Christina A. Logan MS, OTR/L
Tuesday, November 7, 2017
The incidence of anxiety among individuals that suffer from Anorexia-Nervosa or Avoidant Restrictive Fook Intake Disorder (ARFID) is a very common co-morbidity that we see and treat on the ACUTE unit. As with treating a complex eating disorder, treating anxiety can require a myriad of strategies and interventions to figure out what works for what patient and why. As part of the suite of interventions the ACUTE Occupational Therapists (OT) can provide, weighted blankets and lap pads are one of those interventions.
Many of you might be asking, ‘Well what is a weighted blanket and how could it possibly have any effect on my anxiety?” Well that’s a great question. A weighted blanket is a blanket that has evenly distributed weights throughout to provide an even consistent pressure when placed on the body, creating a hugging sensation. Blankets or lap pads can be of various sizes, weights, and fabrics; and they can be filled with materials ranging from sand to rice to synthetic pellets. We all have a natural response to situational stress and anxiety with many people responding positively to a hugging or swaddling sensation. Have you ever stopped to think about ways in which you may innately try to calm yourself down in a stressful situation or environment? Some people innately crawl under the covers or hold themselves tightly. If you are one of those people, have you ever stopped to think why you do that? If you’re anything like me and are still just a little bit afraid of the dark, the feeling of a heavy comforter makes me feel somehow safe and secure. Same question: why does that work? How does it work?
Well, there is evidence in the literature and in clinical settings that deep pressure touch stimulation (DPTS) via weighted blankets and lap pads may have a “dampening influence” on the sympathetic nervous system response, or the flight and fight response. This “dampening influence” in turn has demonstrated promise for decreasing anxiety and insomnia while improving emotional regulation, allowing some adult and pediatric patients to feel more relaxed, secure, comfortable, safe, and calm (Vanderburg, 2001); (Champagne, 2008). Weighted blankets and pads are a form of DPTS, and when administered, can create a “hugging” effect from the weight of the blanket enhancing the production of serotonin which acts as a calming agent for the body. The benefits of DPTS, specifically weighted blankets, have been measured across a variety of populations. As an example, they have been used to reduce anxiety among adults undergoing invasive dental procedures (Champagne et al., 2015; Chen, 2013; Chen et al., 2016). In sum, a weighted blanket has shown promise for being a strategy for treating individuals who may be experiencing moderate to severe anxiety.
So how does it work on ACUTE? Well, here’s the deal. When patients come in, they are automatically evaluated by an Occupational Therapist to assess a number of things, one of them being extent and severity of anxiety. Depending on your medical status, needs, psychological history, and preferences, you may meet the criteria for an OT to administer and trial a weighted blanket or lap pad in a controlled and safe environment. And then it’s yours to use in the room if you decide it’s beneficial. What I like about weighted blankets and lap pads is that it is an intervention that you can participate in without even thinking about it. Some patients have reported that using a weighted blanket or lap pad is intuitive in nature-they pick it up to calm themselves down without even being consciously aware they are doing it. And for some it is very intentional. Some individuals use it before meals to help calm them down, or use it during a difficult situation or conversation. And many people use it to help improve their sleep quality and quantity. In fact, there is promising research about the benefits of the use of a weighted blanket to improve insomnia as well among some groups of people (Ackerley, Badre & Olausson, 2015).
Now it is imperative to note that this might not work for everyone! For some individuals the thought of a weighted blanket or lap pad may actually provoke anxiety! The use of weighted blankets and lap pads has not been formally studied or validated among those with AN-R and ARFID. Although there is evidence that suggests it may be helpful, we are not certain. A weighted blanket and lap pad is not for everyone, and there are contraindications that we screen before we introduce one. And that is exactly why it is required that you have a skilled and trained Occupational Therapist to assess each patient to determine the best interventions available. Even if a weighted blanket is not suitable or beneficial for you, don’t worry there are a number of other ways that an OT as well as other members of your treatment team can address anxiety and sleep disturbances, among other ailments. For instance, we can introduce deep breathing exercises, restorative yoga poses, progressive muscle relaxation and/or mindfulness exercises as alternative or complimentary interventions.
Bottom line, weighted blankets and lap pads can be used in combination with others or as a stand alone intervention to promote increased comfort and safety on ACUTE in efforts to support the recovery process. The ACUTE Occupational Therapists look forward to designing and creating an individualized treatment plan for you, which may include the use of weighted blankets or lap pads.