How are anxiety disorders treated at RCBM?

CBT

The Rochester Center for Behavioral Medicine uses Cognitive Behavioral Therapy (CBT) for the treatment of anxiety and depressive disorders. This therapy combines behavioral exposure therapy and cognitive restructuring to help the patient confront avoidance, correct negative automatic thoughts, and return to optimal functioning.

Mindfulness-based therapies

Mindfulness-Based Cognitive Therapy (MBCT) combines mindfulness-based stress reduction techniques such as yoga or meditation with traditional CBT. Several studies have demonstrated that MBCT can effectively alleviate anxiety, and there is also evidence suggesting that it can be an effective treatment for depression. In addition, deep breathing, relaxation, and visualization are also helpful adjuncts in managing anxiety.

Acceptance and commitment therapy (ACT)

ACT builds on CBT principles and operates on the theory that trying to avoid anxiety can keep you feeling anxious. ACT can help you learn new ways to acknowledge and address complex thoughts and feelings as they arise. Studies show that ACT can be an effective treatment for anxiety.

Treatment for PTSD

At the Rochester Center for Behavioral Medicine, PTSD is treated with a combination of cognitive-behavioral therapy and, when necessary, medications. This practical approach can help individuals with PTSD identify situations that trigger their “fight or flight” response. Using the cognitive-behavioral techniques of flooding and systematic desensitization, the therapist and patient can work together to safely reintroduce situations that have become too anxiety-provoking for the patient. Over time, irritability, flashbacks, and nightmares subside, the patient can return to their pre-trauma functionality, and long-term success is within reach.

Medication management

Medications can help alleviate the symptoms and improve functioning. Common medications for anxiety disorders include:

Antidepressants: While antidepressants are primarily used to treat depression, they can also be beneficial for managing anxiety disorders. These medications work by regulating the brain's use of certain chemicals to enhance mood and alleviate stress. It's important to note that antidepressants may take some time to take effect, so it's essential to be patient. The most commonly prescribed types of antidepressants for anxiety are SSRIs and SNRIs. Tricyclic antidepressants are another option, but they tend to have more side effects.

Benzodiazepines:  These types of medications can reduce feelings of anxiety, panic, and worry. They work quickly, but you can become tolerant of them over time. They also have the potential for addiction, so you should use them with caution. Your healthcare provider might prescribe a benzodiazepine for the short term and then gradually reduce your dosage. Some benzodiazepines that can help with anxiety disorders are alprazolam, clonazepam, diazepam, and lorazepam.

Beta-blockers:  These medications can help reduce some of the physical symptoms of anxiety disorders, such as rapid heartbeat, shaking, and trembling, but they do not address the psychological aspects of anxiety disorders.

Medical Nutrition Therapy

Nutrition intervention is an essential adjunct to the treatment of anxiety. A variety of foods from all food groups provide important nutrients and maintain stable blood sugar levels, which is crucial in managing anxiety. Our registered dietitians can develop a personalized nutrition plan to help with the management of anxiety.

Higher level of care treatment

An inpatient stay is recommended for individuals who are unable to care for themselves or may be a risk to the safety and well-being of themselves or others.

This might include individuals who are:

  • Actively suicidal
  • Actively homicidal
  • Flagrantly psychotic
  • Depressed or anxious to the point that the patient cannot engage in activities of daily living

Partial Hospitalization Program (PHP)

  • This level of care is recommended for individuals who:
  • Exhibit psychiatric severe or co-occurring disorders
  • Present a danger to themselves or others
  • Have not had success using outpatient treatment

This level of care is necessary to provide structure for treating current symptoms that cannot be managed at a lower level of care when current intensive outpatient care has failed to improve functioning or acute coping skill deficits are severe and require daily assessment and intervention.