Anxiety
Worry that has stopped being proportionate
Anxiety is treatable, and the first-line treatments are genuinely good. We start there. The newer options exist for people those have not reached, and we are careful about which is which.
- Therapy first
- because the evidence for it in anxiety is strong
- Often covered
- psychotherapy and psychiatry on most major plans
- Same week
- is usually how quickly we can see you
01Where we start
First-line treatments work We start there
For anxiety, cognitive behavioural therapy and SSRIs have a deep and consistent evidence base. If you have not had a real course of either — a proper dose for a proper length of time, or a therapist you actually connected with — that is where we start.
What brings most people here is that they have done that, and something is still not right. Anxiety that persists through good treatment often has company: unresolved trauma, chronic pain, a serious diagnosis, or a depression sitting underneath it. Treating the anxiety alone underperforms when that is the case.
On ketamine for anxiety: the evidence is thinner than for depression — real, but smaller, and mostly in people who have depression alongside the anxiety. We consider it where standard treatment has not worked, not as a starting point.
For anxiety, cognitive behavioural therapy and SSRIs have a deep and consistent evidence base. If you have not had a real course of either — a proper dose for a proper length of time, or a therapist you actually connected with — that is where we start.
What brings most people here is that they have done that, and something is still not right. Anxiety that persists through good treatment often has company: unresolved trauma, chronic pain, a serious diagnosis, or a depression sitting underneath it. Treating the anxiety alone underperforms when that is the case.
On ketamine for anxiety: the evidence is thinner than for depression — real, but smaller, and mostly in people who have depression alongside the anxiety. We consider it where standard treatment has not worked, not as a starting point.
02What we offer
The routes open to you, in the order we would suggest them
Which of these is right depends on your history and what you have already tried. That is decided in a consultation with a physician.
- 01PsychotherapyCBT, EMDR, somatic and mindfulness-based work, depending on what is driving it. The best-evidenced treatment for anxiety, and covered on many plans.
- 02Psychiatry & medication managementA proper evaluation of what you have taken, at what dose, and for how long. A surprising amount of “medication did not work” turns out to be an under-treated trial.
- 03Integrative medicineAcupuncture, nervous-system regulation, sleep and nutrition. Adjunctive rather than curative, and useful for the physical end of anxiety.
- 04Ketamine-assisted psychotherapyConsidered where anxiety sits alongside depression or trauma and standard treatment has not reached it. Not a first-line anxiety treatment.
03Is this for you
Where this helps, and where it does not
Yes
Often a good fit
- Therapy or medication has helped, but not enough
- Anxiety alongside depression, trauma, chronic pain, or a serious diagnosis
- Panic that has started to shape where you will and will not go
- You want a physician to look at the whole picture rather than one symptom
No
Not the right tool
- You have not yet tried CBT or an SSRI — those work, and they come first
- Benzodiazepines as a treatment plan — we prescribe them rarely, and not on a first visit
- You are in crisis right now — call or text 988
- Anxiety that is entirely situational and recent — that often resolves on its own
04Common questions
Does ketamine work for anxiety?
The evidence is meaningfully weaker than for depression. Most supportive data comes from people who had depression and anxiety together, where both improved. There is some direct evidence in anxiety alone, but it is smaller and less consistent. We consider it where standard treatment has not worked.
Will you prescribe benzodiazepines?
Rarely, and not as a long-term plan. They work quickly, which is exactly why dependence develops, and long-term use tends to make anxiety harder to treat. If you are already taking them, we will not stop them abruptly — we will work with you on a plan.
Is psychotherapy covered?
On many plans, yes, along with psychiatry and medication management. We verify your specific benefits before your first appointment and tell you what your share will be.
How fast can I be seen?
Usually within the same week for an initial consultation. If you are in crisis, do not wait for an appointment — call or text 988, which is free and staffed 24/7.