Online Anxiety Treatment in Pennsylvania and New York

How anxiety is treated

Feeling anxious at times is part of life. MedlinePlus says anxiety can be a normal reaction to stress, but that an anxiety disorder can involve feelings that do not go away and can get worse. It says the main treatments are psychotherapy, medicines or both.

The National Institute of Mental Health (NIMH) says the right plan depends on your needs, preferences and medical situation, and that finding it may take some trial and error. Both therapy and medicine can take time to work. That is an ordinary part of care, and there is room to adjust along the way.

Therapy approaches

Psychotherapy helps you identify and change troubling emotions, thoughts and behaviors. NIMH says it can be effective in person or by telehealth. These approaches come up often in anxiety care. Not every therapist uses every approach, so ask.

• Cognitive behavioral therapy (CBT): noticing automatic thoughts, questioning them, and changing patterns that keep anxiety going. NIMH says CBT is commonly used for generalized anxiety disorder.
• Exposure therapy: a type of CBT that involves spending brief periods in a supportive setting learning to tolerate distress, until fear goes down over time.
• Acceptance and commitment therapy (ACT): NIMH describes it as encouraging nonjudgmental acceptance of thoughts and engagement in meaningful activities, using strategies such as mindfulness and goal setting.
• Mindfulness and relaxation techniques: NIMH lists meditation and breathing exercises among the things therapy can include.

Medication groups

NIMH says medicines often work alongside other treatments, and that it may take several tries to find the one that works well with the fewest side effects. Here is what each group is. See the full list of medicines for pages with FDA label details on each one.

• SSRIs and SNRIs: antidepressants that NIMH says may also be used to treat anxiety. They usually take weeks to work.
• Benzodiazepines: anti-anxiety medicines used for some short-term symptoms. NIMH says long use may lead to tolerance or dependence, and providers usually prescribe them for short periods.
• Buspirone: an anti-anxiety medicine that must be taken every day for 3 to 4 weeks to reach full effect, and is not used as needed.
• Hydroxyzine: an older medicine whose FDA label lists symptomatic relief of anxiety and tension.
• Beta-blockers: prescribed off-label for short-term anxiety symptoms such as rapid heart rate. Generally not recommended with asthma or diabetes.
• Gabapentin and pregabalin: neither is FDA-approved for anxiety. A 2020 review says gabapentin has been prescribed off-label for anxiety despite a lack of research evidence for that use.
• Older antidepressants, such as tricyclics: NIMH says these have more side effects but may be the right option for some people.

Who provides what, and where

Medication care is with our psychiatrist, a Doctor of Osteopathic Medicine (DO) with more than three decades of practice. You must be physically located in Pennsylvania or New York during each visit. He is open to new patients and referrals. Our guide to medication management explains ongoing visits.

Therapy is with our therapists, who see clients in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York. If you are in New York, you can get psychiatry here but not therapy here. Therapists do not prescribe. Learn more about anxiety therapy.

Whether any named medicine is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help, and a visit may not end in a prescription. Some medicines are controlled and have extra rules, so we keep that information on each medicine's page.

What online care looks like

See our pages for online psychiatry in Pennsylvania and online psychiatry in New York for state details. Video visits are for ongoing care, not emergencies. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services.

1. 1Reach outContact us about medication care and share a little about what is going on, in your own words. Ask us about fees and coverage for psychiatry, ages seen and whether you need to be in therapy here.
2. 2Prepare for the visitList all your medicines, including over-the-counter drugs, herbal remedies, vitamins and supplements, and write down your questions. Find a private spot with a good connection.
3. 3Meet by secure videoYou talk through your symptoms, history and goals. From there you and the psychiatrist discuss options and how you will review progress.