Anxiety can take different forms.
People may come in because of persistent worry, physical tension, panic, avoidance, irritability, perfectionism, difficulty sleeping, fear of making mistakes, or a sense of always being on alert. Anxiety can also show up as overpreparing, reassurance seeking, procrastination, or difficulty tolerating uncertainty.
In children and adolescents, anxiety may appear through school avoidance, somatic complaints, irritability, separation difficulty, or a growing need for reassurance. In adults, it may become most visible in work, relationships, parenting, sleep, or situations involving performance and responsibility.
EVALUATION
The goal is to understand the anxiety, not just label it.
I consider symptoms, history, development, relationships, school or work demands, sleep, prior treatment, and the ways anxiety may be helping or limiting the person. I also consider whether attention problems, depression, medical concerns, substance use, stressful circumstances, or other factors are contributing.
For children and teens, parents and other sources of information can be important. For adults, the evaluation may also include patterns around work, relationships, performance, avoidance, and self-expectations.
TREATMENT
Treatment depends on what is maintaining the anxiety.
For some people, psychotherapy is the main treatment. For others, medication is useful as well. Treatment can also involve changes in routines, sleep, avoidance patterns, expectations, or the way someone responds to uncertainty and stress.
Psychotherapy
Psychotherapy can help identify patterns that maintain anxiety, increase awareness of triggers and avoidance, and create more room for deliberate choices rather than automatic reactions.
PsychotherapyMedication
Medication may be useful when anxiety is persistent, significantly impairing, or not improving enough with other approaches. Any medication decision should follow an individualized discussion of benefits, limitations, side effects, and alternatives.
Medication managementOVERLAP
Anxiety often overlaps with other concerns.
Attention difficulties, depression, sleep problems, relationship stress, and demanding environments can all interact with anxiety. Anxiety can also make concentration and follow-through harder, which is one reason it can sometimes resemble or coexist with ADHD.
ACROSS AGES
Anxiety looks different at different stages of life.
Children and teenagers need to be understood in the context of development, family, school, friendships, and increasing independence. Adult anxiety may be shaped more by work, relationships, parenting, identity, health, or major transitions.
COMMON QUESTIONS
Questions about anxiety treatment.
When should anxiety be evaluated by a psychiatrist?
A psychiatric evaluation can be useful when anxiety is persistent, significantly affecting functioning, overlapping with other symptoms, or when medication or diagnostic clarification may be helpful.
Can anxiety look like ADHD?
Yes. Anxiety can interfere with attention, working memory, follow-through, and organization. ADHD and anxiety can also occur together, so the overall history and pattern matter.
Do you treat anxiety in children and teenagers?
Yes. Evaluation considers development, family, school, friendships, sleep, and the different ways anxiety can appear at younger ages.
Do you treat anxiety in adults?
Yes. Adult treatment may address symptoms as well as work pressure, relationships, avoidance, perfectionism, identity, or recurring patterns that contribute to anxiety.
Does anxiety treatment always involve medication?
No. Psychotherapy may be the main treatment for some people. Medication may be useful for others, depending on severity, impairment, prior treatment, and individual circumstances.
Can psychotherapy and medication be combined?
Yes. Some people benefit from one approach, while others benefit from both. The balance can change over time.
GETTING STARTED
Care begins with a thoughtful assessment.
Some people need a focused consultation. Others benefit from medication management, psychotherapy, or an integrated approach. We decide together what fits the situation.