One of the things we should be taught from early childhood and generally aren't taught at all, is how to calm ourselves down. Remarkable, isn't it? After all, from before the time we can speak, when we're just little adorable mewling packets of needs, we get upset. We're hungry, sleepy, wet--with good parenting, our needs are met, but even in the finest childhood, parents can't meet every need every time. Teething and colic, dropping an ice cream on the playground, fighting with other kids--to losing money in the stock market, arguing with a spouse and trying to work out why the baby is crying when we've tried simply everything--life is full of upsets.
The wellbeing world inundates us with advice about calming ourselves, and if we'd actually DO some of those things, we'd probably find ourselves calmer. Unfortunately, the rest of the world is deeply threatened by wellbeing priorities of people who are relatively content,--people steeped in good feelings, compassionate to themselves and others, and easy in their skins are notoriously hard to control. Calm, centred people are bad for an economy based on the ridiculous (and pervasive) notion of unlimited growth. They refuse to buy things they don't need; they don't care a fig for keeping up with the Jones, and instead of turning to shopping or dating apps when distressed, they do things that don't cost anything: look at the sea, breathe deeply and gently, sing a little song. 
I'm not much of a conspiracy theorist, but it's pretty clear that our current model of society rests on making and keeping lots of people uncomfortable and then selling them things. Buying something gives us a short hit of feel-good--very, very short. Then you've got to find something else to buy.
Or, you can learn that when life is trying to capsize your boat, there are simple, effective skills you can learn to stay afloat, regain your sense of ease and navigate to a safe shore. The hardest part is remembering that when the oatmeal hits the fan, to counter the panic or fury with these learnt skills. You have to learn them, and then learn when to apply them, and then practice applying them until they become natural alternatives to freaking out. There are loads of them, and some will work for you and some won't. Because you're an individual, with your own past, hangups and preferences. You may find that you need to modify a calming technique, that it works better for you in a different way. Fine! Do that. 
But if you're new to self-calming, peruse this list and try the strategies, find what works for you and incorporate them into your daily life. By that, I mean, practice them daily. You can use the little annoyances of life--not being able to screw the toothpaste cap back on evenly, or having a partner who won't do it at all--to start building your mental muscles for the big, awful stuff when it comes along. One thing's for certain--we don't have to go looking for troubles in life--they'll come right to the door, crawl in bed with us and keep us up all night with inane chatter and the sound of breaking glass. 
Ways to calm down.
1. Dr Rick Hanson points out that simply looking at the wall of the room you're in can help you access a feeling of stability. When something seems to be pulling the rug out from under your feet, looking at the wall, you remind yourself--"this wall is still standing. It's stable and it's not going anywhere. This, at this time, I can feel relatively certain about."
2. If you're outside, paying attention to a tree can be a calming and centering activity. Look at its height, the branches that shelter birds and protect the earth underneath from drying out in the sun. Consider the root system that may be as large as the part of the tree that's on top of the earth. The trunk that's strong and grounded, that you can run your hand along and feel its skin under your own. 
3. Inside, you can turn yourself into a tree. If something's happening that makes you feel shaky and unsure, put your feet on the ground, grab onto the ground by curling your toes (you don't have to take off your shoes, and no one at the meeting needs to know you're temporarily accessing your tree nature). Imagine roots growing from the bottom of your feet (or shoes), sinking deep into the earth, holding you straight and steady. 
4. Take a break. Sometimes, leaving a stressful situation for a few moments helps us re-orient, get a grip on unruly feelings and then return refueled and ready to re-engage. Getting a glass of water can be a big help--enjoying the coolness of the liquid and the reminder that you're a human being doing what human beings have always done. Getting someone else a glass of water can provide another reason to leave a room when it starts feeling way, way too small, and brings some good feelings into the space. 
5. Everyone and her sister will tell you that one way to calm down is to breathe. That's because, for many many people, conscious breathing is the most immediately effective way to feel better when we're under stress. There are lots of breathing techniques, and some may not help you much, but others can. My personal favourite is to inhale slowly and deeply, feeling my rib cage and stomach expand, breathe out more slowly, so that the exhale takes longer than the inhale, then when the air is gone, just wait a beat or two before inhaling again, feeling the stomach widen with the new incoming air. Practice with different breathing styles until you find your go-to. Notice I said "practice": the more practice you get with calming strategies, the more likely they are to work easily when you need them.
6. Have a cuddle. There's nothing like a safe, secure touch to make us feel safe and secure, even loved. If there's someone around you like to hug, ask for a hug and stay there for at least a count of ten. It doesn't have to be a human, either: you can cuddle your dog, cat, marmot, even a teddy bear. Putting on a fluffy robe can feel like a warm hug. There are lots of ways to access our inner child, the one who wants holding and closeness.
 In a pinch, even hugging yourself can feel really good. You might prefer it, especially if hugging wasn't a thing in your family, or if people haven't touched you respectfully in the past.  Try this: Wrap your arms around yourself, drop your head like a bird with its head under a wing, and go into what online Yoga teacher Adriene calls your "love cave". Stay there a minute to calm down and get over the feeling that it's silly to hug yourself (which we've been taught and need to unlearn!). Then, stay there another minute to enjoy the feeling of being contained, held safe in your own arms. 
7. Singing and humming do wonderful things for our nervous systems. Harmonising with other people is one way to feel connected and even blissful. Singing with your favourite singers, humming as you work, surrounding yourself with music you love can soothe and calm jaded nerves. Sing to your children, to your mate, to your pets. Join a choir. Consider playing calming music when you're cooking, bathing, resting.

When you take the time and make the effort to calm yourself down, you're also building your self- concept as someone worth protecting. Many people didn't learn their worth in childhood--too often they weren't protected, cuddled or sung to. We grow up thinking we're not worth the time it takes to make ourselves feel less agitated--or even that we're not supposed to feel calm and content. Practicing self-calming not only teaches us how to return to a calm state when something has unsettled us; it also helps embed those feelings in a longer-term way in our bodies and brains. Imagine if, in a general sense, you always felt more stable, more easy, less ragged and fraught. Less likely to be upset and more likely to recover quickly when upsetting things happen.  Practicing calming strategies even for a minute at a time can help build a solid core of calm that remains fairly unshakeable, whatever life throws your way. 

​My first therapy job in the UK began during Covid, when we were all seeing each other exclusively online. Being camera-shy all my life, I was secretly horrified to realise that my practice now involved speaking to people through a video camera--to be honest, I nearly chickened out right then. The idea of sitting in front of a camera, talking to someone else who's sitting in front of a camera--it seemed utterly bizarre. And on top of the weirdness of being so divided by geography and virtually brought together by technology--I wasn't at all certain that online therapy could work at all. I had deep misgivings, but needs must, and I decided to give it a go.
Nearly five years later, doing therapy online is second nature: 15-20 minutes before a session, I scan my notes and have a little think, move the laptop to the desk, cue up the email with the link in it, make sure the phone is on Do Not Disturb, adjust the webcam and light and login to the meeting. The client arrives; we fiddle around with our sound for a few seconds, and begin our conversation.
It does "work". It's not the same as being in the room together: I wouldn't say one way is better than the other in terms of connection, conversation or outcomes. The ways are different, certainly.
One thing I noticed is that, in the absence of seeing each other from top to toe, both the client and I pick up on facial and voice cues with more sensitivity: with practice, and knowing each other, micro-expressions can have the same impact as, say, throwing a cushion across the room. And it works both ways: I might say, "I notice you smile when you're telling me this difficult thing," and someone might say to me, "Your eyes just changed: I think I know what that means." We're not only noticing micro-expressions; they become part of the conversation, and deepen the ways that we know each other.
One of my first projects during Covid was to lead groups of students and their tutors from a local college: the counselling centre had contracted to provide online wellbeing sessions. Remember--I was still new to working online. I found in the groups that many students didn't turn on their cameras. Even worse, some of the tutors wouldn't turn theirs on, either! I found myself speaking into a black void, and if I was lucky, someone might respond to a question and let me know there was someone actually out there by a sigh or occasionally, a laugh.
My suspicion was that, as students (and tutors)  didn't have to prove they were paying attention, many put the laptop on, crawled back into bed and spent the hour scrolling on their phones. It felt awful to talk and not know if anyone was listening. People's names showed up in the sidebar when they logged in, so, in theory, at least. people were attending. And when I asked a question of a particular person, their voice would come out of my speaker with an answer. But not seeing anyone whilst knowing they could see me was disturbing to me--even distressing. It seemed unfair, rude even--and it made me cross.  And the sense of anger and injustice arising in me made me curious. Why did it bother me so much?
Therapists who study attachment have found that when an infant's mother doesn't respond to her child--looks at the baby with no particular expression and ignores the baby's invitations to engage--the baby first tries harder, then very soon becomes distressed and despairing. This all happens in about a minute--that's how finely tuned we are. We need to be seen by our mums, and we need to know we are seen. We need that feedback, or we quickly lose hope. 
The problem with a meeting that lets people attend without being on camera is that, although they can see other people, they can't be seen. For many people, that's the wish: to be able to see others and remain hidden. After all, if others see us, they will quite possibly judge us--and find us lacking. (I'll mention here that many times at the start of the session, the client and I are both not only adjusting the sound, but, suddenly aware of being seen, are fiddling with our hair.)
What we think we want is to see whilst staying safe from the eyes of others. Voyeurism--the word is usually pejorative, with all sorts of undertones of sex and control and power--but we can also see it as the wish to see without being exposed ourselves. To some extent, we all have that wish to remain safe, our flaws hidden. For some, it is as strong as the wish to belong: they try to be part of the group without risking actually being seen.
And it doesn't work. We become bored, lost, alienated.
It's not only about the unfairness of seeing others when they can't see you; what is crucial about belonging is that not only do we need to be seen; we need to feel that we are seen by others. Without knowing we are seen, without that feedback of another's eyes on us, we are like the baby whose mother doesn't smile back: we are lost and alone. But as adults, we may not know that on the top of our minds: the need we first experienced in infancy lies buried under layers of experiences and fears about what it is to be seen and possibly judged, and even about what we actually need versus what we think we want. 
In the middle of the night when she wakes up crying, a baby can be held, even in darkness when she cannot see her parent's face. She can smell the unique scent of the person who holds her. As adults meeting online, there are only two points of connection: video and audio. We can't even shake hands online: in the absence of touch, we are even more adrift. 
So, the reasons to be visually present when working online are several--. 
it's polite, yes. It's fair. It's reassuring to the people you're meeting with, as they know they are being seen by you--it nourishes the part that from birth needs the feedback of another's gaze. And by the same token, the thing you may think you don't want, that doesn't seem worth the risk of showing up--is actually the thing you need at a level so deep you may not even recognise it as a need. 
To belong, we all have to take risks: there's no free ride. The payoff is when you know someone is not watching you, but seeing you, and the ways that seeing leads to knowing. As infants we need to be acknowledged and brought closer, as adults we need to feel that someone else is interested in knowing us. Online, that takes the form of looking into another's face and knowing they're looking back. In therapy, research shows again and again that it's not the type of therapy you have that makes it work: it's the relationship between the therapist and client that makes the difference. Being known and accepted, and knowing and accepting in turn create powerful healing. Inside, we're all still the infant who needs to connect with someone who cares. To do that, we have to see them seeing us.
​It didn't take me long to draw a line with the online groups: you had to turn on your camera. In those early days of Covid, no one had really worked out the rules for living together online, but in the intervening years, I think we've all come to some understanding about how to work together online. We have our setup rituals, backup plans for when the internet lets us down and moments of unexpected delight--as when a random cat wanders across someone's keyboard. Sitting in a room or meeting online, we make the time and take the effort to know each other, to belong in that time to each other. Whether we're in the same place or not, the way we see and are seen by each other--that's what nourishes and sustains us: that's where the magic happens.

any of the clients who come to the counselling centre where I work have already tried counselling in some form; usually through sessions offered by the NHS. In most cases, NHS therapy is cognitive-behavioural and time-limited, sometimes to 6-12 sessions. People finish their course of therapy, find their problems still exist, and eventually find their way to a service where they pay for their own therapy.
By the time they reach us, many people are already taking some sort of medication, usually for anxiety or depression, or for symptoms such as sleeplessness and panic.
My initial training took place in the US, where most medical care is privatised and patients can choose to visit a psychologist, psychiatrist, psychotherapist or counsellor withouot first seeing a general practitioner or any other sort of physician. (That's assuming they can afford any help at all, which many, unfortunately, cannot.) 
But in the UK, the way to be referred to a NHS-approved psychological therapy is to first consult your GP. Most GPs know next to nothing about psychology: they receive very little training in matters of the mind, even their own mind--and they're allocated perhaps ten minutes in which to meet, speak to and diagnose a patient. They are trained to prescribe drugs, and the pharmaceutical companies deluge them with marketing materials--medicine is Big Business. And don't forget mile-long waiting lists for psychological therapy in the NHS. What's a GP to do with a patient whose suffering stems from non-physical causes?
When you put together the lack of education in matters of the mind, the lack of time, the pressure of seeing too many patients, the physcians' inability to even take care of themselves at work-- and then add in the easy availability of drugs--it's easy to see why many GPs, when faced with an unhappy patient, reach for the prescription pad. And, as it's the only possibility of quick relief, and it's being recommended by a medical expert, many patients accept medication.
The trouble is, most of the time, what's causing the problem isn't helped, except perhaps superficially and temporarily, by drugs. Sometimes, drugs make the problems worse.  And drugs have side effects that create additional problems, sometimes major ones. 
There are very few psychological problems for which medication is the answer, and these problems are severe. Schizophrenia and bi-polar disorder are two conditions in which the use of drugs may be warranted--but not always even then.  In fact, there is evidence that even severe psychiatric disorders can be worsened by medications, particularly as medications may not be right for the individual. But because the patient is considered mentally ill, prescribers may not be willing to listen to the patient who says, "The medication makes me sick, dopey, unable to think straight. I don't sleep properly; I have new symptoms (which may be found in the list of side effects provided with the medication).  
There is also a big problem with how people are prescribed drugs based on their race, age and gender. Prejudice shows up in the overmedication of women, people who aren't "white", aren't British (or from whatever country they're currently in), and the elderly. basically, if you are a member of a group that is socially marginalised, you are more likely to be medicated, often wrongly so.
My take on medication is, if it's an emergency, take it. In an emergency,  if your life is in danger, it's any port in a storm. Otherwise, be very, very careful; even wary, of drugs.
That said, a course of sertraline once helped (I believe) to save my life.  I had been brought so low by a longterm depression that, after more than a year of struggling with it, I finaly told someone of my desperation. But I also can't swear that it wasn't the kind listening and active helping of the therapist I turned to, who helped me find my way to a prescribing psychiatrist, that turned me around. Her loving acceptance and guidance put a light back in my world and gave me hope. She brought me the energy of hope, I took the pills, started therapy as well, and I recovered. Who can say what it was that saved me? If I had been able to buy the pills direct from a vending machine, would I have had the hope to take them? Would I have found the strength to undertake therapy for my woes, without someone strong and kind, standing in my corner?
So, if your back is to the wall, and you think taking medication might help, try it. But most psychological problems don't occur from chemical imbalance: most of our psychology is related to how we are in the world. Difficult childhood experiences, traumatic events, failures and regrets, cruel inner critics, miserable families, loneliness, unhappy love relationships--these are the basis of psychological troubles. You can drug yourself all you want, but being sleepy, hyper-alert, or stoned won't fix problems that arise from our relations, past and present, with other people. If you're taking an anti-anxiety pill to help because your workplace is supporting a nasty bully who's making your life miserable, it's therapy that's going to make a difference, not amitriptyline.
Therapy helps to find the source of the pain, and helps you make the decisions about changes you want to make in order to live a more fulfilling life.  Finding a good therapist gives you an immediate resource: someone who will listen to you, who finds your situation important and who wants to help. Research shows that the type of therapy isn't all that important--and there are so many brands these days, it's nearly impossible to sort them all out anyway--what's important is the relationship. If you feel your therapist cares, that matters. Everything else follows from that.
You may find low cost therapy at a local counselling centre: some run on grants, and many use the services of young counsellors who are still in training, who see clients and attend supervision with experienced counsellors. Unless something very specific is going on with you, a less-experienced counsellor can be as helpful as one who's been in practice a long time--remember, you're looking for someone who can listen to you with attention and care.  
Can't get therapy? If you've been added to a year-long waiting list and can't afford private therapy (or can't find a therapist), you still have options. Self-help has never been more available or more useful. World-class psychotherapists give online talks, lead meditations and provide resources and exercises that will help if you will do them. (The hardest part of self-help is actually DOING the things that will help!) Youtube is a stellar source of great self-help. Like anything internet, do consider the source! Look for someone with professional credibility; with an education in therapy, philosophy or analysis; who has written books, given talks. I always recommend Dr. Rick Hanson's Youtube talks and meditations, and if you go to Kristen Neff's website, there are exercises and meditations on self-compassion. These are only two of a multitude of experienced professionals who make it part of their ethos to help for free. There's even an anti-therapist online who I follow: her show is called Crappy Childhood Fairy, and I hope it won't annoy her to know that I think she's a great narrative therapist.
When we're overwhelmed or scared, or too ill to manage even simple things, medication can seem like a simple solution to a hopeless situation. And GPs may pressure you to take medication--its the only thing they can provide, and they want to help you even as they're ushing you briskly out the door. Perhaps if you are experiencing really difficult symptoms, ruling out medication could be a mistake. But if you're concerned, get a second opinion: don't just take the first tablets your GP offers. Look up their uses, dosages and side effects before committing yourself. Consider alternatives.
 You might even consider whether something you're taking as normal is affecting your wellbeing--such as caffeine intake (notorious for causing insomnia, and raising anxiety), or sugar, or alcohol which can both create mood swings. You might experiment with changing your diet, or trying herbal remedies such as St. John;s Wort or the Bach Rescue Remedy for anxiety or depression.  Exercise and music are two "natural" remedies for depression and anxiety. Connecting with good friends is another.
Gardening, believe it or not, is extremely helpful to people experiencing even severe mental illness (and to just about everyone else). There's a new branch of wellness called "social prescribing", where people are put into groups that do gardening, dance, singing, walking in nature, swimming--all of which have been shown to contribute to our happiness and reduce depression and anxiety.
Tablets might seem like a quick fix, but better living isn't really accomplished through chemistry. Connecting, with someone helpful and caring, with resources and practices, with new ways of interacting and with interesting activities, with finding meaning and purpose are the ways we turn our lives from suffering into thriving.