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How does PCH treat Anxiety Disorders?

PCH Treatment Center specializes in treating anxiety disorders and their manifestations. Our programs feature daily individual psychotherapy sessions and multiple group therapies. Our highly experienced masters and doctoral level clinicians are versed in both psychodynamic and cognitive behavioral therapy. When we evaluate a person struggling with anxiety, we define the diagnosis and develop an efficacious treatment plan.

Anxiety with co-occurring problems such as depression may be appropriate for our psychodynamic treatment program. More severe manifestations of anxiety, such as OCD or ruminative thinking or behavior patterns may be appropriate for our cognitive-behavioral track. In either program, daily individual therapy is supplemented with dialectical behavior therapy, mentalization, mindfulness based stress reduction, process groups, anger management, trauma timeline, and a multitude of other group therapies. We also utilize neurofeedback, which is very helpful for clients with anxiety, many of whom find it to be calming and reorienting. We also incorporate holistic therapies such as trauma-informed yoga, an arts program and meditative practices. Anxiety Disorders can be effectively managed with psychological treatment and medication, when necessary. At PCH Treatment Center, our philosophy is to medicate appropriately. Our team of psychiatrists understands anxiety and only uses medication as needed, avoiding addictive substances such as benzodiazepines.

Many practitioners, as a first line of therapy, will prescribe benzodiazepines such as valium or xanax or ambien. These drugs are addictive, have negative side effects and actually worsen anxiety once they wear off. A person also develops tolerance and needs to continually increase their dosage. Withdrawal effects can be uncomfortable to life-threatening. At PCH, we believe in using the minimal amount of medication and our policy is eliminate benzodiazepine usage as soon as possible. Many of our clients with anxiety arrive taking antidepressants, Beta-blockers, low dose antipsychotic medications, and other anti-anxiety medications. It is our job to determine what medications are actually needed, if any.

While occasional anxiety is normal and appropriate, an anxiety disorder can negatively impact every aspect of a person’s life. Anxiety can disrupt sleep, which affects a person’s overall health and well-being. Anxiety may prevent someone from achieving success in work or school; it often impacts interpersonal relationships. In severe cases, a person may be afraid to even leave their own house. Anxiety disorders present in many different fashions. Discrete panic attacks are characteristic of a panic disorder. Generalized anxiety or psychological trauma may present more insidiously. Proper diagnosis of an anxiety disorder, therefore, is extremely important to ensure effective treatment. PCH Treatment Center specializes in working with clients suffering from all manifestations of anxiety. In our intensive programs, persons with anxiety are immersed in a healing milieu where they benefit from a highly refined clinical program and they receive support within our psychological milieu.

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What is an Anxiety Disorder?

Anxiety is a physiological response to a stressful or potentially dangerous situation. In its normal state, anxiety is an important human coping mechanism. When anxiety becomes excessive, prolonged, irrational, or inappropriate, interfering with the normal functioning of a person’s life, it is considered an anxiety disorder.

Generalized Anxiety Disorder is marked by “free floating anxiety,” with persistent and pervasive feelings of fright. The person experiencing this anxiety constantly feels threatened. Symptoms may include muscle tension, twitchiness, an inability to relax, autonomic hyperactivity (increased heart rate and sweating), an upset stomach, and headaches. The person may also experience apprehensive expectations or an anticipation that something terrible is going to occur, but they don’t know what it is. Vigilance of Scanning may also be a factor, in which the person has a heightened attention to everything in their environment, often resulting in increased distractibility and decreased concentration. Basically, the person suffering from Generalized Anxiety Disorder experiences a chronic state of hypervigilance and tension without any clear source or focus.

Panic Disorder is comprised of very intense panic attacks of short duration (minutes to a few hours). The person feels as if they are going to faint and even die. Symptoms may include chest pains, heart palpitations, hot and cold flashes, feelings of unreality, dizziness, or faintness (though it is extremely rare for anyone experiencing a panic attack to actually faint). Another important feature in a Panic Disorder is that the person cannot identify any specific reason for the panic. It feels as though it comes out of nowhere, making it even more terrifying.

Phobias are persistent and recurrent fears of a particular situation, object or activity. The person experiencing the phobia knows it is irrational, but cannot stop it.

Types of Phobias

  • Agoraphobia: The most severe of the phobias, it includes a fear of open spaces, public places, and crowds. The person fears and avoids places for which there is no quick escape. It is also common for agoraphobics to fear being alone, so they frequently stay at home with a friend or relative present. If they do leave the house, they are usually accompanied by a friend or family member. This phobia is most often associated with women, and usually arises during their late teens or early twenties. Agoraphobia often begins with a panic attack while the person is away from the house, and the person then stays at home to avoid experiencing that situation again.
  • Simple Phobias: A fear of one particular object or event, such as a fear of flying, snakes, insects, heights, closed spaces, etc. These are typically not difficult to treat, and can be remedied on an outpatient basis.
  • Social Anxiety Disorder (Social Phobia) is when a person has an excessive and unreasonable fear of interacting with other people in social situations. A person with social phobia constantly fears they will embarrass themselves or make mistakes in front of other people, developing a negative self-consciousness. When placed in a social situation, they become anxious or may have a panic attack. As the illness progresses, persons with social anxiety disorder may have distorted thinking, and may begin to avoid contact with other people, becoming isolated. This may interfere with work, school and personal relationships.

Obsessive Compulsive Disorder (OCD) is experienced as obsessive thoughts followed by compulsive behaviors. Those with OCD typically are quite rigid in their thinking and behavior, and seek consistency and avoid spontaneity (which is perceived to be dangerous). Uncontrollable thoughts are usually considered by the person to be socially unacceptable, such as bizarre sexual thoughts, or thoughts of hurting someone. The person then engages in compulsive behaviors (such as counting, touching something repetitiously, and other ritualistic behaviors) in an attempt to control the obsessive thoughts. With severe OCD, the engagement of multiple compulsive behaviors can be extremely debilitating and may result in major disruptions in the person’s life.

Post-Traumatic Stress Disorder (PTSD) is often considered an anxiety disorder and is frequently associated with other anxiety disorders. PTSD develops in response to actual or threatened extreme danger or trauma, such as wartime experiences, torture, natural disasters, rape, incest, or even psychotic. Symptoms include nightmares, dissociative states, vivid flashback memories of the traumatic event, loss of control, emotional detachment (psychic numbing), hyper-arousal, and survivor guilt. Typically, symptoms of PTSD consist of recurrent re-experiencing of the trauma, avoidance behaviors or phobias, and chronic physical signs related to hyper-arousal, including anxiety, sleep disorders, difficulty concentrating, hypervigilance, memory problems, and fatigue.

What causes an Anxiety Disorder?

treatment_018Anxiety disorders are believed to have a genetic basis, as the disorders run in families. Brain chemistry, including abnormal levels of neurotransmitters, also plays an important role in anxiety disorders. Persons with a history of psychological trauma, stress overload, poor self-esteem or personality issues may be predisposed to the development of anxiety disorders. Chronic insomnia, overworking, exposure to high levels of stress, substance abuse, medical problems, and difficulties with family or other interpersonal relationships can all contribute to the onset or exacerbation of an anxiety disorder.

Anxiety disorders can be misdiagnosed or unrecognized. Anxiety-related symptoms such as rapid heart rate, muscle tension, shortness of breath or gastrointestinal symptoms may be wrongly attributed to a medical condition. The diagnosis of an anxiety disorder is based on a specific history of behaviors which meet the criteria for one of the anxiety disorders. A thorough evaluation of current symptoms is performed delineating the specific triggers for anxiety (if possible), the symptoms, and behaviors that have interfered with the client’s everyday living, including negative effects on family, friends, work or school. The client’s family history is also explored, as well as any history of drug or alcohol abuse, which may interfere with treatment.

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