Anxiety Disorders
Worry and fear that take over your days are treatable. Calm is possible again.
This information is educational and is not a diagnosis. Diagnosis requires a comprehensive psychiatric evaluation.
If you are in crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911.
What it is
Anxiety is a normal response to stress and can even be helpful. Anxiety disorders are different: the fear or worry is more intense or lasting than the situation calls for, is hard to control, and interferes with work, school, relationships or daily life.
Anxiety affects both mind and body. It can show up as racing thoughts, a pounding heart, muscle tension, stomach upset or trouble sleeping. Anxiety disorders are among the most treatable conditions in mental health.
Diagnostic features (DSM-5-TR)
A plain-language summary of key features described in the DSM-5-TR. This is not the official criteria text and is not a self-diagnosis tool.
Generalized Anxiety Disorder (GAD)
- Excessive anxiety and worry about a number of everyday events or activities, more days than not, for at least 6 months.
- The worry is difficult to control.
- At least three of the following (one in children): restlessness or feeling keyed up, tiring easily, trouble concentrating, irritability, muscle tension and sleep problems.
- It causes significant distress or impairment and is not due to a substance, medical condition or another mental disorder.
Panic Disorder
- Recurrent, unexpected panic attacks: sudden surges of intense fear or discomfort that peak within minutes, with physical and mental symptoms such as a pounding heart, sweating, trembling, shortness of breath, chest discomfort, dizziness, or fear of losing control or dying.
- At least one attack is followed by a month or more of persistent worry about more attacks or their consequences, or significant changes in behavior to avoid them.
- Not due to a substance or medical condition, and not better explained by another disorder.
Social Anxiety Disorder
- Marked fear or anxiety about social situations in which you may be observed or judged, such as conversations, meeting new people, eating in front of others or giving a presentation.
- Fear of acting in a way, or showing anxiety, that will be judged negatively.
- These situations are avoided or endured with intense fear, out of proportion to the actual threat, typically for 6 months or more, and cause significant distress or impairment. In children, anxiety must occur with peers, not just adults.
Common signs
- Constant or excessive worry
- Feeling restless, tense or on edge
- Trouble sleeping
- Muscle tension, headaches or stomach upset
- Sudden episodes of intense fear with a racing heart
- Avoiding situations, places or people
- Fear of being judged or embarrassed
- Difficulty concentrating
- Irritability
How it's evaluated
I ask about your worries, physical symptoms, triggers, sleep and how anxiety affects your life. Validated tools such as the GAD-7 help measure severity and track progress.
Because many medical conditions and substances can cause anxiety, I review thyroid and heart health, caffeine, alcohol, cannabis and medications, and may recommend lab work. I also screen for depression, trauma and ADHD, which often occur alongside anxiety.
Evidence-based treatment options
Cognitive behavioral therapy (CBT)
CBT, including exposure-based approaches, is a first-line, well-studied treatment for anxiety disorders. It teaches practical skills that last beyond treatment.
First-line medications
SSRIs and SNRIs, such as sertraline, escitalopram, venlafaxine and duloxetine, are recommended first-line medications for many anxiety disorders.
Other options
Buspirone and pregabalin are among the options for generalized anxiety disorder, depending on your history and needs.
Careful use of benzodiazepines
Benzodiazepines can relieve anxiety quickly but carry an FDA boxed warning for misuse, dependence and withdrawal. When used, it is generally short-term and with careful monitoring.
Read my benzodiazepine policyLifestyle supports
Regular physical activity, consistent sleep, and reducing caffeine and alcohol can meaningfully lower anxiety.
How I can help
I offer calm, practical care for worry and panic. I take time to understand what drives your anxiety, rule out medical contributors and identify co-occurring conditions.
Together we decide on a plan that may include medication, referral for CBT, and skills you can use right away, such as breathing and grounding techniques. I follow up regularly and adjust treatment until anxiety no longer runs your life.
Insight
Avoiding what makes you anxious brings relief in the moment, but over time it can make anxiety stronger. Gradually facing feared situations with support is one of the most effective ways to retrain the brain's alarm system.
Sources
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).
- National Institute of Mental Health (NIMH): Anxiety Disorders
- NICE guideline CG113: Generalised anxiety disorder and panic disorder in adults
- NICE guideline CG159: Social anxiety disorder: recognition, assessment and treatment
- U.S. Food and Drug Administration: Boxed warning for benzodiazepines (2020)
Heal • Grow • Thrive
Ready When You Are.
Putting your mental health first is a strength. It is okay to ask for help.