The Drake Institute of Behavioral Medicine provides treatment for anxiety disorder and anxiety-related disorders, such as Generalized Anxiety Disorder, Panic Disorder, Post-Traumatic Stress Disorder, Social Anxiety Disorder, Phobias and Obsessive Compulsive Disorder.
Since 1980, we have been a significant pioneer in the use of biofeedback and neurofeedback treatment in clinical medicine, and have been applying these therapies to improve the quality of life for patients with a variety of anxiety and anxiety-related disorders.
The DSM-V describes anxiety disorders as “including disorders that share features of excessive fear and anxiety and related behavioral disturbances.”
The most common anxiety disorder the Drake Institute treats is Generalized Anxiety Disorder or GAD. DSM-V describes GAD as “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).” The excessive anxiety or worry is difficult to control and can dominate the individual. It causes significant discomfort and impairment in one’s day to day life: personal, social, and/or work/school.
Anxiety is a normal emotion one experiences under challenge, in normal relationship conflicts, work deadlines, day to day living pressures, when loved ones become ill, etc. Anxiety may become debilitating though when it is severe, out of proportion to the situation, and/or becomes constant.
Emotions like anxiety are not just feelings but are actually "psychophysiological". What this means is that every psychological state has a simultaneous physiological state accompanying it and vice versa. When you are in a calm, non-threatened state, you have a different physiology or biochemistry (promoting healing) than when you are in a significant stress or anxiety state ("fight or flight").
Anxiety disorders also cause fatigue due to utilizing additional energy in being locked in a hypervigilant state. Anxiety can negatively hurt your health in many ways. It not only can cause sleeping disturbances, digestive problems, headaches, muscle tensions, immune system weakness, and exacerbated physical illnesses, but anxiety disorders are also linked with heart disease (Harvard Health letter, July 2008), as patients with heart disease have been found to be twice as likely to have a heart attack if suffering from anxiety.
A recent study from Harvard Medical School (Internal Medical News, May 1, 2016) also found an association between increased activation of the amygdala of the limbic system with having increased risks of cardiovascular events (heart attack or myocardial infarction).
All of the disorders listed below are anxiety or anxiety related disorders that the Drake Institute has successfully treated.
It is worth noting that a "panic attack" is one of the most frightening or debilitating emotional experiences one can ever go through. A "panic disorder" can literally cripple one's life if not effectively helped.
In a "panic attack," one is suddenly overwhelmed with crippling fear; you can feel helpless, light-headed, heart pounding or racing, difficulty breathing, and may even feel you could die. It robs a person of their feeling of safety in the world and they live in anticipatory anxiety of having another panic attack or that something catastrophic could occur.
Panic attacks and panic disorder lead people to feel riddled with self-doubt and insecurity, but fortunately, biofeedback treatment and neurofeedback therapy can help people overcome panic disorder.
Our perceptions or misperceptions of a situation determine our emotional-physiological reaction to the situation. If we step out of our car at night onto a garden hose left inadvertently in the driveway but think that we are standing on a snake, then we will have a different psychophysiological reaction or feeling (fear or anxiety) then if we realize it is simply a garden hose and know that we are safe.
In other words, feelings are not only emotional, but are also accompanied with simultaneous physiologic and biochemical changes in the body. These physiologic changes during anxiety, such as increased adrenaline, can intensify anxiety or fear. It is our reaction to the event or situation that determines whether we will experience debilitating anxiety or stress, rather than the event or situation itself.
Imagine you are waiting for a phone call to learn whether or not you landed a job position you applied for. The phone rings and immediately your chest tightens and you experience heart palpitations; this is anxiety at work. The phone call is not elevating your blood pressure or causing palpitations, but your psychophysiological reaction to the meaning of the phone call is driving up your blood pressure and tightening your chest muscles.
If you can realize that you are going to survive and become successful in your life whether or not this job possibility comes through or not, then you are much less likely to experience heightened, debilitating anxiety when that phone call comes in. The Drake Institute’s biofeedback and neurofeedback-based anxiety treatment program helps you learn how to stop anxiety and anxious feelings from overwhelming you in situations like these.
To understand anxiety one needs to understand our limbic system. The "limbic system" in the brain is composed of structures such as the amygdala that are involved in one's emotional regulation. An increased anxiety or fear response, for example, can activate our brain's limbic system with turning on the "fight or flight" or "survival response" which then dominates our perceptions, feelings, and body responses.
Anxiety can be experienced as fear, worry, impending danger, and it can miscolor our perception of reality. Everyone has "limbic responses”, and anxiety is part of the human condition, but it becomes a problem when it overwhelms the individual, harming their quality of life.
At the Drake Institute, our goal is to help patients feel stronger, healthier, safer and more secure by providing them with the ability to overcome an excessive anxiety response. Our patients learn to prevent their limbic system from taking them over, compromising their sense of well-being.
When the limbic system is activated, you are in the "limbic state", which results in feeling threatened whether or not your external reality is truly threatening. Being in the limbic state in a life-threatening emergency is an appropriate response for survival, but not in day to day modern life pressures where actual survival is not at risk.
Many physiological changes occur in the body disrupting homeostasis or physiological balance, including an instantaneous increase in adrenaline levels, increase in your blood pressure and heart rate, an increase in your blood sugar, a compromised immune system response, a slowed down or inhibited digestion, a decrease in hand temperature with cold or clammy/sweaty palms, tension in the facial and shoulder muscles, and a shortness of breath.
Anxious feelings and anxiety become a “disorder” when the feeling of anxiety becomes overly intense and/or constant, out of proportion to the external situation and causes excessive distress and impairment in our functioning. Anxiety disorders can literally dominate one's experience, debilitating the individual.
The resulting fear or worry feels like reality, but it can be a misperception of one's external reality or circumstance where everything is negatively skewed and overwhelming. When one's attention is taken over with fear and worry it can deprive a person of rational problem solving, leading to a decreased quality of life. Overcome by anxiety, predominantly only negative information is experienced, positive reality is blocked out as one loses a rational perspective.
If you have been under severe or heightened stress, or chronic mild to moderate stress for extended periods of time, then your limbic system can become oversensitized or overactivated, and triggered more easily and frequently. The "fight or flight response" or fear response becomes chronically turned on, leaving one with an ongoing sense of fear, worry, pessimism, and anticipation of danger or a negative future.
This obviously can affect your physical health and deprive you of a healthy, fulfilling life. One may even suffer panic attacks. To reemphasize, when your anxiety is out of proportion to the situation, it can become debilitating. Psychophysiologically, you can truly feel threatened even though rationally you know you are safe. When overwhelming anxiety is present, rational problem solving capacity from the frontal lobes is overridden by survival emotions.
The Drake Institute of Behavioral Medicine began providing treatments for anxiety disorders in our first year of operation in 1980 and we have developed a highly successful, leading edge treatment of anxiety disorders, particularly where other treatments were not fully effective.
Our anxiety treatment process uses computerized, state of the art biofeedback and brain map guided neurofeedback instrumentation. Physiological levels of muscle tension, brainwave activity, hand temperature (measuring the sympathetic nervous system activity of the "fight or flight" response), galvanic skin response (sweat gland activity of your fingers) are recorded for elevated tension levels and a custom-tailored treatment is developed for each individual patient to bring these tension levels down to normal. Heart rate variability is also monitored and included in the treatment program to improve homeostasis of the autonomic nervous system.
The physiologic recordings/information are provided back to the patient instantaneously through auditory feedback or visual feedback (hand warming biofeedback, heart rate variability) enabling the patient to reduce abnormal tension levels as one truly learns to relax to physiological relaxation, restoring a healthy homeostasis or physiological balance.
Reducing physiological tension levels with biofeedback will not only reduce anxiety, but will reduce physical manifestations of anxiety. For example, elevated blood pressure will come down, muscle tensions in the head and face causing headaches will resolve to alleviate the headaches, etc., dramatically improving the patient’s ability to deal with common stressors without the overactive anxiety response and accompanying physical symptoms.
The biofeedback instrumentation measures physiological levels of tension that are below one's normal level of awareness. When a person normally relaxes, typically they go to a lower level of tension which feels better relative to their baseline, but may not be true physiological relaxation which maximizes restoring a healthier homeostasis or physiological balance.
Our biofeedback treatment helps patients learn to achieve deeper levels of physiological relaxation, which increases the likelihood of healing anxiety disorders without needing medications to manage or temporarily suppress symptoms, as a new homeostasis is achieved. Because our patients do not rely on the use of drugs, our treatment process could be considered as one of the most effective natural remedies for anxiety.
Though hand warming biofeedback, which relaxes the sympathetic nervous system and muscle relaxation biofeedback in relaxing the autonomic nervous system are both very therapeutically helpful, our clinical results have shown that EEG alpha and EEG alpha-theta biofeedback (also known as neurofeedback) are the most therapeutically helpful treatment for anxiety disorders. Sometimes adjunctive counseling or psychotherapy can be helpful in conjunction with biofeedback.
Patients also gain the benefit of learning heart rate variability biofeedback for anxiety disorders that further strengthens a patient's ability for self-regulation and prevention of panic attacks.
Lastly, a qEEG brain map can further identify dysregulated brain networks linked to anxiety disorders including PTSD and OCD. This also provides the blue print for brain-map guided neurofeedback.
Brain map-guided neurofeedback, including LORETA neurofeedback, offers further help to patients struggling with anxiety disorders, as it better enables them to achieve reduction or resolution of anxiety symptoms via self-regulation and regaining a normal homeostasis.
This process teaches the patient to shift their autonomic nervous system out of the “fight or flight state” to the healing or recovery mode state, which dramatically reduces symptoms of anxiety.
Patients looking for the best cure for anxiety can rest assured that our comprehensive biofeedback and neurofeedback treatment protocols will help reduce or resolve anxiety symptoms by developing a healthier homeostasis.
Furthermore, our treatment process typically produces long-term improvement since it relies on developing the patient’s self-regulation skills, which can be used for the rest of their lives to prevent anxiety or stress from dominating them again.
If anxiety disorder or any anxiety-related disorders are significantly impacting your quality of life, please call us today to schedule a no-cost screening consultation.
Interview with Dr. David Velkoff
Interview with Dr. David Velkoff
Spanish News Feature
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“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Behavioral Medicine and received his initial training in biofeedback/neurofeedback in Behavioral Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Behavioral Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Behavioral Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”