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When to Seek Inpatient Treatment for Anxiety – 7 Signs It’s Time

Living with intense and uncontrollable anxiety can be an overwhelming and isolating experience. For many, traditional outpatient treatments may alleviate symptoms, but in some cases, a higher level of care becomes necessary. 

Deciding when to seek inpatient treatment for anxiety can be a complex and highly individualised process, and this blog aims to shed light on the situations in which inpatient treatment might be a necessary and beneficial step in managing severe anxiety.

Intense and Uncontrollable Anxiety

If anxiety symptoms are consistently intense, overwhelming, and difficult to control, despite trying outpatient treatments like therapy and medication, it may be an indication that a higher level of care is needed. Typical symptoms of anxiety can manifest in different ways, but some common examples include:

  • Persistent racing thoughts
  • Extreme restlessness
  • Constant worry
  • Rapid heart rate
  • Shortness of breath
  • Panic attacks.

Almost everybody has some experience of anxiety in their lives, with approximately 6% of the population experiencing a level of clinically significant anxiety at any one time. However, if you’ve noticed that your anxiety is stopping you from living your life, fulfilling your obligations, or engaging in your hobbies, then this is severe and requires treatment. 

While outpatient treatment options may work for reducing suffering in the majority of anxiety sufferers, this isn’t necessarily enough for everybody. Inpatient treatment offers you an opportunity to intensively work on your anxieties in a safe and controlled environment. 

Safety Concerns

If anxiety is leading to thoughts of self-harm, suicidal ideation, or any actions that endanger yourself or others, immediate inpatient treatment is necessary to ensure safety. This can include risky behaviour, such as substance abuse or reckless actions. 

You may be unsure if you’ve had ‘dark thoughts’ like these, or perhaps you have, but dismiss them as fleeting bad feelings. Some examples of thoughts that could indicate a level of desire to die, or self harm include: 

  • A passive desire to die in your sleep, or simply ceasing to exist
  • Lack of fear of pain, assault, or death
  • Curiosity about how to harm oneself, or end one’s life
  • Impulses to drive your car into traffic, jump off a bridge or swallow harmful things
  • Distinct plans to end one’s life or harm oneself
  • Putting yourself in harm’s way, like going into dangerous situations or ignoring safety advice
  • Pushing yourself in a sporting capacity towards physical harm, like extreme exertion, or not wearing gloves to box

If you are having intense or immediate thoughts and plans about hurting yourself or others, please call your local emergency number, and tell a trusted loved one. Please do not wait to seek help, and please do not be afraid of asking for it.

In cases where there are concerns for safety, seeking inpatient treatment can provide a safe environment where you’re protected from harm. Your safety is paramount, and inpatient care can offer a structured, secure setting.

Severe Panic Attacks

Panic attacks are intense and overwhelming episodes of anxiety that can be debilitating for those who suffer from them. They involve a sudden and intense surge of fear, with an emotional intensity that is often disproportionate to the actual threat. 

Panic attacks often last around 30 minutes on average, but severe episodes can last much longer. Physically sufferers often feel their heart racing, chest pains, hyperventilation, trembling, sweating, nausea, or dizziness. Cognitively people often feel a loss of control, a fear they may be dying, and sensations of derealisation and depersonalisation. 

The immediate experience of a panic attack is not the only way people can suffer. They disrupt daily functioning as people increasingly avoid triggers to prevent attacks. This fear reduces your overall quality of life, interfering with your personal and professional life. 

Frequent and severe panic attacks that disrupt daily life and are resistant to outpatient interventions may require more intensive treatment in a controlled environment. Inpatient care can help you learn to manage and reduce the frequency and intensity of these attacks in a safe and controlled environment. 

Inability to Function

When anxiety significantly impairs your ability to perform essential daily functions such as work, school, caring for yourself or your family, or maintaining relationships, it may be time for inpatient care. Anxiety can also be experienced as quite paralysing, making daily self-care activities such as bathing, eating, or getting enough sleep difficult. This may also cause a severe absence or decline in productivity, as well as avoidance of responsibilities such as school or work to prevent anxiety provoking situations. 

The isolation that many who suffer from anxiety experience is also difficult. Though this isolation is often self-imposed through social withdrawal, the lack of social activities or maintenance of relationships can cripple people emotionally. They may even be increasingly seeking to avoid the risk of judgement or criticism. 

When anxiety becomes a roadblock to your personal and professional life, addressing it with more intensive therapy is crucial.

Co-Occurring Disorders

Co-occurring disorders, also known as comorbidity or dual diagnosis, refer to the presence of two or more distinct conditions or disorders in an individual simultaneously. In the context of anxiety, co-occurring disorders often involve the simultaneous presence of anxiety disorders alongside other mental health conditions, substance use disorders, or medical conditions. 

Some of the most common co-occurring disorders that are often experienced with anxiety include: 

  • Substance Use Disorders (commonly referred to as addiction)
  • Depressive disorders
  • Bipolar Disorder
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Post-Traumatic Stress Disorder
  • Obsessive-Compulsive Disorder
  • Eating Disorders
  • Chronic Pain

Co-Occurring disorders interact with each other which means that it is impossible to adequately address one without addressing the other. A person suffering from anxiety may attempt to adopt healthy coping strategies, but if their underlying trauma is not addressed they will continue to suffer.

If you have co-occurring disorders, such as substance use disorder or a medical condition, that complicate the management of anxiety, inpatient treatment may be necessary to address all aspects of your health simultaneously.

Lack of Response to Outpatient Treatment

This term refers to situations where individuals with anxiety disorders do not experience significant improvement despite engaging in various outpatient therapeutic interventions. Outpatient treatment typically includes therapy sessions, medication management, and other supportive interventions conducted on a non-residential basis. 

People may not be responsive to outpatient treatment for a variety of reasons. Their symptoms may be too severe, they may experience co-occurring disorders as discussed above, or their environment may not be conducive to recovery. 

Addressing the lack of response to outpatient treatment requires a personalised and flexible approach. It involves ongoing collaboration between the individual, mental health professionals, and support systems to tailor interventions to the unique needs and challenges faced by the individual with anxiety. Adjusting the treatment plan based on continuous assessment and feedback is crucial for optimising outcomes and promoting lasting recovery.

If you’ve tried various outpatient treatments for an extended period without significant improvement, inpatient care with a more structured and immersive approach may be beneficial.

Dangerous Coping Mechanisms

This refers to maladaptive strategies individuals may employ to manage or alleviate their anxiety symptoms. These coping mechanisms, while offering temporary relief, are considered harmful, both physically and psychologically.

Self-harm, as discussed above, is not the only dangerous coping mechanism or strategy that people may engage with. Any strategy that causes harm to yourself or others, or even a risk of harm, is not health promoting, and can be considered dangerous. 

Examples of such strategies include but are not limited to: 

  • Substance abuse: Individuals may turn to alcohol, drugs, or other substances to numb or escape from anxiety.
  • Self-harm: Deliberate self-harm, such as cutting or burning, may provide a temporary distraction from emotional pain.
  • Reckless Actions: Engaging in impulsive or risky behaviours without consideration of consequences.
  • Isolation or Avoidance: Withdrawing from social interactions and avoiding anxiety-inducing situations.
  • Destructive Relationships: Remaining in toxic relationships that may contribute to or worsen anxiety.

Engaging in harmful or dangerous coping mechanisms, such as substance abuse or self-harming behaviours, to manage anxiety is a clear sign that inpatient treatment is needed. 

Summary – Is It Time to Seek Residential Treatment for Anxiety?

It is not easy to recognise when it is time to seek inpatient treatment for anxiety. Many may fear the stigma of going ‘into rehab’, and others may not want to dedicate time to being ‘away from life’. However, for those who can identify with any of the signs above, it may be the solution you need to start living the life you want. 

There is no need to suffer, and jump-starting your road to recovery within a residential setting allows you to feel safe, and secure whilst healing in complete privacy. If you, or someone you love, can be described using the above signs, please feel free to reach out to Clinic Les Alpes to ask about how we can help you today. 

Clinically Reviewed By

Brittany Hunt

Brittany Hunt is an internationally experienced clinician, specialised in treating addictions and co-occurring disorders. Having worked in the public and private sector, she utilises holistic and evidence-based approaches designed to empower the patients in their recovery journeys. A graduate of The University of Auckland, she has a Bachelor of Health Sciences majoring in Mental Health and Addictions, a diploma in Psychology and Counselling and a Post-Graduate degree in Health Sciences, majoring in Addictions. She is a fully registered practitioner under the Drug and Alcohol Association of Aotearoa New Zealand (DAPAANZ).

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