Category: Anxiety Disorder

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Mental health rehabilitation centers provide structured, long-term treatment for individuals facing serious mental health disorders. These centers focus on recovery beyond crisis intervention, offering the tools and environment needed to regain stability, function, and independence.

From severe depression to complex disorders like schizophrenia and co-occurring diagnoses, mental health rehabilitation centers support a wide range of conditions that require more intensive care than short-term or outpatient treatment.

What Is a Mental Health Rehabilitation Center?

A mental health rehabilitation center is a specialized facility designed to help individuals with persistent or severe mental health problems. Unlike short-term hospitalization or outpatient therapy, these centers offer structured, residential or semi-residential treatment programs.

Mental health rehabilitation centers provide 24/7 care, therapeutic support, psychiatric services, and holistic wellness plans to guide patients toward long-term recovery. The goal is to stabilize symptoms, improve functioning, and empower individuals to reintegrate into society with lasting coping skills and support systems.

Who Needs a Mental Health Rehabilitation Center?

Rehabilitation centers serve individuals who need more intensive care than weekly therapy sessions or brief hospital stays can provide. Common scenarios include:

  • People with treatment-resistant depression
  • Individuals with schizophrenia or schizoaffective disorder
  • Patients struggling with bipolar disorder in manic or depressive episodes
  • Those recovering from substance-induced psychosis
  • Individuals with chronic anxiety interfering with daily functioning
  • People with co-occurring diagnoses (e.g., addiction coupled with a mental health disorder)  

These individuals often require round-the-clock support and a structured routine to achieve and sustain recovery.

Types of Mental Health Rehabilitation Programs

Inpatient vs. Outpatient Programs

Inpatient programs provide 24/7 care within a secure facility. Patients live on-site and follow a highly structured daily schedule that includes group therapy, medication management, wellness activities, and individual discharge planning.

Outpatient programs allow patients to live at home while attending scheduled treatment sessions several times per week. This format offers flexibility, but is best for those with stable symptoms and a strong support system at home.

Residential Mental Health Programs

Residential programs offer long-term care in a live-in environment. These therapeutic communities integrate individualized therapy, life skill development, and holistic approaches like yoga, nutrition, and mindfulness training.

Patients develop routines, build relationships, and receive care beyond basic symptom management within residential programs. Stay duration can vary between 10 days and 3 months depending on a patient’s needs. At Lindner Center of Hope, the typical length of stay is about 30 days.

Partial Hospitalization and Day Programs

Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs) serve clients who need structured therapy and support but do not require overnight stays. Generally, these programs run several hours per day and can be a step-down from inpatient care or a preventive option to avoid hospitalization.

Therapies and Treatments Provided

Mental health rehabilitation centers offer a variety of evidence-based therapies tailored to individual needs:

  • Cognitive Behavioral Therapy (CBT) addresses negative thought patterns and behaviors.
  • Dialectical Behavior Therapy (DBT) teaches emotional regulation and interpersonal skills.
  • Radically Open Dialectical Behavior Therapy (RO-DBT) targets overcontrolled behavior patterns and promotes openness, flexibility, and social connection.
  • Group Therapy builds peer support and communication.
  • Art and Music Therapy offers non-verbal avenues for emotional expression.
  • Medication Management ensures psychiatric medications are optimized and monitored.
  • Mindfulness and Holistic Practices focus on body-mind wellness.  

How to Choose the Right Rehabilitation Center

Accreditation and Licensing

Always verify that the center is licensed and accredited by recognized agencies (e.g., The Joint Commission). Accredited facilities employ licensed professionals and follow established care protocols. These standards ensure patient safety, privacy, and effective treatment delivery.

Specialized Programs

Look for centers that offer specialized care for your specific needs, such as:

  • Co-occurring diagnosis treatment for mental illness and substance use
  • Trauma-focused care using EMDR or trauma-informed therapy
  • Programs tailored to teens, adults, or veterans  

Specialized programs improve outcomes by targeting the root causes of mental health issues.

Checklist: What to Look for in a Mental Health Rehabilitation Center

 ✅ Licensed and accredited  

 ✅ Qualified staff and therapists  

 ✅ Range of evidence-based treatments  

 ✅ Individualized treatment plans  

 ✅ Aftercare and transition planning  

 ✅ Flexibility working with your financial situation  

 ✅ Positive reviews and testimonials  

 ✅ Specialized programs (e.g., trauma, dual diagnosis, age-specific)

Life After Rehabilitation

Recovery doesn’t end at discharge. The best mental health rehabilitation centers offer aftercare planning. This may include:

  • Outpatient therapy
  • Support groups
  • Medication management
  • Ongoing case management
  • Relapse prevention programming  

These services help maintain progress and prevent setbacks during the transition to independent living.

Taking the Next Step Toward Healing

A mental health rehabilitation center can be a life-changing resource for those facing chronic or serious mental health disorders. These centers provide the structure, care, and therapies necessary for real recovery. Early intervention leads to better outcomes, so begin exploring your options today for yourself or your loved one.


If you or someone close to you needs support, reach out to a licensed mental health rehabilitation center or a qualified professional. Help is available, and recovery is possible. We invite you to learn more about Lindner Center of Hope. Our exceptional team is ready to answer your questions and guide you through the admissions process.

Please consider scheduling a consultation, touring our facilities, or exploring how our residential, inpatient and outpatient programs can help you or your loved ones on a road to recovery. Contact us online or call 513-536-HOPE (4673).

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Seeking help for mental health concerns is a courageous step, and finding the right treatment center can make a significant difference in recovery. With various treatment options available, understanding the types of facilities and their offerings is essential.

This guide will walk you through the different types of mental health treatment centers, how to choose the best one for your needs, and what to expect during treatment.

Understanding Mental Health Treatment Centers

Mental health treatment centers provide structured environments where individuals can receive professional care for mental health disorders. These facilities offer a range of therapies and support systems designed to help individuals:

  • Manage their conditions
  • Regain stability
  • Develop coping strategies

Treatment centers play a crucial role in addressing conditions such as depression, anxiety, bipolar disorder, schizophrenia, and substance use disorders.

Types of Mental Health Treatment Centers

Different treatment centers cater to varying levels of mental health needs. The right choice depends on the severity of symptoms, level of care required, and personal circumstances.

Inpatient Treatment Centers

Inpatient facilities, also known as psychiatric hospitals or mental health wards, provide 24/7 medical supervision in a structured setting. These centers are best suited for individuals experiencing severe mental health crises, including suicidal ideation, psychosis, or an inability to care for themselves. Treatment typically includes intensive therapy, medication management, and crisis intervention.

Outpatient Treatment Centers

Outpatient treatment centers allow individuals to receive care while continuing to live at home. These programs offer therapy sessions, medication management, and support groups, often requiring multiple visits per week. Outpatient care is ideal for those with mild to moderate mental health conditions who need support, but do not require round-the-clock supervision.

Residential Treatment Centers

Residential treatment centers offer a middle ground between inpatient and outpatient care. Patients live at the facility for an extended period—typically weeks to months—while engaging in structured therapy and support programs.

Residential treatment centers provide a more home-like environment and focus on long-term recovery, making them beneficial for individuals struggling with chronic mental health conditions or co-occurring substance use disorders.

How to Choose a Mental Health Treatment Center

Selecting the right treatment center is a crucial decision that should be based on individual needs, treatment approaches, and available resources.

Factors to Consider

  • Accreditation and Licensing. Ensure the facility is accredited by organizations like The Joint Commission.
  • Staff Qualifications. Verify that the center has licensed therapists, psychiatrists, and medical professionals.
  • Types of Therapy Available. Look for evidence-based treatment approaches such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and medication-assisted treatment.
  • Location and Environment. Consider whether a local or distant center is preferable based on family involvement and personal comfort.

Questions to Ask Before Enrolling

Before committing to a treatment center, ask the following:

  • What mental health conditions does the facility specialize in?
  • What is the staff-to-patient ratio?
  • What therapies and treatments are included in the program?
  • What aftercare services are provided?
  • What is the expected length of stay?
  • Are family visits and participation encouraged?

Treatment Options Available at Mental Health Centers

Most treatment centers offer a combination of therapy, medication, and holistic approaches to address mental health conditions.

Therapy and Counseling

Therapy is a cornerstone of mental health treatment, helping individuals process emotions, develop coping strategies, and build healthier thought patterns. Common therapy options include:

  • Individual Therapy. One-on-one sessions with a therapist to address personal challenges.
  • Group Therapy. Sessions where individuals with similar conditions share experiences and support one another.
  • Family Therapy. Counseling for family members to improve communication and support.

Medication-Assisted Treatment

For some mental health conditions, medication is a key component of treatment. Psychiatrists may prescribe antidepressants, mood stabilizers, or antipsychotic medications as part of a comprehensive care plan. Medication is often combined with therapy for the best outcomes.

Holistic and Alternative Therapies

Many treatment centers incorporate holistic approaches to support mental well-being, including:

  • Mindfulness and Meditation. Techniques to reduce stress and improve emotional regulation.
  • Exercise and Physical Activity. Activities such as yoga or outdoor recreation to enhance mental and physical health.
  • Nutrition Counseling. Dietary guidance to support brain health and overall well-being.

What to Expect During Treatment

Understanding the treatment process can help individuals and their families feel more prepared.

Intake and Assessment

The first step in treatment is an intake assessment, where medical and mental health professionals evaluate the individual’s condition, history, and treatment needs. This assessment helps create a personalized care plan.

Daily Life in a Treatment Center

Daily schedules in treatment centers typically include therapy sessions, group discussions, recreational activities, and personal time for reflection. Structured routines help individuals establish stability and focus on recovery.

Aftercare and Ongoing Support

Recovery does not end after leaving a treatment center. Aftercare plans often include continued therapy, support groups, medication management, and relapse prevention strategies. Some centers offer alumni programs to provide ongoing support and community connections.

Taking the Next Step

Finding the right mental health treatment center is a crucial step toward recovery. By understanding the different types of centers, treatment options, and what to expect, individuals can make informed decisions that best suit their needs.

If you or a loved one is struggling with mental health challenges, don’t hesitate to reach out for help. Are you ready to take a powerful step toward healing and well-being? Please contact the Lindner Center of HOPE inpatient team to discuss admission, call 513-536-4673, or contact us online.

You can also contact the National Mental Health Hotline: 1-800-662-HELP (4357) or dial 988 for the 988 Suicide and Crisis Lifeline for immediate attention that doesn’t require emergency services. Dial 911 for emergencies.

Our patients’ journeys are at the heart of what we do. Lindner Center of Hope is proud to be among the top mental health treatment centers that patients and families recommend. You can hear inspiring stories of recovery and well-being that showcase our impact and commitment to providing the best mental health care. Explore some of our patients’ Stories of Hope.

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Tracking symptoms is a critical part of managing mental health conditions. Many individuals experience fluctuating symptoms that can impact their daily lives, but without structured monitoring, it can be difficult to identify patterns or assess the effectiveness of treatments.

The Daily Record of Severity of Problems (DRSP) is a valuable tool designed to provide a systematic way to track symptoms over time. Used primarily for conditions like premenstrual dysphoric disorder (PMDD) and other psychological concerns, the DRSP helps individuals and clinicians gain insights that can lead to better treatment decisions.

What Is the Daily Record of Severity of Problems (DRSP)?

The Daily Record of Severity of Problems (DRSP) is a structured self-report questionnaire developed to track daily symptoms, particularly in relation to PMDD and other mood disorders.

Originally designed as a diagnostic aid, it allows individuals to record their experiences with specific symptoms over the course of a menstrual cycle. However, it has also been used for broader mental health monitoring, helping individuals and healthcare providers detect patterns and assess the severity of emotional and physical symptoms.

Purpose and Benefits of Using the DRSP

The DRSP serves as a powerful tool for symptom tracking in both clinical and personal settings. Some key benefits include:

  • Identifying Symptom Patterns. By recording symptoms daily, individuals can detect cycles and trends that may not be obvious otherwise.
  • Aiding in Diagnosis. Many mental health conditions, including PMDD, require pattern-based diagnostic criteria. The DRSP provides clear documentation of symptom timing and severity.
  • Improving Treatment Plans. With structured tracking, healthcare professionals can adjust treatment strategies based on symptom severity, duration, and frequency.
  • Enhancing Self-Awareness. Individuals can gain deeper insights into how their mood, behavior, and physical symptoms fluctuate over time.

How to Use the DRSP

Using the DRSP is straightforward and requires only a few minutes each day. Here’s how to fill it out effectively:

  1. Record Symptoms Daily. Users rate the severity of various emotional and physical symptoms, such as mood swings, anxiety, depression, fatigue, and sleep disturbances.
  2. Use a Consistent Scale. Each symptom is typically rated on a scale from 1 (none) to 6 (extreme) to measure severity.
  3. Note Lifestyle Factors. Some versions of the DRSP allow users to track medications, exercise, sleep, or diet that may influence symptoms.
  4. Maintain Regular Entries. For accurate pattern analysis, it is important to complete the DRSP every day for at least two months.

Interpreting DRSP Data

Once data is collected, individuals and healthcare providers can analyze trends to identify key insights:

  • Recognizing Cyclic Patterns. For those tracking PMDD, the DRSP can reveal whether symptoms consistently appear in the luteal phase (the time between ovulation and menstruation).
  • Measuring Treatment Effectiveness. If a person starts medication, therapy, or lifestyle changes, the DRSP can help determine if those interventions are making a difference.
  • Detecting Worsening Symptoms. A steady increase in symptom severity could indicate a need for medical intervention.

By regularly reviewing DRSP entries, individuals can work with their healthcare providers to refine treatment strategies and improve their overall well-being.

Who Should Use the DRSP?

The DRSP is beneficial for a wide range of users, including:

  • Individuals with PMDD or Mood Disorders. Those experiencing cyclical emotional and physical symptoms can use the DRSP for better self-management.
  • Healthcare Providers. Psychologists, psychiatrists, and gynecologists often use DRSP data to support diagnosis and treatment adjustments.
  • Researchers. The DRSP is commonly used in clinical studies examining hormonal influences on mood and mental health conditions.

Comparing the DRSP with Other Mood and Symptom Trackers

While many mood-tracking tools exist, the DRSP stands out because of its structured format and focus on cyclic symptoms. Unlike general mood trackers that log emotions without a clear pattern, the DRSP provides a consistent scoring system and is widely accepted in clinical settings.

Other trackers may allow more customization, but the DRSP’s standardized approach makes it highly reliable for research and diagnosis.

Where to Get the DRSP

The DRSP is available in printable and digital formats. You can find it:

  • On medical research websites and mental health organizations’ resources.
  • Through healthcare providers, who may supply it for tracking PMDD symptoms.
  • On symptom-tracking apps, where digital versions are integrated into menstrual and mood tracking tools.

Download a DRSP PDF to track mental health symptoms.

There is Hope

Tracking mental health symptoms with a structured tool like the Daily Record of Severity of Problems (DRSP) can lead to greater self-awareness and improved treatment outcomes. Whether used by individuals managing PMDD, mood disorders, or general mental health concerns, the DRSP provides clear, data-driven insights that help both patients and clinicians make informed decisions.

If you or someone you know struggles with recurring mental health symptoms, consider incorporating the DRSP into your daily routine to gain a deeper understanding of symptom patterns and their impact.

Don’t hesitate to reach out for help. If you want to contact the Lindner Center of HOPE inpatient team to discuss admission, call 513-536-4673, or contact us online.

You can also contact the National Mental Health Hotline: 1-800-662-HELP (4357) or dial 988 for the 988 Suicide and Crisis Lifeline for immediate attention that doesn’t require emergency services. Dial 911 for emergencies.

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By Kelly Heitkamp, LISW-S 

 

 

 

 

Anxiety touches everyone at some point. Whether it’s a fleeting worry before a big event or a chronic struggle that feels all-consuming, it’s important to know there’s hope—and help. Let’s break down what anxiety really is and explore effective ways to manage it, blending professional insight with actionable advice for everyday life.

What Is Anxiety?

Anxiety is more than feeling nervous. It can show up as physical symptoms like a racing heart, tight chest, or stomach troubles; emotional distress like dread or irritability; and persistent, overwhelming thoughts.

Different types of anxiety disorders—like generalized anxiety disorder (GAD), social anxiety, or panic attacks—bring their own challenges, but they all share one thing: they’re treatable. Understanding the roots of anxiety is the first step to taking back control.

Why Does Anxiety Happen?

Anxiety is the brain’s way of trying to keep you safe. When the amygdala (our fear center) senses danger, it activates the fight-or-flight response, releasing stress hormones like cortisol. For some, this system works overtime, reacting to things that aren’t actual threats.

Other parts of the brain, like the prefrontal cortex (responsible for rational thinking), might struggle to calm things down. Add factors like genetics, past trauma, or chronic stress, and you’ve got a recipe for anxiety that can feel hard to shake.

What Can Help? 

  1. Cognitive Behavioral Therapy (CBT)

CBT is like a mental toolbox for managing anxiety. It helps you identify unhelpful thoughts and replace them with more balanced ones. Some key tools include:

  • Challenging Fearful Thoughts: What’s the evidence for this worry? Is there another way to see it?
  • Exposure Therapy: Facing fears gradually, in a safe way, can help reduce their power.
  • Building Confidence: By tackling small, manageable steps, you can create positive change.
  1. Medications
    For some, medication can offer the boost needed to make progress. Options like SSRIs (e.g., sertraline) can balance brain chemicals, while beta-blockers are great for taming physical symptoms like a pounding heart. Always consult a doctor to find the right fit for your needs.
  1. Mindfulness and Relaxation
    Sometimes, the best way to quiet the mind is to connect with the present moment. Techniques that work wonders include:
  • Meditation: Spend even five minutes focusing on your breath or a calming mantra.
  • Progressive Muscle Relaxation: Tense and release each muscle group, noticing the contrast.
  • Deep Breathing: Inhale slowly, hold, and exhale—it signals to your body that you’re safe.
  1. Lifestyle Tweaks
    Small changes can have a big impact on anxiety:
    Move Your Body: Exercise releases feel-good endorphins and reduces stress hormones.
    Eat for Stability: Balanced meals keep blood sugar steady, which helps manage mood swings.
    Prioritize Sleep: Create a routine that supports restful nights.
    Reduce Stimulants: Too much caffeine or nicotine can amp up anxiety.
  1. Emotional Healing
    For some, anxiety has roots in unresolved feelings or past experiences. Therapies that explore deeper emotions or relationship patterns—like psychodynamic therapy—can bring clarity and relief.
  1. Complementary Supports
    From yoga to herbal supplements like chamomile, there are many ways to enhance traditional treatments. Always check with a healthcare provider before trying something new.

How Professionals Can Help

Mental health professionals bring expertise and empathy to the table. They use tools like the Generalized Anxiety Disorder-7 (GAD-7) to assess symptoms and create customized treatment plans. Their goal? Empower you to feel understood, supported, and equipped to manage anxiety.

What Can You Do?

If anxiety feels like it’s running the show, here are some starting points:

  • Reach Out: Whether it’s a therapist, friend, or support group, you don’t have to go it alone.
  • Learn the Signs: Understanding your triggers can help you respond more effectively.
  • Be Kind to Yourself: You’re not failing; you’re facing something challenging—and that takes courage.

A Hopeful Future

Anxiety treatment continues to evolve, with exciting innovations like virtual reality therapy and digital tools making care more accessible. The more we understand about the brain, the better we can help it heal.

Whether you’re a professional supporting clients or someone seeking relief, remember: anxiety doesn’t define you. With the right tools and support, you can reclaim your life and find peace.

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By: Laurie Little, PsyD
Chief Patient Experience Officer and Staff Psychologist,
Lindner Center of HOPE

In recent years, there has been a growing interest in exploring alternative and innovative treatments for mental illness. Among these novel approaches, ketamine has emerged as a promising treatment for various mental health disorders. Traditionally known as an anesthetic and pain-relieving medication, ketamine has shown potential in treating mental health disorders such as depression and anxiety.

History of Ketamine

Ketamine was originally discovered by chemist Calvin Stevens in 1962 for Parke Davis Company and was Food & Drug Administration (FDA)- approved for medical use as an analgesic and anesthetic in 1970.  It is considered a “Dissociative Anesthetic” with different dosages leading to differing effects. Lower dosages can lead to a psychedelic experience and higher dosages can lead to complete dissociation or analgesia. When using Ketamine as an analgesic, researchers noticed an intriguing off-label effect: a rapid and pronounced improvement in mood and depressive symptoms in some patients. This discovery sparked interest in exploring ketamine’s potential as a novel treatment for mental health disorders.

To curb its illicit and recreational use, the United States categorized Ketamine as a Schedule III federally controlled substance in 1999, however research into its mental health benefits continued to flourish. In 2019, the FDA approved the first ketamine derived therapy, called Esketamine, as a therapy for treatment-resistant depression.

Ketamine and Depression

Ketamine’s antidepressant effects are unique compared to traditional antidepressant medications, which typically take several weeks to produce noticeable results. Ketamine often provides immediate relief to patients who are suffering. Ketamine promotes the release of Glutamate, an essential neurotransmitter that is related to cognition, memory and mood.  Traditional antidepressants often affect neurotransmitters such as Serotonin and Dopamine and take longer to notice an improvement in symptoms.

A recently published large, systematic review of published journal articles on Ketamine treatment found “support for robust, rapid and transient antidepressant and anti-suicidal effects of ketamine. Evidence for other indications is less robust but suggests similarly positive and short-lived effects.“ The findings suggest that ketamine facilitates rapid improvements in symptoms among patients with major depressive disorder (MDD), bipolar disorder and suicidality, lasting up to 7-14 days after treatment. In some cases, effects last up to four weeks, depending on the number of ketamine sessions and the underlying mental health conditions.

There is also preliminary but growing evidence base supporting the efficacy of ketamine therapy for substance use disorders, anxiety disorders (generalized, social, OCD, PTSD)  and eating disorders.  However, just like its antidepressant effects, ketamine’s reductions in anxiety are also short-lived, and symptom recurrence is common after several weeks.

Patients who receive adjunctive psychotherapy appear to achieve the most long-lasting benefit compared with ketamine administration alone.

Ketamine Assisted Psychotherapy

Research shows that Ketamine is most beneficial when it is combined with psychotherapy. There is no current standard for how therapy and Ketamine should be combined. Some practitioners combine lower doses of Ketamine and engage in therapy during the treatment. Other practitioners use higher doses of Ketamine and have the patient engage in therapy either the following day or later in the week. Since patients notice an immediate improvement in their mood, they are more able to benefit from therapy and are more open and receptive to thinking about their current circumstances in a new, helpful way.

The Benefits and Challenges of Ketamine Treatment

The most notable benefit of ketamine treatment is its rapid and profound antidepressant effect. Unlike traditional medications, ketamine can provide relief within hours. This immediate response is particularly crucial for patients in crisis, who are suicidal or those struggling with treatment-resistant mental health conditions.

Moreover, ketamine treatment may benefit individuals who cannot tolerate or have not responded well to other standard treatments. Unfortunately, a significant percentage of patients do not find relief from standard therapies and it is important to have multiple treatment options available.

However, ketamine treatment does come with its challenges and risks.

  • Long-Term Data. One major obstacle is the lack of long-term data on the safety and efficacy of ketamine as a mental health treatment. While research has shown short-term benefits, the question of how long the benefits last requires additional investigation.
  • Misuse. Due to its powerful impact, Ketamine is also often misused. Research is still needed on the abuse potential of Ketamine. Interestingly, there is some evidence to suggest that Ketamine itself can be effective in the treatment of other substance use disorders such as alcohol and heroin. There is still much more to be learned
  • Insurance Coverage. Ketamine treatment is often not covered by insurance for mental health conditions, making it financially inaccessible for many patients. The cost of treatment, coupled with the need for repeated administrations to maintain benefits, raises concerns about equitable access to this innovative therapy.

Ketamine treatment represents a groundbreaking shift in the approach to mental health treatment. Its rapid and transformative effects on depression, anxiety and other mental health conditions have sparked hope for those who have exhausted conventional therapies. While ketamine shows immense promise, ongoing research is needed to fully understand its long-term safety and efficacy.

As the field of mental health continues to evolve, ketamine treatment has the potential to offer a lifeline to those who struggle with treatment-resistant conditions. It is crucial for the medical community, researchers, clinicians, policymakers, and insurers to collaborate in ensuring equitable access to this promising therapy.

Ketamine Therapy & Treatment in Cincinnati

If you’re seeking Ketamine Therapy in Cincinnati, the Lindner Center of HOPE is an excellent place to begin your mental health care journey. Reach out to explore your available options.

 

References

Banoff, MD, Young, JR, Dunn, T and Szabo, T. (2020). Efficacy and safety of ketamine in the management of anxiety and anxiety spectrum disorders: A review of the literature. CNS spectrums, 25(3), 331-342.

Berman, R. M., Cappiello, A., Anand, A., Oren, D. A., Heninger, R., Charney, D. S., & Krystal, J. H. (2000). Antidepressant effects of ketamine in depressed patients. Biological Psychiatry, 47(4), 351-354.

Feder, A., Rutter, S. B., Schiller, D., & Charney, D. S. (2020). The emergence of ketamine as a novel treatment for posttraumatic stress disorder. Advances in Pharmacology, 89, 261-286.

Krupitsky, E. M., & Grinenko, A. Y. (1997). Ketamine psychedelic therapy (KPT): A review of the results of ten years of research. Journal of Psychoactive Drugs, 29(2), 165-183.

Mia, M. (2021) Glutamate: The Master Neurotransmitter and Its Implications in Chronic Stress and Mood Disorders. Front Hum Neurosci. 15: 722323.

Murrough JW, Iosifescu DV, Chang LC, Al Jurdi RK, Green CE, Perez AM, Iqbal S, Pillemer S, Foulkes A, Shah A, Charney DS, Mathew SJ. (2013). Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry. 2013 Oct;170(10):1134-42. doi: 10.1176/appi.ajp.2013.13030392. PMID: 23982301; PMCID: PMC3992936.

Chadi G. Abdallah and Lynnette A. Averil

Ragnhildstveit, A., Roscoe, J., Bass, L., Averill, C., Abdallah, C. and Averillhe, L.. (2023). Potential of Ketamine for Posttraumatic Stress Disorder: A Review of Clinical Evidence. Ther Adv Psychopharmacol, Vol. 13: 1–22, DOI: 10.1177/.

Reznikov L. R., Fadel J. R., Reagan L. P. (2011). “Glutamate-mediated neuroplasticity deficits in mood disorders,” in Neuroplasticity, eds Costa e Silva J. A., Macher J. P., Olié J. P. (Tarporley: Springer; ), 13–26. 10.1007/978-1-908517-18-0_2

Walsh, Z., Mollaahmetoglu, O., Rootman, J., Golsof, S., Keeler, J., Marsh, B., Nutt, D., and Morgan, C. (2022). Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review. BJPsych Open (2022) 8, e19, 1–12. doi: 10.1192/bjo.2021.1061

Witt K, Potts J, Hubers A, et al. Ketamine for suicidal ideation in adults with psychiatric disorders: A systematic review and meta-analysis of treatment trials. Australian & New Zealand Journal of Psychiatry. 2020;54(1):29-45. doi:10.1177/0004867419883341

Wolfson, P., & Hartelius, G. (Eds.). (2016). The ketamine papers: Science, therapy, and transformation. Multidisciplinary Association for Psychedelic Studies.

Zarate, C. A., Singh, J. B., Carlson, P. J., Brutsche, N. E., Ameli, R.,

Luckenbaugh, D. A., … & Manji, H. K. (2006). A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Archives of General Psychiatry, 63(8), 856-864.

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by Jessica Kraft, MSN, PMHNP-BC

 

 

 

 

Anxiety and mood disorders are amongst the most commonly diagnosed mental health conditions in the United States. While many find successful treatment through various psychotherapies or medications targeted at managing anxiety and depression, no medication will magically take away all anxiety or life stressors and it is not uncommon to experience breakthrough anxiety or symptoms of depression even while under the care of mental health professionals.  In today’s hectic world it can be challenging to juggle daily responsibilities and find ways and time to take a step back and practice mindfulness or focus on self-care. This article explores different mindfulness activities and alternative therapies, some of the benefits they illustrate, and how to include them in our day-to-day routines.

Meditation: Meditation has been practiced for thousands of years and is considered one of the oldest spiritual practices in ancient India and China. While it can be challenging to find an agreed upon definition for meditation, in general it is agreed upon that meditation is a practice and form of mental training with the goal of calming the mind (Wang et al., 2022). Meditation can look different to different people and can be practiced in as little as a few minutes every day.

Yoga: Yoga is an ancient spiritual practice with roots in Indian culture and is an alternative therapy often combined with meditation that focuses on breathwork and the adoption of physical postures.  There are multiple style of yoga that differ in intensity and length of time, but multiple individual studies and systematic reviews have concluded that yoga can benefit those struggling with depression with symptom reduction seen with 60-minute sessions per week (Saeed et al., 2019).

Exercise: There are numerous studies and clinical trials showing the benefits of exercise related to mental health, particularly for those who struggle with anxiety and depression. A meta-review examining the relationship between anxiety disorders and physical activity (especially aerobic and resistance exercises) with over 69,000 participants showed that on average participants reported significantly reduced anxiety over a 3-year period when engaging in physical activity on a regular basis. Analysis examining sedentary behavior showed an increased risk of depression over time compared to those who engaged in more physical lifestyle activities (Firth et al., 2020). While there can be limitations in studies related to exercise types, additional therapies, and other variables there is one thing that remains consistent: no trials have shown that physical activity worsens anxiety or depression (Saeed et al., 2019).

While mindfulness activities and alternative therapies sound great on paper, they can be challenging to practice regularly. Below are some tips for squeezing in mindfulness activities into a hectic schedule:

  • Utilizing meditation apps. Most popular meditation apps (Calm, Headspace, Healthy Minds Program) have lengthy daily meditations, but they also include quick 1-3 minute meditations/deep breathing exercises that can easily be practiced before going to bed, before starting the work day, or to take a time out when feeling overwhelmed
  • Find exercise you enjoy doing. Motivation to exercise can be challenging enough, but when it is for an activity you don’t even enjoy this can be even more challenging. Find an activity or sport that you actually enjoy or look forward to doing and this will help with consistency, especially if you are able to engage in the activity with friends or family and turn it into a social or group event
  • Make slow, incremental changes to routine. It’s not uncommon to make a self-care plan including things like exercising daily, meditating daily, and making dietary changes. When we try to make multiple changes like this overnight it is easy to get discouraged if we miss a day and sometimes, we don’t even get back to it. Focusing on one change at a time and incorporating it into your routine more slowly helps with habit changing
  • In short, set yourself up for success with the four laws of behavior change. 1) make it obvious – if you want to go to the gym after work every day pack your bag the night before, 2) make it attractive – get yourself a new pair of shoes or a new workout outfit, 3) make it easy – start with a few minutes per day, and 4) make it satisfying – set up incentives to motivate yourself and keep it going (Clear, 2022)

Sources:

Clear, J. (2022). Atomic habits: An easy & proven way to build Good Habits & Break Bad Ones: Tiny Changes, remarkable results. Cornerstone Press.

Firth, J., Solmi, M., Wootton, R.E., Vancampfort, D., Schuch, F.B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S.B., Jackson, S.E., Smith, L., Eaton, M., Jacka, F.N., Veronese, N., Marx, W., Ashdown-Franks, G., Siskind, D., Sarris, J., Rosenbaum, S., Carvalho, A.F. and Stubbs, B. (2020), A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry, 19: 360-380. https://doi.org/10.1002/wps.20773

Saeed SA, Cunningham K, Bloch RM. Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation. Am Fam Physician. 2019 May 15;99(10):620-627. PMID: 31083878.

Wang, Zanyi1,; Rawat, Vikas1; Yu, Xinli2; Panda, Ramesh Chandra3. Meditation and its practice in Vedic scriptures and early Taoism scriptures. Yoga Mimamsa 54(1):p 41-46, Jan–Jun 2022. | DOI: 10.4103/ym.ym_48_22 (https://journals.lww.com/yomi/fulltext/2022/54010/Meditation_and_its_practice_in_Vedic_scriptures.8.aspx)

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By: Dr. Nicole Bosse, PsyD, Lindner Center of HOPE

 

OCD is a disorder that responds very well to a form of Cognitive Behavioral Therapy called Exposure and Response Prevention. Brain imaging studies found that people with OCD have excessive levels of activity in the orbital cortex, the caudate nucleus, the cingulate gyrus, and the thalamus. Differences are unrelated to intelligence and most other cognitive abilities. These studies also show that the brain changes in response to Exposure and Response Prevention. The overactive parts of the brain become less active and similar to others without OCD after engaging in Exposure and Response Prevention.

Exposure and Response Prevention consists of confronting what you are afraid and abstaining from the related compulsions. Specifically, exposures are purposeful and gradual confronting and maintaining contact with feared objects, thoughts, or images to allow the anxiety to rise, peak, and subside. Response Prevention is the halting of neutralizing actions and/or thoughts (i.e., compulsions) to allow habituation to a feared stimulus (e.g., not washing after touching a doorknob). This is done with the help of a trained therapist. It is a form of therapy that is collaborative and the individual works with the therapist to brainstorm various exposure ideas to start forming a hierarchy.

A hierarchy ranges from items that bring about low to high distress/anxiety. An example hierarchy for someone that has a fear of snakes could look like: reading about snakes, looking at pictures of snakes, watching videos of snakes, looking at snakes behind glass, being in the room with someone holding a Gardner snake, being in the room with someone holding a boa constrictor, touching a Gardner snake while someone else is holding it, touching a boa constrictor that someone else is holding, holding a Gardner snake, and being in a bathtub with boa constrictor snakes. The last item can be something that wouldn’t necessarily be done for exposures, it is just used as a something to help scale other exposures.

There are two types of exposures I usually talk about with patients, planned vs. spontaneous. Planned exposures can take various forms, from in vivo to imaginal. In vivo exposures are exposures that are completed in person, for example touching things that could be contaminated with germs or breaking down avoidance of certain people for fear of harming them. Imaginal exposures are usually implemented when it is impossible/unethical to do in person exposures. For example, the individual can be instructed to write sentences about hurting someone or write an imaginal script detailing their worst fear. These exposures can be done over and over in one sitting until it starts to get boring.

Spontaneous exposures are things that happen throughout the day that are unplanned and typically cause significant anxiety. For instance, if someone is afraid of germs and someone sneezes on food etc. With spontaneous exposures, I usually instruct individual to do one of two things, either abstain from the compulsion or do something called ritual weakening. Ritual weakening is completing the compulsion but doing it differently than the OCD desires. For example, postponing washing hands or writing down that you are giving into a compulsion in order to be able to do the compulsion. The idea is it makes it slightly less convenient to do the compulsion, which over time weakens OCD.

In sum, Exposure and Response Prevention is a very successful form of treatment for OCD. To be effective, the individual must be willing and motivated. An individual is never made to do something they are uncomfortable with. It is best to go slow in order for the individual to learn their anxiety will decrease over time.

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By Angela Couch, RN, MSN, PMHNP-BC, Lindner Center of HOPE, Psychiatric Nurse Practitioner

Hypochondriasis has been replaced in the DSM 5 by Somatic Symptom Disorder (SSD) or Illness Anxiety Disorder (IAD), both categorized under Somatic Symptom and Related Disorders.  Previous diagnoses classified under Somatoform Disorders were often interpreted with a negative connotation, implying that the patient’s concerns were not real or valid. However, it is not appropriate to give a person a mental diagnosis for no other reason than no medical cause can be identified, nor does the presence of a medical diagnosis exclude a co-morbid mental disorder.  About 75% of persons previously diagnosed with Hypochondriasis will fall into the category of Somatic Symptom Disorder, while the other 25% will meet criteria for Illness Anxiety Disorder.  Let’s examine the differences.

Somatic Symptom Disorder (SSD)

Somatic Symptom Disorder (SSD), requires the patient to have one or more somatic symptoms (that is to say, pertaining to the body), that are distressing or result in significant disruption of daily life. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns are manifested by at least one of the following: disproportionate and persistent thoughts about the seriousness of one’s symptoms, persistently high level of anxiety about health or symptoms, and excessive time and energy devoted to these symptoms or health concerns.  Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent, generally more than 6 months duration. Specifiers include predominant pain (formerly pain disorder), persistent, and mild, moderate or severe. High health anxiety can be a symptom of SSD but is not necessary for a diagnosis of SSD. Patients with SSD often seek care from multiple doctors and often feel their assessments were inadequate. Reassurance given does not seem adequate nor to last for these patients. Patients with SSD may worry that excessive physical activity may damage their body and may seem more sensitive to medication side effects.  The prevalence in adults may be 5-7% of the population, likely more common in females. In comparison to Obsessive-Compulsive Disorder (OCD), the recurrent worries are less intrusive and individuals may not exhibit repetitive behaviors aimed at reducing anxiety other than seeking assessment.  Usually in OCD, the obsessions would not be confined to somatic symptoms.

Illness Anxiety Disorder (IAD)

Illness Anxiety Disorder (IAD), requires the patient to have a preoccupation with having or acquiring a serious illness. Somatic symptoms are either not present or are mild in intensity. If another medical condition is present or there is a high likelihood of developing a medical condition, the preoccupation is excessive or disproportionate. There is a high level of anxiety about health and the individual is easily alarmed about their health status. The individual performs excessive health related behaviors, such as body checking, or exhibits maladaptive avoidance, such as avoiding medical assessment.  In IAD, the distress has been present for at least 6 months, though the specific illness targeted may change during that time. The preoccupation is not better explained by another mental disorder such as SSD, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder or delusional disorder. In IAD, the distress comes from the distress about the significance, meaning or cause of the complaint, not from a specific physical symptom or sensation. Most commonly, the physical symptoms exhibited are normal type sensations or considered benign or self-limiting dysfunction. Individuals who have IAD may be easily alarmed by reading or hearing about illnesses, and often will seek reassurance about illnesses through internet research or speaking to doctors or friends and family. In a smaller number of cases, the patient may be help avoidant versus help seeking. The reassurance given by medical professionals may potentially heighten the patient’s anxiety. Those who have IAD may avoid activities in order to avoid harming themselves or catching an illness from others.  The prevalence of IAD is possibly between 1.3-10% in the general population, and in ambulatory medical populations the 6-12 month prevalence is between 3-8%, and about equal across the sexes. The prevalence in OCD is also equal across the sexes. Persons with IAD may exhibit the intrusive thoughts about having a disease and may do compulsive behaviors such as reassurance seeking, but the preoccupations are usually focused on having a disease; in OCD, the intrusive thoughts are often about potentially getting a disease in the future or wanting certainty that they do not have one right now. In OCD, the obsessions and compulsions usually extend beyond disease concerns.

One study examined 118 treatment seeking patients with health anxiety, and gave them structured diagnostic interviews to assess for Hypochondriasis, IAD and SSD, as well as co-morbid mental disorders; additionally, the study looked at self-report measures of health anxiety, co-morbid symptoms, cognitions and behaviors, as well as service utilization. 45% of patients were diagnosed with SSD, 47% with IAD, and 8% with co-morbid SSD/IAD.  SSD and IAD were seen to be more reliable diagnoses than Hypochondriasis. Half of the sample group met criteria for Hypochondriasis, and of that sample, 56% met criteria for SSD, 36% for IAD, and 8% for co-morbid SSD/IAD.  SSD was characterized by higher levels of health anxiety, depression, somatic symptoms, and health service utilization, in addition to higher rates of major depression, panic disorder and agoraphobia.

Patients with these diagnoses often present in medical settings initially, and arrive in a mental health care setting via referral from another medical provider. It is important that medical providers validate the individual’s experience of symptoms and their anxiety, but also explain the rationale of supplementing medical interventions with mental health treatment.

Summary of Differences:

IAD                                                                             SSD

Absence/minimal distressing physical                Presence of distressing physical
symptoms                                                                  symptoms

 

High health anxiety not a requirement                 High health anxiety always present

 

Reassurance seeking common, but also             Reassurance/assessment seeking
less frequently can be care avoidant related
to anxiety

Equal across sexes                                                 More common in females

 

May engage in additional compulsions                More frequently associated with co-morbid depression, panic disorder,

higher level of health anxiety, and more utilization of medical services

To learn about anxiety disorders treatment at Linder Center of HOPE, visit https://lindnercenterofhope.org/anxiety-disorders/

References:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.  Arlington, VA, American Psychiatric Association, 2013.

Newby, J.M., Hobbs, M.J., Mahoney, E.J., Shiu, W. and Andrews, G. DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis. Journal of Psychosomatic Research, 101, 31-37.

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By Peter White, M.A., LPCC, LICDC, Lindner Center of HOPE Outpatient Therapist

The problem during Bipolar Mood Disorders is a pattern of swings of the essential elements of mood between the two poles, like the North Pole and South Pole, of Mania and Depression. These swings are not moodiness, which are swings of mood throughout a day. A Bipolar swing is a distinct period of at least one week when the full spectrum of mood elements exhibits depressive and/or manic elements.

Although thought of as a subjective experience, mood deeply influences three areas. First is metabolism – sleep, appetite, libido and energy levels. Second, mood influences both motivation as well as the ability to experience pleasure and/or a sense of accomplishment. Thirdly, mood deeply influences interpretations within thoughts from positive to neutral to negative.

So, we can think of this first spectrum of mood disorder along an axis of depression to neutral to manic. Therefore, a depressed mood will depress metabolism. A person will have difficulty with sleep through either excessive or inadequate or disrupted sleep, loss of appetite or excessive eating despite disrupted appetite, loss of libido as well as loss of energy. Depression will hinder motivation making it difficult to experience the drive to initiate activities as well as hinder pleasure or the reward of activity. This is a very difficult cycle when it is hard to get active in the day compounded by not finding any pleasure or reward in the day’s activities. Lastly, depression will darken the flow of thoughts adding many themes of hopelessness, helplessness, worthlessness and guilt into our thought process.

Conversely, mania will elevate the same essentials. It will increase energy levels often in the face of declining sleep hours. It will increase libido, increase excessive and/or absence of appetite. It will increase motivation often leading to excessive engagement of plans or activities and will create a compounding loop of all activity feeling especially pleasurable or rewarding. Again, conversely is will paint thinking with elevated judgements of specialness, invulnerability, and inevitable positive outcomes.

The second spectrum of mood disorders, like most other behavioral health problems, is along the spectrum of severity – mild to moderate to severe. If you combine this spectrum of severity along with the first spectrum of depressive to manic, we see how varied and individualized any person’s experience with Bipolar Mood disorders can be.  Most people can relate to some degree of depression during periods of their life with perhaps a few weeks or month of low energy, noticing that they are not getting the same rewards in their regular activity as well as perhaps noticing they are thinking unusually negatively about themselves and their outlook on life. We might call this a mild, brief depressive episode. But the reality is that depression is one of the most disruptive and costly of all health conditions as recognized by the World Health Organization. This mean that depression is often moderate or severe to very severe and can disrupt functioning on every level for weeks to months if not years. A severe depression can make it difficult to get out or bed for days on end both from collapsed energy and motivation. It can destroy the pleasure and rewards of living so that all activity feels like a painful chore at best. Finally, it can turn thoughts dangerously dark with so much hopelessness, helplessness and worthless that suicidal thinking emerges nearly with a sense of relief.

Again conversely, though experienced less often by most people, Manic Episodes can present with mild, moderate, severe and very severe intensity. During a sever episode, a person with manic symptoms is often sleeping little but maintaining very high levels of energy. They are often talking very quickly and sometimes laughing excessively and outside the context of humorous things. Given the very high levels of motivation and the reinforcement of pleasure in all activities, they often initiate an excessive number of activities – starting multiple projects with little awareness of the ability to balance or complete them. They frequently initiate conversations or relationship in an open or disinhibited style very unusual for to their character. With elevated thought patterns, they might believe they have a unique or special purpose, and they are convinced that all their activities will be successful and rewarding. Give the excessive energy, motivation, pleasure and elevated sense of self and success, people in manic states will often engage in behavior patterns much riskier than typical – spending money well beyond their mean, unusually disinhibited sexual decision, reckless driving, shop lifting.

I hope it’s useful to review the way mood symptoms fluctuate along these two spectrums, because like all health care conditions, we are best off when we accurately identify what these behaviors are – symptoms. Mood symptoms are not moral challenges, personality traits or unconsciously desired behaviors. Mood symptoms are symptoms, and fortunately, there are many very effective treatments for all symptoms along both spectrums. Please know if you or a loved one or a client is experiencing any degree of Bipolar mood problems, there will be many ways to help and cope, and experience the satisfaction of effectively treating a behavioral health care condition.

 

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What is Panic Disorder?

Panic Disorder is an anxiety disorder that occurs when someone experiences recurrent, spontaneous, unexpected, and untriggered panic attacks. This leads to preoccupation with and fear of experiencing another attack. Panic attacks occur when there is an intense physical surge of symptoms that quickly reach their peak, usually in a few minutes. A panic attack can be felt very differently from one person to another. A combination of the following symptoms is typically experienced during a panic attack:

  • Heart palpitations, pounding heart, or accelerated heart rate
  • Sweating/perspiration
  • Trembling or shaking
  • Sensations of shortness of breath or feeling smothered
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizziness, unsteadiness, light-headedness, or faintness
  • Chills or feeling over-heated
  • Numbness or tingling sensations
  • Feelings of depersonalization (unreality)
  • Feelings of derealization (being detached from oneself)
  • Fear of losing control or “going crazy”
  • Fear of death or dying
  • Sense of impending doom or danger

At least one of these panic attacks is followed by one month or more of persistent concern or worry about having another attack and/or a significant change in behavioral pattern (typically avoidance of certain places or situations).

Panic attacks can be viewed as a “false alarm” related to a fight-or-flight response to a mis-perceived threat. Fight-or-flight is a natural human reaction that prepares us to defend ourselves or flee the situation. When someone becomes hyperaware of their body’s sensations, they may interpret a sensation as a threat when there’s not one.

Panic disorder affects 2-3% of Americans and is affects women roughly twice as frequently as it affects men. The onset of Panic Disorder typically occurs in adulthood, but can also affect children and teens.

What is Agoraphobia?

Agoraphobia occurs when someone persistently avoids situations in which they might become embarrassed or have difficulty escaping. This is often the result of fear of having a panic attack in public. This can manifest in fear of using public transportation (such as planes, buses, trains), being in open spaces (such as parking lots, malls, or stadiums), being in enclosed spaces (such as elevators, stores, or cars), being in crowds or standing in line, or even being outside the home alone.

Panic Disorder can be present with or without Agoraphobia, but these disorders commonly present together. When they occur together, Agoraphobia usually develops following an adverse experience, such as having a panic attack in one of these places/situations in which the person feels trapped, embarrassed, or fearful. Over time, avoidance of these situations and places reinforces one’s fear, leading to further avoidance.

How are Panic Disorder and Agoraphobia treated?

People with Panic Disorder often present to emergency departments or their physician’s office due to their uncomfortable physical sensations (often fearing that they are suffering from a heart attack). While it is important to rule out any physical cause for these symptoms, repeated trips to the ER and doctor visits can also reinforce the symptoms. Instead, it is important to receive appropriate mental health treatment for Panic Disorder and Agoraphobia.

Treatment for Panic Disorder and Agoraphobia typically includes of a combination of medication and psychotherapy. Medications commonly used to treat Panic Disorder and Agoraphobia include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), beta blockers, and benzodiazepines. SSRIs and SNRIs are a category of antidepressants that are also useful in treating anxiety disorders such as Panic Disorder and Agoraphobia. Beta blockers can be used to help control some of the physical symptoms of panic attacks such as a rapid heart rate. Benzodiazepines are useful to provide temporary relief of acute anxiety symptoms. These medications can be very helpful, but they should be used with caution due to their potential for dependence. Benzodiazepines can also interfere with the ability to habituate or learn that situations are safe. Only your health care provider should determine whether these medications are appropriate for use and you should not discontinue any medications without consulting with your provider.

Cognitive-Behavioral Therapy (CBT) is an evidence-based type of psychotherapy that is helpful in treating Panic Disorder and Agoraphobia. This therapy helps people to change their behavior and their way of thinking. Various CBT techniques are useful in treatment of these anxiety disorders. Interoceptive exposures involve purposely provoking uncomfortable physical sensations (heart pounding, shortness of breath, dizziness) to desensitize oneself to them. This should be done with the guidance of a trained mental health professional to ensure that it is done correctly. Similarly, gradually limiting avoidance of circumstances and places (such as driving or going into stores) that are typically avoided allows someone to become comfortable and gain confidence in these situations. Breathing and relaxation exercises can help to lower someone’s overall level of anxiety to prevent them from having a panic attack. And finally challenging faulty beliefs, such shifting from thinking “I’m in danger” to “my body is telling me that I’m in danger, but I’m actually safe” can be helpful in lowering related anxiety. Other helpful interventions include biofeedback and mindfulness. Additional lifestyle changes such as reducing one’s intake of caffeine, sugar, nicotine, regular exercise and sleep, and limiting checking vital signs can be helpful in lowering anxiety.

If you believe that you or someone you know is suffering from Panic Disorder and/or Agoraphobia, it is important to seek the help of a mental health provider. These disorders can become debilitating without proper treatment but can become manageable if properly treated.

by Jennifer B. Wilcox, PsyD
Staff Psychologist, Lindner Center of HOPE