Anxiety & Panic Disorders

Anxiety disorders are the most common category of mental health condition in the United States. Greater Boston Psychiatric Services provides psychiatric evaluation and ongoing medication management for adults experiencing anxiety and panic disorders, by telehealth or in person at our office in Medway.

What Is Anxiety & Panic Disorders?

Anxiety is a normal response to stress, but an anxiety disorder involves worry or fear that is excessive, persistent, and out of proportion to the actual situation — and that interferes with daily functioning. Anxiety disorders cover a range of related conditions, from generalized, free-floating worry to sudden, intense episodes of panic. Left untreated, anxiety tends to persist and can worsen over time, but it responds well to appropriate treatment.

Types of Anxiety & Panic Disorders

• Generalized Anxiety Disorder (GAD) — excessive, difficult-to-control worry about a wide range of everyday things, most days, for six months or more

• Panic Disorder — recurrent, unexpected panic attacks — sudden surges of intense fear with physical symptoms like a racing heart, shortness of breath, or chest tightness

• Social Anxiety Disorder — intense fear of social or performance situations, driven by fear of judgment or embarrassment

• Specific Phobias — intense, focused fear of a specific object or situation, such as flying, heights, or medical procedures

Signs & Symptoms

• Excessive worry that's difficult to control

• Restlessness or feeling on edge

• Rapid heartbeat, chest tightness, or shortness of breath

• Muscle tension or unexplained physical aches

• Difficulty concentrating, or mind going blank

• Sleep disturbance, including trouble falling or staying asleep

• Irritability

• Avoidance of situations that trigger anxiety

• Sudden panic attacks with a fear of losing control or dying

Causes & Risk Factors

• Genetics and family history of anxiety disorders

• Brain chemistry, particularly involving serotonin and norepinephrine pathways

• Chronic stress or a history of trauma

• Certain medical conditions (such as thyroid disorders) or medications

• Caffeine or stimulant use, which can worsen or mimic anxiety symptoms

How It's Diagnosed

An anxiety disorder is diagnosed through a clinical evaluation focused on the pattern, duration, and severity of your symptoms, and how much they interfere with your daily life. Your clinician will also screen for medical causes that can produce anxiety-like symptoms, such as thyroid dysfunction, and for co-occurring conditions like depression, which frequently overlaps with anxiety.

Treatment Options

Anxiety and panic disorders are commonly treated with medication (most often SSRIs or SNRIs, and in some cases short-term use of other medications), psychotherapy — particularly cognitive behavioral therapy (CBT) — or a combination. Our clinicians manage the medication side of treatment: selecting an appropriate medication, monitoring your response, and adjusting as needed over time. We don't provide therapy directly, but CBT in particular has strong evidence for anxiety, and we're glad to coordinate with a therapist you're already seeing or provide a referral.

When to Seek Help

If worry, physical anxiety symptoms, or panic attacks are affecting your sleep, work, relationships, or ability to do everyday things, it's worth scheduling an evaluation — you don't need to wait for a crisis. If you're experiencing a panic attack with chest pain and are unsure whether it's cardiac in nature, seek emergency care to rule out other causes.

Insurance & Self-Pay

We're in-network with Blue Cross Blue Shield, Aetna, Harvard Pilgrim Healthcare, Optum, Tufts Health Plan, Wellpoint, United Healthcare, HPI, Mass General Brigham, Carelon, UMR, and UniCare. Self-pay options are available. We are unable to bill Medicare, Medicaid, or supplemental plans.

Frequently Asked Questions

What's the difference between everyday stress and an anxiety disorder?

Everyday stress is usually tied to a specific situation and resolves once that situation passes. An anxiety disorder involves excessive worry or fear that persists, often without a clear trigger, and that interferes with daily functioning.

Are panic attacks dangerous?

Panic attacks are frightening but not physically dangerous on their own — the physical symptoms (racing heart, shortness of breath) are the body's stress response, not a sign of a heart attack. That said, if you've never had a panic attack before and aren't sure what's happening, it's reasonable to seek emergency evaluation to rule out other causes.

Do I need therapy, medication, or both?

It depends on the severity and type of anxiety. Many people do well with medication alone; others benefit most from combining medication with therapy, especially CBT. Your clinician will discuss what approach makes sense based on your evaluation.

How long does anxiety medication take to work?

If your clinician prescribes an SSRI or SNRI, it typically takes two to six weeks for full effect, similar to antidepressant treatment for depression. Other medications used for acute anxiety symptoms can work more quickly, but aren't intended for long-term daily use.

Can anxiety be cured, or only managed?

Many people achieve full remission of symptoms with treatment. For others, anxiety is a long-term pattern that's well controlled with ongoing medication management. Either way, most people see substantial improvement in their quality of life.

Is it normal to have both anxiety and depression?

Yes, anxiety and depression frequently occur together. Your evaluation will look at both, since treatment sometimes needs to address them together rather than in isolation.

Related Conditions We Treat

Anxiety & Panic Disorders often overlaps with, or can be mistaken for, other conditions. We also provide evaluation and medication management for Depression, OCD (Obsessive-Compulsive Disorder), Sleep Disturbance.

Get Started

If you're experiencing symptoms of anxiety & panic disorders, the first step is a comprehensive psychiatric evaluation, available by telehealth or in person at our office in Medway. Schedule an appointment or view our full list of conditions we treat.