The Anxiety Toolkit:
Types, Triggers & Treatment
Anxiety isn't just "worrying too much." It's a physiological state where your body's alarm system gets stuck. Here is how to turn it off.
Medically Reviewed by David Glenn, PMHNP-BC
Real Psychiatric Services • Columbus, OH
We all feel nervous before a big presentation or a first date. That is normal stress. Anxiety is different. Anxiety is the engine revving at 8,000 RPM while the car is parked in the driveway.
At Real Psychiatric Services, we treat Anxiety Disorders as medical conditions, not personality flaws. Whether you are dealing with the slow burn of Generalized Anxiety or the sudden crash of a Panic Attack, our goal is to help you move from "surviving" to "thriving."
The "False Alarm" Mechanism (Amygdala Hijack)
To understand why you can't just "calm down," you have to look at the brain's Amygdala. Its job is to detect threats—a bear, a fire, a cliff.
The Hijack
In people with anxiety, the Amygdala becomes hypersensitive. It interprets safe situations—an email from your boss, a crowded grocery store—as life-threatening danger. It hits the "Panic Button" before your logical brain has a chance to vote.
The Cortisol Flood
This triggers a flood of Cortisol and Adrenaline. Your heart races to pump blood to your legs (to run), your digestion stops (nausea), and your muscles tense. You are physically prepped for a fight that isn't happening.
The Many Faces of Anxiety
Anxiety is not a "one size fits all" diagnosis. Identifying your specific type is key to selecting the right medication and therapy.
1. Generalized Anxiety Disorder (GAD)
The "Worry Loop." This is chronic, low-level dread. You might worry about money, health, work, and family all at once, even when things are going well. The defining characteristic is the inability to control the worry.
2. Social Anxiety Disorder
Often mislabeled as "shyness," this is an intense fear of judgment or scrutiny. It can be debilitating for professionals, leading to missed opportunities because the fear of speaking up in a meeting is paralyzing.
3. Panic Disorder
Characterized by sudden, intense spikes of fear that peak within minutes. Symptoms often mimic a heart attack (chest pain, shortness of breath, dizziness). Patients often end up in the ER, only to be told "it's just anxiety."
4. High-Functioning Anxiety
"On the outside, you are the first one in the office, the most organized, the high achiever. On the inside, you are running on a treadmill of fear that you are about to fail."
This is common among our professional patients in Columbus. You channel your anxiety into perfectionism. While it makes you successful, it leads to severe burnout and physical exhaustion.
How We Turn Down the Volume
Effective anxiety treatment usually requires a two-pronged approach: quieting the biological alarm (Medication) and retraining the brain (Therapy).
Medication Management
SSRIs & SNRIs (The "Floor"): Medications like Zoloft (Sertraline), Lexapro (Escitalopram), or Effexor. These regulate Serotonin levels. Think of them as raising the "floor" of your mood so you don't fall into the basement of panic.
Beta-Blockers (The "Physical Shield"): Originally used for blood pressure, drugs like Propranolol block the physical effects of adrenaline. They stop the shaking, sweating, and racing heart without affecting your mental clarity. This is excellent for performance anxiety.
Rescue Meds: For acute panic attacks, short-acting medications may be prescribed sparingly to break the cycle of panic.
Cognitive Behavioral Therapy (CBT)
CBT is the gold standard for anxiety. It helps you identify "Cognitive Distortions" (lies your anxiety tells you), such as:
- Catastrophizing: "If I make a mistake, I'll get fired and lose my house."
- Mind Reading: "They didn't say hello, so they must hate me."
Care That Fits Your Life
We know that for someone with anxiety, the process of finding a doctor can itself be a trigger. That is why we have simplified our onboarding.
Located at 4770 Indianola Ave in Columbus, we offer a calm, non-judgmental environment. For those with social anxiety or tight schedules, our robust Telehealth program allows you to have your appointments from the comfort of your home, reducing the stress of the commute and waiting room.
Patient FAQ
Will medication make me a "zombie"?
This is a common fear. The answer is no. When dosed correctly, anxiety medication should simply turn down the "background noise" so you can think clearly. If you feel numb or emotionless, the dose is too high, and we will adjust it. You should still feel joy, sadness, and excitement—just not constant dread.
Can't I just use supplements like Ashwagandha?
Supplements can support mild stress, but for clinical anxiety disorders (where the brain chemistry is altered), they are rarely enough on their own. We practice integrative care—we are happy to discuss supplements, but we will also give you honest medical advice about when stronger tools are needed.