How to Use the Levels of Self Care to Support Depression

When we think about self care, we often think about a big, long list: a bunch of ideas for things you try when you need support. But when those things aren’t necessarily organized, how do you know what to choose for specific situations? And if you’re dealing with significant depression, anxiety, trauma recovery, or other mental health concerns, that list can become incredibly overwhelming!


Instead, I’d love to introduce you to the idea of the Levels of Self Care. The Levels are 5-step system that breaks down self care and coping skills into groups based on the intensity of the distress you’re experiencing. It’s a way to make coping feel more accessible, more in your control, and less overwhelming.


When you work through the Levels, always start at Level 1. Sometimes Level 1 is all you need to find some relief. But if you’re experiencing more intense distress, you may need to then go to Level 2 or 3, and so on. Think of the Levels like a ladder: you can’t jump to the top rung. You need to climb up one at a time to reach the correct rung. By going up one Level at a time, you can feel more regulated and more empowered to manage distress when it comes up.



Level 1: Distraction Skills


Distraction Skills are generally quick and fairly simple. Some can be grounding skills, such as deep breathing exercise, or grounding that involves your 5 senses. Others might be pretty basic distractions: watching a little TV, scrolling your phone, petting your dog or cat, laughing at funny TikToks…. Whatever helps you get out of that headspace for a few minutes!


Sometimes distraction skills are all we need to calm a bit, take a deep breath, and re-evaluate the situation. You may find yourself needing Level 1 several times a day to reset!


Level 2: Solo Coping Skills


Level 2 is all about coping skills that feel more intentional than the distraction skills, and are all things you can do by yourself if needed. Some of these coping skills might look similar to distraction skills, but just with a little more thought put into it. For example: watching a random TV show for 15 minutes might be a distraction skill, but tuning in to your absolute favorite show that always makes you laugh could be a solo coping skill. Petting your dog might be a distraction skill, but taking your dog on a walk could be a solo coping skill.


Solo coping skills could also include things like taking a hot bath, any kind of exercise or mindful movements, using a meditation app, listening to or playing music, reading, writing or journaling, watering plants, picking up your favorite takeout food…. Anything that helps you feel a little better!


If you feel less distressed at that point, you may be able to stop at Level 2. If not, it’s time to consider Level 3.


Level 3: Group/Support Coping Skills


These are coping skills that involve other people. This could look like calling a friend or loved one, engaging with supportive communities on social media, asking your partner for a hug or some quality time, going to a group class at the gym, attending a faith service, or anything that involves others.


If it feels hard to find others to engage with, sometimes just being around people can help. Maybe you could work at a coffee shop for the afternoon, or take a walk through a busy park instead of your neighborhood.


And don’t forget- pets can count as supports too! Sometimes our animals understand us better than most people, and that’s okay.


If you are feeling a little better after Level 3, you can stop there. If not, move on to Level 4.


Level 4: Professional Coping Skills


Level 4 is when you reach out to professionals who can support you. This could look like reaching out to your therapist (or scheduling an appointment for the first time!), attending a support group or recovery meeting, or calling a warm line. If you’ve never heard of a warm line, these are phone numbers you can call when you’re feeling distressed, but it’s not an emergency (the difference between a hotline and a warmline is that hotlines are more for emergencies).


People are often surprised when I say that reaching out to your therapist is at Level 4, and ask why it’s not Level 1 or 2. There are a couple of reasons for this. The first is that your therapist may not be immediately available, especially if it’s in the evening or on the weekends. So if your only option is to call someone who might not be available, that could make you feel worse!


The second reason is that pausing before you call your therapist can help you first remember what you’ve recently been discussing in therapy. You may realize that your therapist has already helped you find some answers to managing your distress, and you have those answers within you now.


If you have gone through the first 4 Levels and are still at a high level of distress, or feeling unsafe, now it’s time for Level 5.


Level 5: Emergency Services


Level 5 is for emergencies and mental health crisis situations. If you call your therapist in an emergency and they don’t answer, don’t wait for a call back. If you are feeling unsafe to yourself or to others because of your mental health, contacting emergency services is essential. The easiest option to remember is to call 911. You can also call the local police non-emergency line, go to the nearest Emergency Room, go to a local crisis walk-in center, or call a crisis hotline. The national hotline is really easy: call 988. These services are typically organized by county, so start your search with your location! Try to tell someone you know what’s happening, so they can support you or perhaps take care of things for you (like feeding a pet).


Back to You


What do you think of the Levels of Self Care? Does it help to conceptualize coping skills for you? If you have other ideas, or aren’t sure which Level your go-to coping skills fit into, we’d love to hear from you!


And if you’re looking for a therapist as a professional support, the psychologists at North Berkeley Counseling are here to help. We are located in Berkeley, California, but can see clients online throughout California, Florida, Virginia, and Hawaii.