One of the biggest things I’ve learned through DBT is that my physical health and emotional health are

closely linked. When my body is run down — whether I’m in pain, overtired, or not eating well — my

emotions become so much harder to manage. DBT has a set of strategies called the PLEASE factors,

which help reduce emotional vulnerability by taking care of the body.

PLEASE stands for:

PL — Treat Physical Illness

E — Balanced Eating

A — Avoid Mood-Altering Substances

S — Balanced Sleep

E — Exercise

These factors don’t have to be perfect. They’re simply gentle reminders that supporting our physical wellbeing helps us feel stronger, calmer, and better able to cope with life’s challenges. In this post, I want to share what each PLEASE factor means — and how I personally use them in my daily life.

PL — Treat Physical Illness

When my body is unwell, my emotions feel so much harder to manage. This PLEASE factor reminds me to take my physical health seriously — following medical advice, taking medications properly, and paying attention to symptoms. But there’s another side to this too. It’s important not to become overly focused on health issues. I used to struggle with health anxiety and would spend a lot of time worrying that something was wrong. DBT has helped me find a healthier balance — taking care of my body, without letting anxiety take over.

My example:

Because I live with chronic pain and certain medical needs, I’ve learned how valuable it is to look after myself — attending appointments, using helpful supports, and resting when I need to. One important part of looking after my health is having my weekly immunoglobulin infusion. I have an immune deficiency, and when I was younger, I used to avoid doing the infusions and would end up getting sick much more often. Now, I’ve accepted that these infusions help keep me healthy, and I’ve embraced them as an important part of caring for myself. When I treat my physical wellbeing as important, my emotional wellbeing follows.

E — Balanced Eating

Balanced eating supports both our body and our emotions. When we fuel ourselves with regular, nourishing meals, we’re less likely to experience energy crashes, irritability, or brain fog. This factor isn’t about dieting — it’s about giving our body what it needs to work at its best. I’ve noticed that when I rely too heavily on sugary foods or skip meals, I feel tired, overwhelmed, and much more vulnerable to stress. Balanced eating is a way of being kind to myself.

My example:

For years, I was encouraged to focus on calorie counting, but it didn’t work for me. If I had only a few calories left for the day, I would choose junk food, then later feel hungry and end up overeating. Recently, I started seeing a new dietitian who took a totally different approach. She encouraged me to focus on eating enough protein. Before, I was having less than 20 g of protein a day and constantly felt exhausted.

Now that I’m eating more protein, I have more energy, I’m not craving junk food as much, and I feel better both physically and emotionally. It has made such a positive difference to my mood and ability to cope.

The calorie-counting approach never helped me lose weight — but since I stopped worrying about calories and focused on getting enough protein, I have actually started losing weight in a healthy way.

A — Avoid Mood-Altering Substances

This PLEASE factor is about paying attention to how substances like alcohol, drugs, nicotine, and caffeine can impact our emotions. Even though they may seem to help in the moment, they often make things harder later — increasing anxiety, making sleep more difficult, and throwing off emotional balance.

My example:

Recently, I quit vaping completely by using nicotine spray instead, and even though it has only been a short time, I already feel so much calmer and clearer. I’m really proud of that change, because vaping became something I relied on for stress relief — AND in the long run, it made my anxiety worse.

I’ve also realised that caffeine affects me way more than I used to think. If I have more than one cup of coffee a day, I feel extremely anxious and start worrying a lot and overthinking. Limiting myself to one coffee a day has made a huge difference to how I feel. Making these changes has supported my emotional wellbeing in a really noticeable way.

S — Balanced Sleep

Sleep has a huge impact on how we feel. When I don’t get enough good sleep, I find everything more overwhelming and much harder to cope with. Balanced sleep means trying to keep a consistent routine and finding habits that support good rest.

My example:

Sleep is something I’m still working on. For many years, I took a medication called Seroquel, which I needed at the time but no longer need in the same way. One good thing about taking Seroquel was that it really helped me sleep. However, it also came with some difficult side effects, including weight gain and nighttime eating that I found hard to control. At one point I was on 800 mg, and over the last 18 months I’ve been gradually reducing it. I’m now down to 300 mg, and the decrease has made it a lot easier to manage the nighttime eating. My psychiatrist and psychologist have both been encouraging and supporting me through this change. It’s tough work AND I’m really motivated to keep going.

I recently started an online CBT-I (Cognitive Behavioural Therapy for Insomnia) course, and it has already given me practical tools that help. Some strategies that make a big difference for me include:

• Going to sleep and waking up at the same time every day
• Taking magnesium
• Using melatonin
• Avoiding my phone for an hour before bed
• Listening quietly to an audiobook before sleep
• Using a sleep mask and earplugs
• Sleeping with a weighted blanket
• Making sure I get enough exercise during the day, even when I’m tired I often wake up every couple of hours during the night. Instead of panicking that I can’t sleep — AND stressing that I’ll be exhausted the next day — I’m learning to stay calm. Sometimes I make up a gentle story in my head or imagine a relaxing scene. Even if I don’t fall asleep straight away, resting quietly is still helpful.

Sleep is still a journey for me, AND the improvements I’ve made so far have helped my emotions feel more stable, and I’m proud of how far I’ve come.

E — Exercise

Exercise can be a powerful support for emotional health. Movement releases tension, boosts mood, and builds overall resilience. It doesn’t have to be intense — even gentle exercise makes a difference.

Swimming is my favourite way to move my body, and I usually go about four times a week. Being in the water is calming, and it helps reduce my chronic pain. When I’m swimming, I feel strong, peaceful, and more connected to myself — I’ve always been a bit of a water baby.

I also love riding my electric bike to work and to appointments. Even though it’s an e-bike, it still gives me exercise, gets me outdoors, and I soak up some vitamin D while I ride. It also saves me money on buses and Ubers, which is a bonus!

Sometimes I think back to before I started DBT, about two years ago. Back then, my chronic pain was so much worse, and I often needed to use a walking stick to get around. It’s hard to imagine that now, when exercise is such a regular part of my life. Moving my body has helped reduce my pain significantly, and I feel more capable and independent than I ever have before.

It took time to build up this routine, AND I’m really proud of how consistent I’ve become. Even on days when I’m tired or not feeling my best, I try to get some form of movement in, because I know it will help my mood. After swimming, I feel relaxed, happy, and proud of myself.

Since I’ve been exercising regularly, I feel so much happier and healthier. Swimming supports my body, my energy, and my mental health — and it’s something I truly look forward to.

Learning the PLEASE factors has shown me how much of a difference it makes when I take care of my physical health. My emotions feel more stable, I cope better with stress, AND I feel more in control of my life. It’s not always easy — AND I don’t get it right every single day — but every small step helps me build a healthier foundation for my mind and body.

If you’re working on your wellbeing too, I hope these examples show that progress is possible. You don’t have to make huge changes all at once. You can start with one area that feels manageable and build from there. You deserve to feel supported and cared for — especially by yourself.

I’m still learning and growing, AND I’m proud of how far I’ve come. AND I’m excited to keep going.