Getting the subtype right
"Anxiety" covers several distinct disorders that respond differently to treatment. Generalized anxiety is continuous worry that resists reassurance. Panic disorder is discrete surges of physical terror plus the fear of the next one. Social anxiety is specifically about evaluation by others. PTSD is anxiety anchored to a traumatic event. Getting this right changes medication choice, therapy referral, and what improvement should look like.
A first visit covers:
- Evaluation distinguishing anxiety subtypes and identifying co-occurring depression or ADHD
- GAD-7, PHQ-9, PCL-5, and AUDIT-C as indicated — you can take the GAD-7 beforehand
- Medical differential: thyroid, anemia, caffeine load, stimulant and substance use, cardiac symptoms
- Therapy coordination with Seattle-area CBT and exposure-trained clinicians
Anxiety and adult ADHD are frequently confused and frequently coexist — see telling them apart and treating both at once.
Medication options
- First-line SSRIs and SNRIs: escitalopram, sertraline, venlafaxine XR, duloxetine. Started low, because anxious patients are sensitive to early activation. The SSRI timeline applies: four to six weeks for full effect.
- Non-sedating adjuncts: buspirone, hydroxyzine, gabapentin, and propranolol for performance situations.
- Trauma-related: prazosin for nightmares, alongside referral for trauma-focused therapy. See PTSD symptoms and DSM-5 criteria.
Where we stand on benzodiazepines
We are conservative with benzodiazepines. They work quickly, which is exactly why they are difficult: tolerance develops, they interfere with the extinction learning that exposure-based therapy depends on, and discontinuation after long-term use is genuinely hard. We will discuss short-term, limited use in specific circumstances, and we will be honest about the trade-off rather than declining without explanation.
Serving Seattle and King County
We see adults across Seattle and the wider Puget Sound region — Capitol Hill, Ballard, West Seattle, Fremont, the University District, Bellevue, Redmond, Kirkland, Renton, Kent, Shoreline, Everett, and Tacoma — entirely by secure video. There is no MindHealth office in Seattle; Washington care is delivered by telehealth statewide.
Our Washington patients skew toward working adults: software and biotech employees on hybrid schedules, healthcare staff at the major Seattle hospital systems, graduate students, and parents fitting appointments between school runs. Telehealth is usually the point rather than a compromise — a 30-minute follow-up does not cost anyone two hours of I-5.
We send a visit summary to your primary care provider within one business day when you request it, whichever Seattle-area system they practice in.
Insurance & self-pay
In-network in Washington with Regence BlueCross BlueShield, Premera, Cigna / Evernorth, Aetna, First Choice, and Optum. Most patients pay a specialist copay.
Washington Apple Health (Medicaid) is not accepted. Self-pay rates are available by phone, superbills are provided for out-of-network reimbursement, and Good Faith Estimates are issued before your first visit. Full details on the Washington insurance page.
Frequently asked questions
Can I see a psychiatric provider for anxiety in Seattle by telehealth?
Yes. MindHealth Psychiatry treats adult anxiety disorders throughout Washington, including Seattle, entirely by secure video. New-patient appointments are typically available within about a day.
Can anxiety medication be prescribed by telehealth in Washington?
Yes. SSRIs, SNRIs, buspirone, hydroxyzine, and most anxiety medications are non-controlled and fully prescribable by video across Washington.
Do you prescribe Xanax or other benzodiazepines?
Rarely, and with a clear rationale. Benzodiazepines carry tolerance and dependence risks and can interfere with exposure-based therapy. We favor SSRIs, SNRIs, and non-sedating adjuncts, and we will explain the reasoning rather than simply declining.
How long does anxiety medication take to work?
SSRIs and SNRIs typically take four to six weeks for full effect, with earlier improvement in sleep and physical tension. Fast-acting options exist for specific situations but are not a foundation for treatment.
Which Washington insurance plans do you accept?
Regence BlueCross BlueShield, Premera, Cigna / Evernorth, Aetna, First Choice, and Optum. Washington Apple Health (Medicaid) is not accepted.