Must-Have Tools to Reduce Negative Triggers and Increase Positive Ones: Navigating Mental Health in Crisis

This podcast episode, hosted by Dr. Donnelly Snipes, delves into the critical topic of identifying and managing triggers for stress, relapse, and mental health issues, particularly within the context of a crisis. It begins by defining triggers as sensory inputs, situations, or memories that prompt specific thoughts or emotions, emphasizing that they can be both positive (e.g., puppies, push notifications for self-care) and negative (e.g., alcohol for substance users, stress itself). The core argument is that while negative triggers are potent and often unavoidable, individuals can proactively develop strategies to mitigate their impact and cultivate positive triggers to enhance well-being and recovery. The discussion highlights that during a crisis, the prevalence of anxiety, anger, hopelessness, and helplessness necessitates a focused approach to mental health.

A key distinction made is the concept of emotional valence, where negative triggers are noted to have approximately five times more impact than positive ones, a mechanism rooted in evolutionary survival. Dr. Snipes introduces the framework of physical, affective, cognitive, environmental, and relationship triggers, stressing that complete elimination of unpleasant triggers is unrealistic. Instead, the focus shifts to developing distress tolerance and coping resources. The episode draws upon principles from Acceptance and Commitment Therapy (ACT), specifically Steven C. Hayes' concept of "living in the and" – acknowledging that one can experience pain and challenges while still pursuing a rich and meaningful life. This nuanced perspective encourages acceptance of difficult circumstances while actively engaging in controllable actions.

The podcast offers a wealth of practical insights and recommendations, particularly through the lens of gamification for therapeutic engagement. Dr. Snipes details various group and individual activities like Pictionary, Taboo, Jenga, and Jeopardy, explaining how these interactive methods foster learning, competitive spirit, and better retention of coping strategies. For physical triggers, specific advice includes ergonomic adjustments, systematic relaxation, proper sleep hygiene, healthy eating, hydration, and awareness of illness symptoms. The importance of removing problematic substances from the environment and setting reminders for self-care is also underscored. The episode also addresses the physiological impact of stress, such as HPA axis activation, cortisol release, and inflammation, linking these to fatigue, altered hormones, and depressive symptoms.

Regarding affective triggers, the episode tackles anger (as a response to powerlessness and threat) and loneliness (exacerbated by social distancing). Practical solutions include focusing on controllable aspects, seeking virtual connections, fostering pets, and engaging in acts of kindness for others. The broader implication is the cultivation of resilience and proactive self-management. By understanding the mechanisms of triggers, adopting engaging therapeutic techniques, and implementing concrete self-care practices, individuals can navigate challenging times more effectively, reduce the likelihood of relapse into prior negative states, and foster a greater sense of happiness and control over their mental well-being, even amidst ongoing crises. The episode emphasizes that learning is enhanced when people are happy and comfortable, making the gamified approach particularly effective for internalizing these vital coping skills.

"relapse is returning to a prior state"

"Triggers are sites including people places and things sounds smells and situations that make you think about doing something or bring up a particular memory or emotion."

"Hays talks about the fact that we can't avoid pain it's gonna happen sometimes but we can have a rich and meaningful life and experience problems at the same time."

"negative triggers and events are about five times stronger or have about five times more valence than positive ones"

"you're never going to be able to eliminate all unpleasant triggers that's just not realistic"

"a lot of times we don't really know what we don't know until we try to teach it"

"when people are happy when they're comfortable they actually learn better"

"when we're under stress people also tend to have an upset stomach which can cause you know gastric upset which can be painful"

"there's a lot of research out there that has correlated the people's levels of depressive symptoms increase in not in direct proportion but they increase as their inflammation increases"

"Anger is a response to powerlessness to threat to loss of control"