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Residential Treatment of Anxiety Disorders

CooperRiis farm campus
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Living in a residential treatment community can be an adjustment for someone who is suffering from an anxiety disorder. We are careful to honor each person’s journey and to ease them into life at CooperRiis. After all, we don’t want to cause more anxiety to the resident. Residents are empowered to be an essential part of their own recovery team and they set a comfortable pace of healing for themselves.

At CooperRiis we focus on recovery rather than the illness or diagnosis. This shifts the focus from a perceived lack to one of wellness and possibility. Each new resident who arrives at CooperRiis meets with our clinical team and takes part in a full mental health evaluation. This enables us to get a clear picture of the whole person, present and past symptoms, and their medical treatment history. Along with this full evaluation of the resident’s past, we partner with residents to develop a plan for their future. We call this plan the Dream Statement.

The Dream Statement

Imagine living your life with no plan, no hopes for the future, and nothing to motivate you. Sounds pretty bleak, doesn’t it? This is the situation that many of our residents find themselves in when they arrive at our residential community because they don’t feel that they are in charge of their own healing, or that healing is even possible. The Dream Statement helps our residents to embrace the possibility that recovery and a fulfilling life are possible.

The Dream Statement gives our residents clear goals to work toward. It is far more than a bucket list of goals. Over time, the Dream Statement becomes a roadmap to recovery. By identifying their larger hopes and dreams for their lives, residents begin to immediately focus on the future, instead of negative memories from the past.

Residents begin by setting small, achievable goals along with their larger goals for the future. Even seemingly insignificant goals which are easily achieved in a week’s or even days’ time are always working toward the larger goal or dream.
For example, residents may dream of having a job that enables them to support themselves and live independently. Smaller goals of getting out of bed, taking medication at the same time every day, and learning skills to work well with others all contribute to this larger goal. In this way, small victories contribute to the larger goal. The dream gets closer with each small step forward.

Medication, Therapy, and Other Treatment Modalities for Anxiety Disorders

The most effective treatment for anxiety disorders is multidisciplinary. Medication can be very helpful and is generally seen as safe and effective especially when prescribed as part of an integrated treatment plan. Medication can be a long or short-term treatment option depending on the resident’s needs. Our Director of Integrative Psychiatry works with residents to find the most effective medications at the best dosage to reduce anxiety symptoms without provoking harmful side effects. Our goal is to minimize symptoms without sacrificing overall quality of life.

Supplements, such as nutraceuticals, vitamins, minerals and plant extracts, are also used as a part of the treatment. In some instances, the medication dosage can be reduced because supplements have such a positive effect on symptoms.

While data suggests that medication is helpful for anxiety disorders, a combination of medication, psychotherapy, and exercise in a community context is most helpful for resident recovery.

Psychotherapy for Anxiety Disorders

Depending on the person and the anxiety disorder diagnosed, the following are some of the most useful therapy modalities for treating anxiety:

  • Group Therapy (these sessions can be particularly helpful for those with social anxiety because people are so supportive and patient at CooperRiis)
  • Individual Therapy
  • Cognitive Behavioral Therapy (CBT) CBT is the root therapy modality at CooperRiis. CBT focuses on solutions, encouraging residents to challenge distorted cognitions and change destructive patterns of behavior.
  • Dialectical Behavior Therapy (DBT) Dialectical behavior therapy (DBT) provides residents with new skills to manage painful emotions and decrease conflict in relationships. DBT specifically focuses on providing therapeutic skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
  • Eye Movement Desensitization and Reprocessing (EMDR) therapy is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of anxiety that results from trauma. It is particularly helpful for residents who suffer from PTSD. EMDR is helpful in shifting the emotional reactivity around a belief and bringing down the ‘charge’ around it, encouraging a more rational thought process.

Along with therapy and medication, we teach mindfulness and relaxation techniques to our residents. Yoga, meditation, and other practices can be wonderfully beneficial to those with an anxiety disorder.

Thriving in a Supportive Residential Community

True recovery involves far more than a one-size-fits-all prescription, which is why CooperRiis addresses every single facet of our residents’ lives.

Seven Domains of a Whole, Healthy Person

  1. Physical wellness
  2. Emotional and psychological health
  3. Spirituality
  4. Intellectual creativity and learning
  5. Social and community connectedness
  6. Purpose, productivity, and fulfillment
  7. Empowerment and independence

Because every person is different, some domains will receive more emphasis than others during treatment, but all are attended to. An exciting addition to CooperRiis is our new Spiritual Director. This new staff member provides more opportunities for residents to go to church, celebrate holidays, participate in mindfulness exercises, yoga, and other spiritual pursuits. For people dealing with anxiety symptoms, relaxation and mindfulness, as well as yoga, can be helpful.

After the hectic pace of modern life, our property is a great break for the nervous system. There are opportunities for quiet and contemplative space, as well as communal spaces to interact with others. We have meandering trails, a lake, trees, and opportunities to work on the land. In fact, within weeks of joining us as CooperRiis, residents often express to us that they feel like they can breathe a little easier because our community is so supportive, and the property is so relaxing.

Along with living in a community, our residents also have the opportunity to learn how to work in community with others. Residents spend about half their day at CooperRiis on a work crew. The work crews provide structure and purpose. Residents receive guidance and support from other people while developing transferable skills that they will be able to use for the rest of their lives. There are several crews — kitchen, garden, wood shop, animal, greenhouse, and art crews — all of which contribute to our community and to the individual well-being of participants.

Seven Domains Enhanced Recovery Model
The Seven Domains Enhanced Recovery Model by Sharon Young, Ph.D.

What are Anxiety Disorders?

Fight or flight! Almost everyone has heard of this essential reaction of the body. Anxiety, the subjective experience of the fight or flight response, is an entirely normal reaction to stress and can be beneficial in some situations. When your fight or flight response is working correctly, it alerts you that there is danger without over-stressing the body. Danger is perceived and you either leave the situation as quickly as possible, or you stand your ground and fight. Once the danger is past, the body relaxes once again into its normal. When the fight or flight response isn’t working properly, an anxiety disorder can develop in which excessive feelings of fear, nervousness, and anxiety flare up when there is no discernible danger.

Anxiety disorders affect nearly 30 percent of adults at some point in their lives. In any given year the estimated percent of U.S. adults with some of the specific anxiety disorders are:

  • 7-9% a specific phobia
  • 7% social anxiety disorder
  • 2-3% panic disorder
  • 2% agoraphobia
  • 2% generalized anxiety disorder
  • 1-2% separation anxiety disorder

Women are more likely than men to experience anxiety disorders. (Above data from the American Psychiatric Association)

Anxiety Disorders Signs and Symptoms

Because the signs and symptoms of anxiety disorders are so varied and imitate so many diseases, anxiety is often misdiagnosed. Anxiety symptoms can affect almost any area of the body.

The most common signs and symptoms of anxiety include:

Common Emotional Symptoms of Anxiety:
  • Excessive and irrational fear
  • Excessive and irrational worry
  • Always anticipating the worst
  • Feeling tense and/or jumpy
  • Inability to stay calm
  • Irritability
  • Nervousness
  • General uneasiness
  • Feelings of apprehension or dread
  • Constantly watching for signs of danger
  • Difficulty concentrating
Common Physical Symptoms of Anxiety:
  • Sweating
  • Dizziness
  • Headaches
  • Rapid heartbeat
  • Stomach upset/diarrhea/nausea
  • Frequent urination
  • Shortness of breath
  • Dry mouth
  • Muscle tension or twitches
  • Trembling
  • Insomnia/issues with sleep
  • Inability to be still
  • Cold, sweaty, numb or tingling hands or feet (Paresthesia)

This list of the most common symptoms of anxiety is by no means exhaustive. Anxiety manifests in hundreds of ways and combinations and is unique to the individual.

Since anxiety can manifest in many ways, there are several types of anxiety disorders:

Generalized Anxiety Disorder

People suffering from generalized anxiety disorder feel excessive, persistent worry with little or no reason. This constant worry interferes with daily activities and can have a negative impact on personal relationships. With generalized anxiety disorder, everyday life is overwhelming and often exhausting.

Panic Disorder

Those diagnosed with panic disorder experience recurrent panic attacks. During a panic attack, the intensity of anxiety disorder symptoms is heightened for a short period of time – usually 10 minutes or less. The intensity of the symptoms during a panic attack can be so extreme that people believe they are having a heart attack or other life-threatening issues.
Common symptoms of a panic attack include:

  • Surges of overwhelming panic and/or terror
  • Heart palpitations or chest pain
  • Sweating
  • Trembling or shaking
  • Difficulty breathing or hyperventilation
  • Choking sensation
  • Nausea or upset stomach
  • Feeling dizzy, faint, or lightheaded
  • Hot flashes or chills
  • Feelings of unreality or being detached from oneself
  • Fear of losing control or “going crazy”
  • Fear of dying
Phobias, Specific Phobia, and Irrational Fear

A specific phobia is an intense and persistent fear of a specific object, situation or activity that is generally not harmful. Those with phobias often know that their distress is disproportionate, but they still cannot overcome it. People suffering from a phobia will go to extremes to avoid whatever frightens them.

One common phobia caused by anxiety which greatly interferes with normal activities is agoraphobia. Agoraphobia is the fear of being outdoors or of being in a situation from which one either cannot escape or from which escaping would be difficult or embarrassing.

Social Anxiety Disorder

Everyday social situations and interactions are a landmine for people with social anxiety disorder. Those suffering from this disorder are preoccupied with the possibility of being embarrassed, ridiculed, judged, or rejected in social situations. As a result of this fear, they avoid social situations and often miss out on connecting with friends and family.

Separation Anxiety Disorder

A person with separation anxiety disorder experiences excessive fear of losing the person they are closest to. They are extremely anxious when separated from the people to whom they are attached and may refuse to be separated from the people who are the focus of their attachment. These extreme feelings of anxiety and fear last beyond established norms for children (4 weeks) and adults (6 months).

Substance-Induced Anxiety Disorder

A substance-induced anxiety disorder is directly caused by the effects of an ingested substance. Symptoms can result directly from the intoxication or may be due to withdrawal from alcohol, drugs, caffeine, and related substances.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops after experiencing or witnessing a traumatic event or learning that a traumatic event has happened to a loved one. PTSD is most often associated with veterans and wartime involvement, but there are many experiences that can cause PTSD. Learn more about treatment of PTSD at CooperRiis by clicking here.

Michael Groat

About the Author

Michael Groat, MSc, PhD is President and CEO of CooperRiis residential treatment program located in Asheville and Mill Spring, North Carolina. Michael earned his Ph.D. in Counseling Psychology from SUNY-Albany. Prior to joining CooperRiis, he was associate professor of psychiatry and behavioral sciences at the Baylor College of Medicine, Houston, TX, where he also served as director of the division of adult services at the Menninger Clinic.

Michael is also a former candidate in adult psychoanalysis at the Center for Psychoanalytic Studies, Houston, and completed a 4-year fellowship in psychodynamic psychotherapy at the Austen Riggs Center. He has published on suicide prevention, applications of attachment research, and uses of clinical outcomes, and has lectured nationally and internationally on the same. Michael has long-standing interest in suicide prevention, therapeutic communities, organizational and systemic interventions, personality assessment, and intensive psychotherapy.

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