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Common Daily Habits to Cope with Teen Anxiety

Posted on by Carl Lovejoy

Anxiety is much more than being nervous. In this country, 7.1% of children between three and seventeen (which rounds to a whopping 4.5 million!) are diagnosed with anxiety. With so many children, including teens, struggling only six out of ten teens receive treatment (Centers for Disease Control and Prevention, 2021-a). So, what does a parent do? How do they help? While treatment is extremely important, this is only part of the picture. Self-care, outside of treatment, is important as well. Tying formal therapy and day-to-day strategies together can be a challenge. These are some common daily habits that can help your teens cope with anxiety in their everyday lives.

1. Have a healthy eating plan

Eating the right type of food can make a difference. Healthy eating falls under self-care. When taking care of ourselves, we can feel more in control of our anxiety symptoms. Good foods include fruits, vegetables, whole grains, legumes (for example, beans, peas, and lentils), lean protein sources, and nuts and seeds (Centers for Disease Control and Prevention, 2021-a). 

2. Physical activity

Getting at least 60 minutes of physical activity a day can make a difference with anxiety (Hirschlag, 2018). This can include running, walking, yoga, or even a more organized workout. The benefits of exercise are that it: decreases muscle tension, changes brain chemistry as the heart rate goes up which releases antianxiety chemicals in the brain, and helps build resistance to stormy emotions (Ratey, 2019). 

3. Get plenty of sleep

It is important not only to get enough sleep but enough GOOD sleep. This means sleep without access to screens such as cell phones. Teens are supposed to receive 8-10 hours of sleep a night in order to be fully rested (Centers for Disease Control and Prevention, 2021-b). 

4. Writing

Writing is a great skill to help combat anxiety (Hirschlag, 2018). It allows for teens to release their emotions in a healthy, private way. This also gives them time to reflect on their emotions and process them as they write their feelings down. They can keep writing as a nightly journal, something they keep on hand throughout the day, or simply something they write and shred as needed. 

5. Limit Social Media

This may feel like a difficult one in this day and age with everyone having constant access to phones, computers, or tablets. In the long run, though, the extra effort is worth the benefits. One study had shown that 48% of teens who use social media for five hours a day have at least one suicide risk factor, compared to the 33% of teens who just use social media for two hours daily(Shafer, 2017). Social media use affects everyone differently, but lack of self-control using it can lead to struggles with anxiety, insecurity, and poor self-esteem (Shafer, 2017). This is not saying to take phones away, but to break up the day with more social activities off the screen. Use the time to have fun with friends and family which is good for everyone!

 

References

 

Centers for Disease Control and Prevention. (2021, March 22-a). Data and Statistics on Children’s Mental Health. https://www.cdc.gov/childrensmentalhealth/data.html. 

Centers for Disease Control and Prevention. (2021, March 22-b). Anxiety and Depression in Children. https://www.cdc.gov/childrensmentalhealth/depression.html. 

Hirschlag, A. (2018, December 18). How to Cope with Anxiety: 11 Simple Ways and When to See a Doctor. Do You Live with Anxiety? Here Are 11 Ways to Cope. https://www.healthline.com/health/mental-health/how-to-cope-with-anxiety#long-term-strategies. 

Ratey, J. (2019, October 24). Can exercise help treat anxiety? Harvard Health. https://www.health.harvard.edu/blog/can-exercise-help-treat-anxiety-2019102418096.  

Shafer, L. (2017, December 15). Social Media and Teen Anxiety. https://www.gse.harvard.edu/news/uk/17/12/social-media-and-teen-anxiety.   

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Supporting Teenagers with Anxiety and ADHD

Posted on by Mountain Valley Treatment Center

Parenting a teenager comes with its own set of challenges, but when your teen is struggling with both anxiety and Attention Deficit Hyperactivity Disorder (ADHD), the journey can feel especially daunting. As therapists, educators, and caregivers, it’s essential to understand the unique intersection of anxiety and ADHD in teenagers and how to provide effective support.

Anxiety and ADHD often coexist in teenagers, creating a complex interplay of symptoms that can significantly impact their daily lives. ADHD is characterized by difficulties in attention, hyperactivity, and impulsivity, while anxiety manifests as excessive worry, fear, apprehension, and avoidance. When these conditions intersect, they can exacerbate each other, leading to heightened stress levels, decreased functioning, and an increased risk of academic, social, and emotional difficulties.

Parents and therapists should be vigilant in recognizing the signs of anxiety and ADHD in teenagers. Symptoms of ADHD may include difficulty concentrating, impulsivity, forgetfulness, disorganization, and restlessness. On the other hand, anxiety symptoms may manifest as excessive worrying, perfectionism, avoidance of social situations, somatic symptoms such as stomachaches or headaches, and difficulty sleeping.

Effective support for teenagers with ADHD and anxiety requires a collaborative approach involving parents, therapists, educators, and other supporting professionals. Collaborate on developing a comprehensive treatment plan that addresses both ADHD and anxiety symptoms, taking into account the teenager’s individual needs and preferences.

Empower teenagers to become active participants in their treatment journey. Educate them about ADHD and anxiety, helping them understand how these conditions affect their thoughts, feelings, and behaviors. Teach practical coping skills for managing stress and anxiety, such as deep breathing exercises, mindfulness techniques, and time-management strategies. Encourage teenagers to advocate for themselves and communicate their needs effectively.

Establishing Structure and Routine

Consistent structure and routine are crucial for teenagers with ADHD. Help them create a daily schedule that includes time for homework, relaxation, exercise, and social activities. Break tasks down into manageable steps and provide clear expectations to reduce overwhelm and improve focus.

Encouraging Self-Care

Encourage teenagers to prioritize self-care activities that promote physical, emotional, and mental well-being. This may include regular exercise, adequate sleep, healthy eating habits, and engaging in hobbies or activities they enjoy. Model healthy coping strategies by practicing self-care yourself and prioritizing your own well-being.

Seeking Professional Support

Encourage teenagers to seek professional support from therapists, counselors, or psychiatrists specializing in ADHD and anxiety. Therapy, such as cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP), can be highly beneficial in helping teenagers develop coping skills, challenge negative thought patterns, and reduce anxiety symptoms. Medication may also be prescribed in some cases to alleviate symptoms of ADHD or anxiety.

Fostering Open Communication

Create a supportive environment at home where teenagers feel comfortable expressing their thoughts, feelings, and concerns. Foster open communication and active listening, validating their experiences and providing reassurance during times of distress. Encourage teenagers to share their successes and setbacks, celebrating their achievements no matter how small.

Remembering Patience and Compassion

Above all, remember to approach the journey with patience, compassion, and empathy. Supporting a teenager with ADHD and anxiety can be challenging, but with understanding, support, and guidance, they can learn to navigate their challenges and thrive. Celebrate their strengths, celebrate their progress, and remind them that they are not alone on this journey.

Supporting teenagers with ADHD and anxiety requires a multifaceted approach that addresses their unique needs and challenges. By working collaboratively, empowering teenagers, establishing structure and routine, encouraging self-care, seeking professional support, fostering open communication, and practicing patience and compassion, parents and therapists can provide effective support and help teenagers reach their full potential. Together, we can navigate the journey and empower teenagers to overcome obstacles and embrace their strengths.

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When the Holidays Aren’t So Happy

Posted on by Mountain Valley Treatment Center

For many years, I’ve kept a secret from many of my friends and coworkers: I really don’t like the holiday season. For many of us, the holidays are a time of stress, anxiety, and even loneliness and isolation. Those of us who don’t naturally boil over with holiday cheer can feel alienated from the festivites around us and fear being labeled a grinch by the apparent sea of revelers around us. There is a guilt that comes with not feeling festive during the holidays, and that can drive us into a vicious circle of further anxiety and depression.

There are many reasons many of us feel less-than-merry during this time of year. Among them are:

Social Expectations: The holiday season is often associated with spending time with loved ones and engaging in festive activities. For those who don’t have close relationships or struggle with social connections, the emphasis on togetherness during this time can intensify feelings of loneliness.

Comparison with Others: The holiday season is frequently portrayed as a time of joy, family gatherings, and celebrations. Seeing others seemingly enjoying these aspects of the season can lead to feelings of inadequacy or exclusion in those who don’t have similar experiences.

Loss or Grief: For individuals who have experienced the loss of a loved one or are going through a challenging time, the holiday season can be a stark reminder of their absence. This can contribute to feelings of sadness and loneliness.

Isolation: Some people may not have a strong support system or may be physically isolated from friends and family during the holidays. This sense of isolation can contribute to feelings of loneliness.

Financial Strain: The pressure to give and receive gifts during the holiday season can be financially stressful for some individuals. Those who are unable to participate in gift-giving due to financial constraints may feel isolated or left out.

Seasonal Affective Disorder (SAD): Some people experience a form of depression known as Seasonal Affective Disorder, which tends to occur during the winter months. The lack of sunlight and colder weather can contribute to low mood and feelings of loneliness.

Unpleasant Past Experiences: Negative past experiences associated with the holidays, such as family conflicts or traumatic events, can lead to an aversion to the holiday and a reluctance to participate in festivities.

So what can we do about this if we’re feeling any or all of the above, or other related emotions during the holiday season? Coping with anxiety or sadness during the holidays can be challenging, but there are several strategies that may help improve your emotional well-being. Keep in mind that everyone is different, so it’s essential to find what works best for you. Here are some general tips that might be helpful:

Acknowledge Your Feelings: It’s okay to feel anxious or sad during the holidays. Allow yourself to acknowledge and accept your emotions without judgment. Understanding your feelings is the first step toward addressing them.

Reach Out for Support: Share your feelings with someone you trust, such as a friend, family member, or therapist. Talking about your emotions can provide comfort and support, and you may find that others can relate to what you’re going through.

Set Realistic Expectations: Don’t put excessive pressure on yourself to create a perfect holiday experience. Set realistic expectations for what you can accomplish and focus on what brings you joy rather than adhering to societal expectations.

Establish Boundaries: If certain holiday activities or gatherings contribute to your anxiety, consider setting boundaries. It’s okay to decline invitations or limit your participation in events that may be overwhelming.

Create New Traditions: If past traditions are associated with negative emotions, consider creating new ones. This can help you reshape your holiday experience in a way that feels more positive and aligned with your current needs.

Practice Self-Care: Take care of your physical and emotional well-being by engaging in self-care activities. This could include getting enough sleep, eating nourishing foods, exercising, and practicing relaxation techniques such as deep breathing or meditation.

Focus on Gratitude: Reflect on the positive aspects of your life and the things you are grateful for. Gratitude can shift your perspective and help you appreciate the good things, even during challenging times.

Limit Social Media Exposure: Comparing your holiday experience to others on social media can contribute to feelings of inadequacy or loneliness. Consider limiting your time on social media platforms if it negatively impacts your mood.

Volunteer or Give Back: Helping others can be a powerful way to lift your spirits. Consider volunteering your time or making a donation to a charitable cause. Acts of kindness can bring a sense of purpose and fulfillment.

Seek Professional Support: If your feelings of anxiety or sadness persist, consider seeking help from a mental health professional. Therapy can provide valuable support and coping strategies tailored to your specific needs.

Remember that it’s okay to prioritize your well-being and make choices that support your mental health. Taking care of yourself during the holidays can be the best gift you can both give and receive.

 

Spending time at a residential treatment program can be a challenging experience for young people. Click here to read about what the holiday season is like at Mountain Valley.

 

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Monitoring the Voice of Anxiety: “The Critic, The Coward, and The Coach”

Posted on by Mountain Valley Treatment Center

As human beings, we all have an internal voice – an inner dialogue that narrates our everyday experience, helping us to determine what is happening in our environment and dictating how we respond to the events unfolding in our life.

Our ability to have awareness of our internal dialogue is distinctly unique to the human the experience. We have evolved beyond our animal counterparts, to develop what we call in psychology, “metacognition” – or an awareness of our own thoughts and thinking processes. Monitoring our own thought processes, the way we think about ourselves and our life circumstances, is a key component to cultivating good mental health, and an integral part of conquering fear and anxiety.

In this article we will discuss three common “voices” that often arise in the face of fear: The Critic, The Coward, and The Coach. This article is meant to further develop your metacognition, helping you label and become more aware of the dialogue that consume your mind when you’re anxious. With this awareness, you can then intervene, fostering a healthier and more effective inner voice.

The Critic – This inner voice is “demanding” in nature. It has high expectations of what you “should” be able to do. In moments of fear and anxiety the inner critic can be brutal force, shaming you for what you are not capable of, which often leads you to mask your emotions, push too far beyond your limits, and eventually burnout. The inner critic is associated with an exaggerated “fight” response, except the person you are fighting is yourself. Therefore, rather than building you up, the inner critic breaks you down, leaving you less capable of approaching and conquering your fears.

Example: “You can’t speak up to your boss, he is smarter and more experienced than you. You need to work harder and establish yourself before your even qualified to voice your opinion.”

The Coward – This inner voice is “protective” in nature. It senses a threat in your environment and encourages you to step down or step away to avoid any potential pain. In moments of fear and anxiety the inner coward tells you to “be small and stay small” as means to avoid conflict, challenge, and other forms of distress. The inner coward is associated with exaggerated “flight” response, holding you back from confronting situations that could lead to your personal growth. Therefore, rather than stepping up, you step down, holding you back from achieving your potential.

Example: “You can’t speak up to your boss, if he senses any confrontation from you, he could fire you or let you go. It’s better to keep these thoughts to yourself.”

The Coach – This inner voice is “supportive” in nature. It is the balance of the critic and the coward. The inner coach responds to fear and anxiety by breaking down the threat, , assessing your skills and capacity, and providing practical steps forward on how to bridge the gap between you are capable of and what is required of you. The inner coach provides an honest evaluation of what you can currently do, while recognizing your future potential. Therefore, rather than being too hard on yourself, or to easy on yourself, the inner coach provides the necessary feedback, support, and encouragement you need to face your fears, find growth, and become all you can be.

Example: “You have feedback for your boss, but he has more knowledge in this area. You should do some research first and come to him with a list of questions related to your concerns. This will be hard but not impossible. I know you can do it.”

As you read this, I hope it became clear that the goal is to develop a strong and healthy inner coach. Therefore, when facing fear and anxiety, you want your inner dialogue to do what all good coaches do:

  • Assess the situation – Objectively break down the feared situation and the tasks that need to be completed.
  • Assess your skill set – honestly appraise your strengths and weakness as it relates to managing the feared situation.
  • Create a plan – provide practical steps that can support you in approaching the situation with confidence.
  • Express confidence – provide yourself positive encouragement and remind yourself that you are capable of growing and learning through practice and experience.

Additional Tip: If you are fortunate enough to have encountered an effective coach and are looking to further develop your own inner coach, it may be helpful to reflect on that experience and to try to channel their voice until you have become more effective at making that voice your own. If you have never had the experience receiving support from an effective coach, expose yourself to the ideas, principles, and practices of effective coaches presented in common media (books, movies, podcasts, etc.)

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Embracing Peaceful Holidays at Mountain Valley

Posted on by Mountain Valley Treatment Center

As the holiday season approaches, images of festive cheer and family gatherings flood our minds. However, for teens and young adults grappling with anxiety, obsessive-compulsive disorder (OCD) or related challenges, this time can often amplify their struggles. The bustling environment, family dynamics, and the break from routine can trigger intense anxiety episodes. In this context, Mountain Valley Treatment Center emerges as a sanctuary, offering a therapeutic alternative to the traditional holiday experience. Here’s why spending the holidays at Mountain Valley can be a transformative experience for these young individuals.

1. Empowering Through Exposure and Response Prevention

Mountain Valley Treatment Center takes a proactive approach to the amplified stress the holiday season can bring for those with anxiety, OCD, and related challenges. Instead of simply providing a refuge from triggers, the center engages young people in Exposure and Response Prevention (ERP) therapy, an evidence-based treatment highly effective for anxiety and OCD. This therapy involves gradual exposure to feared situations or thoughts, coupled with guidance on how to refrain from typical anxiety-driven responses.

In the controlled and supportive environment of Mountain Valley, ERP allows individuals to confront their fears incrementally. This approach reduces anxiety and enhances the ability to cope with triggers. By building resilience and empowering young people to face their fears with reduced apprehension, this therapy integrates specific holiday-related scenarios, under the guidance of skilled therapists. Participants learn to manage these situations, gaining confidence and tools to handle their reactions. This structured approach provides immediate relief and equips them with long-term skills for emotional stability and resilience, making the holiday season a time of significant therapeutic progress.

2. Specialized Care and Attention

The holiday season often leaves little room for the focused care required by these conditions. Mountain Valley’s experienced therapists and caregivers provide personalized attention and treatment, addressing each individual’s unique needs, a challenging task in the often hectic family holiday atmosphere.

3. Building Coping Skills in a Real-World Setting

Mountain Valley is more than a retreat; it’s a real-world learning environment. The center offers various programs and activities to build coping skills for use beyond the holidays. This immersive experience is invaluable in equipping participants to manage anxiety and OCD symptoms effectively in their daily lives.

4. Fostering Independence and Self-Confidence

Spending the holidays away from home can be empowering, allowing young individuals to develop independence and self-reliance. Mountain Valley’s safe and nurturing environment encourages steps towards managing their condition, fostering self-confidence and a sense of achievement.

5. A Community of Understanding

A significant benefit of Mountain Valley is the sense of community. Being surrounded by peers who understand and share similar challenges creates a supportive and non-judgmental environment, particularly therapeutic during a time when feelings of isolation can be pronounced.

6. Continuing Education and Growth

For young adults, the Center ensures that their educational growth continues uninterrupted. With programs accommodating their learning needs, the holiday season at Mountain Valley becomes a period of personal and academic development, rather than a stressful break.

7. Balancing Treatment with Holiday Traditions

Recognizing the importance of the holiday spirit, Mountain Valley Treatment Center thoughtfully balances its therapeutic program with the essence of seasonal celebrations. For those who wish to experience the festive cheer, the center hosts low-key holiday events on-site. These celebrations are mindfully designed to be joyful yet not overwhelming, allowing young people to engage in the festive spirit in a manner that respects their therapeutic journey. Whether it’s a serene Christmas gathering or a peaceful Hanukkah celebration, these events are infused with the warmth of the season, providing a sense of normalcy and joy.

For some, going home for a few days to celebrate with family is an integral part of their emotional and psychological well-being. Mountain Valley supports these short home visits, viewing them as opportunities to apply newly learned coping strategies in a familiar environment. This flexibility in the treatment approach underscores the center’s commitment to holistic care, blending the healing process with the valuable experiences of family traditions and warmth. By doing so, Mountain Valley ensures that the holidays can still hold a special place in the hearts of its residents, offering a blend of therapeutic progress and festive joy.

While the holidays are traditionally a time for family, for teens and young adults with anxiety, OCD, or related challenges, the unique offerings at Mountain Valley present a valuable alternative. It’s a place where the holiday season can be a time of healing, growth, and peace — a truly transformative experience that arms them with resilience and skills for the future.

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Surgeons General Connect on Mental Health at Dartmouth

Posted on by Mountain Valley Treatment Center

One of the many benefits of Mountain Valley’s beautiful location in the Upper Valley region of New Hampshire is our proximity to Dartmouth College and its world class medical school and teaching hospital. Mountain Valley’s relationship with Dartmouth provides us with many benefits, such as Dartmouth psychology interns and psychiatry fellows doing clinical rotations in Mountain Valley’s therapeutic milieu, our residents undergoing exposure work on the Dartmouth campus, and ample cultural and recreational activities for our residents to enjoy on the weekends. Occasionally, it also allows us the fortune of being first-hand witnesses to historic events such as Dartmouth hosting U.S. Surgeon General Vivek Murthy and his seven living predecessors for a panel discussion titled, “Future of Mental Health and Wellness.”

During the discussion, Murthy and his predecessors discussed their concerns about the national mental health crisis and how to combat it. This comes on the heels of Murthy releasing a new Surgeon General Advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in our country.

Murthy said that in the face of unprecedented loneliness and mental health issues, community is one of the keys to repairing the crisis. Murthy brought the conversation to the challenge of community and interpersonal connection. “For a lot of us this issue is very personal,” he said, asking the audience to raise their hands if they or someone in their lives had struggled with mental health or loneliness; almost everyone in attendance in the basketball arena raised their hand.

This discussion prompted me to reflect on how loneliness in particular can have profound and far-reaching effects on mental health, impacting various aspects of well-being. We humans are social creatures, and a lack of meaningful social connections can contribute to a range of emotional and psychological challenges, including debilitating anxiety. It is no coincidence that coming off the devastating effects of the COVID 19 pandemic and the explosion of social media and other immersive online experiences that our country is facing epidemics of both loneliness and anxiety.

Loneliness and anxiety are interconnected, and the relationship between the two can be complex. Loneliness, characterized by a perceived lack of social connection or meaningful relationships, can have various effects on anxiety.

Here are some ways in which loneliness can impact anxiety:

  • Increased Stress Levels: Loneliness often leads to heightened stress levels. The absence of social support can make it challenging for individuals to cope with life’s stressors, contributing to increased feelings of anxiety.
  • Negative Thought Patterns: Social isolation can give rise to negative thought patterns and self-perceptions. Individuals who feel lonely may be more prone to self-doubt, negative self-talk, and a heightened sense of vulnerability, all of which can contribute to anxiety.
  • Rumination and Overthinking: When individuals are lonely, they may spend more time ruminating on negative thoughts and experiences. Overthinking and dwelling on perceived social inadequacies can exacerbate anxiety symptoms.
  • Impaired Coping Mechanisms: Social connections often serve as a crucial support system for coping with life’s challenges. Loneliness can limit the availability of these coping mechanisms, making it harder for individuals to manage stress and anxiety effectively.
  • Physical Health Impact: Loneliness has been linked to various physical health issues, including increased inflammation, cardiovascular problems, and compromised immune function. The stress associated with loneliness can contribute to these health issues, potentially worsening overall well-being and increasing anxiety.
  • Social Anxiety Development: Long-term loneliness may contribute to the development or exacerbation of social anxiety. The fear of judgment, rejection, or negative evaluation can intensify in the absence of positive social interactions, further isolating individuals and perpetuating a cycle of anxiety.
  • Sleep Disturbances: Loneliness can disrupt sleep patterns. Difficulty falling asleep, staying asleep, or experiencing restful sleep can contribute to fatigue and irritability, which are common symptoms of anxiety.
  • Reduced Emotional Regulation: Social connections play a role in emotional regulation. Loneliness may impair an individual’s ability to regulate emotions effectively, leading to heightened emotional reactivity and an increased susceptibility to anxiety.

Addressing loneliness involves not only building social connections but also addressing the underlying thoughts and beliefs that contribute to feelings of isolation. Seeking support from friends, family, or mental health professionals can be crucial in breaking the cycle of loneliness and alleviating associated anxiety symptoms.

This is why the importance of group therapy, exposure and response prevention (ERP) therapy, and the therapeutic milieu approach to treatment are so invaluable in confronting the epidemic of anxiety and loneliness that is currently confronting young people across the country. ERP has many benefits, but one of the greatest in this context is breaking the cycle of avoidance. It’s important to note that the relationship between loneliness and anxiety is bidirectional. While loneliness can contribute to anxiety, individuals with anxiety may often struggle with forming and maintaining social connections, creating a vicious circle of reinforcement of maladaptive behaviors and responses.

Regina Benjamin, surgeon general from 2009 to 2013, emphasized the complex challenge of mental health issues. “Health does not occur in the doctor’s office or in a hospital alone,” Benjamin said. “It occurs where we live, where we learn, where we work, where we play, where we pray — everything that we do.” Treatment that takes place within a therapeutic residential milieu allows those struggling with anxiety to heal and learn not simply in the siloed isolation of an office, but alongside peers in a collaborative environment that enhances feelings of autonomy and self-efficacy.

When loneliness and anxiety have reached a crisis point, the therapeutic milieu fosters a sense of community and belonging. Individuals often share common experiences and goals, and the supportive environment encourages social interaction, reducing feelings of isolation and loneliness, and promoting a sense of connection. A therapeutic milieu plays a pivotal role in the holistic approach to mental health treatment. By emphasizing safety, community, and collaboration, it creates an environment where individuals can feel secure, connected, and supported on their journey toward recovery. The sense of belonging, mutual support, and normalization of daily activities within the therapeutic milieu contribute to the overall well-being of individuals receiving mental health care.

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Interoception – Making Sense of Our Inner World

Posted on by Mountain Valley Treatment Center

As the external sensations of our world continue to become more abundant and all consuming, we often overlook the sensations of our inner world. One of the most important and foundational sensory systems we have is our interoceptive system. Interoception is our body’s internal radar of the condition of our body, conveying information about the state of what is happening within the bounds of our skin.

Our internal organs like our heart, lungs, intestines, bladder and even skin have receptors that send signals to our brain about the condition of those major organs. Interoception is our body’s ability to recognize and respond to those signals. For example, interoception includes awareness of changes in heart rate, blood pressure, body temperature, or sensations of pain, hunger, thirst, and other autonomic functions. Interoception also plays a significant role in emotional regulation, as emotions are a cascade of autonomic internal physiological responses that need our interpretation.

As with all things, when it comes to interoception, balance is key. People with limited interoception experience a disconnect between their mind and internal states, therefore they are often unaware of their emotional experiences and have challenges appropriately responding to the cues and signals their body is sending.  A common situation most of us have probably had at some point is the phenomenon of being “hangry.” When this happens, we are disconnected from our bodies and missing the cues for hunger, resulting in irritability or dysregulation. On the other hand, some people are hyperaware of their internal sensations. To provide a similar example, this is when we have a hard time focusing on a meeting or class before lunch because all we can think about how our stomach is growling and feeling empty.

Whether you have limited or heightened interoceptive awareness, building a better relationship with your body’s internal cues is valuable for emotional wellness.

Limited Interoceptive Awareness 

If you experience limited connection to your internal sensations and are often unaware of what is happening in your body, here a few ways to foster a stronger mind-body connection:

  • A guided body scan meditation that cues you to focus on the sensations happening in specific parts of your body.
  • Yoga, Tai Chi, or other movement practices that require you to be attuned to sensations such as breathing, heart rate, etc.
  • Biofeedback is the process of conducting vitals or using a heart monitor to practice recognizing what different states of arousal feel like inside your body.
  • Expand your vocabulary and practice using a variety of different language to describe your internal experiences.  Communicating a visceral experience to yourself or others can be really challenging! Practice naming and describing sensations like their location, intensity, texture, size, color, etc.

 Heightened Interoceptive Awareness 

If you experience hyperawareness, and maybe even a little anxiety about your internal sensations, engage in interoceptive exposures to develop resilience to rebuild your relationship with those internal experiences. Examples of interoceptive exposures include:

Breathing: hold your breath for 30 seconds or breathe through a straw for 60 seconds.

Heart Rate: engage in intense exercise (burpees, running up and down stairs, jumping jacks) for 30 or 60 seconds.

Dizziness: shake your head side to side for 30 seconds or spin in a chair for 30 seconds.

Derealization: Stare at yourself in a mirror for 2 minutes or stair at a wall without blinking.

Temperature: Turn the cold water in the shower for 30 or 60 seconds or sit in a sauna/steam room for several minutes.

*These can be graded up or down according to your comfort level and can be increased as you build interoceptive tolerance.*

With each exposure, try to turn towards the internal sensations that you are having or practice diffusing the from the sensation (i.e. removing judgement and objectively observing and describing what is happening). As with all exposures, the most important part is to REFLECT on your experience. What happened? What did you learn? How does experience change how you might engage with your internal sensations moving forward?

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Motion through Emotions

Posted on by Mountain Valley Treatment Center

Ever wonder why we rock babies to sleep, get dizzy when we spin, or find swinging in a hammock so relaxing?

All these activities engage our vestibular system. Although it is not commonly discussed, our vestibular system is one of our seven sensory systems (touch, smell, sight, hearing, taste, proprioception, and vestibular) and plays a vital role in our functionality from a physical, psychological, and social perspective. On the level of the body, our vestibular system helps us find a center of gravity, stay balanced, and feel grounded. From a psychological perspective, a well-functioning vestibular system helps support self-awareness, organized thinking, and stable sense of self. Due to its role in stabilizing the body and mind, it influences how we respond to our environment, including our social surroundings.

Engaging in activities that challenge the vestibular system and improve vestibular processing lead to higher levels of cognitive, emotional, and physical functioning. It is recommended that people of all ages get out to move their bodies and challenge their vestibular processing to achieve a general a sense of general well-being.

However, for the purpose of this hack, we want to equip you with ways to engage the vestibular system to quiet the mind and body during intense anxiety. Here a few simple ways to use vestibular input to soothe the nervous system:

  • Rocking– use a rocking chair, office chair, or simply sway back and forth if it is socially appropriate to do so. Focus on slow, rhythmic, movement forward and backward.
  • Swinging– set up a hammock, go to a playground, or swing on a porch swing. Focus on slow, linear movement, either front-to-back or side-to-side.
  • Yoga– engage in slow, rhythmic movement that incorporate changes body and position, challenging one’s balance.
  • Sit on an exercise ball or unstable surface– slowly bounce on an exercise ball or try to practice being still and balanced on an unstable surface such as a trampoline, balance board, or balance beam.
  • Paced walking– walk in a slow rhythmic pattern of either back and forth, a circle, or a “figure 8” pattern.
  • Ride a bike–focus on pedaling a slow, controlled, and consistent pace or bike in a circle or figure-8 pattern.

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Pre-Gaming and Reframing: Helping Families Return To College After a “Failure”

Posted on by Mountain Valley Treatment Center

Mountain Valley interviews Lisa Rosen, PsyD, about how she helps prepare families for a return to college after an anxiety-based withdrawal.

MV: So, Dr. Rosen, in our last newsletter we discussed how Mountain Valley helps prepare residents and parents for the transition from high school to college. But today we want to hear about the experience of families who have tried college, and it just didn’t work the first time. What’s that like for a family to have to try again after a false start?

Dr. Rosen: Well, there’s no denying that this experience is painful and disorienting for the resident and the parents. The level of anxiety over trying again can be very high, which is why we really focus on “pre-gaming” the return to college very early in the family’s treatment experience. The more pre-gaming we can do, the better. Pre gaming means really digging into the initial experience of college and gleaning insights from that experience for this next attempt, an attempt that includes a whole new set of skills and insights that the young person, and her parents, did not have the first time around. Pre-gaming is our way of getting really practical and concrete about what steps to take to be successful in college. We do this with the resident as a part of their treatment, and we do this with parents to empower them to better support their child’s return to college. This includes teaching them how to navigate their own anxiety!

MV: What are some examples of this support?

Dr. Rosen: We provide two categories of support for the child. First, we explore the setting itself, asking questions together like what supports are available in that setting? Is there enough support at this college? Is this the right setting to optimize this particular young person’s learning? Is this the right school? This kind of analysis is part of the resident’s therapeutic journey at MV. We use the resident’s past experience to look at their future experience from all sides—the social emotional setting and supports, the academic rigor, the learning support. In other words, we have to help the young person become reflective and analytical about the setting they may return to. The other category of support involves, of course, reflection regarding the state of the resident when they had that initial college experience. How much of their struggle was simply driven by what was going on emotionally for them at the time, separate from the external environment. What new skills and insights do they have to bring to this or another college environment?

MV: So, it sounds like you kind of flip the initial “failure” on its head, looking at it as an important source of information and as the beginning of a process of understanding that can form the basis of a successful college experience. To carry your “pre-gaming” analogy forward, is this a little like debriefing an early season loss in sport so that you can improve and succeed going forward, viewing this “loss” as a useful and instructive beginning rather than as an unsuccessful ending?

Dr. Rosen: Yes, and that brings me to the parents. We talk a lot about cognitive distortions as a part of our work with our residents. But this is also very useful in our work with parents. Reframing is an important part of correcting cognitive distortions around what can feel, understandably, like a crisis. Parents may think “our child has been working toward this very specific goal of this very specific college for twelve years and we have had this very linear view of how life is supposed to unfold and suddenly the plan is upended, it’s a disaster.” We help parents reframe this “crisis” as a “challenge” and one that has yielded important data. In terms of empathy for these parents, we know that reframing does not mean denying their feelings—it’s really hard, we know, and it can still feel terrible to the parent and the child. But ultimately, it’s really an opportunity to revisit some initial assumptions, to learn about our patterns and our child’s needs, and craft a more effective strategy for reengaging college.

It’s a balance of empowering the young adult to own their experience and apply new insights to their college experience and it’s also a chance to help parents balance their own role as supports. They are still parents after all, and their college-aged child is part adult and part child and still needs engaged parenting. But we also need to allow space for the child to learn from their own bumps and setbacks.

The pregaming we do helps the parents not only reframe the initial setback of a college withdrawal, it also helps them reframe future setbacks with a more flexible attitude, viewing each success and each setback as an opportunity for growth and learning—as a new and useful data point and an opportunity to practice new skills. It’s a win-win. We win if our kid succeeds. We also win if our kid experiences a setback and is equipped to reflect and say, “you know, mom and dad, here’s what I really need to be successful, here’s what I really care about, here’s what’s not working for me on this campus.”

The years from 18 to 22 may be what we define as “adult,” but what do we really want as parents? We want our kids to succeed from 25 to 80! We have to learn to play the long game here. That’s what we want college to prepare our kids for—a long and positive adult future. With that perspective, what a great opportunity college provides as a relatively safe laboratory to prepare our children for the challenges and opportunities of adulthood. That’s at the core of our pre-gaming and reframing approach to returning to college.

 

MOVING MOUNTAINS

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Anxiety Goes to College!

Posted on by Mountain Valley Treatment Center

Have you ever felt anxiety during a big vacation or dread at news of a new job or promotion?  Maybe a little (or a big) panic before a happy event like your graduation or wedding?  If so, that’s actually pretty normal!  Big life events generally involve transition and transitions are characterized by a disruption of routine and homeostasis—the predictable, familiar habits and circumstances that anchor us and help us feel calm and rooted. Big events bring big change, which is why even happy events can trigger an anxiety response—especially if you are already prone to anxious emotions.

One of the biggest transitions in young adulthood is leaving home to go to college. This transition, as traditionally navigated in the U.S., involves an instantaneous and wholesale change of virtually every aspect of a young person’s life and is, as a result, fraught with emotional obstacles. In fact, longstanding statistics indicate that about a quarter of all college students respond to these stressors by dropping out during their freshman year and up to 40 percent of all college students drop out over the course of their college experience and fail to earn a degree (based on six-year tracking). For young people with a history of anxiety, this wholesale transition can seem particularly overwhelming and can trigger staggering fear for both the would-be freshman and their parents!

So, we asked Mountain Valley therapist Sharon McCallie-Steller a question common among parents of college-aged young people: “How do you deal with anxiety when your child goes to college—both your child’s and your own?”

MV: Sharon, talk a little about what it’s like for young people who are getting ready for college. College should be a great thing, an exciting adventure. Why is it so scary and overwhelming for some?

Sharon: Anxiety is always focused on the anticipation, the uncertainty, about what might happen—fear around all the “what-ifs?” Since college represents a whole new life experience for a student—leaving home, leaving a familiar school situation, leaving friends, changing your whole environment and support network—there is a lot to process. It should be exciting, of course, but high levels of excitement often feel a lot like anxiety! So, for a student who is prone to anxiety, this very exciting time of anticipation can trigger an anxiety response.

MV: How can parents be helpful to their child during this time?

Sharon: Sometimes a parent’s well-intentioned and understandable impulse is to try to fix their child’s anxiety. They often make two mistakes. The first is to minimize their child’s emotional experience. Again, this is always well-intentioned, and it takes the form of trying to calm the child with statements like, “it will be fine,” “you’ll do great,” “just relax,” “everything’s going to be fine,” et cetera. This communicates to the child that they should not feel anxious, which can actually increase the anxiety and create separation between the parent and the young person. The reality is that it makes sense to be anxious in the face of so much change—it’s normal!

So a better place to start is to validate your child’s anxiety by simply acknowledging it: “Wow, yes, this is a big change. It sounds like you are really feeling anxious.” This immediately connects you with your child’s experience and creates room for helpful conversation. “Okay, mom gets it.” It makes you a safer ally. At this point, you might be in a better position to ease into the work that I call “planning to cope.” You can work with your child to dig a little deeper into the specific worries to  visualize real situations and discuss possible solutions: what if you struggle to find your classes, where can you can go for help and guidance, what do you want to make sure you’re involved in and how do you access that. But, again,  the first step for parents is to validate the childs experience.

MV: So the main points I’m hearing are: 1) validate the feelings—they are normal and acceptable, 2) visualize the specific points of anxiety, 3) discuss a practical plan for coping with those points.

Sharon: That’s right.

MV: So that covers how to help you deal with your child’s anxiety when they go to or go back to college. But what about your own anxiety as a parent?

Sharon: Yes, well parental anxiety around this time of year is often very high as well. I won’t see my child every day, I won’t be able to monitor their safety and wellbeing. Home like will change. I won’t have the same access to their friends. There are very real threats living on your own away from home and the familiar. You know as a parent that this transition is not all sunshine and rainbows. So just know that it’s normal and appropriate to have some anxiety. But as a parent you can reflect on what is, maybe, an outsized fear: what am I catastrophizing, what is my own anxiety and fear that I might be projecting onto my child, what is my own stuff that might be getting in the way of me being excited.

If significant fear comes up for you during this transition, it’s a great opportunity to do your own work, to seek support and growth. This can take the form of joining a parent group—which many colleges provide, or processing with your spouse, or joining a PTA group for parents of seniors. If the fear begins to interfere with your relationship with your child or ability to enjoy this adventure, you might consider therapy or parent coaching.

As part of your own work, this can be a great opportunity to reflect on what you know about your child’s capabilities and to anchor yourself in that. “She’s spent so much time preparing. She got into college based on her abilities. She has these attributes and abilities.” And like you’ve now done with your child, you can create your own practical coping plan for addressing concerns that cause anxiety.

MV: So, the plan for dealing with anxiety when your child goes back to college is much the same for the parent as for the child?

Sharon: That’s right. Validate and normalize the feelings, right-size the threats—gauging anxiety against reality, make a coping plan, and use this as an opportunity to work on yourself and build a support network.

MV: So if, after doing all this preliminary work, your child’s anxiety remains very high, how do you know if it might be smart to pause and get some help before?

Sharon: The question to ask is if the anxiety is interfering with daily functioning. Is my child making it to work, engaging socially, doing the things necessary to prepare for college like packing and planning? Or are they avoiding, staying in their room, not getting basic tasks done. If the latter, they might not be ready and you might consider speaking with your child, and a professional, to assess whether to hit pause and get some help addressing the anxiety itself. One thing to consider is whether deferring is, itself, an avoidance strategy or just a wise decision to prioritize growth and increase the odds of success. Conversation with a parent coach, educational consultant, or therapist can help you assess this question. Many parents and students choose to defer for these reasons and most colleges are set up to accommodate such a decision.

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