Anxiety treatment that looks at the whole picture
Anxiety is one of the most common reasons people contact us. For some it shows up as constant worry and a mind that will not switch off; for others it arrives as sudden panic attacks with a racing heart, shortness of breath and a fear that something is badly wrong. Many people have both. Anxiety is very treatable, but it often comes back when only the surface symptoms are addressed. Our approach treats the anxiety itself and also looks for what keeps the nervous system on high alert.
Common signs of anxiety and panic
- Persistent worry that is hard to control, often about several areas of life at once
- Restlessness, muscle tension, jaw clenching or headaches
- Trouble falling asleep, or waking at night with a racing mind
- Irritability and difficulty concentrating
- Panic attacks: sudden surges of fear with a pounding heart, sweating, trembling, chest tightness, dizziness or a sense of unreality
- Avoiding places, driving, crowds, work tasks or social situations because of anxiety
- Digestive symptoms such as nausea, an unsettled stomach or IBS-type flares
If chest pain, shortness of breath or fainting are new, see a medical provider promptly to rule out heart and lung causes before assuming they are anxiety.
What can drive anxiety underneath
Anxiety has psychological roots, including past experiences, learned patterns of thinking and current stress. It can also be amplified by the body. As part of a root-cause assessment we look at:
- Sleep. Short or broken sleep makes the brainโs threat system more reactive the next day. See sleep and insomnia.
- Caffeine, alcohol and other substances. High caffeine intake and alcohol rebound can both trigger anxiety and panic.
- Blood sugar swings. Skipped meals and long gaps between eating can produce shakiness and adrenaline surges that feel like panic.
- Thyroid and hormones. An overactive thyroid can mimic anxiety, and perimenopause and the postpartum period often bring new anxiety. See thyroid and mental health and perimenopause and mental health.
- Nutrient status. Low iron, vitamin B12 or vitamin D can add fatigue and low resilience. See magnesium for anxiety and sleep.
- Stress physiology. Long-term stress shifts cortisol rhythms and keeps the body in a fight-or-flight state. See cortisol, stress and anxiety.
- The gut-brain axis. Digestive problems and anxiety frequently travel together. See gut-brain and digestive health.
How we treat anxiety and panic
Psychotherapy and skills
Evidence-based therapy is the foundation. Cognitive behavioral approaches help you notice and change anxious thinking patterns, and gradual exposure helps the brain learn that feared situations are safe. For panic, learning how panic works and practicing the body sensations in a controlled way can take much of its power away.
Calming the nervous system
Breathing techniques, relaxation training and biofeedback teach the body to come out of fight-or-flight. These are practical skills you can use at work, in traffic or at 3 a.m.
Sleep, nutrition and lifestyle
We address sleep directly, adjust caffeine and alcohol, stabilize meals and build in movement and daylight. These changes often reduce the baseline level of anxiety so that therapy works faster. See natural anxiety treatment for more on non-medication options.
Targeted testing and supplements
Where your history suggests it, we check thyroid function, iron, vitamin B12, vitamin D and other markers, and use supplements only when there is a clear reason, checked for interactions. See lab testing for mental health.
Medication when it helps
For moderate to severe anxiety, medication can be an important part of care. We review options and manage medication carefully as part of the whole plan. See psychiatric medication management.
Our providers are licensed naturopathic physicians and mental health counselors led by Dr. Koichi Tanji, ND, LMHC. In Washington, controlled substances such as ADHD stimulants and benzodiazepines are outside naturopathic prescribing scope, so when one is part of the right plan we coordinate with your prescribing physician or nurse practitioner.
Anxiety in children and teens
Children often show anxiety as stomachaches, school avoidance, meltdowns, clinginess or trouble sleeping rather than describing worry. We involve parents, look at sleep, screens and eating, and coordinate with schools where helpful. A sudden, dramatic onset of anxiety or obsessive-compulsive symptoms after an infection can point to PANS / PANDAS.
What to expect
Your first visit is a thorough assessment of your symptoms, history, sleep, diet, medications and goals. We agree on what progress looks like, often using the GAD-7 questionnaire alongside your own goals, and review it at each visit. Many people notice changes within a few weeks of starting therapy skills and sleep changes; lasting improvement usually builds over two to three months.
Related reading: panic attack treatment, psychiatric care for anxiety, when anxiety isnโt just anxiety, anxiety treatment in Bellevue and anxiety treatment in Seattle.
Getting started
We see patients in person at 2135 112th Ave NE, Suite 201, Bellevue, and by secure telehealth anywhere in Washington. We are in-network with Premera, Regence, BlueCross BlueShield, Aetna, Cigna and Kaiser PPO. Most people begin with our Biopsych Assessment. Book online or call (425) 278-6166.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
