Taking Care of the Basics: How the DBT Skill PLEASE Can Support Your Emotional Health

When emotions feel overwhelming or we find ourselves reacting in ways we later regret, it's easy to overlook the basics—like how we're sleeping, eating, or even if we’re getting sick. In Dialectical Behavior Therapy (DBT), there's a skill that focuses exactly on this: the PLEASE skill.

PLEASE is an acronym that helps us remember five key areas of physical health that directly impact our emotional well-being. It reminds us that sometimes the most effective way to manage our emotions isn’t through deep analysis, but through simple, consistent self-care.

In this post, we’ll break down what PLEASE stands for, why it matters, and how you can start using it in your daily life—whether you’re in therapy or just looking for practical ways to feel more balanced.

What Does PLEASE Stand For?

Each letter in PLEASE represents a different area of physical well-being that, when taken care of, can help us regulate our emotions more effectively.

PL – Treat Physical Illness

When we’re sick—whether it’s a cold, chronic condition, or something undiagnosed—our emotional tolerance goes down. Pain, fatigue, and discomfort activate the body’s stress response system, which increases cortisol production (Waszkiewicz, 2023). This can heighten anxiety and emotional reactivity.

What you can do:

• Follow up with doctors and take prescribed medications as directed.

• Pay attention to physical symptoms instead of ignoring them.

• Rest when your body needs it.
  

E – Eat Balanced Meals

Skipping meals or consuming high-sugar foods can cause blood sugar spikes and crashes, leading to irritability, poor focus, and mood swings (Benton & Sargent, 2018). Your brain needs stable blood glucose to support neurotransmitters like serotonin and dopamine.

What you can do:

• Eat regular, nourishing meals throughout the day.

• Aim for a balance of protein, carbs, and healthy fats.

• Notice how certain foods make you feel afterward.
  

A – Avoid Mood-Altering Substances

Substances like alcohol and recreational drugs interfere with the brain’s ability to regulate mood and process emotions effectively (Stellern et al., 2022; NIAAA, n.d.). Even caffeine, in large amounts, can contribute to anxiety or restlessness.

What you can do:

• Be honest about your substance use and how it impacts your mental health.

• Seek support if you're using substances to cope with difficult emotions.

• Consider reducing or eliminating substances that lead to mood swings or regret.
  

S – Get Enough Sleep

Sleep is foundational to emotion regulation. Poor sleep impairs the prefrontal cortex (responsible for decision-making and impulse control) and over-activates the amygdala, which governs fear responses (Goldstein & Walker, 2014; Palmer & Alfano, 2017).

What you can do:

• Aim for 7–9 hours of sleep each night.

• Keep a consistent sleep schedule, even on weekends.

• Create a calming bedtime routine to wind down.

E – Get Regular Exercise

Exercise increases natural mood-enhancing chemicals like endorphins and serotonin. It also boosts brain-derived neurotrophic factor (BDNF), which supports brain health and adaptability (Szuhany et al., 2015; De Cunha et al., 2023).

What you can do:

• Find movement you enjoy—walking, dancing, yoga, stretching, anything counts.

• Aim for at least a few minutes of movement each day.

• Use exercise as a tool for self-care, not punishment.
  

Why the PLEASE Skill Works: The Science Behind Each Step

Each component of the PLEASE skill is grounded in research about how physical health supports emotional regulation.

• Physical illness increases inflammation and cortisol, which are linked to depressive and anxious symptoms (Waszkiewicz, 2023).
  
  

• Balanced eating supports neurotransmitter function by stabilizing glucose (Benton & Sargent, 2018).
  
  

• Avoiding substances prevents artificial disruption of dopamine and serotonin, which helps maintain emotional stability (Stellern et al., 2022; NIAAA, n.d.).
  
  

• Sleep allows your brain to process emotions and strengthen self-control (Goldstein & Walker, 2014; Cheng et al., 2020).
  
  

• Exercise improves mood through endorphins and reduces stress hormones like cortisol (Szuhany et al., 2015; De Cunha et al., 2023).
  

Final Thoughts

The PLEASE skill is about reducing emotional vulnerability by taking care of your body. When our basic physical needs are met, we’re in a much stronger position to cope with life’s ups and downs.

If you’re feeling emotionally off, check in with these five areas first. You might be surprised how much a solid meal, a restful night’s sleep, or even a short walk can help shift your mood.

References

1. Benton, D., & Sargent, J. (2018). Effects of glucose and sucrose on mood: A systematic review of interventional studies. Nutrition Reviews, 76(2), 1–17. https://doi.org/10.1093/nutrit/nuy047
   
   

2. Cheng, W., et al. (2020). The effect of sleep deprivation and restriction on mood, emotion, and emotion regulation: three meta-analyses in one. Sleep, 43(1), zsaf227. https://doi.org/10.1093/sleep/zsaf227
   
   

3. De Cunha, G. R., Feter, N., Alt, R., & Rombaldi, A. J. (2023). Disentangling the biological mechanisms underlying the effects of physical exercise in major depressive disorder: A comprehensive systematic review of randomized controlled trials. Psychological Medicine. https://doi.org/10.1017/S0033291723000973
   
   

4. Goldstein, A. N., & Walker, M. P. (2014). The role of sleep in emotional brain function. Annual Review of Clinical Psychology, 10, 679–708. https://doi.org/10.1146/annurev-clinpsy-032813-153716
   
   

5. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.). Neuroscience: The Brain in Addiction and Recovery. Retrieved from https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/neuroscience-brain-addiction-and-recovery
   
   

6. Palmer, C. E., & Alfano, C. A. (2017). Sleep and emotion regulation: An organizing, integrative review. Sleep Medicine Reviews, 31, 6–16. https://doi.org/10.1016/j.smrv.2015.12.006
   
   

7. Stellern, J., Xiao, K. B., Grennell, E., Sanches, M., & Gowin, J. L. (2022). Emotion regulation in substance use disorders: A systematic review and meta-analysis. Addiction, 118(1), 30–47. https://doi.org/10.1111/add.16001
   
   

8. Szuhany, K. L., Bugatti, M., & Otto, M. W. (2015). A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. Psychiatry Research, 224(1), 1–13. https://doi.org/10.1016/j.psychres.2014.10.018
   
   

9. Waszkiewicz, N. (2023). Chronic stress-associated depressive disorders: The impact of HPA axis dysregulation and neuroinflammation on the hippocampus—A mini review. International Journal of Molecular Sciences, 26(7), 2940. https://doi.org/10.3390/ijms26072940