When Anxiety Won't Shut Off

If you're reading this, chances are anxiety has become more than just occasional worry. Maybe it's the constant hum that never quite goes away. Maybe it's panic attacks that hijack your body without warning. Maybe it's avoiding things because the anticipatory anxiety is too much to bear.

Here's what we want you to know: Anxiety disorders are real medical conditions. You're not weak. You're not "just worrying too much." And you're definitely not alone.

Table of Contents

What Anxiety Disorders Actually Look Like

Anxiety isn't just feeling nervous or worried. Anxiety disorders involve persistent, excessive worry or fear that interferes with daily life.

Physical Symptoms:

  • Racing heart or palpitations
  • Chest tightness or pain
  • Shortness of breath or feeling like you can't breathe
  • Sweating, trembling, or shaking
  • Nausea or stomach problems
  • Dizziness or lightheadedness
  • Tension headaches
  • Muscle tension that won't release
  • Fatigue from constant vigilance

Mental/Emotional Symptoms:

  • Constant worry that won't shut off
  • Racing thoughts, especially at night
  • Feeling like something bad is always about to happen
  • Difficulty concentrating
  • Irritability
  • Feeling restless or on edge
  • Mind going blank
  • Catastrophic thinking ("what if" spirals)

Behavioral Symptoms:

  • Avoiding situations that trigger anxiety
  • Seeking reassurance repeatedly
  • Difficulty making decisions
  • Procrastination due to anxiety
  • Sleep problems (difficulty falling or staying asleep)
  • Difficulty being present or enjoying things

Types of Anxiety Disorders We Treat

Generalized Anxiety Disorder (GAD):

  • Excessive worry about multiple things (health, work, relationships, money, etc.)
  • Difficult to control the worry
  • Present more days than not for at least 6 months
  • Physical symptoms like tension, fatigue, restlessness
  • Worry is out of proportion to actual likelihood of events

Panic Disorder:

  • Recurrent unexpected panic attacks
  • Worry about having more panic attacks
  • Avoidance of situations where panic attacks have occurred
  • Panic attacks include intense physical symptoms (racing heart, chest pain, shortness of breath, dizziness, feeling like you're dying)
  • Panic attacks peak within minutes

Social Anxiety Disorder (Social Phobia):

  • Intense fear of social situations where you might be judged
  • Fear of embarrassment or humiliation
  • Avoidance of social situations
  • Physical symptoms when in social situations (blushing, sweating, trembling, nausea)
  • Recognition that the fear is excessive

Specific Phobias:

  • Intense fear of specific objects or situations (heights, flying, blood, animals, etc.)
  • Immediate anxiety response when exposed to the feared object/situation
  • Active avoidance
  • Recognition that the fear is excessive

Agoraphobia:

  • Fear of places or situations where escape might be difficult
  • Fear of being outside home alone, using public transportation, being in crowds
  • Avoidance of these situations
  • Often co-occurs with panic disorder

Health Anxiety (Illness Anxiety Disorder):

  • Preoccupation with having or getting a serious illness
  • High level of anxiety about health
  • Excessive health-related behaviors (checking body, seeking reassurance) or avoidance of medical care
  • Anxiety persists despite medical evaluation and reassurance

Medical Causes We Rule Out First

Before diagnosing an anxiety disorder, we check for medical conditions that can cause or worsen anxiety symptoms:

We Test For:

  • Thyroid problems: Hyperthyroidism commonly causes anxiety symptoms
  • Anemia: Can cause fatigue, rapid heartbeat, shortness of breath
  • Vitamin deficiencies: B12, vitamin D, magnesium deficiencies
  • Blood sugar issues: Hypoglycemia causes anxiety-like symptoms
  • Heart conditions: Some heart problems mimic panic attacks
  • Hormonal imbalances: Estrogen, progesterone, cortisol fluctuations
  • Caffeine/substance use: Can trigger or worsen anxiety
  • Medication side effects: Some medications cause anxiety

We order comprehensive lab work before finalizing treatment.

Considering Other Conditions: Sometimes what looks like anxiety is actually:

  • Depression: Anxiety and depression often co-occur
  • ADHD: Attention difficulties cause anxiety
  • PTSD or trauma: Hypervigilance and fear from past experiences
  • Bipolar disorder: Agitated depression or mixed states
  • OCD: Obsessive thoughts cause significant anxiety
  • Eating disorders: Often include significant anxiety
  • Substance use: Self-medication for anxiety or causing anxiety

We assess the full picture to understand what's really going on.

Our Approach to Anxiety Treatment

Comprehensive Evaluation: We understand your anxiety in context:

  • What you're experiencing and how long it's been happening
  • Specific triggers and patterns
  • How anxiety affects your daily life
  • What you've already tried
  • Your history and any traumatic experiences
  • Medical factors
  • Life circumstances and stressors

Treatment That Works: We use evidence-based approaches tailored to your situation.

Medication Management: When appropriate, medication can provide significant relief:

First-Line Medications (SSRIs/SNRIs):

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
  • Take daily, work over weeks, very effective for most anxiety disorders
  • Not addictive, no withdrawal with proper tapering
  • Help with both physical and mental anxiety symptoms

Other Antidepressants:

  • Buspirone (especially for GAD)
  • Mirtazapine (helps with sleep and anxiety)
  • Tricyclic antidepressants (when first-line options don't work)

Anti-Anxiety Medications (Used Carefully):

  • Hydroxyzine (non-addictive, helps with physical anxiety)
  • Benzodiazepines (short-term use only, for severe anxiety or panic)
    • We prescribe these thoughtfully and temporarily
    • Not a long-term solution
    • Risk of dependence with extended use
    • Can help during acute crisis while other medications take effect

Beta-Blockers:

  • For physical anxiety symptoms (racing heart, trembling)
  • Especially helpful for performance anxiety
  • Not for everyone, but useful in specific situations

Off-Label Options:

  • Gabapentin
  • Pregabalin
  • Others when standard treatments aren't effective

Our Medication Philosophy:

  • Start with evidence-based first-line treatments
  • Use benzodiazepines sparingly and short-term
  • Consider your concerns, preferences, and past experiences
  • Adjust based on your actual response
  • Address side effects promptly
  • Plan for long-term management

Beyond Medication: Medication is often very helpful, but we also address:

Lifestyle Factors:

  • Sleep: Anxiety disrupts sleep, poor sleep worsens anxiety
  • Caffeine: Often makes anxiety worse
  • Alcohol: Temporarily reduces anxiety but worsens it long-term
  • Exercise: One of the most effective anxiety treatments
  • Nutrition: Blood sugar stability affects anxiety

Skills and Strategies:

  • Breathing techniques for panic attacks
  • Grounding skills for acute anxiety
  • Sleep hygiene
  • Stress management
  • When to use therapy (we can connect you with excellent anxiety-specialized therapists)

Therapy Referrals: We're not therapists, but we work closely with therapists who specialize in:

  • Cognitive Behavioral Therapy (CBT) - gold standard for anxiety
  • Exposure therapy - especially for phobias and OCD
  • Acceptance and Commitment Therapy (ACT)
  • Mindfulness-based approaches

Combined medication and therapy is often most effective for anxiety disorders.

What Treatment Looks Like

Initial Evaluation (60-90 minutes): Comprehensive assessment of your anxiety, including triggers, patterns, history, and impact on functioning.

Lab Work: Blood work to rule out medical causes of anxiety symptoms.

Treatment Planning: Collaborative discussion of medication options, therapy referrals, and lifestyle modifications.

Starting Medication: If we use medication, we typically start with SSRIs or SNRIs at low doses and increase gradually.

Follow-Up Appointments: Initially every 2-4 weeks to monitor response and adjust treatment. Once stable, appointments every 1-3 months.

Between Appointments: You can reach out if medication isn't working or side effects are problematic.

Ages We Serve

We provide anxiety disorder treatment for:

  • Teens (12+): Anxiety often begins in adolescence
  • Young adults: Peak time for anxiety disorder onset
  • Adults: Ongoing management or new onset anxiety
  • Older adults: Age-related anxiety and transitions

Telehealth Throughout Colorado

All appointments are virtual, which can actually help with anxiety:

  • No anxiety about getting to appointments
  • Comfortable in your own safe space
  • Reduced exposure triggers
  • Available throughout Colorado

Insurance & Access

We accept most major insurance including:

  • Aetna
  • Cigna
  • United Healthcare
  • Oscar
  • Optum
  • Blue Cross Blue Shield
  • Private pay options

Note: We do not accept Medicaid or Medicare at this time.

Crisis Support

If you're having a panic attack:

  • Remember it will pass (usually peaks in 10 minutes)
  • Focus on slow breathing
  • Ground yourself (5 things you can see, 4 you can touch, etc.)

If you're in crisis:

  • 988 Suicide & Crisis Lifeline: Call or text 988
  • Crisis Text Line: Text HELLO to 741741
  • Colorado Crisis Services: 1-844-493-8255
  • 911 if in immediate danger

Anxiety Is Treatable

Here's the good news: Anxiety disorders are among the most treatable mental health conditions. With proper treatment, most people experience significant improvement.

It might take time to find the right approach, but relief is genuinely possible. You don't have to live with constant anxiety.

Ready to Feel Calmer?

If you're tired of anxiety controlling your life, if panic attacks are disrupting your days, if you're ready for treatment that actually works—we're here.

Book an appointment online or call us at (719) 212-1951.

Same-week appointments available. Relief is possible.

Frequently Asked Questions

Will I need to be on anxiety medication forever?

Not necessarily. Some people need medication long-term; others use it for months to years and then taper off. It depends on your situation.

Are benzodiazepines addictive?

Yes, they have addiction potential with long-term use. That's why we use them sparingly and short-term, if at all.

How long before anxiety medication works?

SSRIs/SNRIs typically take 4-6 weeks for full effect, though you might notice some improvement sooner. Anti-anxiety medications like hydroxyzine work faster.

What if medication makes me feel worse?

Some people experience increased anxiety when starting SSRIs. This usually passes within 1-2 weeks, but we monitor closely and adjust if needed.

Can therapy cure anxiety without medication?

For some people, yes. For others, medication is necessary. We discuss what makes sense for your situation.

What should I do during a panic attack?

Remember it will pass, focus on breathing, use grounding techniques. We teach specific strategies during appointments.

Forest Path Psychiatry & Healing is a nurse-led psychiatric practice serving all of Colorado via telehealth. Our board-certified PMHNPs provide evidence-based, trauma-informed treatment for anxiety and panic disorders.