Something I learned while I was in hospital was the use of sensory tools as coping mechanisms. This was explained to me by the occupational therapy staff, and with their help I was able to identify the things that work and don’t work for me. Since then, I have experimented with more stuff and now I have a good range of options not just for coping with distressing feelings, but to make my life easier and more enjoyable in general.
Since becoming stable I have also realised that some aspects of my sensitivity to some sensory input are not to do with an ongoing mood episode or a warning sign of one necessarily. Rather, it’s just the way my brain works even when stable. Sometimes it’s also related to migraines.
The first thing I learned was the importance of the two senses that are not commonly talked about: vestibular and proprioceptive.
The vestibular sense has to do with movement and balance. The name comes from the vestibular receptors located in the inner ear. These detect different types of motion of the head and send that information to the brain.
The proprioceptive sense has to do with awareness of our body. It’s how we know where our body parts are. For example, if you close your eyes and try to touch your nose, you’re able to do it. This is because of proprioception allowing you to know where those body parts are in relation to each other without looking at them.
We all process sensory stimuli differently. Some people, for example, have a higher tolerance to noise than others. A common analogy is thinking of our tolerance for each type of stimuli as a cup, with the stimuli being liquid filling it; while the liquid is the same, different people have cups of different sizes accommodating different volumes.
There’s also sensory processing disorder, where common stimuli is overwhelming or even painful for someone. However, even without having sensory processing disorder it is helpful to know the kind of stimuli that has a positive or negative effect on you.
In my personal experience, when my mood is dysregulated I become more overwhelmed by certain stimuli, and when I’m exposed to certain stimuli my mood starts to become dysregulated. But as I said, some of my sensitivity isn’t indicative of an incoming episode, it’s just my baseline.
Over the last few months I have learned more about myself in terms of sensory processing (both seeking and avoiding stimuli), so I want to share my experience with that.
This is the one that causes the most distress for me.
I am very sensitive to sound. I’m aware of the most subtle sounds and I get overwhelmed by anything loud. This can be a loud conversation nearby, loud music, the sound of traffic, machinery, the sound of the sea or strong winds, etc. Sometimes I can also get overwhelmed by a combination of several relatively quiet noises happening at once.
I find that when I’m exposed to what is too much noise for me, I become irritable, I can’t focus, and I withdraw. It becomes difficult to think, let alone follow a conversation, and my brain basically shuts down. I just get the urge to get away as quickly as possible and go to a quiet and dark space.
When I have reached my limit, my threshold gets lower. I become hyperaware of every sound. If I’m at work, I can hear people typing, clicking, walking, eating a cracker, moving their chair, etc. It gets to the point where I can’t focus at all and I just become more and more irritable. If I’m at home, I can hear the noises outside, people walking upstairs, my flatmate’s quiet music, and the sound of appliances. These are sounds I normally tolerate and often don’t even notice, but if I’ve gone past my limit already, if I’m in an episode, or if I have a migraine, it becomes impossible not to hear them. Sometimes it feels close to being in pain.
What helps me with this is protecting myself from sound. When I’m outside I often wear headphones, either playing music I’m familiar with, a podcast or audiobook I can focus on, or not playing anything, just having them to drown out the noises around me a bit. You would think playing music or a podcast would just add to the rest of sounds, and sometimes it does, but a lot of the time it just gives me one sound that I tolerate and I can anchor my attention on it so that I’m not as aware of the rest of sounds.
I recently bought a pair of earplugs meant for music environments. They allow you to hear clearly, but at a lower volume. I can wear these outside and still hear the traffic on the street or the people in a store, and I can wear them at work and still be able to clearly understand people.
I don’t often wear ear defenders outside because I do want to be aware of traffic and people around me, but I often wear them at work when I don’t need to listen to or interact with other people, and at home when I’m doing something noisy like hoovering. Sometimes, I’ve worn ear defenders and earplugs at the same time at work.
This makes me comfortable and allows me to get through situations that would otherwise be stressful due to the noise being more than I can process.
I also know when to make people aware of this issue. If someone is talking to me in a noisy environment, especially if it’s other people talking around us, I let them know I will struggle beforehand. My brain doesn’t seem to have a filter for sound, I hear everything at once, so if someone talks to me I can’t necessarily focus to isolate their voice from everything else and make sense of the words they’re saying.
Something else that helps me as well is subtitles. I used to avoid this because English is not my first language and I used to think reading subtitles somehow meant my English wasn’t good enough. But I now do this both in English and in my native language. I don’t read them at all times, but it helps to have them as it’s not so much of an effort to keep up with what’s being said. This is not so much to do with my tolerance to sound as such, but more with my ability to process it. I wish people had subtitles. Oftentimes I can hear what someone is saying, but I don’t understand a thing. I tend to rely on context and lipreading when that happens.
When I’m overwhelmed, I try to remove myself from the situation whenever possible. I go to a quieter space for a few minutes before I’m ready to go back.
There are situations I avoid altogether unless it’s impossible. I don’t shop at busy times, I don’t go out if it’s very windy unless I have to, and I avoid areas like the town centre where there’s more people and noise, or streets with a lot of traffic.
Bright lights can trigger my migraines, so I avoid them. My screens are always set to the lowest brightness I can see, I use dark mode wherever possible, and I close the blinds if I have to sit with a window in front of me for long periods of time.
Apart from lights, I find it difficult to process what I see if it’s too crowded. It takes me a long time to find what I’m looking for if I’m at a store with lots of different products on a shelf, or to find a book or folder on a shelf even if it’s clearly labelled. I see the whole picture and not so much the individual parts that make it up.
Something else I struggle with is moving crowds such as a busy street or even people in a store. I find keeping up with all that movement very tiring and not only that, but it’s also a migraine trigger.
There’s not much I can do about these things other than avoid them, although I have considered getting glasses that block certain light to prevent migraines. I also use a sleeping mask to sleep sometimes, but mostly when I have a migraine and want to block out all the light.
Some people use visual stimuli like lava lamps to calm down or relax. I haven’t found those helpful for me, but I like watching painting restoration or carpentry videos.
Not much going on with this one for me as there aren’t any tastes I seek or avoid in a significant way. I know for some people a strong taste like spice or biting a lemon can help them self-regulate, but it hasn’t worked for me.
This is more to do with my migraines than with my mood. Strong smells (particularly perfumes and air fresheners) are a migraine trigger for me, so I avoid them. Some people benefit from things like scented candles or essential oils, but for me it has to be a very subtle smell to enjoy it.
I find certain textures soothing, and in general having something I can touch or fidget with helps me stay grounded, focus, and cope with other sensory stimuli better.
I have a round rock I always carry with me for this purpose. Also for sentimental reasons. When I was in hospital I used sharp rocks from the garden to hurt myself a couple times, so I decided to pick a round one to fidget with and distract myself. when I got home I carved the date I attempted suicide on it and it serves as a reminder to turn to healthy coping skills instead of being self-destructive. Anyway, it’s nice because I can fidget with it in my pocket or under a desk and I really like the texture and size of it.
I also have a chain necklace with a ring which I often fidget with.
I have tried a variety of fidget toys. My favourites are the tangle and a little zipper I can zip and unzip. I carry the tangle in my pocket if I know I’m going to sit to read or study at lunch break or something. I have others like a marble mesh, fidget spinner, bubble pop fidget thingy, a regular stress ball and an orbeez one that I don’t use because I made my last one explode.
I also like brushing my beard. When it’s really long it feels nice to just brush the thick hair, and when it’s shorter, I like how the brush lightly scratches my face. I heard about ‘acupressure’ brushes so I bought one. It’s a bit too soft for my liking, but it does feel nice against my skin.
In terms of tactile input I avoid, I cannot stand anything sticky. I use moisturiser because it’s good for me, but it’s rather unpleasant. I don’t eat fruit I have to peel for the same reason (except bananas, they’re so clean and convenient, big fan). And I use gloves when doing the dishes.
VESTIBULAR AND PROPRIOCEPTIVE
I’m putting these two in the same category because they kind of intersect sometimes. These are really the things I do and enjoy the most, whether it’s to self-regulate or just because they’re nice.
I love pressure. I sleep so much better with a weighted blanket. I have a big one and when I’m anxious or upset I fold it twice to make it heavier on me and lie under it for up to an hour. Except when it gets really hot in the summer, I always sleep with it.
Being trans, I remembered a while ago the days when I had to bind and how physically and mentally uncomfortable it was for dysphoria reasons… But I thought hey, I might enjoy something tight like that now that it’s a choice and not a necessity? So I bought a compression shirt online, it’s tight but comfortable, stretchier and not as thick as a binder, and not so constricting that it’d be unsafe to wear for longer than 8 hours unlike binders. Turns out it’s really nice to wear it when I have that need to feel ‘contained’ and have some pressure on me.
I have a migraine hat for migraine reasons. But sometimes even without a migraine it’s nice to have that bit of pressure on my head, especially along with a sleeping mask
I have a gym/yoga/Swiss ball. I use it to sit on it and either bounce a bit or rock myself (I rock on any surface I sit on actually), and to lie on it on my stomach or my back either static or rolling back and forth. The pressure my own body weight creates against it is really nice and relaxing.
I also like lying flat on the floor on my back, with my legs up a wall either straight or cross-legged. Very comfortable and, for whatever reason, very calming. I can use a pillow to put my laptop on it so I can watch or read stuff in that position. Sometimes I meditate like that too.
In terms of big movements, I rock myself a lot whether I’m sitting or lying down, I bounce my leg up and down, and I shift my weight from one side to the other or back and forth if I’m standing.
When I’m out in busy/noisy environments like a supermarket, I sometimes find myself shaking my right hand. I guess it just gives me something to focus on so that I distract myself from everything else going on around me.
These are all my sensory tools/coping skills that I can think of right now, I might be missing some.
But in conclusion, I recommend exploring what sensations you like/dislike/can’t tolerate, and seeing how seeking or avoiding certain sensory stimuli can benefit you.