Tag: Anxiety

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Ativan vs. Xanax: Differences, Uses, and Risks

If you’re exploring options for anxiety treatment, you’ve likely heard of Ativan (lorazepam) and Xanax (alprazolam). These medications belong to a group called benzodiazepines, and while they’re similar in many ways, they each have unique characteristics that make them better suited for different situations.

While these medications are related and share many traits, each has its own distinct profile. Understanding the differences between Ativan and Xanax can help you have more productive conversations with your healthcare provider about which option might work best for you.

Both of these medications work with your brain’s natural calming system by enhancing the effects of GABA, a neurochemical that helps reduce anxiety. But they differ in important ways—including how quickly they kick in, how long their effects last, and what they’re typically used for.

Ativan vs. Xanax: Key Differences

Duration of Action

One of the main things that sets these medications apart is how long they stay active in your system. Ativan typically works for 6-8 hours,1 making it helpful for people who need steady anxiety relief throughout the day. Think of it like a slow-release capsule that provides consistent support over a longer period.

The effects of Xanax peak at around 1-2 hours2 and last for up to 6 hours. While this shorter duration means you might need to take it more often, it can be helpful for people who need quick relief from sudden anxiety or panic attacks and prefer not to have long-lasting effects.

Onset of Effects

These medications also differ in how quickly they start working. Xanax typically starts working within 15-30 minutes, making it especially effective for managing unexpected anxiety or panic attacks. It’s like having a rapid-response remedy ready when you need quick relief.

Ativan usually takes 30-60 minutes to kick in. While this slower onset might not be ideal for panic attacks, many people appreciate its more gradual approach. This gentler onset can mean less intense initial effects, which some people find more comfortable.

Approved Uses

Doctors prescribe these medications for slightly different purposes, based on how they work in the body and what they’re approved to treat.

Ativan is usually prescribed for:

  • Managing ongoing anxiety
  • Helping with anxiety before surgery
  • Treating severe seizures
  • Supporting sleep in some cases

Xanax is often prescribed for:

  • Managing different types of anxiety
  • Treating panic disorders
  • Helping with anxiety that occurs alongside depression

How Do Ativan and Xanax Work?

Both Ativan and Xanax work by boosting GABA’s effects in the brain. GABA is a brain chemical that reduces neural activity, helping to create a calming effect. However, these medications process through the body differently.

Xanax vs. Ativan effects in the Body

Ativan metabolizes directly into an inactive compound, while Xanax breaks down into several active metabolites3 before your body then eliminates them. This metabolic difference partly explains why Xanax may have more pronounced effects initially but can also cause more complicated withdrawal symptoms.

Side Effects of Ativan and Xanax

Common Side Effects

Both Ativan and Xanax’s side effects4 typically include:

  • Drowsiness or fatigue
  • Dizziness
  • Reduced coordination
  • Mild memory problems
  • Changes in appetite
  • Dry mouth

Most people experience mild side effects when they start taking anxiety medications. These usually improve as your body adjusts. If you’re concerned about any effects you’re experiencing, discuss these with your prescribing doctor.

Severe Side Effects

While less common, both medications can potentially cause more serious effects:

  • Severe confusion or disorientation
  • Significant memory problems
  • Mood changes
  • Trouble balancing
  • Breathing problems, particularly when combined with other substances

People commonly combine benzos with alcohol, either recreationally or to cope with anxiety. This dramatically increases the risk of adverse side effects, addiction, and overdose. Learn more in our article on mixing alcohol and other substances.

Differences in Side Effects 

While both medications share many similar effects, there are some differences in how people typically experience them:

Ativan often causes:

  • More pronounced sedation
  • Less intense rebound anxiety between doses
  • Fewer morning-after effects

Xanax typically involves:

  • More noticeable initial effects
  • More pronounced rebound anxiety between doses
  • Greater likelihood of morning grogginess if you take it at night

Risks of Dependency and Withdrawal

It’s important to have an open conversation about the risks associated with these medications. Both Ativan and Xanax can lead to physical dependence, even if you take them exactly as prescribed. This is simply a result of how these medications work in the brain.

Dependency Risks

When you take benzodiazepines regularly, your brain adjusts to their presence. Over time, you might notice that you need a higher dose to get the same calming effect—this is called tolerance. Some people may become dependent on benzos5 within just a few weeks, which is why healthcare providers typically prescribe these medications for short-term use or as needed.

If you’re experiencing any of the following, it could be a sign that you’re developing a dependency:

  • Feeling like you need anti-anxiety medication to get through normal situations
  • Experiencing increased anxiety about not having your medication available
  • Needing higher doses to get the same feeling of relief
  • Having trouble sleeping or feeling anxious if you miss a dose

Withdrawal Symptoms

If you’ve been taking Xanax or Ativan regularly, you should not stop taking it suddenly. Always work with your healthcare provider to create a safe tapering plan. Withdrawal symptoms can be uncomfortable—and potentially dangerous—if they’re not managed properly.

Common withdrawal experiences include:

  • Return of anxiety symptoms (often stronger than before)
  • Restlessness and irritability
  • Sleep problems
  • Muscle tension
  • Difficulty concentrating

Xanax’s shorter half-life6 means withdrawal symptoms might appear more quickly and feel more intense. Ativan’s longer-acting nature usually means a more gradual withdrawal experience.

Safe Usage Recommendations

Using these medications safely means taking them exactly as prescribed and avoiding alcohol and other sedating substances while taking them. That said, it’s also crucial to be honest with your healthcare provider about any other substances you’re using. Keep attending your regularly scheduled medication management appointments to monitor your progress. And of course, store your medications securely and never share your prescription with others.

Which Is Better: Ativan or Xanax?

When deciding between Ativan vs. Xanax for anxiety, there’s no one-size-fits-all answer. Think of these medications like different tools in a toolbox—each has its ideal use. Your prescriber will consider several factors to determine which might work better for you.

Factors to Consider

Type of Anxiety

Ativan might be your better option if you have persistent, daily anxiety that needs consistent management. If you deal with panic attacks or sudden anxiety spikes, Xanax could be more suitable.

Lifestyle Considerations

Which anxiety medication is best for you also depends on your:

  • Work schedule (including whether you operate machinery or drive frequently)
  • Daily responsibilities
  • Sleep patterns
  • Other medications you take

Personal Factors

Other factors can also affect your treatment plan:

  • Your medical history
  • Previous experiences with anti-anxiety medications
  • Your age and overall health
  • Personal preferences about medication scheduling

Doctor’s Recommendation

Your healthcare provider brings valuable expertise to this decision. They’ll consider:

  • Your specific symptoms and diagnosis
  • Other health conditions you might have
  • Potential interactions with other medications
  • Your treatment history
  • Your lifestyle and daily routine

Keep an open line of communication with your doctor about your concerns and preferences. This will help them make the best recommendation for your situation.

Alternatives to Ativan and Xanax

While benzodiazepines are helpful for a lot of people, they’re not the only option for managing anxiety. There are many effective alternatives, both in terms of other medications and non-medication approaches.

Non-Benzodiazepine Medications

Several other types of medications can help manage anxiety symptoms:

SSRIs and SNRIs

These medications (like Zoloft, Lexapro, or Effexor) work differently from benzodiazepines. Instead of providing immediate relief, they help regulate brain chemistry over time. They’re typically used to treat depression, but many people find them effective for long-term anxiety management without the risk of dependence.

Beta Blockers

These medications primarily help with the physical symptoms of anxiety, like racing heart and trembling. They’re usually used for specific situations like public speaking or performances.

Buspirone

This medication specifically treats anxiety without causing significant sedation or dependency.7 It works well for many people, though it typically takes a few weeks to feel the full effects.

Behavioral Therapies and Coping Strategies

Medication isn’t the only way to manage anxiety. Many people find these approaches helpful, either on their own or alongside medication:

Cognitive Behavioral Therapy (CBT) and Other Talk Therapies

CBT helps you understand and change thought patterns that contribute to anxiety. It’s like learning a new language—at first it takes conscious effort, but it becomes more natural with practice. Research shows CBT can be just as effective as medication for anxiety. According to the American Psychological Association, 

For anxiety disorders, cognitive-behavioral therapy, antidepressant medications and anti-anxiety medications have all been shown to be helpful. Research generally shows that psychotherapy is more effective than medications, and that adding medications does not significantly improve outcomes from psychotherapy alone.

Mindfulness and Meditation

Mindfulness is the practice of staying grounded in the present moment. Many people find this helps ease their anxiety, as the brain tends to get caught up in anxiety about the future. Significant scientific evidence supports this. A study of 187 adults seeking treatment for mood and anxiety disorders found that mindfulness helps reduce anxiety by reducing worry.8 Even a few minutes of daily mindfulness can make a noticeable difference in managing anxiety symptoms. 

Exercise and Lifestyle Changes

Getting daily physical activity, maintaining good sleep hygiene, and learning techniques for managing stress can help lower your anxiety levels. Some people find that making these changes reduces or even completely eliminates their need for anxiety medication.

Getting Support

Remember, seeking help for anxiety is a sign of strength, not weakness. Whether you’re considering starting one of these medications, currently taking them, or looking for alternatives, your healthcare provider can discuss your options and create a treatment plan that’s personalized to your needs.

Working with your treatment team to find the right approach—whether that includes Ativan, Xanax, other medications, or non-medication alternatives—is an important step in managing anxiety and improving your quality of life. Don’t hesitate to ask questions and share your concerns as you work together to find the best solution for your specific situation.

If you’re looking for a strong start to your anxiety healing journey, anxiety treatment programs offer comprehensive treatment in an immersive, recovery-focused setting. Search for an anxiety treatment center that fits your needs and speak directly with an admissions specialist today.

Frequently Asked Questions About Ativan vs. Xanax

Can you take Ativan and Xanax together?

No, healthcare providers don’t prescribe these medications together because they work in very similar ways. Taking both could increase the risk of side effects without providing additional benefits.

How long can you safely use Ativan or Xanax?

Most healthcare providers recommend using benzodiazepines for short periods (a few weeks to months) or as needed for specific situations. Long-term use should be carefully monitored by your healthcare provider.

Are there non-addictive alternatives to benzodiazepines?

Yes, many alternatives exist, including SSRIs, SNRIs, buspirone, and various non-medication treatments like therapy and mindfulness practices. Work with your healthcare provider to find the best option for your situation.

What should I do if I want to stop taking Ativan or Xanax?

Always work with your healthcare provider to create a tapering plan. Never stop taking these medications suddenly, as this can lead to withdrawal symptoms that can range from uncomfortable to very dangerous.

Is it safe to drive while taking these medications?

Until you know how either medication affects you, avoid driving or operating machinery. Some people experience significant drowsiness or decreased coordination, especially when first starting the medication or after dose changes.

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What Does Xanax Do?

Xanax (alprazolam) is a widely prescribed medication for managing anxiety and panic disorders. It works by calming the brain and nervous system, providing relief from overwhelming fear, tension, and restlessness. While it’s effective in reducing symptoms of anxiety, it also carries significant risks, including addiction. Here’s what you need to know about how Xanax works, its uses, and the potential consequences of both short- and long-term use.

Understanding Xanax

To understand what Xanax does and why it’s effective, it helps to know how it interacts with your brain to ease anxiety and panic symptoms.

How It Works 

Xanax is part of a class of medications called benzodiazepines that work by enhancing the effects of gamma-aminobutyric acid (GABA), a naturally occurring chemical messenger in your brain. Think of GABA as your brain’s natural calming system: It helps regulate brain activity by reducing excitability in the nervous system. When you take Xanax, it amplifies this natural calming effect, which is especially helpful when anxiety or panic has kicked your brain into overdrive. Essentially, Xanax increases the effects of GABA1 to turn down the volume on excessive brain activity, making it easier to feel relaxed and in control.

Immediate Effects 

One reason Xanax is often prescribed for anxiety and panic disorders is its rapid onset of action. Most people start to feel its calming effects within 30-60 minutes of taking the medication. During this time, Xanax works to reduce common anxiety symptoms:2

  • Physical tension and restlessness that make it hard to sit still
  • Racing heart rate and chest tightness
  • Excessive sweating and trembling hands
  • Overwhelming feelings of worry or irrational fears
  • Racing thoughts that feel difficult to control

The quick-acting nature of Xanax makes it helpful for managing acute anxiety episodes or panic attacks, where the person experiencing symptoms needs rapid relief.

Uses of Xanax

Most people take Xanax for anxiety or panic disorders, though it has occasional off-label applications.

Anxiety Disorders

Xanax is most commonly prescribed for generalized anxiety disorder (GAD),3 a condition marked by more than just occasional stress or nervousness. People with GAD feel persistent worry that’s hard for them to control, which is often accompanied by physical symptoms like fatigue, irritability, and muscle tension that can significantly impact daily life. By working with the brain’s natural calming system, Xanax can provide relief from both the emotional overwhelm and physical discomfort of anxiety.

Panic Disorders

For people living with panic disorder, Xanax can be a key part of their treatment plan. Panic attacks often strike without warning, triggering intense physical and emotional symptoms4 that can feel terrifying:

  • Rapidly heartbeat
  • Chest discomfort or pain
  • Difficulty breathing or shortness of breath
  • Feeling lightheaded or dizzy
  • An intense sense of impending doom

During these episodes, Xanax’s quick-acting properties can help break the cycle of panic, allowing the person to regain their sense of control.

Off-Label Uses

Healthcare providers sometimes prescribe Xanax for conditions beyond its FDA-approved uses, a practice known as “off-label” prescribing. These might include:

  • Insomnia: When anxiety is preventing sleep, Xanax’s calming effects might help establish better sleep patterns.
  • Depression: In some cases, particularly when anxiety and depression occur together, a doctor might prescribe Xanax alongside antidepressants.
  • Social anxiety: Though not its primary use, some providers may prescribe Xanax for specific social situations.

Off-label use should always happen under close medical supervision, with clear communication about benefits and risks.

You should always use high addiction-risk medications like Xanax with careful guidance from a qualified medical professional. To learn more about who can prescribe benzos and what to look for in a provider, see our article on clinical staff qualifications.

Effects of Xanax

A closer look at Xanax’s effects—including the short-term benefits and the potential long-term changes that can occur with extended use—helps us understand how it affects the body and mind.

Short-Term Effects

When you take Xanax, you’ll likely notice its effects within an hour. Most people experience:

  • A sense of calm spreading through the body
  • Reduced muscle tension and physical restlessness
  • Relief from racing or intrusive thoughts
  • Mild drowsiness or feeling more relaxed than usual

While these effects can provide welcome relief from anxiety symptoms, they can also affect your ability to perform certain tasks. Do not drive or operate machinery until you understand how Xanax affects you personally. Some people also notice temporary changes in appetite or mild dizziness as their body adjusts to the medication.

Long-Term Effects

Using Xanax over an extended period can change how your body and brain respond to the medication:

Tolerance often develops first. This means your body gets used to the current dose and starts to need higher amounts to achieve the same calming effect. While this is a normal biological response, it’s important to discuss any changes in the medication’s effectiveness with your prescribing doctor rather than adjusting the dose yourself.

Physical dependence can develop even when you’re taking Xanax exactly as prescribed. This doesn’t necessarily mean you’re addicted; it simply means your body has adapted to the presence of the medication. However, this physical dependence does mean you’ll need medical supervision to safely stop taking Xanax when the time comes.

Some people notice subtle changes in their memory or concentration with long-term benzodiazepine use. One scientific review of 13 studies on the cognitive effects of benzodiazepine use5 found that “long-term benzodiazepine users were consistently more impaired” than people who didn’t take benzos. These effects often improve over time, after reducing or discontinuing use under medical guidance.

Risks of Xanax Use

While benzos provide relief that some people find very helpful in acute situations, understanding the risks of Xanax use—including side effects and the potential for dependence—helps to ensure you’re using it as safely as possible.

Dependency and Addiction

The calming properties that make this medication effective for anxiety are also what make Xanax habit-forming.6 As your brain adapts to taking Xanax regularly, physical dependence sets in. Here’s what that looks like: 

  • Needing higher doses for the same therapeutic effect
  • Experiencing uncomfortable symptoms when you miss a dose
  • Difficulty reducing or stopping the medication without support

One woman in recovery, Grace, talks about her struggle to quit taking Xanax7 after realizing she had become addicted: 

It’s honestly miserable. It’s definitely a mind game because I want nothing to do with this, yet in order to function and in order to get off of it I have to keep taking it.

Grace’s Xanax use started as many others’ have: with a standard prescription from her doctor. But Grace’s doctor didn’t sufficiently warn her about its risks. Unfortunately, Grace’s story is not uncommon. Many medical professionals don’t receive adequate training in addiction—which is why it’s important to educate yourself on the true ins and outs of benzos.

If you start to feel you can’t cope with stress or anxiety without Xanax, this could also be a sign that psychological dependence is taking hold. That’s why it’s essential to combine medication with other anxiety management strategies, like therapy and lifestyle changes.

Side Effects

Like all medications, Xanax can cause side effects that range from mild to more serious. Most common Xanax side effects are temporary and usually lessen as your body adjusts.

Common side effects tend to be mild and manageable. You might notice:

  • Feeling more tired than usual, especially when you first start taking it
  • Slight dizziness or unsteadiness on your feet
  • Changes in your appetite
  • Mild headaches
  • Feeling fuzzy-headed

While these effects are usually not cause for concern, keeping track of how you feel and sharing this information with your prescribing doctor helps them adjust your treatment plan if needed. 

More serious side effects require immediate medical attention. Watch for: 

  • Significant changes in mood
  • Unusual aggression or agitation
  • Severe confusion
  • Problems with memory and coordination

The risk of serious side effects increases significantly when you combine Xanax with alcohol or other sedating medications. That’s why it’s important to tell your healthcare provider about all substances you use, including over-the-counter medications and supplements.

Safely Using Xanax

Following Prescription Guidelines

Getting the most benefit from Xanax while minimizing risks requires careful attention to how you use it. 

Start with the lowest effective dose. This gives your healthcare provider room to adjust your dose as needed while minimizing side effects. Take the medication exactly as prescribed, even if you’re tempted to take an extra dose during extra-stressful times.

Attend all follow-up appointments with your healthcare provider. These check-ins are important for monitoring how well the medication is working and addressing any concerns early on in the process. Be honest about any side effects or changes you notice—this helps your provider to accurately guide your treatment plan.

Never share your prescription with others, even if they have similar symptoms. Xanax affects everyone differently, and what works for you could be dangerous for someone else.

When to Avoid Xanax

Some situations make Xanax use particularly risky:

Pregnancy and breastfeeding require special consideration—Xanax can affect fetal development and pass through breast milk. Always discuss family planning with your healthcare provider.

Mixing Xanax with alcohol significantly increases the risk of dangerous side effects. Even small amounts of alcohol can intensify Xanax’s effects on your nervous system.

If you have a history of substance use disorders, you might be at higher risk of developing patterns of problematic use. If this is the case, you may need to explore alternative treatments for anxiety.

How to Stop Using Xanax

Risks of Sudden Withdrawal

Never stop taking Xanax abruptly, as this can cause withdrawal symptoms that range from uncomfortable to dangerous:

  • Rebound anxiety8 that feels worse than before
  • Sleep disturbances and irritability
  • Physical symptoms like tremors or sweating
  • In severe cases, seizures or other serious complications

Tapering Off Safely

The key to safely discontinuing Xanax is working closely with a qualified medical professional who can create and oversee a personalized tapering plan. This typically involves:

  • Gradually reducing your dose over time
  • Regular check-ins to monitor your progress
  • Support for managing any withdrawal symptoms
  • Development of alternative anxiety management strategies

Treatment for Xanax Dependence

If you find yourself struggling with Xanax use, a range of treatment options are available:

  • Medical detox programs provide supervised support during the withdrawal process, ensuring your safety and comfort. These programs often combine medical care with counseling to address both physical and psychological aspects of dependence.
  • Addiction rehab programs, both inpatient and outpatient, offer comprehensive care that combines talk therapy, complementary therapies, and peer support to kickstart your healing process.  
  • Individual therapy helps you understand patterns around anxiety and medication use while developing healthier coping strategies. Many people find cognitive behavioral therapy (CBT) particularly helpful for managing anxiety without medication.
  • Support groups connect you with others who understand your experience. Whether in person or online, these communities provide an outlet to process what you’re going through and motivation for sticking with your recovery.

While Xanax can be helpful for severe anxiety in the short-term, longer-term use can lead to addiction. If you’re struggling to quit Xanax, there are plenty of options available to detox safely and learn alternative strategies for managing anxiety. Search for a benzo addiction treatment center to start your journey to a healthy, Xanax-free life. 

Frequently Asked Questions About Xanax

Can Xanax Be Used Long-Term?

Medical professionals do not recommend using Xanax long-term because of its risks of tolerance, dependence, and cognitive impairments. It’s safer to use Xanax short-term under medical supervision.

What Should I Do If I Miss a Dose?

If you miss a dose of Xanax, don’t double up on doses to make up for the missed one. Contact your prescribing doctor to learn how to manage this situation in accordance with your treatment plan.

How Can I Recognize Signs of Xanax Misuse?

Signs of Xanax misuse include:

  • Taking Xanax more often than indicated on your prescription
  • Taking higher doses than what you’re prescribed
  • Using Xanax without a prescription
  • Experiencing withdrawal symptoms between doses
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Designing a Sensory Room in a Mental Health and Substance Use Recovery Center: Dr. Sarah Anderson

Creating a sensory room within a mental health or substance use recovery center offers an innovative and holistic approach to healing. These dedicated spaces are designed to promote relaxation, reduce anxiety, improve focus, and provide therapeutic support. For individuals struggling with mental health conditions or addiction, sensory rooms are invaluable in meeting a wide variety of sensory needs, facilitating self-regulation, and enhancing overall recovery outcomes. This article delves into the essential components of designing a sensory room, the role of mental health occupational therapists, and how to create a sensory environment that fosters balance, safety, and emotional well-being. 

Understanding Sensory Rooms

A sensory room is a carefully constructed space that integrates a variety of sensory experiences, intended to help individuals manage stress, anxiety, and emotions. It encourages engagement with different sensory modalities—sight, sound, touch, smell, and movement—promoting regulation and offering relief from overwhelming stimuli (Champagne & Stromberg, 2004; Haig & Hallett, 2023). 

For individuals facing mental health challenges or recovering from substance use disorders, sensory rooms can provide tools for developing coping and self-regulation skills, increasing self-awareness, and fostering overall recovery. A sensory room provides a structured environment for processing emotional triggers, learning self-regulation techniques, and reducing physical symptoms of anxiety or distress (Champagne & Stromberg, 2004). Sensory processing challenges, commonly associated with ADHD, autism, or substance use disorders, can be effectively managed by thoughtfully selecting and organizing sensory modalities to support nervous system regulation and function.

Key Elements of a Sensory Room

When designing a sensory room, it’s important to have a balance between different sensory modalities. Each individual’s needs will differ, so the space should allow for flexibility and personalization while also providing common features that can be broadly helpful. Here are several key components of an effective sensory room:

  1. Visual Stimulation: Soft lighting (or the ability to dim the lights), calming colors, and soothing visual displays play a critical role in promoting relaxation. For example, adjustable light displays such as bubble tubes or fiber-optic lights can create a calming effect. Visuals that change slowly or projections of peaceful scenes help to engage the visual senses without overwhelming the user. Colors like pastel blues, greens, and purples are commonly used for their ability to promote calmness. 
  1. Auditory Experiences: Sound has a powerful impact on emotional states. Gentle sounds such as nature sounds or soft music can create an environment of tranquility. Instrumental or ambient music, in particular, is known to help clients focus and reduce stress. Personalized playlists or soundscapes can be tailored to individual preferences, making the auditory experience more effective for each user. While white noise is common in mental health settings, it is important to note that it has the potential to be overstimulating to some due to its constant and unchanging rhythm (Champagne & Stromberg, 2004; Haig & Hallett, 2023).
  1. Tactile Tools: Tactile experiences are essential for individuals who benefit from touch-based regulation. Sensory rooms should include a variety of textures for exploration and self-soothing, such as soft cushions, blankets, fidget tools, textured panels, and tactile mats. These materials allow clients to engage their sense of touch, providing opportunities to relax or self-regulate.
  1. Olfactory Elements: Calming scents, such as lavender, eucalyptus, and citrus, can significantly enhance the calming atmosphere of a sensory room. Essential oil diffusers or scent pads are common ways to introduce these scents. When introducing new fragrances, it’s important to consider allergies and sensitivities, as certain scents may trigger negative emotional responses. For example, some clients may have trauma-related sensitivities to specific scents. If a scent is used in the room, it needs to be easily removable. 
  1. Kinesthetic Activities: Sensory rooms should incorporate opportunities for physical movement. Swings, rocking chairs, exercise balls, and climbing walls are just a few examples of kinesthetic tools that allow clients to release energy, regulate their bodies, and express themselves physically. Gentle stretches, yoga mats, exercise bands, ankle/wrist weights, or spaces designed for relaxation also provide much-needed physical relief. 
  1. Safe Space for Retreat: Some individuals may need a quiet, secluded area within the sensory room where they can retreat when feeling overwhelmed. This space should include soft, comfortable seating and soundproofing to offer both physical and emotional safety. These private spaces allow for reflection and provide a place where clients can regain control over their emotional state during moments of distress.
  1. Interactive Technology: Digital tools like interactive touchscreens, virtual reality, and therapeutic apps can enhance sensory experiences by providing unique, engaging options. For instance, some programs combine visual stimulation with auditory feedback, helping clients participate in activities that promote relaxation or mindfulness. While not everyone finds interactive technology calming, some individuals do benefit from it. The key is to use technology thoughtfully and purposefully, tailoring it to each person’s needs and preferences.
  1. Weighted Products: Weighted blankets, vests, animals, pillows, and lap pads are often included in sensory rooms. These items offer deep pressure stimulation, which can help clients feel grounded and calm. Research shows that deep touch pressure can activate the parasympathetic nervous system, helping to reduce stress and anxiety. This makes weighted products beneficial for many individuals with sensory processing challenges (Champagne & Stromberg, 2004).

The Role of Occupational Therapists in Sensory Room Design

Mental health occupational therapy practitioners (MHOTPs) play a crucial role in designing and implementing sensory rooms. Their expertise lies in understanding how sensory input influences an individual’s emotional, cognitive, and physical states. A sensory room should never be designed without first understanding the sensory profiles of its potential users. Here’s how MHOTPs contribute to creating effective sensory rooms:

Client Assessments 

MHOTPs begin by conducting comprehensive sensory assessments of potential users. My preferred assessment is the Adolescent/Adult Sensory Profile, as it provides valuable insights into an individual’s sensory processing patterns. 

This assessment should always be administered by a highly trained mental health occupational therapy practitioner. It is important to know that both occupational therapists and occupational therapy assistants can administer The Adolescent/Adult Sensory Profile, however, only an occupational therapist can interpret the results. Additionally, a detailed occupational profile and supplemental interview questions are conducted to ensure accurate interpretation of the results. This thorough approach supports a well-rounded clinical assessment tailored to each individual’s unique needs and goals. 

Once enough assessments are completed, the therapist can analyze the data to identify common sensory patterns among potential users and design the space accordingly. Sensory rooms must be flexible and adaptable to meet the diverse needs of all users. (Brown et al., 2019).

Individualized Planning

Sensory needs differ greatly among individuals. Based on assessment results, MHOTPs can create a tailored plan for the sensory room that addresses the diverse needs of its users. For example, some individuals may require reduced auditory input due to sound sensitivity, while others may benefit from more auditory stimulation. This tailored planning ensures that the sensory room is equipped with tools and features that effectively support each person’s recovery (Brown et al., 2019).

Training and Support

MHOTPs also provide guidance on how to use sensory tools effectively. They educate clients on the purpose of each tool and offer strategies for engaging with the sensory room in ways that promote regulation as well as function. 

Through these efforts, MHOTPs ensure that sensory rooms are designed not only to meet the needs of potential users, but also to support their long-term well-being and recovery.

Designing Your Own Sensory Space at Home

Designing a sensory space at home can offer many of the same benefits as a sensory room in a recovery center, promoting relaxation and emotional regulation in a familiar environment. Start by choosing a quiet, comfortable area free from distractions, where you can control sensory input like lighting, sound, and visual stimuli. Tailor the space to your sensory preferences, such as dim lighting, calming music, or tactile textures like soft fabrics or weighted blankets, to create an atmosphere that supports relaxation. Incorporate a variety of sensory tools that engage different senses, such as textured pillows, fidgets, calming scents, ambient sound machines, or visual projections, experimenting to find what works best for you. Most importantly, ensure the space feels safe and supportive, offering a peaceful environment where you can process emotions and feel grounded.

Conclusion

Designing a sensory room in a mental health or substance use recovery setting is a powerful tool for promoting emotional regulation, enhancing self-awareness, and supporting overall healing. By integrating a range of sensory experiences and involving mental health occupational therapist practitioners in the process, these rooms offer a personalized and therapeutic space to help individuals in their recovery journey. Whether within a treatment center or at home, sensory spaces play a critical role in creating a holistic, supportive environment that nurtures emotional, cognitive, and physical well-being.

****The term “MHOTP” is used to refer to both Mental Health Occupational Therapy Practitioners (MHOTPs) and Mental Health Certified Occupational Therapy Assistants (MH-COTAs), providing inclusive language that encompasses both roles within mental health occupational therapy. Mental Health Occupational Therapy Practitioners (MHOTPs) are licensed occupational therapists who hold advanced knowledge and training in mental health interventions and assessments. They are responsible for designing and implementing treatment plans, conducting assessments, and providing direct therapeutic services. On the other hand, Mental Health Certified Occupational Therapy Assistants (MH-COTAs) work under the supervision of MHOTPs, assisting with the implementation of treatment plans, supporting clients with therapeutic activities, and ensuring that interventions are carried out effectively. Using “MHOTP” ensures that both practitioners and assistants are acknowledged for their valuable contributions to mental health care.

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Managing Panic Attacks: How to Pack Your Panic Pack: Dr. Sarah Anderson

Panic attacks can feel terrifying, overwhelming, and all-consuming. They arrive suddenly, often without warning, and can make it difficult to feel like you’re in control of your body and mind. If you’ve ever experienced one, you know how distressing they can be. A racing heartbeat, rapid breathing, dizziness, chest tightness, and an overwhelming sense of impending doom—these are just some of the common symptoms of a panic attack.

But here’s the good news: Panic attacks, while unpleasant, are not life-threatening. Once you understand what’s happening in your body during a panic attack, you can start to reduce their frequency and intensity. The key to managing panic attacks lies in having a toolbox of strategies that can interrupt the overwhelming cycle of panic and help you regain a sense of control. One such tool is a “Panic Pack”—a collection of sensory-based grounding items that can help soothe your body and mind when panic strikes.

Understanding Panic Attacks: What Are They?

Panic attacks are sudden, intense episodes of fear or anxiety that often come without warning (American Psychiatric Association, 2013). These episodes can happen at any time, even when you’re feeling calm and relaxed. Panic attacks typically involve a combination of physical symptoms (like a rapid heartbeat, dizziness, chest tightness, or sweating) and emotional symptoms (such as feeling disconnected from reality, or a sense of impending doom). Although panic attacks can feel life-threatening, they are generally harmless and do not cause lasting damage.

Research suggests that panic attacks are caused by the body’s overreaction to stress or perceived danger, triggering the “fight or flight” response (Vickers & McNally, 2006). During this response, the body releases stress hormones like adrenaline and cortisol, which elevate heart rate, blood pressure, and breathing rate, preparing you to flee from danger. In the case of panic attacks, there is no real threat, but the body reacts as though there is.

Sensory-Based Grounding: Why It Works

When you experience a panic attack, your body is overwhelmed by heightened sensory input, and your mind can feel flooded with anxiety. Sensory grounding techniques work by redirecting your attention away from the panic and engaging your senses in a way that helps calm your nervous system. By using tools that appeal to the senses—sight, sound, touch, taste, smell, and movement (remember proprioception can be a helpful sense to engage to reduce anxiety)—you can help interrupt the cycle of panic and return to a state of calm.

Research shows that sensory-based grounding strategies can be highly effective for managing panic attacks. For example, tactile stimulation (such as squeezing a stress ball) has been found to activate the parasympathetic nervous system, which helps the body shift from the “fight or flight” response to a “rest and digest” state (Haynes et al., 2022). Similarly, scents like lavender and peppermint have been shown to reduce anxiety by stimulating the limbic system, the brain region responsible for processing emotions (Barati,, 2016).

Packing Your Panic Pack: Essential Items for Grounding

A Panic Pack is a personalized collection of sensory tools designed to help ground you and alleviate anxiety. Below are several items you can include in your kit, each chosen for its ability to engage different senses and promote relaxation.

1. Weighted Lap Pad

Weighted lap pads are tools used by occupational therapists, typically as a sensory integration modality, to help with emotional and physical regulation. A weighted lap pad provides gentle pressure, which can have a calming effect. Weighted products stimulate the parasympathetic nervous system, promoting a sense of grounding and relaxation (Eron et al., 2020).

2. Fidget Items

Fidget toys such as orbeez squish balls, stress balls, or fidget spinners are simple, portable tools that can help distract the mind during a panic attack. These tactile items allow you to focus on a repetitive motion or texture, which can help redirect your attention away from overwhelming anxiety. (Kriescher,et al., 2023).

3. Earbuds or Headphones and a Calming Playlist

Music and sound have powerful effects on our emotions. Create a calming playlist with soothing music that helps you feel grounded and less anxious. Alternatively, consider having a calming podcast on hand, whether it’s guided meditation, breathing exercises, or a favorite calming show. Studies have shown that listening to calming music can reduce heart rate and lower levels of cortisol (Thoma et al., 2013).

4. Grounding Smells

Scent is one of the most powerful senses for evoking emotional responses. A portable essential oil diffuser, essential oil rollerball, or lotion with calming scents like lavender, chamomile, or peppermint can help reduce anxiety during a panic attack (Barati,, 2016).

5. Sour Candy (e.g., Warheads or Sour Patch Kids)

Engaging your sense of taste with something intensely sour can be a surprisingly effective grounding tool. Sour candies like Warheads or Sour Patch Kids can interrupt the cycle of panic by providing strong sensory input that shifts attention away from overwhelming thoughts and bodily sensations. This grounding effect helps bring focus back to the present moment. The sour taste acts as a sensory distraction, redirecting attention from anxiety to the immediate sensory experience (Rainville, 2013).

6. Breathing Exercise Guide

Consider packing a small device (like a Breathing Buddha Meditation Tool) or having an app with visual cues, such as color-changing lights or animations, to guide deep breathing. These devices often display colors that correspond to the in-breath, hold, and out-breath phases (e.g., blue for inhale, yellow for hold, green for exhale). Visual tools help regulate breathing patterns while using the sense of sight to anchor attention to the present, reducing physiological arousal during panic attacks (Bentley et al., 2023).

7. Personal Comfort Items

Personal items that evoke comfort and safety can be incredibly soothing during a panic attack. A small memento such as a piece of jewelry, a comforting photo, or a soft fabric (like a scarf or blanket) can help you feel more grounded and safe. These items provide a tangible reminder of calm and support, which can be particularly helpful during moments of overwhelming anxiety.

8. Water

Staying hydrated is crucial for both physical and emotional well-being. Including a water bottle in your Panic Pack ensures you’re prepared to stay hydrated during an anxiety attack. Taking slow, deliberate sips of water can be a soothing ritual that helps you re-focus and regain control. This simple act not only hydrates you but also activates the vagus nerve, which plays a key role in calming the body’s stress response. Drinking water offers a grounding task that interrupts the cycle of panic, providing a moment of clarity and connection to the present (Masento et al., 2014).

9. Phone Numbers of Trusted Contacts

Sometimes, the best way to reduce the intensity of a panic attack is by reaching out for support. Include a list of trusted friends, family members, or a therapist that you can contact when you feel overwhelmed. Research has shown that talking to a supportive person can help reduce feelings of isolation and anxiety, providing emotional relief and a sense of connection during a panic attack (Maulik et al., 2010).

Final Thoughts

Having a Panic Pack ready and accessible can be an empowering way to manage panic attacks. By using sensory grounding techniques, you can interrupt the cycle of anxiety and regain control over your body and mind. The key is to personalize your Panic Pack with items that work best for you, helping you feel safe, calm, and supported when panic strikes.

With practice, these tools can become second nature, providing you with a reliable strategy for reducing the intensity of panic attacks and navigating them with confidence. If you are needing more individualized support regarding your sensory processing and how it impacts your mental health, please reach out to a mental health occupational therapist.

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Navigating the Conversation: Talking to Your Boss About Mental Health Needs

Navigating the Conversation: Talking to Your Boss About Mental Health Needs

By Dr. Malasri Chaudhery-Malgeri 

In today’s high-stress work environments, mental health has catapulted to the forefront of workplace wellness discussions. Yet, many employees still hesitate to approach these conversations with their bosses, fearing stigma or professional repercussions. However, broaching this subject thoughtfully can enhance your well-being and professional performance. Here’s a nuanced guide on effectively communicating your need for support or time off for mental health reasons.

Setting the Stage

Preparation Is Key: Before setting a meeting, clarify what adjustments would help ease your mental burden. Are you looking to lighten your load, extend a few deadlines, hand off specific projects, or take some time off? Concrete solutions will guide the conversation.

Know Your Rights: Arm yourself with knowledge about your workplace policies and any relevant laws—like the Family and Medical Leave Act (FMLA) in the U.S., which safeguards your position during extended leaves for health reasons. This preparation ensures you understand the boundaries and possibilities within your discussion.

Timing and Atmosphere

Choosing the Moment: Timing is everything. Opt for a moment when office rhythms are calm—perhaps a quiet morning or a slow afternoon. Avoid the crunch times, like the hectic end-of-quarter weeks, when stress levels are already high.

The Setting Matters: Privacy is paramount. A secluded spot, away from the hustle of office life, sets a tone of confidentiality and seriousness. A quiet conference room or a scheduled private office meeting can make a difference in how comfortably you can speak.

Crafting the Dialogue

Open Positively: Begin with a nod to the positive aspects of your role and the company. This shows your appreciation and frames the conversation as coming from someone invested in the company’s success.

Clarity and Honesty: Without delving into overly personal details, be clear about how your mental health impacts your work. Stick to specific examples and focus on the effects rather than the causes. Use “I” statements to keep the conversation personal and less accusatory.

Propose Smart Solutions: Bring potential solutions rather than presenting your problems alone. This could involve suggesting temporary help from colleagues, tweaking deadlines, or introducing new tools to improve your productivity without lowering the team’s output.

Highlighting Mutual Benefits

A Two-Way Street: Emphasize how supporting your mental health benefits you and the company. A healthier mindset can lead to sustained, even enhanced, productivity. It’s an investment with a valuable return.

The Preventative Approach: Stress the importance of tackling these issues to prevent more significant problems—this can minimize potential future disruptions.

Preparing for All Responses

Be Ready for Anything: While you hope for understanding and support, prepare for any outcome. If the response is less supportive, be ready to suggest a follow-up meeting after they’ve had time to consider your requests.

Plan B: If the conversation does not yield the hoped-for support, know where to turn next—perhaps HR can offer another pathway or external professional advice may be necessary.

What to Do If You Cry During a Conversation with Your Boss

Crying during a conversation with your boss, especially when discussing personal needs or challenges, can be an unexpectedly emotional experience. While it might feel awkward or uncomfortable, it’s important to remember that crying is a natural human response to stress, frustration, or even relief. Here’s how you can navigate this situation with professionalism and grace:

1. Acknowledge Your Emotions

If tears start to flow, acknowledge them without feeling ashamed. You can say, “I apologize, I’m just very passionate about this,” or “I didn’t expect to become this emotional.” Recognizing your tears helps to normalize the situation, showing that while you are emotionally affected, you are still in control of the conversation.

2. Take a Moment

Allow yourself a moment to breathe and collect your thoughts. You can ask for a brief pause, like saying, “Please bear with me for a moment while I gather my thoughts.” Use this time to take deep breaths and regain your composure. Deep breathing helps control your emotions and signals your body to calm down.

3. Maintain Your Composure

Once you’ve acknowledged your tears and taken a moment to breathe, try to continue the conversation. Maintain eye contact and keep your voice steady. If you feel overwhelmed, it’s perfectly acceptable to say, “I might need a moment, but I’d like to continue discussing this.” This demonstrates your commitment to the conversation and your professionalism.

4. Refocus on the Topic

Direct the conversation back to the main topic. Reiterate your key points or where you left off to demonstrate that, despite the emotional moment, your focus remains on addressing the issue at hand. For example, you can say, “To return to what I said earlier, I believe making these changes could improve my productivity.”

5. Use the Opportunity to Emphasize Your Point

Sometimes, showing emotion can underscore the seriousness of your statements. You can frame your emotional response as a demonstration of how much you care about your work and your commitment to performing well. For instance, “My reaction shows how important this is to me and how much I want to find a way to make this work for both of us.”

The Follow-Up

After the meeting, consider sending a follow-up email summarizing the discussion and expressing your thanks for the understanding shown during the conversation. This serves as a professional courtesy, reinforces your points in writing, and demonstrates your proactive approach to resolving workplace issues.

Crying is not a sign of professional weakness but reflects your sincerity and dedication. By handling the situation with poise and focus, you can move past the moment of vulnerability and continue to engage in meaningful dialogue with your boss.

Seal It with Gratitude

Follow up your conversation with a thank-you email outlining what was discussed and any agreed-upon steps. This shows your professionalism and provides a written record of your proactive approach.

Opening up about mental health in the workplace can seem daunting. Still, with the right preparation and approach, these conversations can significantly improve your work life and mental well-being. By framing your needs within the context of mutual benefits and coming prepared with solutions, you can foster a more understanding and supportive workplace culture.

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Climate Anxiety: Muskan Lamba

Caring for the Climate and One Another

I’m Muskan Lamba (she/her), a mental health researcher, expert by experience, and facilitator, deeply curious about the impacts of climate change on human well-being. I am conducting the first study on climate anxiety among youth in the Indian subcontinent, particularly in climate-vulnerable communities. With a passion for nurturing communities and anti-burnout culture, I’ve been creating spaces where individuals can confront anxiety and find care amidst the polycrisis affecting the world, destabilizing our connection to nature and one another. 

Witnessing ecological instability firsthand in the form of massive heatwaves, with temperatures reaching 50°C and AQI soaring to 1000+ in Delhi, India, fuels my passion for this work. Through initiatives like hosting Resilience Circles with the Resilience Project UK, I’ve seen firsthand how shared struggles within climate movements—such as the pressure to constantly “do more” or feelings of helplessness—can be transformed when met with communal empathy and conversations that emphasize creativity, connection, and rest as an act of resistance.

What Even Is Climate Anxiety?

Climate anxiety, also sometimes referred to as eco-anxiety or ecological grief, is a psychological distress people experience in response to the existential threat of climate change. It manifests as chronic fear, worry, and a sense of helplessness, triggered by thoughts, or experiences, of environmental threats such as extreme weather events (think flooding, forest fires), rising temperatures, and the destruction of ecosystems. 

Research has shown that this anxiety can lead to physical symptoms like insomnia, loss of appetite, and panic attacks, and more recently, is even being theorized as a Pre-Traumatic Stress Syndrome (PreTSS). While it is not classified as a mental illness, climate anxiety reflects a rational human response to the looming environmental crisis.

The Psychological Toll of Intense Heat

Rising global temperatures and intensifying heat waves are straining the ecosystems, and also our minds and bodies, leaving a profound psychological imprint as people face the upheaval of migration, loss of familiar landscapes, and an insecure, uncertain future.

The lived experience of climate anxiety is particularly pronounced among vulnerable communities struggling with multiple crises at once, yet much of the literature so far comes from High-Income Countries (HICs). In regions where systemic inequalities limit access to mental health resources, the burden is heavier, leaving communities with fewer tools to cope, governmental apathy, and worse, stigma around these troubles.

My research, which surveyed ~300 respondents from South Asian countries, revealed a strong sense of distress amongst young people aged 18-30, with respondents expressing feelings of isolation, helplessness, and frustration. This emotional burden is exacerbated by social inequalities, leading to more vulnerable groups, such as women and minorities, bearing the brunt despite contributing the least to the climate crisis.

In the words of a survey respondent: “Experiencing extreme heat waves, especially those reaching up to 50°C, makes daily life unbearable, often causing physical discomfort and mental stress. The heat disrupts routines, worsens health, and creates an overwhelming sense of helplessness. The stress of managing daily tasks under such harsh conditions, coupled with the anxiety of seeing others suffer, is overwhelming.”’ 

Sensemaking of our Emotional Responses

As we live through multiple crises intertwined—ecological, economic, socio-political—it is slowly, but surely, becoming clear that our emotional selves are not quite okay, and they require a brave space to be acknowledged and nurtured.

Historically, communities have gathered around firesides—sharing stories, singing, and connecting—to process their collective struggles. In some cultures, such as in rural India, the act of storytelling would allow them to process grief and celebrate resilience. In many African cultures, fireside conversations are central to the philosophy of Ubuntu (“I am because we are”). In Native American traditions, too, the council fire served as a place to discuss important matters, resolve conflicts, and honor ancestors. 

In today’s fractured, isolated world, where emotions are as it is stigmatized much of the time, we must recreate safe “third spaces” where individuals can come together to collectively process their emotions and tap into collective wisdom.  Further, the prevailing culture of “do more” has contributed significantly to burnout, and shifting towards a regenerative approach allows individuals to preserve their mental and emotional health while continuing to call for change. 

Resilience Circles

A purposeful and deeply impactful initiative I have been part of is the facilitation of Resilience Circles with the Resilience Project UK. These circles provide a unique opportunity for youth navigating burnout, climate anxiety, and the like, to come together, come undone, and foster a sense of hope amidst the overwhelm as we make sense of the pain, and develop coping strategies. 

By bringing individuals together in a safe, supportive environment, free from jargon or the pressure to perform, these circles allow participants to express themselves openly without fear of judgment or invalidation. These circles are rooted in practices like mindfulness, storytelling, and brainstorming ways to heal, empowering participants to see their emotions not as weaknesses but as sources of curiosity and wonder. For instance, transforming a narrative such as “Vulnerability is a weakness.” to “Vulnerability can be a strength around the right people.”

Climate anxiety can lead people to isolate themselves when they don’t see it as something rational or real. Some describe feeling they must carry the burden alone or be constantly active in the fight against the crisis. However, circles such as this, challenge the notions by encouraging rest and regenerative practices as essential forms of resistance and self-care. For example, in one session, a participant shared feelings of guilt about needing to take a break from activism. This feeling was reframed, through the group’s input, as an important form of sustenance in the movement. 

Closing Thoughts: Tap into Collective Wisdom

Climate anxiety is an evolving concept, with subjective lived experience depending on one’s culture, society, personal stories, and intermingling with other crises. It’s isolationary, but it’s a highly common experience that many are grappling with today.

Community creates a foundation for collective sensemaking, where the burden of climate change may be carried together. By creating more spaces, digital and otherwise, that prioritize rest, creativity, and shared wisdom, we enable more sustainable forms of coping with climate anxiety. 

At the end of the day, this shift requires systemic change, where mental health is seen as integral to action against polycrisis, and emotional well-being is prioritized alongside traditional notions of productivity and achievement.

We must recognize the importance of third spaces—places where individuals can come together to connect, share stories, and find common ground. In doing so, we may create ripples of resilience that extend far beyond ourselves—just as our ancestors did by the firelight. 

Interested in contributing to understanding and addressing topics like climate anxiety? Join CliMind, a youth-centric virtual community focused on exploring the connections between climate change and well-being: https://chat.whatsapp.com/DPW2866mRbfDNZKWo11GUH

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The Relationship Between Alcohol and Anxiety

Many people who struggle with anxiety turn to alcohol to cope with their stress. But what if that drink makes anxiety worse? We explore the self-perpetuating relationship between alcohol and anxiety, and provide insights and resources to help you manage both.

How Alcohol Affects Anxiety

People use the term “anxiety” so casually, we often forget what it means. One man in recovery, Leon, reminds us how profoundly it can impact your life:   

When I’m feeling extremely anxious I can’t talk to people; I can’t work; I can’t get out of my bedroom; I don’t even want to move; It’s horrible…It’s one of the hardest things that I’ve ever experienced. 

Those who use alcohol to cope with their anxiety often find that it bounces back even stronger when they stop drinking. “When I stopped drinking, I had a lot of experiences of up-and-down anxiety,”1 says Leon.

Short-Term Effects

Alcohol is a depressant, meaning it slows down the central nervous system. Initially, this makes people feel calm and relaxed—which is why so many people who live with anxiety turn to alcohol for symptom relief. In the short term, drinking makes it seem like social inhibitions are lowering and worries are fading away. But this calming effect is short-lived—and misleading—because alcohol makes anxiety worse down the line.

Kevin O’Hara, who is in alcohol recovery, recalls how he used to rely on alcohol to deal with social anxiety:2 

When I was younger and just I wasn’t able to speak to anyone—especially women—alcohol provided that lubricant that I needed at the time.

Long-Term Effects

Unfortunately, alcohol’s initial calming effects don’t last. Long-term alcohol use upsets the harmony of chemicals in your brain, such as GABA and serotonin, that regulate your mood. This worsens anxiety symptoms over time, creating a cycle that leads to dependence. As alcohol wears off and anxiety intensifies, you might start to drink even more. This cycle feeds anxiety and increases alcohol use. Before you know it, this can ramp up into a full-blown alcohol use disorder that further complicates your ability to manage your anxiety.

Leaning on alcohol in awkward moments also keeps us from learning the social skills we need to function without it. “You’re sort of priming yourself now for problems later on,” says O’Hara, “because you’re using an outside substance for a problem which is inside, and that is always going to cause problems.”

Alcohol-Induced Anxiety

Not only does heavy drinking disrupt brain chemistry in the long term, but it can also trigger immediate anxiety spikes. As your blood alcohol concentration (BAC) drops, your body goes into alcohol withdrawal. This results in a cascade of physical symptoms which might include sweating, tremors, and racing heart rate (which can be very anxiety-provoking). Heavy drinking also disrupts your sleep quality, and poor sleep is a major risk factor for anxiety. The physical effects of withdrawal combined with poor sleep quality can make your anxiety feel much worse both during and after heavy drinking episodes.

How Anxiety Influences Alcohol Use

Self-Medication

Anxiety symptoms can make life feel so much harder, and it’s common for people who struggle with this condition to self-medicate with alcohol. And understandably so—the initial calming effects of alcohol can feel like a welcome escape from the overwhelm of anxious spiraling. 

Danay, who founded Sober Girls Houston while in alcohol recovery, recalls how she started drinking to cope with academic pressures3 in high school: 

I went to a private school, and if I didn’t get an A there was a problem. So I always felt like I had the weight of the world on my shoulders. I was pretty hard on myself if I didn’t do everything exactly right every time. Drinking was like a way out of it. I mean, that’s all I saw, right? Everybody just got a drink when they were stressed out or when they had a lot going on. It was just what you did to survive, so I didn’t think anything different.

The relationship between alcohol and anxiety is so normalized that we often don’t even see it.

Cycle of Dependence

At first, you might drink to find temporary anxiety relief. But the problem with using substances to cope is that they ultimately don’t work—and you’re often left with an even bigger problem. Alcohol weakens your body’s natural ability to regulate anxiety. And as it wears off after a night of drinking, anxiety rebounds4 and intensifies. When that happens, it creates a strong urge to drink again to relieve your alcohol-induced anxiety. As tolerance builds over time, you have to drink more to get the same calming effect. This cycle eventually becomes deeply entrenched, making both problems worse.

Co-occurring disorders (also known as dual diagnoses)—mental health conditions that occur alongside substance use disorders—are notoriously complex and require specialized treatment to address both conditions at the same time. The best way to avoid this scenario is to find healthier alternatives to drinking, such as therapy, medication, and lifestyle changes, and talk therapy, as a way of managing anxiety.  

The Biochemical Connection

The connection between alcohol and anxiety goes deeper than the temporary stress relief you feel after a few drinks. 

Neurotransmitter Disruption

Alcohol disrupts the chemical balance in your brain. The neurotransmitter GABA, for example, has calming properties. Alcohol mimics the effects of GABA, which reduces anxiety in the moment. But over time, alcohol causes your brain to produce less GABA—and fewer GABA receptors.5 The same process happens with serotonin, dopamine, and other mood-regulating brain chemicals. This builds long-term anxiety by reducing your natural capacity to manage stress.

Impact on Sleep

While alcohol’s drowsiness-inducing effects might help you fall asleep, it negatively impacts your sleep quality throughout the night. Alcohol reduces the amount of time we spend in deep sleep, which in turn affects our mood and ability to regulate emotions. Poor sleep quality due to alcohol6 makes you feel sleepy throughout the day, affects your productivity, and worsens anxiety symptoms. Chronic sleep disturbances make anxiety far worse and create a feedback loop where poor sleep due to alcohol fuels anxiety, which then further disrupts sleep.

Psychological and Social Factors

Behavioral Patterns

Alcohol-related behaviors can also fuel anxiety. For someone with social anxiety, for example, drinking might seem like a welcome icebreaker. But those relaxed inhibitions can be a double-edged sword, as poor decision-making and awkward interactions only reinforce social anxieties once the fog clears. Depending on alcohol to be social can make you afraid to socialize without it, which limits your scope of connections as your social circle narrows to focus on party friends. 

Social Consequences

We don’t often think our behaviors pose risks to those around us, but problematic drinking will eventually affect our friends. 

The behavioral patterns that stem from heavy drinking are notorious for ruining relationships. Drinking destabilizes our mood, making us more irritable and less likely to show up to our relationships as our best selves. You might be more short-tempered or cynical for days following a heavy drinking session—which, if you drink several times a week, means your mood is affected virtually all the time. The effects of this get worse as alcohol dependence sets in: “Evidence suggests that alcoholics experience increasing dysphoria7 as a consequence of alcohol consumption,” say researchers. 

Drinking causes us to act impulsively, without regard for consequences, or without even realizing what we’re doing, leaving us with an embarrassing emotional hangover as we try to remember our actions the night before. 

All of this strains relationships and makes us feel isolated and more socially anxious. This erodes the very support systems that are so important when we’re changing our drinking behaviors and learning to manage anxiety.

Identifying the Signs of Co-Occurring Alcohol Use and Anxiety Disorders

Behavioral Signs

Spotting a co-occurring problem with alcohol and anxiety can be tricky. Here are some signs to watch for: 

  • You only feel comfortable socializing after drinking. 
  • You avoid social situations where alcohol isn’t available.
  • You drink more during periods of heightened anxiety.
  • You’re becoming more socially isolated.
  • Your sleep patterns are changing. 

If you notice any of these signs, it might be time to reevaluate your relationship with alcohol. 

Physical and Emotional Symptoms

Physical symptoms can also signal co-occurring alcohol use and anxiety disorders. These might include tremors, sweating, or difficulty sleeping, which can be caused by both anxiety and alcohol withdrawal. 

Emotional signs include chronic worry, irritability, and difficulty concentrating. Panic attacks8 (a hallmark of anxiety disorders) might also become more frequent. If these symptoms worsen with alcohol use or persist even when you’re sober, it may be time to seek professional help.

Treatment and Management Strategies

Professional Help

Breaking the cycle of anxiety and alcohol dependence is a complex process and is best taken on with professional support. 

If you require alcohol detox, it’s important to do so in a medically supervised environment. Alcohol withdrawals can be highly dangerous and should not be attempted alone. You can contact a detox center for an over-the-phone assessment to determine your level of need.

In a reputable addiction and mental health treatment program therapists provide a safe space to explore the underlying causes of both conditions, teach coping skills to manage anxiety without the use of alcohol, and help you implement lifestyle changes that sustainably support your well-being. Rehabs offer programs at different levels of intensiveness and use a variety of treatment approaches (which may include medication management, talk therapy, and complementary therapies) according to your needs. Your treatment team can help you determine the most effective path toward getting—and staying—well.

Integrated Treatment Programs

For people who struggle with both alcohol use disorder and anxiety, the most effective treatment is a comprehensive program that specializes in dual diagnosis treatment. These programs address both conditions simultaneously and recognize the synergy between them. Therapists experienced in treating co-occurring disorders can tailor interventions to treat symptoms and address the root causes of anxiety and alcohol addiction. This might include therapies like CBT alongside medication management for anxiety, as well as relapse prevention strategies for staying sober long-term. Integrated programs can be highly effective, healing underlying problems and teaching the skills you need to manage your anxiety and live a fulfilling, alcohol-free life.

Medications

As part of your treatment plan, doctors might prescribe medications to target anxiety symptoms,9 such as selective serotonin reuptake inhibitors (SSRIs). These medications may also reduce cravings for alcohol. 

Your treatment team might also recommend medications like buspirone or hydroxyzine to address anxiety and potentially decrease alcohol use as a coping mechanism. 

Medications should only be prescribed by a qualified prescribing doctor after in-depth psychological testing to determine your specific needs and best course of action. 

Not everyone is open to medication, and that’s okay. But for those who are, it can be effective for managing both alcohol and anxiety. Medication is most effective when combined with psychotherapy,10 which helps you learn coping strategies and make lasting behavioral changes. Medication management can help you get symptoms under control so that talk therapy is more effective. 

Self-Help and Lifestyle Changes

Mindfulness and Stress Reduction

Mindfulness practices and stress reduction techniques can help you manage anxiety without relying on alcohol. Mindfulness meditation helps you cultivate self-awareness as you learn to observe your thoughts and feelings without judgment. This can also help you place some distance between feeling triggered and acting on it, meaning you’ll gain more control over your reactions as you learn to self-regulate your emotions.

Stress reduction techniques can include deep breathing exercises, which slow your heart rate and activate your body’s natural relaxation response. Spending time in nature, taking up a new hobby (or rediscovering an old one), and getting regular, good-quality sleep all support your emotional well-being. By making these practices a regular part of your life, you’ll build resilience and get better at managing your anxiety.

Healthy Habits

Long-term recovery from anxiety requires a strong foundation of healthy habits. These lifestyle changes include getting regular exercise, nourishing your body with a nutrient-dense, anti-inflammatory diet, and improving your sleep hygiene. Doing things that nourish your spirit and allow your mind and body to recharge increases your capacity for handling stress and sets you up for success in daily life. 

Support Systems

No one should fight anxiety or alcohol addiction alone—strong support systems are key to long-term success. As you make these life changes, surround yourself with friends and family who understand your struggles and offer nonjudgmental support. Consider joining a local or online support group specifically focused on anxiety. Sharing your experiences openly and hearing those of others reminds you that you’re not alone. 

Feeling Anxious and Doing It Anyway 

There are times when it’s okay to pull back from situations that make us uncomfortable, and times when it’s helpful to push through to achieve your goals. O’Hara says he finds it helpful to put himself in social situations without alcohol11 even if it feels uncomfortable at times: 

You have to put yourself into situations where, if there was no alcohol around, you might normally feel awkward about it. But every time you do that, you learn something. You gain a more confidence in yourself and your abilities.

Resources for Further Help

These hotlines, websites, and support groups are great starting points to learn more about co-occurring anxiety and alcohol use disorder and find the help you need: 

If you’re struggling with anxiety and alcohol addiction, a treatment center can help you uncover the cause of both conditions and make a plan to address them. Search co-occurring disorder treatment centers and reach out to their admissions teams directly to find the right program for you.

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Understanding the Physical Toll: How Anxiety Impacts the Body and Ways to Cope

Learning how anxiety affects the body can help you understand mysterious symptoms and the impact untreated mental health conditions can have. Although anxiety can manifest in many ways, not everyone will experience physical symptoms. On the other hand, some people may feel the physical symptoms most acutely. 

Anxiety’s physical symptoms could first seem purely like a physical health condition, especially if you’ve never been diagnosed with it. Set an appointment with your doctor if you’re wondering if your symptoms may be caused by or related to anxiety.

What Is Anxiety?

People with anxiety disorders experience frequent and persistent worry1 out of their control.  This can manifest as generalized anxiety disorder or as a specific phobia, such as social anxiety disorder or panic disorder. Even when temporary stressors resolve, people with anxiety disorders don’t experience relief. Anxiety can be thought of as a constant anticipation of future threats2.

For example, someone with anxiety may constantly worry about their job, their health, or the safety of their loved ones. They’ll perseverate on worries like, “What if I’m not performing well and get fired? What if my loved one gets into an accident or gets sick? What if I get sick or hurt?”  It may feel like a preventative measure to prepare for worst-case scenarios, but in reality, these festering worries just lead to stress and anxiety.

A lack of issues does not alleviate their anxiety. That often means they need to learn how to reduce their anxiety manually, since it won’t fade in times without stress. They can learn to counter recurrent and persistent worries, stopping the thoughts from lingering and causing symptoms of anxiety.

Physical Symptoms of Anxiety

Some of the most common physical symptoms of anxiety3 include:

  1. Headaches
  2. Shortness of breath
  3. Nausea
  4. Diarrhea
  5. Back pain
  6. Insomnia
  7. Racing heart (also called tachycardia)

Anxiety affecting your physical health is also called somatization4, where emotions and feelings express as physical pain or discomfort. This can happen with other mental health conditions too, but is especially common with anxiety. 

Cognitive Effects

Anxiety can affect how you process and take in information5. For example, if you’re in a near-constant state of hyperarousal, benign events could seem scary or exacerbate your anxiety. Feeling anxious can also make it harder to make educated decisions and react appropriately.

Anxiety may prevent you from concentrating and remembering dates, information, and tasks you need to get done. If your brain is stressed, it may not feel like those things are important enough to be remembered. Instead, you may perseverate on potential threats and prepare for fear.

Anxiety can also distort your perception5. It can cause stronger reactions to cues of threat, like fearful expressions, an edged tone, or an unwanted task you suddenly must do. The threat itself may not even be a threat or is a small one, but a distorted perception from anxiety makes it feel much scarier. You may experience friends and loved ones questioning your reactions or anxiety levels and telling you “it’s no big deal.” From your perspective, though, it does feel like a big deal. 

Immune System and Stress Response

A perceived threat triggers your body’s stress response2. Since anxiety can alter perceptions and make non-threats seem threatening, it can regularly activate the stress response. This sends floods of stress hormones and other stress responses throughout the body. 

The stress response is intended to help you survive2 and escape threats, so your heart rate increases, you get a spike in adrenaline, your muscles tense for action, and you breathe faster. While this works great in certain situations, it’s not always intended to happen and can feel distressing.

Excess stress hormones can affect the immune system6 similarly to an inflammatory disorder. Hormone-releasing glands may work ineffectively after continued activation and use. This can also make you more susceptible to autoimmune diseases and other health problems, especially if you have chronic stress or long-term untreated anxiety.

Gastrointestinal Effects

Anxiety can sometimes feel like a pit in your stomach. Your brain and gut share a strong connection7, which is why anxiety can cause nausea, pain, and diarrhea. The gut-brain axis is a complex communication network that involves the central nervous system and the enteric nervous system, linking emotional and cognitive areas of the brain to your gut. Anxiety can activate the autonomic nervous system8, which can impact your gut and lead to symptoms such as nausea and diarrhea. These painful and disruptive physical symptoms can also worsen your anxiety, creating a cycle.

Treating one or both parts of the cycle can help you find relief. Therapy and medications for anxiety can relieve gastrointestinal symptoms, and treatment for gastrointestinal symptoms can relieve anxiety. Treatment targeted at both may be most effective for you.

If you’re feeling nauseous before a presentation or other anxiety-inducing event, you can practice coping skills to soothe stress. Deep, mindful breathing can calm your nervous system. You can try box breathing, where you breathe in through your nose for 4 seconds, hold the breath for 4 seconds, and breathe out through your mouth for 4 seconds, then start again from the top. Physical activity and healthy distractions (like reading, cooking, or watching a show you enjoy) can help, too.

Sleep Disturbances

The hyperarousal state caused by anxiety can make it hard to fall asleep9 and stay asleep. Your brain may wake you up more often if it’s used to feeling under threat, especially if you’re having nightmares that trigger the stress response. Anxiety can also trigger nightmares; for example, a parent may have persistent nightmares of losing a child. 

You may compulsively worry about what happened during your day, replay interactions, or start mentally preparing for tomorrow’s threats as you try to fall asleep. Worrying about what happened and what could happen can trigger your stress response and bar your brain from the relaxed state it needs to sleep. 

Those diagnosed with sleep conditions like insomnia could find their anxiety improves once they get insomnia treatment9, and vice versa. Treatment for insomnia depends on which kind you have (trouble falling asleep, staying asleep, or both), but often includes therapy and medications. Short-term hypnotics, certain antidepressants, and benzodiazepines can calm the mind and allow sleep.

Muscular Tension and Pain

The stress response causes your muscles to tense2 and prepare to fight or flee. If your anxiety often activates this response, you can experience muscle pain from the prolonged tension. This could also lead to skeletal conditions like low back pain and make pre-existing osteoarthritis more painful. Anxiety can lower your ability to tolerate pain10 and make other musculoskeletal conditions more painful as well. 

Relaxation techniques can help relieve tension and pain. Try progressive muscle relaxation, where you’ll mindfully tense and untense your muscles (head to toes, toes to head, or another pattern.) You can also apply topical remedies to relieve pain.

Respiratory System

The stress responses speeds up breathing to ensure your cardiovascular system has enough oxygen to react to threats. You may experience shortness of breath when anxiety triggers this response11 without a threat to run from or fight. Feeling like you can’t breathe or aren’t getting enough air can intensify your anxiety and create a self-feeding cycle. 

Sometimes, this can worsen to a panic attack, which may cause you to hyperventilate or hold your breath. Both of these can cause someone to pass out (or feel close to it). 

Feeling constantly short of breath or like you’re just barely getting enough air could be a sign of anxiety. Practice deep breaths, filling and expanding your stomach, and bring your concerns to your doctor.

Hormonal Imbalance

Anxiety can interfere with hormone production and release12, which can lead to thyroid problems and menstrual irregularities. This can even extend to reproductive issues. Stress and anxiety can cause endocrine disorders when they go untreated. 

Anxiety treatment can alleviate the disruptions in your endocrine system and restore it to health. Treatment options for anxiety include therapy, medications, and a combination of the two.

Seeking Professional Help

If you notice physical or emotional symptoms of anxiety, you can start your treatment journey by scheduling an appointment with your doctor. They will help you determine the cause of your symptoms and rule out other potential conditions. They may also refer you to therapy and prescribe an anxiety medication. At your appointment, you can ask questions like these to better understand your condition and treatment:

  1. Do I meet diagnostic criteria for anxiety?
  2. Should I be on medications for my symptoms? If so, what are the potential side effects?
  3. What are my next steps in treatment?
  4. Can you refer me to therapy or a different level of care?

Behavioral therapies for anxiety aim to change unhelpful thought patterns and challenge the compulsion to worry. Cognitive behavioral therapy, for example, invites you to notice the thoughts and emotions behind your behaviors and question their validity. Dialectical behavioral therapy encourages you to notice and accept your emotions while also aiming to adjust how you respond. 

Exposure therapies can reduce anxiety around places or situations that trigger anxiety. You may imagine the exposure or go out and experience it. For example, you may take small drives to reduce anxiety around driving, especially if you’ve been in a car accident. Your therapist will be careful to not retraumatize you or suggest anything you don’t feel able to do, but you’ll likely venture outside your comfort zone with their support.

Lifestyle Changes for Anxiety Management

Lifestyle changes can have a huge impact on your overall wellness and anxiety levels, especially when combined with professional treatment. You can try any combination or number of changes to see what works best. 

Strengthen Your Sleep Hygiene 

Good sleep can help you feel more rested and capable of handling challenges. The amount you need varies by person, but you can shoot for 6-8 hours. Set up a nighttime and morning routine to align your circadian rhythm and ease anxiety about falling asleep and waking up. 

Set Boundaries at Home and at Work

Setting emotional boundaries can shield you from additional stress and anxiety. For example, if interactions with a family member cause you anxiety, set a boundary. You could do this by limiting the time you spend with them, how often you text them back, and by what information you share with them. You can verbalize your boundary or let your actions express it.

At work, you can clearly communicate your working hours and set an expectation to work within them closely. Creating a healthy work-life balance can lower anxiety and give you more time to pursue activities you enjoy. 

Eat Well

Healthy eating allows you to function at your full capacity, which can help you manage stress and anxiety. Prioritize whole foods with nutrients and vitamins. As much as you can, avoid processed foods, fast food, and sugar. Sugar rushes can feel like panic attacks13, so limit how much you have. Similarly, excess caffeine can cause a spike in adrenaline, heart rate, and make you feel panicky.  

Make sure you’re drinking enough water, too. Dehydration can sometimes cause or mimic anxiety symptoms13; sip on water throughout the day and shoot to drink an ounce for every 2 pounds of your body weight. Someone who weighs 150 lbs would drink 75 ounces of water following that suggestion.

Exercise

Exercise can help relieve stress and make you feel good (thanks to endorphins). Gentle and intense exercise offers these benefits. You could go on walks, try yoga, or weightlift. Exercise can lower stress levels and help you relax. Align your exercise with your lifestyle and ensure it’s something you enjoy.

Meditation

Meditation can reduce anxiety symptoms14. Many phone apps offer free guided meditation sessions you can attend anytime. You can also meditate with binaural beats, other music you like, or no music at all. 

Meditation can help align your mind and body in a state of calmness. It’s often described as a spiritual experience; you could also use prayer as a form of meditation.

Resources and Hope for Healing

Anxiety has multiple effects on the body and multiple avenues for recovery. Talk with your doctor or mental health provider today to assess your symptoms and seek treatment. 
You can also browse Recovery.com to find treatment centers for anxiety with photos, reviews, pricing information, and more.

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Understanding Psychodrama Therapy: Techniques and Benefits

Psychodrama is a therapeutic method that uses dramatic techniques, such as role-playing, to help people understand and resolve their emotional conflicts1. During sessions, patient groups enact scenes from their lives or dreams to gain insights and practice new ways of being in the world2. 

The goal of psychodrama is for patients to gain mental clarity so they can learn new ways of thinking and cope with their feelings surrounding the event. Through these exercises, patients may see improved social skills, a boost in self-esteem, or a positive attitude shift3. Psychodrama can teach adaptive coping strategies, leading to resilience4. 

Incorporating psychodrama into your recovery plan can offer a new perspective on healing and a deeper understanding of yourself.

Origins and Development

Jacob Levy Moreno, a Romanian psychiatrist and psychoanalyst, invented psychodrama in 19215. Moreno studied the power of relationships and group interactions, seeing a person become the healing agent for another. His creation was inspired by improvisation theater and the rise of the psychoanalytic movement led by Sigmund Freud. It became the first form of group psychotherapy.

Moreno quickly developed one of the fundamental concepts, role theory, which shows how social roles shape behavior6. People take on different roles in their lives, and exploring these roles in a therapeutic setting can lead to insights and personal growth.

In the 1940s-60s, interest grew in psychodrama, and it became a therapeutic practice. Psychodrama was applied not only in clinical settings but also in educational and community settings. Today, psychodrama can be applied to family therapy, trauma work, and addiction treatment. It’s even being discussed as an alternative method of education in schools. 

Core Principles of Psychodrama

Psychodrama therapy is guided by several core principles. Moreno defined these principles7 as:

  1. Warming up: A process that creates an appropriate environment for spontaneity. This may look like physically shaking your body to loosen up, clearing any doubts, and having silly conversation. 
  2. Spontaneity: By being in the present moment, you can react to things without any preconceived notions. This can benefit role play.
  3. Creativity: Spontaneity helps catalyze creativity—it is born by reacting the way you normally would, a true-to-self reaction. When you are rooted in the here and now, there’s more opportunity for play, creativity, and new ways of thinking.
  4. Encounter: Meeting another person where they are at and mentally viewing the event from their perspective.
  5. Tele: Sensing the feeling/bond between 2+ people. During the first encounter between a group, the tele should be neutral. Then, a positive or negative feeling forms over time and between interactions.
  6. Co-conscious vs co-unconscious: These are states shared between 2+ people. A co-conscious state is when a particular feeling in a group is voiced or acted out, so it is known. A co-unconscious state occurs when 2+ people who are closely existing develop a normal atmosphere amongst themselves. This is created through shared and unshared feelings, actions, and beliefs, but it is not outrightly stated.
  7. Role: An identity that someone takes on in the moment, depending on the context. For example, the eldest sibling may assume the role of parent if the younger sibling is in distress and the parent is not nearby.
  8. Role vs ego: The ego is a concept that helps us balance between societal norms and our true desires. In psychodrama, the ego actively explores roles, emotions, and conflicts. It aims to strengthen ego function.
  9. Role reversal: Changing from your current role to the other person’s. This can help you gain insight.

Looking at all these principles, we can form the inner workings of psychodrama. Focusing on spontaneity and creativity while role-playing allows you to develop a new perspective on past events, feelings, and behaviors. 

Key Roles in Psychodrama

There are 3 key characters in a psychodrama session: the protagonist, auxiliary egos, and the director.

The protagonist takes center stage during a psychodrama session. They are the main focus and typically present an issue or situation they want to explore and work through. The protagonist enacts personal situations, bringing them to life through role-playing.

Auxiliary egos are people in the group who play roles within the protagonist’s enacted scenario. They may portray significant people, objects, or aspects of the protagonist’s internal world. Auxiliary egos offer alternative perspectives for the protagonist.

The director is the therapist or facilitator guiding the session. They set the stage, facilitate interactions, and ensure a supportive environment. The director leads warm-up activities, and they may intervene or suggest things to facilitate exploration and resolution.

Techniques and Processes: How It Works

In a psychodrama session, you may participate in various techniques to find the best for your healing. At the core, you will be role-playing as the protagonist or acting out specific roles or situations to explore emotions, thoughts, and behaviors. 

From there, you could practice mirroring, where the auxiliary egos copy your behaviors, emotions, or body language—this can foster self-awareness.

Another group member may practice doubling, voicing your thoughts and opinions for you. Speaking your internal feelings aloud can help deepen your understanding of the event. 

You may role reverse with another person, allowing you to experience the situation from a new perspective. 

Sometimes, you, as the protagonist, talk through your inner thoughts, providing insight into your internal dialogue and expressed emotions. This is called soliloquy.

Practices such as these can strengthen your emotional awareness. The director (your therapist) will ensure that the sociometry of the group is healthy and balanced, meaning the auxiliary egos are well suited to support the protagonist. As group dynamics grow, these techniques will become easier and easier, making room for deeper exploration.

The Role of Action and Enactment

Physically acting out past experiences is what sets psychodrama apart from traditional talk therapy. This approach is immersive and engaging, and activating all the senses can help patients work through buried feelings. Psychodrama pulls patients out of their internal world and allows them to experience emotions, thoughts, and behaviors directly.

Psychodrama can be particularly effective for patients who feel limited by traditional talk therapy. Reenacting certain events can provide insights and much needed emotional release.

Applications of Psychodrama

Psychodrama is commonly done in group therapy, although it can be used in individual and family therapy, as well. In a group or family setting, other participants in the group would help set the scene, while individual therapy usually involves the counselor and the patient engaging in this practice.

Psychodrama can be beneficial for specific conditions, such as trauma. Trauma affects both the brain and the body8, and it can be hard to find words to describe trauma (because Broca’s area, the part of the brain responsible for language, is less active when remembering trauma9), making it difficult to process in traditional talk therapy. Psychodrama provides an alternative way to connect the mind and body to work through trauma.

As this approach aims to boost self-esteem and self-sufficiency, psychodrama can improve depression and anxiety symptoms10. It can also aid addiction recovery. Role playing a patient’s addictive behaviors helps them understand the roots of their substance use and develop healthier coping strategies.

Any patient can benefit from psychodrama—it’s not only for self-proclaiming “creative” people. With the right guidance, engaging in these practices can improve communication, self-awareness, and promote healing.

Integrating Psychodrama with Other Therapies

Psychodrama can be integrated with other therapeutic modalities to create a well-rounded treatment plan. 

Cognitive behavioral therapy (CBT), one of the most common and effective therapies for addiction11 and mental health disorders, can combine with elements of psychodrama. Your therapist may use role-play or family of origin imagery12 (exploring mental images, memories, and perceptions of your family and childhood) in addition to CBT techniques that replace unhealthy thought patterns with more positive ones.

Psychodrama can also work in conjunction with Gestalt therapy. This therapy takes a “whole person” approach to healing and looks at many aspects of someone’s life that may have contributed to their struggles instead of just one event or trauma. Gestalt therapists can use role reversal and the empty chair method13 (similar to role-playing with an auxiliary ego, but instead, you interact with an empty chair) in addition to Gestalt techniques such as “I” statements.

Dialectical behavioral therapy (DBT) compliments psychodrama, as well. DBT has similar processes to CBT; however, there is an emphasis on mindfulness and healing in the present moment. While engaging in role play and other psychodrama practices, focusing on mindful words and movements can increase spontaneity and creativity—thus facilitating exploration and recovery breakthroughs. 

Questions to Ask Your Provider About Psychodrama

Before beginning psychodrama sessions, you may consider asking your provider a few questions, such as 

  1. How do you act as the director of the group? Can you give examples of how you mediate sessions?
  2. How do you determine who would be a good auxiliary ego for my role-playing session?
  3. How would you evaluate my progress in the sessions?
  4. Are there follow-up sessions to break down what we’ve learned in the psychodrama sessions?

Training and Certification

As a therapist, proper psychodrama training can ensure that your patients get the most out of your sessions. You can receive training through many organizations; some are in person, while others are virtual. At the American Board of Psychodrama14, you can learn the theory, master the techniques, and understand group dynamics to facilitate your patients’ healing.

If you’re seeking out a psychodrama therapist, ensure that they have this certification and proper experience and education—this should be a Master’s degree or higher, and their credentials can look like Psy.D., M.S.W., and L.M.H.C. Ask them questions such as

  1. What does a typical psychodrama session look like?
  2. How do you integrate psychodrama practices into other therapies?
  3. How will you manage the group dynamics?

To find more resources to support your recovery journey, visit our Resources Hub.

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25 Recovery Quotes for the Christmas Season

Although addiction has no yearly time frame, the holidays can be a hard time for people with an addiction, those in recovery from substance use disorders, and their loved ones. Staying aware of recovery-related topics can help ensure that each family member or friend feels comfortable to celebrate. Discover recovery words of wisdom to inspire you this holiday season.

Recovery Quotes

Quote #1 

“Forgiving yourself, believing in yourself, and choosing to love yourself are the best gifts one could receive.” ― Brittany Burgunder

Quote #2 

“I am not defined by my relapses, but in my decision to remain in recovery despite them.” ― Anonymous 

Quote #3 

“Believe you can, and you’re halfway there.” ― Theodore Roosevelt

Quote #4

“Be stronger than your strongest excuse. Be greater than your most negative voice.”

― Alan Maiccon

Quote #5

“The best way to predict your future is to create it.” ― Abraham Lincoln

Quote #6

“It’s the days you have every right to break down and fall apart, yet choosing to show up anyway is what matters most. Don’t diminish the small steps that others can’t see.” ― Brittany Burgunder

Quote #7

“I am a great believer in luck, and I find that the harder I work the more luck I have.” ― Thomas Jefferson 

Quote #8

“Courage isn’t having the strength to go on―it is going on when you don’t have strength.” ― Napoléon Bonaparte

Quote #9

“It does not matter how slowly you go as long as you do not stop.” ― Confucius

Quote #10

“Rock bottom became the solid foundation on which I rebuilt my life.” ― J.K. Rowling

Quote #11

“The only person you are destined to become is the person you decide to be.” ― Ralph Waldo Emerson

Quote #12

“One of the hardest things was learning that I was worth recovery.” ― Demi Lovato

Quote #13

“Change your thoughts, change your life.” ― Lao Tzu

Quote #14

“Don’t judge each day by the harvest you reap but by the seeds that you plant.” ― Robert Louis Stevenson

Quote #15

”At the end of the day, you can either focus on what’s tearing you apart or what’s keeping you together. ” ― Anonymous

Quote #16

“Courage is resistance to fear, mastery of fear, not absence of fear.” ― Mark Twain

Quote #17

“Recovery is hard. Regret is harder.” ― Brittany Burgunder

Quote #18

“Every worthy act is difficult. Ascent is always difficult. Descent is easy and often slippery.” ― Mahatma Gandhi

Quote #19

“The most common way people give up their power is by thinking they don’t have any.” ― Alice Walker

Quote #20

“Don’t let the past steal your present.” ― Terri Guillemets

Quote #21

“Hardships often prepare ordinary people for an extraordinary destiny.” ― C.S. Lewis

Quote #22

“Turn your face to the sun and the shadows fall behind you.” ― Charlotte Whitton

Quote #23

“The journey of a thousand miles begins with a single step.” ― Lao Tzu

Quote #24

“We can’t solve problems by using the same kind of thinking we used when we created them.” ― Albert Einstein

Quote #25

“When everything seems to be going against you, remember that the airplane takes off against the wind, not with it.” ― Henry Ford

Recover in Love

Whether it’s the holiday season or not, you can always prioritize healing. Discover the best version of yourself by exploring and connecting with rehabs near you.