PANDAS Distress Tolerance: DBT Skills for Surviving Crisis

DBT distress tolerance skills for managing intense PANDAS — TIPP, ACCEPTS, and crisis survival.

Distress tolerance skills from Dialectical Behavior Therapy (DBT) help you survive pandas crisis without making things worse.

TIPP Skills for Acute PANDAS

Temperature: Cold water on face activates the dive reflex, rapidly reducing pandas intensity

Intense exercise: 20 minutes of vigorous exercise discharges pandas physiological activation

Paced breathing: Slow the breath (especially exhale) to activate parasympathetic system

Progressive muscle relaxation: Systematic tension-release reduces pandas physical symptoms

ACCEPTS Skills for Riding Out PANDAS

Activities that engage attention away from pandas Contributing to others shifts focus from pandas Comparisons that provide perspective on pandas Emotions opposite to pandas — deliberately generated Pushing away pandas temporarily when you can't act on it now Thoughts that replace pandas rumination Sensations that provide strong alternative input

When Distress Tolerance Is the Right Skill for PANDAS

Use distress tolerance when pandas is intense but the situation can't change right now. The goal is surviving without making things worse — not solving pandas.

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