Helpful ways to keep distress in check : Life Kit : NPR

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Photo Illustration by Becky Harlan/NPR

Photograph of a woman faceplanting onto a wooden table due to stress and overwhelm. Behind her is a blue backdrop.

Photo Illustration by Becky Harlan/NPR

A few years ago, I had a bad day at work. My boss and I disagreed on a major financial investment and the conversation escalated. They criticized my working style and said that I just didn’t have enough experience to understand the decision. And I took those comments personally.

I remember walking out of the office feeling anxious and panicked. And what was strange was that I couldn’t seem to snap out of it — those emotions hung over me for weeks. I eventually had to reach out to a therapist for help.

It turns out I was experiencing distress, says Dr. Kali Cyrus, a Washington, D.C.- based psychiatrist. It’s what happens when you experience negative emotions and physical symptoms like stress, fatigue and anxiety over a long period of time, to the point that it affects your everyday life. Cyrus calls it « discomfort at extreme levels. »

Distress may stem from a fight, like in my case; a major life disruption, like losing a job or going through a breakup; or a high-pressure situation, like having to plan a big event.

Cyrus says you can prevent discomfort from ratcheting up to distress by paying more attention to your body and mind — and learning how to be OK with being uncomfortable.

You want to do that because « stress adds excess work to our body, exacerbating its wear and tear, » she says. Research shows that long periods of stress can lead to high blood pressure, elevated hormone levels and conditions like chronic fatigue, depression and immune disorders.

Is it discomfort or is it distress?

Let’s say you’ve been triggered by a stressful incident. Notice what’s going on in your body and mind. Do you feel uncomfortable?

« When you are not feeling good, your body is trying to tell you something, » says Cyrus.

After my fight with my boss, for example, my chest felt tight, my stomach hurt, I had trouble sleeping and focusing, and I felt like I was on high alert.

These symptoms are a sign of discomfort, says Cyrus, which you may be able to manage with simple grounding techniques (a few are outlined below). But they can turn into distress if they stick around for more than a few hours or days. Mine lasted for weeks.

When you are in this state, your « nervous system gets dysregulated and that messes up the balance of hormones in your body, » she adds, preventing it from « regulating in these times of need. »

Distress can also show up « in the form of depression, chronic pain or anxiety » that impact you « most days of the week and get in the way of your ability to work or spend time with friends, » she says.

If you are experiencing any of these symptoms, Cyrus recommends seeing your primary care doctor. Get a physical exam and blood work done to narrow down any possible health issues. If your symptoms aren’t related to your physical health, talk to your doctor about seeking mental health intervention, like therapy or medication prescribed by a psychiatrist.

How to keep distress in check

Photograph of a man sitting with his elbows on a wooden table and face palming due to distress and overwhelm. He holds his glasses in his hands. He sits in front of a blue backdrop.

Photo Illustration by Becky Harlan/NPR

Photograph of a man sitting with his elbows on a wooden table and face palming due to distress and overwhelm. He holds his glasses in his hands. He sits in front of a blue backdrop.

Photo Illustration by Becky Harlan/NPR

The good news is that there are ways to prevent feelings of discomfort from escalating into distress. Cyrus shares a few techniques.

Change the scene

If you catch yourself spiraling — you can’t seem to catch your breath, you’re feeling anxious or you’re having trouble focusing — find a way to snap out of it. « Go outside, go to the bathroom, call a friend, take a few deep breaths, » says Cyrus.

Your nervous system is being flooded with stress hormones, making it hard to calm down or see things clearly. So you need to interrupt the feelings that are overwhelming you by changing your environment, she adds.

I didn’t realize I had done this after my fight with my boss. After our argument, I left the office immediately and went for a long walk. Just noticing the trees and the birds around me got me out of my head.

Recount what happened

Go over your situation again and create a narrative, says Cyrus. This can help pinpoint what is giving you distress and jog your memory of details you may have overlooked that can add levity to the situation. Do this with a friend, a family member, a therapist — or even yourself, by journaling or « talking out loud as you walk your dog, » says Cyrus, as she likes to do.

Name your emotions

As you describe what happened, name your emotions, she adds. She recommends using the feelings wheel, a tool that can help you express your emotions more specifically (for example, instead of saying you simply feel « bad, » maybe you actually feel « indifferent. »)

I turned to a therapist to help me unpack my fight with my boss. She helped me realize that it wasn’t my boss or the argument that was making me upset, but the feeling of being dismissed and made to feel small. That allowed me to see a different perspective on the issue.

Identify your triggers

Examine what gives you discomfort. For example, if you have terrible road rage, Cyrus says to have a conversation with yourself about it. You might ask yourself: Why am I prone to being so angry on the road? Is it because I am in a rush? Or is it because I hate sitting in traffic?

Then, find ways to alleviate the situation. To avoid being rushed, maybe leave the house a half hour early. To avoid traffic, ask your boss if you can work from home a couple times a week.

As for me, I’ve learned that I tend to be sensitive to feedback when it includes a reference to my lack of experience. It makes me defensive and angry.

So now, when I find myself in this circumstance, I remind myself to breathe deeply, pause, tell the other person that I need time and space to consider their feedback — and that I’ll come back to them when I’m ready. This helps me feel more in control of my feelings.

The audio portion of this episode was produced by Sylvie Douglis. The digital story was edited by Malaka Gharib. The visual editor is Beck Harlan. We’d love to hear from you. Leave us a voicemail at 202-216-9823, or email us at

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