As I talked about last week, decompensation is a psychological emergency. It is a significant worsening of your psychological functioning, a collapse set off by extreme stress. If you have DID, OSDD, or complex PTSD, you’ve likely experienced decompensation. It’s quite overwhelming, especially when it first occurs. There aren’t likely to be quick fixes, but there are actions you can take to help yourself.
The first priority is to ensure your safety. This may mean going to an inpatient facility or an IOP or PHP program. Those are intensive programs that do not involve overnight stays at an inpatient facility. Another possible option would be to search for “behavioral health urgent care” or “mental health urgent care” to see if there are any urgent care resources in your area where you can go get some immediate help. For instance, some metro areas have behavioral health urgent care clinics which accept walk-ins and can even prescribe medications if appropriate. Ensuring your safety may mean making sure you have no means to attempt suicide. It may mean having a trusted person remove items that you might use to hurt yourself. If you have made a safety plan with your therapist, make sure you have it at hand and review it as often as you need to.
Next, if possible, you want to reduce the stressors contributing to the overwhelm and decompensation. This might look like not working on processing traumatic memories in therapy (if you were) and instead focusing on helping to re-regulate yourself. Be extra vigilant about TV and social media, avoiding content that is likely to trigger you whenever possible.
Next, you can start working on regulating your system. If there are routines or habits that you have, returning to those as much as possible can help provide a feeling of stability, structure, and normality. If there are activities you find soothing, calming, or regulating, take part in those as often as you can. And of course, doing things which relax your body will help calm your nervous system overall. And since you all share one body, calming and regulating it will have a spillover effect to your system, helping to reduce the intensity of emotions.
And watch how you talk to yourself during this whole process. You might be tempted to use harsh self-talk or you might be doing it without even noticing. But how we talk to ourselves directly affects our nervous system and how regulated or dysregulated it is. (See my video This Bad Habit Worsens Your Symptoms for more information). Speak kindly to yourself and the rest of your system. You’ve likely survived worse and with fewer resources than as an adult, and it may help a small bit to remember that. If you have trusted others, lean on them and let them help you and support you.