Riding the Waves: Understanding Distress Tolerance from a Neuropsych Perspective

Whether we like it or not, to be human is to experience stress—at least every now and again. Whether it’s a tight deadline, a difficult relationship dynamic, the impact of a traumatic experience, or the cumulative effect of the noise and pressure of daily life, those feelings can hit hard.

An all-too-common reaction for many of us? Avoidance. We try to dodge discomfort (“If I just stay busy, I won’t have time to feel my feelings!”), ignore painful emotions (cue the Lego movie theme song… “EVERYTHING IS AWESOME!!!”), or numb out with distractions (“How did I lose 3 hours scrolling/shopping/sleeping??”). But from a neuropsychological standpoint, while avoidance might seem to bring short-term relief, it often backfires in the long run.

Avoiding vs. Managing: What’s Really Happening in the Brain

When you avoid distress—say, by falling down a social media rabbit hole or avoiding a tough talk—you’re essentially telling your brain, “This feeling is too much; you can’t handle it so let’s not deal with it.” This can temporarily reduce the activation of your brain’s stress systems, mainly the amygdala, which signals danger and triggers the fight-or-flight response. However, avoidance doesn’t teach your brain to regulate stress effectively. Over time, this can lead to heightened sensitivity, where even small stressors cue a sense of overwhelm and your nervous system stays on high alert.

On the flip side, managing stress through distress tolerance techniques and acceptance practice skills activates different brain pathways. Instead of running from discomfort, you’re strengthening your prefrontal cortex—the part of your brain responsible for thinking, planning, and regulating emotions—to work with the amygdala. This collaboration helps you to sit with difficult feelings without experiencing the compulsion to escape them. When we learn to do that consistently, we gradually decrease the brains threat response; it becomes easier to move out of the sympathetic nervous system’s chaotic “Fight, Flight, or Freeze” response and into parasympathetic nervous system’s calmer “Rest and Digest” response.

The Nervous System Benefits of Riding the Waves

Think of distress tolerance like learning to surf. You can’t control the waves, but you can learn to ride them instead of being knocked over. When you practice tolerance and acceptance, your nervous system gets a workout that improves resilience and skill. Over time, the body’s stress response will calm more quickly after a spike, your heart rate will stabilize faster, and in turn your overall anxiety experience will decrease. This doesn’t mean you stop feeling stress or anxiety—it means you build a kind of emotional fitness that helps you stay steadier in the wake. Strengthening the prefrontal cortex will foster an increased sense of internal safety that enhances reasoning and decision-making skills, improves emotional regulation capacity, keeps our working memory sharp, and helps with impulse control and focus. Sounds pretty nice, huh?

Here’s how we get started…

Real-Life Skills to Build Distress Tolerance

1. Activate the parasympathetic nervous system: There are so many easy ways to do this! You can try diaphragmatic breathing—slow, steady inhales and exhales from your abdomen (not your chest); try breathing in for 4 counts, hold for 7, and exhale for 8, repeat. Progressive muscle relaxation is also helpful: while breathing mindfully, gradually tense all of the muscles in your body beginning at the tips of your toes and making your way to the crown of your head, and then release them back down to your toes just as gradually. Cold water exposure and humming are also quick, effective ways to activate the vagus nerve and promote activity in the parasympathetic nervous system. Simple but powerful.

2. Grounding Techniques: When anxiety spikes, grounding yourself in the present can reduce the flood of overwhelming sensations. Try the 5-4-3-2-1 method: take a few diaphragmatic breathes and then name 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, and 1 thing you taste.

3. Radical Acceptance: This skill is about fully accepting reality as it is, not as you wish it were. It’s saying, “This is painful, AND I can handle it.” Our brains latch onto and exacerbate the things we resist, repeat, and avoid; when we can get to a place of acceptance (“This uncomfortable thing is happening AND I’m coping and continuing to give energy to the things are within my control”) and reduce the struggle against discomfort, in turn we reduce our emotional suffering and increase plasticity and self-efficacy.

Distress tolerance isn’t about ignoring pain or “just toughening up.” It’s a scientifically backed approach to working with your brain’s natural wiring to make stress less disruptive. By learning to tolerate discomfort, you’re not only improving your mental health—you’re training your brain and body to be more resilient.

As simple as the techniques outlined above may seem, most of us won’t just magically master them by reading one article or watching a couple of TikTok’s—but consistent practice will help your brain to develop new neural pathways that lead to easier access to those skills and responses over time. A therapist skilled in trauma treatment modalities, Dialectical Behavioral Therapy, and/or EMDR can be a great resource, too.

The next time you feel stress or distress rolling in in, remember it’s not about getting out of the water, it’s about learning to surf the wave. Your brain—and your nervous system—will thank you.