember my name, I remember the axioms which "get me through" it, or try to. Spell out the key sustaining ideas, boil them down to nothing, and keep them with you always.

When you're fighting off anxiety or despair, have them at the ready. "This is unbearable, it'll never get better," a part of your brain shouts. "No, it is bearable, and it will get better," you calmly recite from your packed list of ideas. The suitcase is useful because — and you must remember this — your thinking isn't sound when you're upset. So you don't want to respect, as it were, any conclusions you draw while miserable; thus you need conclusions to defer to; work them out in advance and remember them as best you can so you don't need to bother with "real thoughts" until you feel better. I literally refuse to think about whether I'm a "good person" while in a state, for example.

Get out of yourself. Music, movies, literature, and video games — but not the Internet, which brings with it crowds, social dynamism, people, judgments, stresses — can help with the most basic task: passing time without kicking off that cycle of thoughts that obsesses you. I spend lots of time doing these things so that I'm not always engaged with my own mind.

As with the "hunker down" strategy, this strategy accepts as a given that there will be no "relief" from the problem in the immediate future, so you need to keep time moving along without miring again inside your mind. Make a list of books, television shows, movies, and / or video games (or other types of comparable activities: exercise, board games, etc.) that you can do.

They should be things you can do alone, things which you don't need to do and which you feel no pressure about. For example: don't buy Ulysses and then try to read it during a panic attack and then despise yourself for not being smart enough! Instead, buy comic books, or lighter novels, or whatever you feel like reading. Try documentaries, non-fiction, whatever.

Doctors, working out, diet, more pills. I know you're already on meds, but: maybe you need different meds, or more, or fewer. If nothing works, it's important to talk to a doctor. They may recommend changes to your cocktail, more exercise, changes to your diet, and/or much more.

The key is to do your best to make progress, but never let yourself get stuck; if you're suffering and stuck and can't use any of these (or other) techniques to get through it, go back to your doctor (or a new doctor) and make sure you keep making progress. That's important, too.

One more thing: Medications themselves can add to instability; in my experience, this is true even of medications that are ostensibly stabilizing! As such, you should make sure you've discussed possible side effects from medications as a source of your difficulty. There's always the possibility that a minor adjustment (or the substitution of another drug) might make this go away.

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