Expert Telehealth Care for Anxiety in New York
Anxiety disorders are the most common mental health conditions in the United States, affecting approximately 40 million adults — nearly 19% of the adult population — in any given year, according to the Anxiety and Depression Association of America. Despite being among the most treatable psychiatric conditions, fewer than 37% of people with anxiety disorders receive care. In New York's fast-paced, high-pressure environment, anxiety can quietly take over daily life before a person even recognizes what is happening.
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At Strong Enough Mental Health, Salvatore Marchica, PMHNP-BC, specializes in the evaluation and treatment of anxiety disorders — providing compassionate, evidence-based telehealth care for adolescents and adults across New York State.
What is an Anxiety Disorder?
Anxiety is a normal, adaptive response to perceived stress or threat. However, when anxiety becomes persistent, excessive, and begins to interfere significantly with daily functioning, relationships, and quality of life, it may have crossed into an anxiety disorder. Anxiety disorders involve a level of fear or worry that is disproportionate to the actual situation and difficult to control.
Anxiety disorders treated at Strong Enough Mental Health include:
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Generalized Anxiety Disorder (GAD): Chronic, pervasive worry about a wide range of everyday concerns — work, health, relationships, finances — that is difficult to control and causes significant distress
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Social Anxiety Disorder: Intense fear of social or performance situations involving potential scrutiny or embarrassment, often leading to significant avoidance
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Specific Phobias: Intense, irrational fear of a specific object or situation leading to avoidance behavior
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Health Anxiety: Excessive worry about having or developing a serious illness, often persisting despite medical reassurance
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Separation Anxiety Disorder: Excessive fear about separation from attachment figures, which can persist into or first present in adulthood
What Are The Signs And Symptoms of Anxiety?
Emotional and Cognitive Symptoms
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Persistent, excessive worry that is difficult to control or "turn off"
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Feelings of dread, apprehension, or a sense that something bad is about to happen
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Restlessness, feeling keyed up, or on edge
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Irritability and emotional sensitivity
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Difficulty concentrating — the mind goes blank or is pulled away by worried thoughts
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Catastrophic thinking — automatically assuming worst-case outcomes
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Avoidance of anxiety-provoking situations, people, or activities
Physical Symptoms
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Racing or pounding heart, shortness of breath
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Muscle tension, headaches, or jaw tightening
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Excessive sweating or trembling
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Fatigue and chronic sleep disruption
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Gastrointestinal symptoms — nausea, stomach upset, frequent urination
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Dizziness or lightheadedness
What Are The Risk Factors of Anxiety?
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Family history of anxiety or other mental health conditions
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Chronic or significant life stressors — work pressure, financial difficulties, relationship problems
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Trauma or adverse childhood experiences
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Personality factors: perfectionism, high sensitivity, negativity bias
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Medical conditions: thyroid disorders, heart conditions, and chronic pain are frequently associated with anxiety
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Substance use: caffeine, alcohol, and stimulants can worsen or trigger anxiety symptoms
How is Anxiety Diagnosed?
Anxiety disorders are diagnosed through a thorough clinical evaluation reviewing your symptoms, their duration and severity, their impact on daily functioning, and any contributing medical or psychological factors. At Strong Enough Mental Health, Salvatore takes time to understand the full picture — because anxiety frequently co-occurs with depression, ADHD, and other conditions, and accurate diagnosis is the foundation of effective treatment.
What Are Possible Treatments For Anxiety?
Medication for Anxiety
Several medication classes are effective for anxiety disorders. At Strong Enough Mental Health, we walk through all options together, explain how each works, and find the approach that is the best fit for your specific situation, preferences, and health history.
Selective Serotonin Reuptake Inhibitors (SSRIs) — First-Line Treatment
SSRIs are typically the first-line pharmacological treatment for anxiety disorders. They work by increasing serotonin availability in the brain, helping regulate mood and reduce anxiety over time. SSRIs take 2–6 weeks to reach full effectiveness — a timeline worth discussing openly at the start of treatment.
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Sertraline (Zoloft)
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Escitalopram (Lexapro)
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Fluoxetine (Prozac)
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Paroxetine (Paxil)
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Citalopram (Celexa)
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Common side effects: nausea (usually temporary), insomnia, sexual side effects. Most diminish as your body adjusts.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs act on both serotonin and norepinephrine and are particularly effective for generalized anxiety disorder and when anxiety co-occurs with depression.
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Venlafaxine XR (Effexor XR) — FDA-approved for GAD, social anxiety disorder, and panic disorder
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Duloxetine (Cymbalta) — FDA-approved for GAD; also helpful when chronic pain co-occurs
Buspirone
Buspirone is a non-addictive, non-sedating anxiolytic particularly effective for generalized anxiety disorder. It carries no risk of dependence and does not impair cognition or coordination. It takes 2–4 weeks to reach full effectiveness. Side effects are mild — dizziness, headaches, nausea.
Benzodiazepines — Short-Term or Situational Use
Benzodiazepines provide rapid relief from acute anxiety and are useful for short-term or situational use. They are not recommended as a long-term primary treatment for anxiety disorders due to dependence risk and cognitive effects.
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Lorazepam (Ativan)
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Clonazepam (Klonopin)
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Alprazolam (Xanax)
At Strong Enough Mental Health, benzodiazepines are prescribed with careful clinical judgment, taking into account your history, risk factors, and goals.
Beta-Blockers — For Situational/Performance Anxiety
Beta-blockers such as propranolol can reduce the physical symptoms of situational anxiety — racing heart, trembling, sweating — without affecting cognition. They are not a treatment for chronic anxiety disorders but can be helpful for specific high-stakes situations such as presentations, interviews, or medical procedures.