Bipolar disorder Brain Mental health

How a coping card can help people manage emotional distress

man looking sad while looking at his phone in his bed

Sometimes feelings of anxiety, worry, stress and other uncomfortable emotions can be overwhelming. There may be certain times or triggers than can heighten these emotions and it can feel like it is difficult to cope.

One way to deal with these emotions, especially when an individual is in a crisis, is to have a plan.

When Mansoor Nathani experiences feelings of distress, he uses a tool called a coping card.

“It is a quick and easy way to remind yourself of the ways you can distract yourself from negative emotions and lower your distress,” explains Mansoor, a member of Sunnybrook’s department of psychiatry’s Patient and Family Advisory Committee (PFAC). “The coping card can also remind you of the people and resources you can reach out to for support. It is also a reminder of the things you can do to give your life meaning. These are all helpful in times of distress.”

Twenty years ago, Mansoor was diagnosed with bipolar I disorder. Individuals with this illness can experience a cyclical pattern of mental states that include periods of mania, which are abnormally heightened levels of energy and euphoria that can disrupt judgement, and periods of depression.

“I would spiral out of control and lose track of reality,” says Mansoor. “I was making decisions that were not the best decisions. If I had had a coping card back in the early days of my illness, maybe it would have helped me handle things differently.”

What is a coping card?

Simply put, a coping card is an action plan that patients can develop with their mental-health team.

“Emotional crises are extremely common across the population in general and among patients with mental health concerns,” says Dr. Mark Sinyor, psychiatrist and suicide prevention expert in the Hurvitz Brain Sciences Program at Sunnybrook. “People often don’t have an action plan for how to deal with their mental health. Having a plan is important, especially for individuals who experience suicidal crises.”

The coping card can be personalized and asks questions that include:

  • What are my warning signs?
  • How can I distract myself?
  • Who do I trust to share my distress and ask for help?
  • Who can I contact in my expert support system?

Filling out the card when an individual is in a state of wellness can help them to comprehensively identify different coping strategies and resources that can be deployed when a crisis arises.

“When you’re in distress, it can be hard to remember how to cope or what important phone numbers are. When you have a coping card already filled out, all that information is at your fingertips,” says Mansoor.

He also points out that an individual’s coping card can change over time.

“It’s like a living document, that can be changed or modified to suit your needs,” explains Mansoor. “A person may want to remove or add things to keep their coping card up-to-date.”

Sunnybrook’s coping card in multiple languages

Sunnybrook’s coping card is digital and can be downloaded or printed out.

It is available in 10 languages including: English, Brazilian Portuguese, Chinese (simplified), Chinese (traditional), French, Italian, Korean, Russian, Spanish and Tamil.

“We originally began translation based on the most common languages of patients at Sunnybrook and ended up expanding translation to other community groups as a result of our staff’s work with various organizations. The translated coping cards continue to be shared with agencies and their clients throughout the community,” says Dr. Rosalie Steinberg, psychiatrist at Sunnybrook.

“The coping card has also been widely disseminated for use in Sunnybrook’s emergency department and general medicine to help support staff and patients in crisis,” says Dr. Ayal Schaffer, head of the mood and anxiety disorders program at Sunnybrook. “Patients who screened positive for significant emotional distress were encouraged to utilize this approach. It’s a tool that can be used beyond the department of psychiatry.”

Why is it important to share your coping card with your support system?

It can be extremely beneficial for the patient, their health-care teams and caregivers to know about the coping card, and perhaps provide more details.

The patient must provide consent to share their coping card with others.

“Talking about the coping card with your physician and family can help offer extra input. They might provide insight on symptoms that they have observed,” says Mansoor.

“We encourage patients to share their completed coping cards with those in their support system because friends and family are often unsure of how to best help someone they care about who is in crisis,” Dr. Schaffer explains. “When they are aware of the coping card details, it can help them support their loved one work through the various strategies.”

“I am glad I invested the time to create my coping card,” says Mansoor. “You don’t realize how useful it can be until you need it.”

Learn how to create your own coping card


Mental health resources for coping during COVID-19 from Sunnybrook experts

If you need help in an emergency, please call 911 or visit your local emergency department.

If you’re feeling like you’re in crisis or need somebody to talk to, please know that help is also available through community resources:

About the author

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Jennifer Palisoc

Jennifer Palisoc is a Communications Advisor at Sunnybrook.

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