Anxiety Disorders
Anxiety is the most common psychiatric presentation we see, and one of the most treatable. It is also frequently mismanaged, because the physical symptoms send people to cardiology and gastroenterology long before anyone asks about anxiety.
What counts as an anxiety disorder?
Worry becomes a disorder when it is disproportionate, difficult to control, and interfering with function. The common presentations:
- Generalized anxiety — persistent worry across many
tension, fatigue, and difficulty concentrating - Panic disorder — discrete attacks of intense fear with
often followed by fear of further attacks - Social anxiety — fear of scrutiny or judgment, frequently mistaken for introversion
- Health anxiety — persistent fear of serious illness despite reassurance
Why does anxiety cause physical symptoms?
Because the autonomic nervous system does not distinguish between a threat and a thought about a threat. Racing heart, chest tightness, shortness of breath, nausea, dizziness, and tingling are physiological consequences of a stress response: not imagination. This is why panic attacks are so often mistaken for cardiac events, and why many people arrive having had a normal ECG, normal bloodwork, and a clean imaging studies. Those results do not mean nothing is wrong: they mean the mechanism is a different one.
What medical conditions mimic anxiety?
- Hyperthyroidism — produces a near-identical picture
- Anemia and iron deficiency
- Cardiac arrhythmias
- Perimenopause — see perimenopause depression and anxiety
- Caffeine, stimulant medication, and withdrawal from alcohol, benzodiazepines, opioids, and several other substances
- Reactive hypoglycemia — blood sugar instability produces symptoms indistinguishable from panic
That last one is frequently missed and easily addressed. For more Info, see nutritional psychiatry.
Is anxiety or ADHD causing my concentration problems?
It can be either, and sometimes both. Anxiety impairs concentration by occupying working memory; ADHD impairs it through a different mechanism. The distinction matters because stimulant medication frequently makes untreated anxiety considerably worse. This is one reason we test objectively rather than diagnosing ADHD from questionnaires alone. See adult ADHD.
How is anxiety treated?
Anxiety responds well to treatment. Options include SSRI/SNRI/SerM medications, which are first-line and not habit-forming; cognitive behavioral therapy, which has evidence comparable to medication; and attention to sleep, caffeine, alcohol, and blood sugar, which are not trivial contributors.
On benzodiazepines (aka Ativan, Valium, Xanax, Klonopin): they work quickly and carry real risks with sustained use. We prescribe them sparingly and within defined limits — see our prescribing policies, so you know our approach before scheduling.
We do not provide therapy in-house, but we deeply value the opportunity to make informed, personalized referrals. Medication and therapy together generally outperform either treatment modality alone.
If you are in crisis, please immediately call or text 988 for the Suicide & Crisis Lifeline, or call 911. Safety is our top priority, and our outpatient office is not equipped to handle emergencies.
Treatment in person and throughout Arizona
We see patients in person at our office in Glendale (in the Arrowhead area) and via telehealth anywhere in Arizona — from Tucson, to Flagstaff, to the east valley, and everywhere between. Virtual visits are the same appointment with the same provider at the same rate.
Getting Started
Our comprehensive, new patient evaluations are $375 and require 60 to 90 minutes.
Our psychiatric follow-up visits are $125 and require 30 minutes.
(Thank you for arriving early, as we are unable to see late patients and must reschedule if life gets in the way of you arriving on time.)
We are out-of-network with all insurance carriers but will gladly provide a superbill you can submit to insurance to seek reimbursement.
For more info, please see our fees page.
Pinnacle Psychiatry
17505 N 79th Ave, Suite 309, Glendale, AZ 85308
Phone 623.321.2221 · Text 877.749.7502
Monday–Wednesday 8:00am–5:00pm · Thursday 7:00am–5:00pm