Understanding Anxiety Disorders

Anxiety disorders aren't simply feeling worried or stressed. They represent dysregulation of the threat detection system—specifically the HPA axis (hypothalamic-pituitary-adrenal) and the autonomic nervous system. When I assess anxiety, I'm evaluating how the brain detects threat, processes fear, and regulates the stress response. Chronic anxiety isn't just psychological—it's physiological.

Anxiety disorders include generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, specific phobias, and other related conditions. The National Institute of Mental Health reports that anxiety disorders are among the most common mental health conditions, affecting approximately 31% of adults at some point in their lives.

What makes anxiety particularly challenging is that it can create a feedback loop: anxiety causes physical symptoms (rapid heart rate, shortness of breath, dizziness), which triggers more anxiety about those symptoms, which intensifies the physical response. Breaking this cycle requires addressing both the underlying anxiety and the physiological response.

An Integrative Approach to Anxiety Treatment

Integrative psychiatry recognizes that anxiety has multiple drivers—neurobiological, psychological, and physiological. Treatment addresses these comprehensively rather than focusing solely on symptoms.

My approach includes:

Comprehensive Evaluation: Thorough assessment of anxiety symptoms, triggers, patterns, medical history, medication history, lifestyle factors, sleep patterns, and stress levels
Medication Management: When medication is indicated, I use evidence-based approaches including SSRIs, SNRIs, or other medications when appropriate. Medication decisions are made collaboratively, with attention to your comfort and long-term well-being
Psychotherapy Integration: Evidence-based psychotherapeutic approaches including cognitive-behavioral therapy (CBT), exposure therapy for phobias, and techniques for managing panic attacks and anxious thoughts
Lifestyle Medicine: Attention to sleep architecture, circadian rhythms, stress management, physical activity, and techniques that support autonomic nervous system regulation
Nutritional Support: Assessment of nutritional factors that may influence anxiety, including magnesium, B vitamins, and other nutrients that support nervous system function

This integrative model recognizes that anxiety affects multiple body systems. Treatment addresses these systems comprehensively, supporting both symptom reduction and increased capacity for resilience.

Panic Disorder

Panic attacks involve sudden activation of the sympathetic nervous system—the fight-or-flight response triggered inappropriately. This isn't "just anxiety"—it's a physiological cascade: amygdala activation triggers locus coeruleus norepinephrine release, which activates the sympathetic nervous system, causing rapid heart rate, hyperventilation, and the cascade of physical symptoms that make panic feel like dying.

Understanding this mechanism helps patients recognize that panic is intense but not dangerous—the body is responding as if there's a threat, but there isn't one. Treatment for panic disorder typically includes medication to reduce the frequency and intensity of attacks, psychotherapy to address underlying triggers, and techniques for managing panic when it occurs.

Many patients find that addressing sleep disruption, optimizing stress management, and supporting autonomic nervous system regulation significantly reduces panic frequency, even before medication takes full effect.

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder involves persistent, excessive worry about multiple areas of life—work, relationships, health, finances, and daily responsibilities. This worry is difficult to control and is accompanied by physical symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

Treatment for GAD typically includes medication to reduce baseline anxiety, psychotherapy to address worry patterns and develop coping strategies, and lifestyle modifications to support nervous system regulation. Many patients find that improving sleep quality, managing stress, and developing mindfulness practices significantly supports treatment outcomes.

Social Anxiety Disorder

Social anxiety involves intense fear of social situations, fear of being judged or embarrassed, and avoidance of social interactions. This can significantly impact work, relationships, and quality of life.

Treatment typically includes medication to reduce anxiety in social situations, exposure therapy to gradually build comfort with social interactions, and cognitive techniques to address negative thoughts about social situations. Many patients find that addressing underlying issues such as trauma or attachment patterns significantly supports treatment.

What to Expect in Treatment

Your initial evaluation is comprehensive—typically 90 minutes—allowing time to understand your anxiety symptoms, triggers, patterns, and goals thoroughly. We develop initial diagnostic impressions and discuss evidence-based treatment options. Treatment proceeds collaboratively, with regular check-ins to assess progress and adjust approaches as needed.

Follow-up appointments may focus on medication management, psychotherapy, or both, depending on your needs. Some patients benefit from short-term treatment for a specific concern. Others benefit from ongoing treatment focused on long-term stability and resilience.

The goal isn't just symptom reduction—it's restored function, improved quality of life, and increased capacity to engage with life without excessive anxiety. Treatment is individualized, paced thoughtfully, and grounded in clinical evidence.

Serving Los Angeles Area

I provide adult anxiety treatment to patients throughout Los Angeles County, including Hollywood, Beverly Hills, Santa Monica, West Hollywood, Burbank, Glendale, Pasadena, and surrounding areas. The practice is located in Hollywood and offers both in-person and telepsychiatry visits for adults throughout California.

If you're experiencing symptoms of anxiety, know that effective treatment is available. Anxiety disorders are treatable conditions, and many patients experience significant improvement with appropriate care.

References & Resources

For additional information about anxiety disorders, I recommend these authoritative sources:

Contact us to schedule a consultation or learn more about our approach to anxiety treatment.

Adult Anxiety Treatment in Los Angeles