The COVID-19 pandemic has been accompanied by a range of intense emotions, and for many people, this includes acute feelings of uncertainty and worry. It seems some people have tried using weighted blankets to find comfort, as sales have increased during the pandemic.

Manufacturers often tout the blankets as a nonpharmaceutical method to help quell anxiety, sleeplessness, stress, restlessness, unease and other symptoms.

A 2015 Journal of Sleep Medicine & Disorders study by Swedish researchers found that subjects with insomnia who began using weighted blankets reported improved sleep quality, being better able to settle down to sleep and feeling more refreshed in the morning.

In the realm of professional counseling, how do these claims stack up? Are these blankets truly helpful for symptoms of mental illness? Are practitioners and clients talking about the use of weighted blankets — and their possible benefits — in counseling sessions?

CT Online collected thoughts on the use of weighted blankets from professional counselors across the U.S. Add your experience in the comment section at the end of this article.

 

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The challenge to weighted blankets is that they provide physical weight but not the compression or true pressure that many with attention-deficit/hyperactivity disorder (ADHD) and autism may be seeking. Although many people do report that a weighted blanket assists in reducing their overall stress and allows more effective sleep, I believe the question really should be: Does the weighted blanket actually create those improvements, or are the reported positive changes actually due to the weighted blanket causing us to sit still for a little bit?

This slowdown during our typically fast-paced day might be a significant reason so many of us truly believe that weighted blankets help. Trend or not, I think weighted blankets show true promise in helping people learn to be more mindful of their busy lives.

I have found that weighted blankets appear to provide minimal benefits to kids with ADHD or autism. Although many of the kids I work with do enjoy the weight, parents nor children typically report significant benefits. In fact, although a large number of my families have purchased weighted blankets, very few use them on any consistent basis. I believe this is due to the concept of weight versus compression.

Although the weight can feel good, for the kids I work with, it does not provide enough sensory input to make a difference. Instead, they often seek compression or pressure.

Although weighted blanket [retailers] often talk about the “pressure” it provides, the difference is in the details. It does provide pressure, but not the deep pressure that many with ADHD or autism are seeking in times of dysregulation. In fact, kids with tactile and or proprioceptive sensory behaviors often seek out deep pressure to help regulate their nervous system. This means they often need more than what a weighted blanket can provide.

I have found that my kids who do like weighted blankets use all the weighted blankets in the house and they are oftentimes using three or four weighted blankets at once! This means the weight they are seeking is much higher than the 10% of their own body weight [that is the recommended guideline].

Although weighted blankets are definitely a trending item, I fully believe they are here to stay. However, they will probably be most useful for those who like to sleep with extra blankets purely because they like the [feeling of the] weight. For everyone else, I think compression items are often the way to go.

• Michelle Tolison, a licensed clinical mental health counselor and owner of Dandelion Family Counseling in Charlotte, North Carolina. A registered play therapist, she works with children who are twice-exceptional (particularly those with ADHD).

 

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As a child therapist, I’ve long known that occupational therapists use weighted blankets to help children with sensory issues and anxiety, including children with ADHD and autism spectrum disorder. These blankets have moved into the mainstream, but just because they’re popular does not mean they can be used to help children without first consulting a medical doctor or an occupational therapist.

A weighted blanket provides deep pressure to the body, which can help induce relaxation. However, there are physical safety concerns when it comes to children and weighted blankets. They shouldn’t be used on a child younger than 2 years old. The child needs to be able to remove the blanket themselves, and their head should never be covered. If the pellets fall out of the blanket, they can be a choking hazard. Parents should always supervise their child when using a weighted blanket.

The American Occupational Therapy Association advises against sensory-based interventions, such as weighted blankets, unless children have been thoroughly assessed. In my opinion, professional counselors are not trained to provide sensory assessments nor suggest sensory-based interventions. Suggesting a weighted blanket as an intervention for a child would be outside of the scope of our practice and could be considered unethical.

If a parent has concerns about their child’s anxiety, hyperactivity, autism, sensory processing disorder, or just an inability to go to sleep and stay asleep, I encourage them to speak to their pediatrician before they utilize a weighted blanket. Their pediatrician may recommend an evaluation by an occupational therapist.

• Pam Dyson, a licensed professional counselor supervisor and registered play therapist supervisor in Spring Hill, Tennessee, who offers virtual play therapy supervision and consultation services.

 

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During the COVID-19 pandemic, there’s no doubt that mental health symptomology is on the rise, most commonly anxiety and depression, but also for people diagnosed with autism and ADHD, since it seems to be much more of a struggle to regulate one’s emotional/behavioral state during these uncertain times. Interestingly enough, it’s also been noted that the sales of weighted blankets have increased during the pandemic. Coincidence? I think not.

Adding weight/pressure to our large muscle groups (with a weighted blanket) activates the body’s proprioceptive sensory system. Activating this system increases both dopamine and serotonin in the brain, helping people to feel more emotionally regulated, calm and in better control of their emotions and behaviors.

Dopamine is our main “feel good” neurotransmitter and main “focus” neurotransmitter. When there is an insufficient amount of dopamine being produced, retained or transported, it’s like there is a “reward deficiency syndrome” occurring. Therefore, the brain requires increased stimulation to obtain a sense of satisfaction/reward, which can be seen in the hyperactive response of those with ADHD or autism when they sensory-seek (spinning around and around) or when they novelty-seek (hanging over a two-story banister). Due to these struggles, they tend to seek excessive proprioceptive input with the intention to calm their nervous systems — but in maladaptive manners. Their excessive movement can come across as chaotic to themselves and disruptive to others.

During a pandemic, with an increased amount of time at home and without the full structure of school, clubs, organized sports, etc., that in itself can cause these symptoms to increase. A weighted blanket can assist in the retention of dopamine so these people don’t need to seek stimulation in such maladaptive manners and therefore can remain more in control of themselves. This means that a weighted blanket can be beneficial for people with autism and ADHD who have difficulty planning their movements and regulating their level of arousal. When they feel pressure from a weighted blanket on their large muscle groups, it can actually give them this proprioceptive input in a more organized manner, leading to increased attention, less internal chaos and less disruption to others.

Serotonin is a neurotransmitter that helps soothe us when we feel stressed. Serotonin is also involved in our survival mechanism to help regulate our sleep, food cravings/appetite and sexual desire. It’s involved in memory, mood/irritability levels and sensitivity/insecurity/self-confidence levels. With an insufficient amount of serotonin being produced, transported or retained, people tend to feel anxious, irritable and can have difficulty sleeping. A weighted blanket can add proprioceptive input to help retain serotonin in the brain, so one can feel calmer, soothed and more self-confident and self-secure.

Physical containment from a weighted blanket can help facilitate emotional containment [and] a sense of stability and promote behavioral regulation. (Think about it as a similar concept to “swaddling” a baby to soothe them when they are upset and to help them sleep.) It’s no wonder that the sales of weighted blankets for children and adults are on the rise during a time of uncertainty.

• Donna Mac, a licensed clinical professional counselor at a school in the Chicago area that specializes in helping students with emotional disorders, higher-functioning autism, secondary learning disabilities and other health impairments.

 

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More than one client has reported an improvement in their sleep after using a weighted blanket (or even multiple regular, heavy blankets if they couldn’t afford a weighted one) at home to give them a sense of pressure. Given all that we know now about how trauma impacts the body, it makes a lot of sense to look at as many sensory modalities as possible when working with this population.

As a personal anecdote, I have a nephew on the autism spectrum, and there was a dramatic change in his behavior after he started using a weighted blanket to improve his sleep quality at night. I do realize that the plural of anecdotes is not data, but I’ve certainly had enough positive feedback from people to suggest it to clients as an option to explore.

• Kirsti Reeve, a licensed professional counselor at a group practice, Transcendence Behavioral Health, in Royal Oak, Michigan. She specializes in working with self-injury, teens and trauma and is also a certified drug and alcohol counselor.

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.