Choose a pleasant activity you can do seated or lying down, if upright time is difficult. A short, reassuring contact may be enough.

Practise one manageable skill, such as asking for a chair or recognising an early need to pause. Mastery does not require enduring dizziness.

Before an appointment or outing, plan seating, transport, a quieter waiting area and an exit or rest option. Write the plan down if mental rehearsal is difficult.

Follow your individual care plan. Fluids, salt and compression for POTS need appropriate advice. Review disrupted sleep, meal tolerance and medication effects with your clinician.

Do not assume palpitations, faintness or breathing symptoms are anxiety. If focusing on breathing increases discomfort, choose external grounding instead.

Choose an enjoyable activity with comfortable joint support. Adapt the position, equipment or duration rather than abandoning what matters to you.

Practise an accessible task or a joint-protection strategy. A smaller task or using assistance can still build confidence.

Plan seating, carrying help, equipment and recovery time before demanding tasks. Include a backup if pain or instability increases.

Movement should match your diagnosis and stability. Seek guidance from a physiotherapist familiar with your condition; avoid forcing unstable joints to their end range.

Marfan syndrome and some EDS types need specific specialist advice. Generic exercise suggestions cannot replace condition-specific care.

Try a small pleasant experience that adds little physical or sensory load: a comfortable view, a familiar story or a brief contact with someone supportive.

Choose a task small enough to avoid a push-and-crash pattern. Recognising limits, requesting help or using an aid can be meaningful skills.

Write a flare plan: what to pause, what comfort measures are already suitable, who can help and when to seek medical advice.

Follow your pain plan and discuss sleep, food access and medication side effects with your care team. Adapt movement to pain, joint stability and any post-exertional malaise.

DBT does not establish that pain is psychological. Severe or changing symptoms need assessment; coping skills should not be used to pressure someone to push through.

Choose something enjoyable that fits known food, environmental and energy needs. A pleasant activity may be very brief or passive.

Build confidence in one practical skill, such as preparing a tolerated snack, asking about ingredients or explaining an accommodation.

Prepare for meals, travel or appointments with suitable supplies, prescribed treatments and a recovery option. Keep existing asthma or allergy action plans accessible.

Support adequate nourishment within medical needs. A dietitian can help with a restricted diet. For ME/CFS or Long COVID with PEM, prioritise energy management; do not use fixed activity increases.

DBT is not a treatment for allergy, MCAS or ME/CFS. Breathing difficulty or allergic emergencies need the appropriate medical response, not an emotion-regulation exercise.

Choose a small source of comfort, connection or meaning. You do not have to feel happy for the action to count.

Pick a modest, achievable task that matters to you. Adjust the task when energy is low; progress is not a measure of personal worth.

Prepare for a difficult conversation: one clear request, a pause phrase, a boundary and a support option. Rehearse in writing or aloud if imagery is not useful.

Discuss sleep, appetite, substance effects and medication with your clinician. DBT skills may be part of a wider plan with therapy, practical support and medical care.

Cope Ahead should not become prolonged replaying of trauma or rehearsing every possible problem. Keep it brief; a therapist can help adapt it if rehearsal increases distress.

Choose sensory-friendly enjoyment or a preferred interest. Quiet time and reduced stimulation may be more pleasant than a busy social activity.

Practise one step with a reminder, visual cue or another person’s support. Using accommodations is compatible with building skills.

Prepare a short script, a written sequence and a quiet-break option. Ask what will happen next and allow extra processing time.

Use reminders or practical help for meals, medication and rest. Adapt food textures and movement to sensory needs while seeking support for nutritional or health concerns.

Sensory overload is not something to solve by trying harder. Avoid using mastery as pressure to mask or tolerate harmful overload. New hearing, balance or visual symptoms need appropriate assessment.