Jayakumar Patil, MDPsychiatry · Bedford, NH
Conditions/Anxiety

Anxiety Disorders

Persistent worry that gets in the way of living.

Anxiety is the brain's alarm system — useful in genuine danger, but in anxiety disorders, the alarm fires too often, too loudly, and in response to threats that aren't actually there. It's one of the most common psychiatric conditions, and one of the most responsive to treatment when properly addressed.

Signs and symptoms

Generalized anxiety

  • Excessive worry about multiple areas of life that is difficult to control
  • Feeling on edge, keyed up, or easily startled
  • Muscle tension, headaches, or GI discomfort
  • Fatigue and sleep difficulty despite exhaustion

Panic attacks

  • Sudden, intense surges of fear peaking within minutes
  • Racing heart, shortness of breath, chest tightness
  • Dizziness, trembling, or feeling detached from yourself
  • Fear of dying, losing control, or going crazy during the episode

Social anxiety

  • Intense fear of being judged, embarrassed, or humiliated in social situations
  • Avoidance of meetings, gatherings, or speaking up at work or school
  • Physical symptoms (blushing, sweating, voice shaking) in social settings

Dr. Patil's approach

How this condition is treated here.

Dr. Patil works to identify what type of anxiety is present — generalized anxiety, panic disorder, social anxiety, and PTSD each respond to somewhat different treatments. Medication can reduce the baseline level of arousal enough for therapy to take hold. In many cases, therapy (particularly exposure-based CBT) produces the most lasting change.

01

SSRIs and SNRIs

First-line medications for most anxiety disorders. They take several weeks to work fully but reduce overall anxiety burden without the dependency risk of benzodiazepines.

02

Benzodiazepines (short-term)

Used cautiously for acute or situational anxiety. Not a long-term solution due to tolerance and dependence risk, but can provide relief while longer-term treatments take effect.

03

Buspirone

A non-addictive option that works specifically for generalized anxiety. Takes 2–4 weeks but has a favorable side effect profile.

04

Therapy referral

Cognitive behavioral therapy, particularly exposure and response prevention, produces durable anxiety reduction. Dr. Patil coordinates with therapists in the area.

What to expect at your first visit

The first visit focuses on understanding the history and pattern of anxiety — when it started, what triggers it, how it affects daily function, and what has or hasn't helped before. A physical or thyroid issue that mimics anxiety is also ruled out.

  • Discussion of symptom patterns — when anxiety peaks, what triggers it, how long episodes last
  • Review of any prior anxiety treatment and its effects
  • An honest conversation about the role of medication vs. therapy vs. both
  • If panic attacks are present, a cardiac and medical review is part of the workup

Common misconceptions

Myth

"Anxiety is just worrying too much — it's not a real illness."

Fact

Anxiety disorders involve dysregulation of the brain's threat-detection system and produce measurable physiological responses. They are among the most studied and best-understood psychiatric conditions.

Myth

"The only way to manage anxiety is to avoid what triggers it."

Fact

Avoidance typically worsens anxiety over time by reinforcing the brain's assessment that the trigger is dangerous. Gradual, supported exposure is the most effective treatment.

Frequently asked questions

Is it normal to have anxiety every day?

Occasional anxiety is normal. When worry is persistent, difficult to control, and interfering with work, relationships, or sleep most days for six months or more, it crosses into generalized anxiety disorder territory.

Will I need medication forever?

Many people take anxiety medication for 6–12 months while also working with a therapist, then taper off successfully. Others benefit from longer-term treatment. This is a conversation, not a fixed decision.

Can anxiety cause physical symptoms?

Yes. Chest tightness, shortness of breath, GI problems, headaches, and muscle tension are all common physical manifestations of anxiety. This is why a thorough medical review is part of the first evaluation.

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