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Birch Grove Mental Health

Anxiety Medication Management
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Effectively managing your anxiety might start with smart, personalized medication strategies

Living with Anxiety

 

Anxiety

Anxiety disorder is more than just feeling nervous before a big event or worried about a tough situation. It’s a mental health condition where fear, worry, or nervousness go into overdrive, often without a real threat or reason.

Imagine your body treating a casual walk to the grocery store like you’re facing a dangerous situation—your heart races, you start sweating, and you feel this overwhelming sense of dread. For people with anxiety disorders, this isn’t occasional—it can happen every day, sometimes multiple times a day.

Anxiety has a way of worming itself into every corner of life. It can interfere with your thoughts, making it harder to focus or think clearly. It can also affect your emotions, leaving you feeling irritable, restless, or like you’re always on edge. And let’s not forget the physical toll—difficulty sleeping, muscle tension, headaches, or even gastrointestinal issues can all stem from this mental health condition.

What’s important to remember is that anxiety disorders are treatable. Therapy, medication, lifestyle changes, and a solid support system can make a significant difference. With the right help, people living with anxiety can manage their symptoms and regain control of their lives… it happens every day.

Forms of Anxiety

While this can be a bit much, it’s important to understnd that an anxiety disorder comes in many forms.

Generalized Anxiety Disorder
The most common form of anxiety, involves excessive worry about a range of everyday issues – work, health, finances, relationships…  This can lead to restlessness, fatigue, difficulty concentrating, and trouble sleeping, making it hard to relax or simply enjoy life.

Panic Disorder
The sneaky version of anxiety, Panic is marked by unexpected and intense panic attacks, which often feel overwhelming, frequently with no clear trigger.  Can include a racing heart, chest pain, shortness of breath, or dizziness… leaving one fearful of when the next attack might occur.  If you have had a panic attack, you know how deblilitating it can be.

Social Anxiety Disorder
Most of us have social anxiety to some degree… but the disorder goes beyond feeling shy or nervous… it’s an intense fear of social situations where one worries of being judged, embarrassed, or rejected.  It often disrupts daily life, leading to avoidance of events like parties, public speaking, or even casual conversations – which can make forming relationships or pursuing opportunities challenging.

Phobias
Not your everyday worries or nerves, they are overwhelming and sometimes downright irrational feelings of terror that can grip you in specific situations or when encountering certain things, like flying, snakes, or tight spaces. They’re not just a passing discomfort; they often lead to behaviors that can take a toll on daily life, as people go to great lengths to avoid whatever triggers their fear.

Obsessive-Compulsive Disorder (OCD)
Simply put, OCD involves persistent, intrusive thoughts (obsessions) that can cause significant anxiety, leading to the performance of repetitive actions or rituals (compulsions) to reduce those feelings.  These behaviors, like excessive handwashing or checking, can interfere with daily life and are sometimes challenging to control, even when the person recognizes they’re unnecessary.

Post-Traumatic Stress Disorder (PTSD)
PTSD is a severe form of anxiety that can develop after experiencing something deeply traumatic, such as violence, accidents, or natural disasters. It often causes symptoms like vivid flashbacks, difficulty sleeping, and heightened alertness.  PTSD is intrusive and can be intense, which often interferes with daily life and relationships.

Untreated Anxiety

Anxiety disorders are incredibly common, affecting millions of people.

In the United States alone, approximately 19% of adults experience some form of anxiety each year. Despite how widespread these disorders are, only about 37% of those affected seek help or receive treatment. This gap underscores the significant number of individuals struggling with anxiety on their own.

For people living with anxiety disorders, whether it’s generalized anxiety, social anxiety, or one of the others… the challenges often share common threads: feelings of social isolation, disruptions to daily routines, and a sense of being disconnected from the world around them. Anxiety can act as a barrier, making it harder to maintain relationships, enjoy activities, or even just get through the day.

When left untreated, anxiety has a way of becoming all-encompassing. It can feel as though you’re locked in a constant battle with your own mind, struggling to concentrate, avoiding situations that might trigger your fear, and feeling trapped in a relentless cycle of ‘what if’ thoughts. The internal state of anxiety is not just mentally exhausting – it can also spill over into physical health, affecting sleep, energy levels, and overall well-being.

Over time, the struggle to manage these overwhelming feelings can increase the risk of developing depression or turning to substances as a form of escape.

It’s a heavy burden to carry alone, but it’s important to remember that anxiety disorders are treatable.

blog article: When to Seek Help for Anxiety

Living with Someone who has Anxiety

Anxiety affects not only the person experiencing it but also the dynamics of their relationships. Family and friends can sometimes face moments of confusion, helplessness, or frustration, especially if they don’t fully understand what anxiety entails or how it feels.

It’s important for folks to recognize that anxiety isn’t just ‘nervousness’ or something that someone can ‘snap out of’.  Reactions to stress, social situations, or daily tasks might seem exaggerated to others, but the feelings are very real and overwhelming to someone with anxiety.

Someone with anxiety may avoid certain situations, struggle to express their feelings, or react in ways that feel unpredictable.  This can make friends and family feel unsure of how to help.

Those close to someone with anxiety may experience a mix of emotions – compassion, frustration, and even guilt if their support doesn’t seem to alleviate the anxiety.  It’s common for those close to feel exhausted, especially when the anxiety leads to frequent reassurance-seeking or impacts daily routines.

Education for everyone involved is key in these situations. Learning about anxiety can help those close to understand that one doesn’t ‘choose’ to feel this way.  Patience and empathy are important, but it’s vital to set boundaries and maintain self-care.  Again, education is key for everyone close.

Supporting someone with anxiety shouldn’t come at the cost of your own mental health. Encouraging them to seek treatment, like therapy or medication, can be a huge step toward improvement.

Living with Anxiety

There are two views of anxiety… the external, observational view and that which is managed internally.

Living with anxiety while maintaining relationships can be a constant challenge.  Anxiety often promotes overthinking simple conversations or interactions, which can lead to tension with a partner.

Anxiety can frequently motivate one to repeatedly seek reassurance, not because they doubt their loved, but because their mind is overwhelmed by intrusive “what ifs.”

Within family dynamics, anxiety may drive one to avoid gatherings or seem distant.  This is not out of a lack of care, but because social interactions can feel draining or overwhelming, especially when faced with questions or attention.

In the workplace, those with anxiety may struggle to balance their responsibilities while managing internal worries. They may spend excessive time perfecting emails or replaying interactions, worrying they made a mistake or gave the wrong impression. These behaviors often go unnoticed by colleagues, who may misinterpret them as insecurity or lack of effort

Anxiety takes different forms but touches every relationship in our lives.

Treatment

When it comes to treatment, there’s no one-size-fits-all approach (as usual), but frequently it takes a combination of therapy, medication, and lifestyle changes to see meaningful progress… but be assured positive change is very attainable.

Each individual’s experience with anxiety is unique, so finding the right mix of treatments may take some time. Therapy, such as CBT, is a cornerstone for addressing the thought patterns and behaviors that fuel anxiety, while lifestyle changes like regular exercise, mindfulness, and proper sleep can provide additional support.

In many cases, medication can play an important role in treatment. For some, anxiety is deeply tied to biological factors, like brain chemistry or genetic predispositions, that can’t always be addressed with therapy or lifestyle changes alone.

Medications like SSRIs or anti-anxiety drugs can reduce symptoms to a manageable level, making it easier for individuals to fully engage in therapy and their daily lives. While not everyone needs medication, it’s a tool that has helped countless people regain control and reclaiming their sense of self again.

With proper care, anxiety is manageable.
Whether it’s through therapy, medication, lifestyle adjustments, or a combination of all three, there is relief ahead.

Anxiety Treatment at Birch Grove Mental Health

Experienced in Anxiety Medication Management

Creative Approaches
to an Anxiety-free You

We see it Every Day
Let’s Get Started

Taking control of your anxiety means taking back the moments that matter

Birch Grove Mental Health

we are not just anxiety specialists…

other conditions we treat

Bipolar Disorder – Mood swings, irritable, impulsive

  • Manic episodes of high energy, grandiosity, risky behaviors
  • Hypomanic episodes of less severe mania & elevated activity
  • Depressive episodes characterized by sadness & apathy
  • Mixed episodes include both mania and depression

more…
Bipolar Disorder Medication Management

ADHD – Inattention, hyperactivity, impulsivity

  • Difficulty staying focused or on-tasks
  • Hyperactivity includes constant movement, fidgeting
  • Impulsively or hastily acting without thinking
  • Difficulty with detail resulting in careless mistakes

more…
ADHD Testing & Treatment

Depression - Sad, fatigued, unmotivated

  • Persistently low or depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Significant changes in appetite or weight
  • Sleep disturbances such as too much or too little sleep

more…
Depression Medication Management

Trauma – Nightmares, hypervigilance, flashbacks

  • Intrusive, distressing flashbacks of the traumatic event
  • Avoid people & situations that remind you of the trauma
  • Persistent negative emotions, feeling detached from others​
  • Easily startled, feeling on edge, or difficulty sleeping

Thought Disorders – Disorganized, paranoid, delusional

  • Disorganized thinking, incoherent speech.
  • Loose associations by jumping between unrelated topics.
  • Tangentiality through inclusion of irrelevant information.
  • Incoherence (word salad), illogical word combinations

Obsessive Compulsive Disorder (OCD) – Checking, counting, germaphobic

  • Compulsive repetitive behaviors or rituals
  • Repeatedly intrusive disturbing or unwanted thoughts
  • Obsessive, recurrent urges or anxiety causing mental images
  • Avoid situations that trigger obsessions or compulsions

more…
OCD Medication Management

Panic Disorder – Intense, sudden fear

  • Panic attacks episodes of intense fear & discomfort
  • Symptoms include palpitations, sweating, trembling
  • Fear of future attacks creates worry of more attacks
  • Avoids places where previous attacks occurred

The stuff of life

  • Stress Management
  • Life Transitions
  • Relationship issues

What patients say about us…

My teen son has started seeing Sunami for several months. It’s been great to see and hear his trust in her grow. We are building a toolset that my son can practice and use. It takes a village; happy and relieved to have found Sunami for my son’s mental health journey.

I’ve had nothing but positive experiences with my provider at Birch Grove. Sessions start on time. They get back to me promptly if I ever need anything. They had emergency coverage the one time I was struggling and my provider was on vacation. Highly recommend.

This practice has been so helpful for my whole family.  They have been so flexible with appointments and are always responsive.  Our NP is very knowledgable and caring.  Highly recommend!

Meet The Team

We are a team of psychiatric nurse practitioners united by a shared passion for making a difference in the lives of those facing mental health challenges.

Sunami Gurung

Sunami Gurung

CT, MA, NH, NY, RI, VT

Psychiatric Nurse Practitioner

Natasa Ristivojevic

Natasa Ristivojevic

MA, NH

Psychiatric Nurse Practitioner

Salma Trainor

Salma Trainor

MA, NH

Psychiatric Nurse Practitioner

James Quackenbush

James Quackenbush

MA, NH, NY

Psychiatric Nurse Practitioner

Juliana S Pires

Juliana S Pires

CO, CT, MA, NH, NY, OH, OR, RI, UT, VT

Psychiatric Nurse Practitioner

Erin Savage

Erin Savage

MA, NH

Psychiatric Nurse Practitioner

Insurance, payments, costs, locations

Costs
Evaluation $300
Follow-up $180

Payment Options
Zelle/Venmo
Major Credit Cards

Anxiety does not define you,
your resilience does

Why Birch Grove Mental Health?

Our team of Psychiatric Nurse Practitioners are passionate about supporting individuals affected by mental illness

Through effective and practical medication management, we see victories every day

In Person Sessions

MA & NH

You-Centered

Prioritizing your Care, Progress, and Wellbeing

Your Goals

Personalized Treatment Plans

Telehealth

Flex to your schedule and life

Your Voice Matters

Collaborative Decision Making

You Have a Life

Flexible hours and ways to connect

FAQs

Benefits of Online Psychiatric Treatment?

  • Easy scheduling: Book appointments at your convenience without the need to commute.
  • Support when you need it: Access professional care from the comfort of your home.
  • Privacy and flexibility: Maintain confidentiality while receiving care tailored to your schedule.

How long does the appointment last?

  • Initial appointments are typically 60 minutes
  • Subsequent appointments are 30 minutes or more – durations vary based on need

How will I know where to start my online session?

Once we confirm your appointment date & time, the link to your session room will be forwarded via email.

What types of therapy do you offer?

We provide individual therapy for children, teens, adults, and older adults. Our approaches include Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and Solution-Focused Brief Therapy (SFBT).

Where do you offer services?

We provide services in:

In-person & telehealth

  • Massachusetts
  • New Hampshire

Telehealth only

  • Rhode Island
  • Utah
  • Maine
  • Ohio
  • Vermont
  • New York
  • Colorado
  • Connecticut

What can Birch Grove psychiatric nurse practitioners diagnose and treat?

We provide care for a wide range of mental health concerns, including:

  • AnxietyDepression
  • Bipolar Disorder
  • ADHD (Attention Deficit Hyperactivity Disorder)
  • Stress management
  • Behavior Issues
  • Mood Disorders
  • Medication Management
  • Thinking Disorders
  • Weight Loss

What meds do autonomous psychiatric nurse practitioners prescribe?

Autonomous psychiatric nurses, or advanced practice psychiatric nurses (APRNs), can prescribe a variety of medications to treat mental health conditions. These include:

  1. Antidepressants: For depression and anxiety disorders (e.g., fluoxetine, sertraline).
  2. Antipsychotics: For schizophrenia and bipolar disorder (e.g., risperidone, olanzapine).
  3. Mood stabilizers: For bipolar disorder (e.g., lithium carbonate).
  4. Anxiolytics: For anxiety disorders (e.g., alprazolam, lorazepam).
  5. Stimulants: For ADHD (e.g., methylphenidate, amphetamine/dextroamphetamine).

These medications help manage symptoms and improve the quality of life for individuals with mental health conditions.

What are your hours of operation?

Telehealth and in-person appointments hours are  
Mon-Fri, 6:30am – 6:30pm

What is the cancellation policy?

You can reschedule or cancel your appointment with at least 24 hours’ notice to avoid cancellation fees.

What should I expect from the scheduling process?

Our scheduling process involves a few simple steps:

  • Contact us via the Get Started button
  • Complete intake forms via our secure patient portal.
  • Add payment information: To confirm your appointment, you will need to add your payment information to the portal. This information is securely stored and only accessible to you via your personal login and password.
  • Submit insurance information: If applicable, we will need to verify your insurance information to ensure that we can process your payment and accept your coverage.
  • Choose your provider and appointment time: Once your forms and payment are completed, you can select your preferred provider, date, and time for the appointment.
  • Appointment confirmation: After all forms are filled out and payment is processed, we will confirm your appointment.

Are your providers licensed to prescribe medications?

Yes, all of our providers are fully licensed and able to prescribe both controlled and non-controlled medications as part of a comprehensive treatment plan.

How can a parent or guardian schedule an appointment for a minor?

Parents or guardians can schedule appointments for their children by contacting us through the Get Started link at the top of the page. Parental consent will be required before the first session.

Anxiety, Depression, OCD, ADHD, Bipolar, thought disorders, panic, trauma

Birch Grove Mental Health