Anxiety Treatment in Southlake, TX

Anxiety is treated here, at your regular visits, usually starting the same day you bring it up. Waiting three months for a psychiatry opening is the main reason people go untreated, and for most adults it is not necessary.

Screening and diagnosis

We screen with the GAD-7 at every physical and any time symptoms come up. The score is not the diagnosis. It is a way to measure severity and then track whether treatment is working, which is otherwise easy to lose sight of.

We also ask which pattern this is, because the treatment differs. Generalized worry, panic attacks, social anxiety, health anxiety and post-traumatic symptoms respond to different approaches, and lumping them together is why some people get treated for a year without improving.

Ruling out physical causes

Several medical conditions produce symptoms indistinguishable from anxiety, and testing first is not a delay tactic. It is how you avoid treating the wrong thing for a year.

We check thyroid function, a CBC for anemia, and an EKG when palpitations are prominent. We ask about caffeine intake in actual cups, alcohol in actual drinks, stimulants including ADHD medication and decongestants, and cannabis, which worsens anxiety in a substantial number of people who use it to treat anxiety.

Sleep apnea presents as anxiety often enough that we screen for it in the right patients. See sleep apnea and thyroid disorders.

Treatment

SSRIs and SNRIs are where most people start. We pick based on your symptoms, your other conditions, side effect profile, and what has or has not worked for you before.

We start at a lower dose than we would for depression, because anxious patients are more sensitive to the early activation these drugs can cause. Then we check in at two weeks, by phone or telehealth if that is easier.

That early contact matters enormously. Side effects peak before benefit arrives, and most people who quit do it in that window, having concluded the medication made them worse.

Buspirone is a reasonable option for generalized anxiety without the dependence issues. Hydroxyzine helps situationally. Propranolol works well for performance anxiety and physical symptoms.

Benzodiazepines

We prescribe them rarely and briefly, if at all.

They work quickly, which is exactly why they are appealing and exactly why they cause problems. Tolerance builds, stopping is genuinely hard, and in older adults they raise the risk of falls, fractures and cognitive impairment substantially. Combined with opioids they are dangerous.

If you are already on one, we do not simply stop it. Tapering safely takes months and we do it with you rather than to you.

Therapy

Cognitive behavioral therapy has the strongest evidence in anxiety, and its benefits persist after treatment ends in a way medication effects do not.

We keep a referral list and help you sort through what your insurance covers, which is usually the actual barrier rather than motivation.

What else helps

Regular aerobic exercise has a genuine, measurable effect on anxiety. Alcohol reduction helps more than most people expect, since alcohol reliably worsens anxiety the following day. Sleep is both a cause and a consequence, covered on our sleep disorders page.

Anxiety and depression overlap heavily and we screen for both.

In a crisis

If you are in danger, call or text 988 any time, or go to your nearest emergency department. We are a scheduled outpatient practice and are not equipped for emergencies.

Anxiety is followed through our chronic condition management program. Read about our primary care Southlake practice.