Self-Care

DBT includes many skills that can be part of self-care, but “Self-Care” itself is not one formal DBT skill or acronym.

Related DBT skills include:

• PLEASE
• Self-Soothing
• Build Mastery
• Mindfulness
• Opposite Action
• Interpersonal-effectiveness skills

Relaxation can be self-care.

But so can:

• Going to bed on time
• Eating when you have not eaten
• Calling the doctor
• Taking care of paperwork
• Leaving an unhealthy situation
• Asking someone for help

Self-care is better understood as:

responding to a real need

rather than:

doing something pleasant.

Sleep, movement, connection, relaxation, and daily routines can support wellbeing.

They are not substitutes for needed:

• Medical care
• Mental-health treatment
• Medication
• Crisis support

Sometimes one of the most important forms of self-care is getting professional help.

Sometimes what you want is also helpful.

You may want:

• A nap
• A good meal
• A walk
• Time with a friend

and those things may meet real needs.

You may want:

to stay awake watching one more episode

while knowing you need sleep.

Or want:

to ignore an appointment you are anxious about

while knowing you need the care.

Self-care can involve choosing the action that supports you beyond the immediate moment.

Choosing a difficult but useful action does not mean:

“The harsher I am with myself, the healthier it is.”

Self-care should respond to genuine needs, not become another way to criticize, deprive, or punish yourself.

Ask:

• Have I eaten?
• Have I had enough to drink?
• How much sleep have I been getting?
• Do I need to use the bathroom?
• Am I physically uncomfortable?
• Do I need medication or medical care?
• Have I moved my body recently?

These questions may sound basic, but basic needs are easy to overlook when you are:

• Busy
• Depressed
• Anxious
• Overwhelmed
• Focused on other people

Hunger, dehydration, sleep loss, pain, or physical discomfort can make it harder to:

• Concentrate
• Regulate emotion
• Be patient
• Make decisions
• Handle stress

Fixing the physical issue will not solve every emotional problem.

But it may make the problem easier to handle.

If you need food, eating is a basic form of care.

Try not to make:

“Did I accomplish enough to deserve a meal?”

part of the decision.

Your body needs regular fuel whether the day went well or badly.

If preparing food feels overwhelming, self-care may mean choosing the easiest reasonable option available.

The goal does not need to be:

“Prepare the ideal meal.”

It may simply be:

“Eat something.”

Break Tasks Into Smaller Steps can help if preparation itself feels too complicated.

Sleep can easily become whatever is left over after:

• Work
• Chores
• Entertainment
• Other people's needs

Self-care may involve deliberately protecting enough time to sleep.

You may need:

sleep

because you are sleepy.

Or you may need:

rest

because you are mentally or physically depleted.

Sleep Hygiene, Rest, and Recharge / Unplug explore these areas in more depth.

Depending on your body and current capacity, movement might include:

• Walking
• Stretching
• Gentle movement
• Dancing
• Gardening
• Exercise

The amount and type should fit your:

• Health
• Mobility
• Energy
• Medical guidance

There is a difference between:

“Moving my body supports me”

and:

“I have to punish myself for what I ate or how my body looks.”

Exercise / Movement explores movement as a broader wellbeing skill.

Self-care may mean:

• Brushing your teeth
• Taking a shower
• Changing clothes
• Washing your face
• Doing basic grooming

When depression, exhaustion, illness, or overwhelm is high, these can become genuinely difficult tasks.

If:

“Take a complete shower”

feels impossible, ask:

“What part would help most right now?”

Maybe:

• Wash your face
• Brush your teeth
• Change your shirt
• Take a quick shower without doing everything else

Partial care is still care.

Self-care is not limited to what you can do entirely by yourself.

It can include:

• Making an appointment
• Getting a prescription refilled
• Following a treatment plan
• Attending therapy
• Talking with a clinician about worsening symptoms

Getting appropriate help is not a failure of self-care.

If you are experiencing serious, persistent, or worsening symptoms, another:

bath, walk, meditation, or day off

may not be the intervention you need.

Seeking professional support can itself be the self-care action.

Daily life requires energy for:

• Work
• School
• Relationships
• Caregiving
• Chores
• Managing emotions

Rest and breaks are part of maintaining the capacity to keep going.

Try not to wait until you are completely depleted before allowing yourself to pause.

Regular smaller breaks may be easier than repeatedly reaching:

“I cannot do one more thing.”

You may spend an hour scrolling and still feel:

• Overstimulated
• Restless
• Drained

Ask:

“Did that actually help me recharge?”

Recharge / Unplug focuses specifically on this distinction.

Self-care can include:

• Music
• Art
• Games
• Hobbies
• Time outdoors
• Reading
• Play
• Activities you simply enjoy

Enjoyment does not need to produce:

• Money
• A skill
• A finished product
• An achievement

to have value.

Do not assume an activity is self-care merely because:

“People say it should be.”

Ask:

• Do I enjoy this?
• Does it help me feel engaged?
• Do I feel restored afterward?
• Does it fit what I need today?

Self-care can include:

• Calling someone
• Spending time together
• Asking for emotional support
• Asking for practical help
• Joining a shared activity

Caring for yourself does not mean doing everything yourself.

Sometimes you need:

connection.

Sometimes you need:

privacy, quiet, or time alone.

Ask which need is actually present instead of assuming either socializing or isolation is always better.

If your schedule is already overloaded, adding another:

“self-care activity”

may not solve the underlying problem.

Self-care might instead mean:

• Saying no to another commitment
• Canceling something optional
• Asking someone else to help
• Reducing unrealistic expectations

Ask:

“If I say yes, what will I realistically have to give up or neglect?”

Sometimes maintaining:

• Sleep
• Health
• Existing responsibilities
• Needed downtime

requires limiting what you take on.

Examples:

• Keep water somewhere visible
• Keep easy food available
• Put medication where you will remember it, if safe
• Put important appointments in your calendar
• Keep needed supplies together
• Prepare part of tomorrow's routine tonight

Self-care does not need to depend entirely on remembering and feeling motivated at the right moment.

Ask:

“What makes this harder than it needs to be?”

If the answer is:

“My walking shoes are buried in the closet,”

part of self-care may be putting them somewhere accessible.

If you need food, high-capacity self-care might be:

cook a meal.

Lower-capacity self-care might be:

eat something simple that requires almost no preparation.

The need is the same.

The response changes with your capacity.

On a difficult day, your goal may be:

• Eat something
• Drink water
• Take needed medication
• Brush your teeth
• Get through essential responsibilities
• Rest

A lower-capacity day does not require the same routine as a high-capacity day.

Self-care is often imagined as something you do after reaching:

total exhaustion.

It can also be ordinary maintenance:

• Regular meals
• Regular sleep
• Breaks
• Movement
• Connection
• Routine health care

Your signs might include:

• Becoming unusually irritable
• Skipping meals
• Sleeping poorly
• Withdrawing
• Feeling mentally foggy
• Letting basic tasks pile up
• Losing interest in things you normally enjoy

Treat these as:

information

rather than proof that you are failing.

If you have been:

• Isolating
• Staying in bed
• Avoiding responsibilities
• Not doing anything meaningful

self-care may involve:

getting up and doing something.

Behavioral Activation can help with this.

If you have been:

• Working continuously
• Taking care of everyone else
• Overscheduling yourself
• Pushing through exhaustion

self-care may mean:

stopping.

The right direction depends on the pattern you are currently in.

Compare:

“I've been working for three hours. I'm taking twenty minutes to eat and rest.”

with:

“This task makes me anxious, so I've taken a break for the last four days.”

The same word— break— can describe very different patterns.

A useful question is:

“Does this help me return to my life, or is it helping me disappear from something I eventually still need to face?”

Avoidance is not automatically wrong.

Sometimes postponing something is appropriate.

The goal is to notice whether the pattern is helping.

Resting, eating, connecting, or enjoying something does not need to be justified by:

“This will make me work harder later.”

Supporting your wellbeing can be worthwhile in itself.

Practical functioning is also part of life.

Self-care may help you maintain enough capacity for responsibilities.

The point is not to turn every act of care into another productivity tool.

Some enjoyable forms of self-care cost money.

Many do not.

Examples include:

• Going to bed
• Drinking water
• Taking a walk
• Calling a friend
• Sitting outside
• Listening to music you already have
• Saying no to an extra obligation
• Taking a quiet break

Spending money can be enjoyable.

Ask whether the purchase fits your:

• Budget
• Needs
• Longer-term wellbeing

If:

“self-care”

creates significant financial stress afterward, it may not be caring for the whole situation.

You may think:

“I shouldn't rest while someone else still needs help.”

Ask:

• What is genuinely my responsibility?
• What can wait?
• What can someone else do?
• What happens if I never recharge?

Care for other people and care for yourself are not automatically opposing goals.

Sometimes guilt is appropriate because you are neglecting a real responsibility.

Other times, guilt appears simply because:

someone else would prefer that you keep giving.

Check the Facts, Setting Boundaries, and FAST may help distinguish the two.

One person may recharge by going to:

a social event.

Another may recharge by spending:

an evening alone.

One person may find exercise restorative.

Another may currently need:

physical rest.

Ask what fits:

you, today, in this situation.

What helps during:

• A busy work week
• An illness
• A period of grief
• A vacation
• A depressive period

may be very different.

Self-care is an ongoing process of noticing and adjusting.

Consider:

• Sleep
• Food
• Hydration
• Movement
• Health care
• Physical comfort

Consider whether you need:

• Space to feel
• Validation
• Calming
• Expression
• Support

Consider whether you need:

• Connection
• Help
• Companionship
• More solitude
• A boundary

Consider whether something unresolved is repeatedly creating stress.

Maybe you need to:

• Pay a bill
• Make an appointment
• Do laundry
• Clean a small area
• Answer an important message

Practical maintenance can reduce ongoing friction.

Consider whether you need:

• Rest
• Play
• Nature
• Creativity
• Quiet
• Something enjoyable

Consider whether you have had enough room for things that matter beyond immediate obligations.

Maybe:

• Learning
• Creativity
• Relationships
• Service
• Spirituality
• Personal growth

When everything feels harder than expected, ask:

• Have I eaten?
• Have I had water?
• Did I sleep?
• Am I in pain or uncomfortable?
• Do I need medication or health care?
• Have I had any break?
• Have I been alone too long?
• Have I had enough time alone?

Address the most obvious unmet need first.

Complete:

“Right now, I need ______.”

Then:

“One thing I can do about that is ______.”

Keep the action small enough to do.

Choose one need and create three levels.

Example:

Need: Food

Minimum:
Eat something easy.

Better:
Put together a simple meal.

More:
Cook something and prepare extra for tomorrow.

Use the level that fits your capacity.

When you want to do something comforting, ask:

“Is there a basic need I should take care of first?”

Maybe:

eat first, then watch the movie.

Or:

take medication, then play the game.

You do not need to eliminate the enjoyable activity.

List the three things currently taking the most energy.

For each one, ask:

• Can I reduce it?
• Can I postpone it?
• Can I ask for help?
• Can I approach it differently?
• Is it necessary?

Self-care sometimes means reducing the drain, not adding another activity afterward.

Make a list of things that tend to leave you:

• More rested
• More connected
• More grounded
• More interested
• More like yourself

Keep the list for times when you are too depleted to generate ideas.

Choose one helpful behavior that you frequently forget or avoid.

Ask:

“How could I remove one step?”

Examples:

• Put a water bottle on your desk
• Keep an easy meal available
• Set a bedtime reminder
• Put your walking shoes by the door
• Schedule the appointment before leaving the current one

Create a short menu for different needs.

When I need physical care:

______

When I need rest:

______

When I need connection:

______

When I need enjoyment:

______

When I need practical maintenance:

______

Use the category that matches the need rather than choosing randomly.

At the end of the day, ask:

1. What did I do today that supported me?
2. What need did I ignore?
3. What is one thing I can make easier tomorrow?

Keep the review brief.

It is information for tomorrow, not a judgment of whether today was good enough.

Start with categories.

Ask:

• Body?
• Rest?
• Emotion?
• Connection?
• Practical problem?
• Enjoyment?

Then look for the area with the clearest unmet need.

Do not fix your whole life at once.

Ask:

“Which need is most immediate?”

Maybe:

food first.

Then reassess.

One Small Step may help.

It can become one if your self-care plan contains:

• A long checklist
• Rigid rules
• Unrealistic routines
• Too many goals at once

Shrink it.

Ask:

“What would actually make today easier?”

Basic care does not need to be earned through:

• Productivity
• Perfect behavior
• Other people's approval

If shame or self-criticism is making basic needs feel illegitimate, consider:

• Self-Validation
• Self-Acceptance
• Self-Compassion
• Countering Negative Self-Talk

Ask whether:

something truly needs your attention right now

or whether:

stopping itself feels uncomfortable.

If the guilt does not fit the facts, practice allowing the rest anyway.

Ask:

“When will I return to the thing I am stepping away from?”

If there is never a return point, consider whether avoidance is taking over.

A specific break with a return plan may work better.

Completing tasks can reduce stress and provide accomplishment.

But if every:

“break”

becomes another chore, ask whether you also need:

• Rest
• Enjoyment
• Play
• Connection

Some needs genuinely require time.

Also look for:

• Five-minute actions
• Things already built into your day
• Responsibilities that can be shared
• Commitments that can be reduced

Self-care may involve changing the schedule, not fitting more into the same schedule.

Self-care is not a guarantee that difficult emotions disappear.

Ask:

“Did the action meet the need I chose it for?”

A meal may help hunger without fixing grief.

A break may help exhaustion without solving a conflict.

You may need another skill for the remaining problem.

If distress, low mood, anxiety, sleep problems, loss of interest, or difficulty functioning are persistent or worsening, self-care alone may not be enough.

Consider speaking with a health-care or mental-health professional.

Getting more help can be part of taking care of yourself.

Self-Soothing may use:

• Touch
• Sound
• Sight
• Taste
• Smell

to help make distress more tolerable.

Self-care can include self-soothing, but also:

• Sleep
• Nutrition
• Health care
• Boundaries
• Connection
• Practical maintenance

PLEASE focuses on physical vulnerability factors such as:

• Physical illness
• Eating
• Mood-altering substances
• Sleep
• Exercise

Self-care can include all of those areas plus:

• Rest
• Connection
• Enjoyment
• Boundaries
• Health care
• Your environment
• Meaning and values

Recharge / Unplug focuses especially on:

• Breaks
• Reducing demands
• Stepping away from stimulation
• Restorative downtime

Sometimes self-care is:

rest.

Sometimes it is:

getting up, making the appointment, eating, moving, or reaching out.

Self-care asks what the current need is.

Behavioral Activation deliberately increases meaningful or rewarding activity when low mood and avoidance have reduced engagement with life.

Self-care may involve activation when withdrawal is the problem.

It may involve doing less when overextension is the problem.

The current pattern helps determine which direction fits.

Self-care helps maintain things such as:

• Sleep
• Nutrition
• Connection
• Rest
• Health care

that influence how much capacity you have overall.

If you are extremely overwhelmed, panicking, or fighting a strong urge, you may need:

• TIPP
• Grounding
• Breathing
• Urge Surfing
• Distraction
• ACCEPTS

first.

Then return to broader self-care once the immediate intensity is manageable.