Specializing in medication management for anxiety, with your goals at the center
Living with Anxiety
What Is Anxiety?
Anxiety disorders go beyond everyday nervousness or worry. They involve persistent feelings of fear, unease, or tension that may arise even when there’s no immediate threat. These reactions can be intense and difficult to manage, affecting both emotional and physical well-being.
Imagine your body responding to a routine trip to the grocery store as if it were a dangerous situation, such as a racing heart, sweating, and a sense of dread. For individuals living with anxiety disorders, these experiences can occur frequently, sometimes daily.
Anxiety can influence many aspects of life:
- Thoughts may become harder to organize or focus
- Emotions may feel heightened, leading to irritability or restlessness
- Physical symptoms may include sleep disturbances, muscle tension, headaches, or digestive discomfort
While anxiety can feel overwhelming, supportive care is available. At Birch Grove Mental Health, our team of we create individualized treatment plans tailored to each person’s needs and lifestyle.
At our Birch Grove Mental Health center, our team of psychiatric nurse practitioners works closely with clients to set realistic and measured treatment plan goals for anxiety to ensure ongoing progress and emotional balance.
Forms of Anxiety
Anxiety-related conditions can take many forms, each with unique patterns and challenges. Understanding these variations helps individuals and families recognize symptoms early and seek help from a qualified mental health professional for anxiety. At Birch Grove Mental Health, our experienced team provides compassionate and evidence-based care
Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder involves persistent and excessive worry about everyday concerns such as work, health, finances, or relationships. It may lead to restlessness, fatigue, difficulty concentrating, and trouble sleeping.
Treatment often includes Cognitive Behavioral Therapy for Generalized Anxiety Disorder (CBT-GAD), which helps individuals challenge negative thought patterns and develop healthier coping strategies under the guidance of a psychiatric nurse practitioner or therapist.
Panic Disorder
Panic disorder involves sudden, intense episodes of fear known as panic attacks. These episodes can arise unexpectedly and may include symptoms such as a racing heart, shortness of breath, or dizziness.
Evidence-based care for panic disorder may include structured therapies like cognitive behavioral therapy (CBT), relaxation techniques, and—in some cases—medication prescribed by a qualified provider. These approaches help individuals recognize triggers, reduce the frequency of panic attacks, and rebuild confidence in daily life.
Social Anxiety Disorder
Social anxiety disorder goes beyond everyday shyness. It involves an intense fear of being judged, embarrassed, or rejected in social situations—often leading to avoidance of gatherings, conversations, or performance settings.
Collaborating with a qualified mental health professional for anxiety can help individuals develop personalized treatment goals that may include exposure therapy, social skills training, confidence-building strategies, and, when appropriate, medication. These approaches support gradual progress and greater ease in daily interactions.
Specific Phobias
Phobias involve intense, often irrational fears of specific objects or situations—such as flying, heights, or animals. These fears can lead to avoidance behaviors that interfere with daily routines and limit quality of life.
Effective anxiety treatment programs for phobias may include gradual exposure, desensitization techniques, and, when appropriate, medication prescribed by a qualified provider. These approaches help individuals confront fears safely and regain a sense of confidence through structured therapeutic support
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder (OCD) involves intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce anxiety. Common examples include excessive cleaning, checking, or counting.
Evidence-based approaches such as Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and, when appropriate, medication prescribed by a qualified provider are widely recognized for helping individuals manage OCD symptoms and improve daily functioning.
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder can develop after a distressing or life-threatening event. Symptoms may include flashbacks, nightmares, heightened alertness, and emotional distress.
Through trauma-informed care, psychiatric nurse practitioners and therapists provide evidence-based approaches that promote healing, emotional resilience, and overall well-being.
Untreated Anxiety
Understanding the Impact
Anxiety disorders are among the most common mental health conditions. In the U.S., nearly 1 in 5 adults experiences some form of anxiety each year, yet fewer than 40% seek or receive professional support. This gap underscores how many individuals navigate life without formal care from a qualified mental health professional for anxiety.
Whether it’s generalized anxiety, social anxiety, or another subtype, the challenges often share common threads:
- Feelings of isolation or emotional disconnection
- Disruptions to daily routines and responsibilities
- Difficulty maintaining relationships or engaging in activities
- Persistent worry and mental fatigue
When left unaddressed, anxiety can become overwhelming—interfering with concentration, sleep, and overall well-being. Physical symptoms such as headaches, muscle tension, or digestive discomfort may emerge, and the emotional strain can increase the risk of co-occurring conditions like depression or substance use.
At Birch Grove Mental Health, we recognize that untreated anxiety rarely resolves on its own. Even a single intervention can make a meaningful difference in day-to-day life. Recognizing the signs and reaching out is the first step toward recovery. With compassionate support and thoughtful treatment planning for anxiety, individuals can manage symptoms effectively and regain emotional balance and control.
Supporting Someone Living with Anxiety
Anxiety doesn’t just affect the individual; it can influence the emotional dynamics of their relationships. Family members, partners, and friends may experience moments of confusion, helplessness, or frustration, especially when they’re unsure what anxiety truly feels like.
It’s important to understand that anxiety isn’t simply nervousness or something a person can “snap out of.” Reactions to stress, social situations, or everyday tasks may seem exaggerated from the outside, but the internal experience is often intense and overwhelming.
Individuals living with anxiety may avoid certain situations, struggle to express emotions, or respond in ways that feel unpredictable. This can leave loved ones unsure of how to offer support or how to set healthy emotional boundaries.
Those close to someone with anxiety may feel a mix of compassion, concern, and even guilt if their efforts don’t seem to help. Reassurance-seeking or disrupted routines can be draining, and it’s common to feel emotionally stretched.
Education and open communication are essential. Learning about anxiety can foster empathy and help loved ones recognize that these reactions aren’t intentional; they stem from a genuine emotional and physiological response.
Encouraging someone to seek help from a mental health professional for anxiety can make a real difference. Therapy, mindfulness techniques, and in some cases medication management from a qualified professional can empower individuals to manage anxiety more effectively while also bringing greater understanding and stability to relationships.
At Birch Grove Mental Health, we emphasize collaboration not just with individuals, but also with families, helping everyone involved learn supportive communication strategies and cultivate emotional resilience together.
Living with Anxiety
Navigating Relationships and Daily Life
Anxiety can be experienced in many ways, both externally observed and internally managed. For some, it shapes how they communicate, connect, and move through the world.
Relationships
Anxiety may lead to overthinking everyday conversations, creating tension or misunderstandings with partners. Reassurance-seeking behaviors often stem not from doubt, but from a mind overwhelmed by intrusive “what ifs.” Compassion and open communication can help bridge these gaps and strengthen emotional connection.
Family Dynamics
Social interactions can feel draining or overstimulating, especially in group settings. Avoidance or emotional distance may be misinterpreted, even though the underlying experience is often rooted in being overwhelmed, not in a lack of caring. Support from a mental health professional for anxiety can help families understand these patterns and develop healthier ways to respond.
Workplace Challenges
In professional settings, anxiety can affect focus, productivity, and confidence. Individuals may spend extra time perfecting emails or replaying interactions, worried they’ve made a mistake or left the wrong impression. These efforts often go unseen and may be misunderstood by colleagues, leading to added stress or self-doubt.
Anxiety expresses itself differently for everyone, but its impact often touches many aspects of life, including how we relate to others and handle daily responsibilities. At Birch Grove Mental Health, we believe that with understanding, personalized guidance, and consistent support, individuals can learn strategies to navigate these challenges with greater clarity, calm, and confidence.
Treatment
There’s no one-size-fits-all path when it comes to anxiety care. Many individuals find that a combination of therapy, medication, and lifestyle changes can lead to meaningful progress over time.
Each person’s experience with anxiety is unique, and finding the right mix of support often takes patience, collaboration, and professional guidance. At Birch Grove Mental Health, our integrated approach focuses on understanding the individual behind the symptoms, offering care that feels both personal and effective.
Therapy: Cognitive Behavioral Therapy for Generalized Anxiety Disorder (CBT-GAD) is often a foundational approach for addressing the thought patterns and behaviors that contribute to anxiety. Licensed mental health professionals for anxiety help clients identify triggers, challenge negative thinking, and build healthier coping strategies.
Lifestyle Changes: Incorporating regular physical activity, mindfulness practices, and restorative sleep can greatly support recovery. These habits work hand in hand with therapy to promote emotional balance and overall well-being.
Medication: For some individuals, medication may be beneficial, especially when anxiety is influenced by biological or genetic factors. Under the guidance of a psychiatric nurse practitioner or psychiatrist, pharmacological support can help manage symptoms, making it easier to engage fully in therapy and daily life.
While not everyone requires medication, combining evidence-based therapy, lifestyle adjustments, and medical support when needed can lead to significant improvements. With compassionate care and expert treatment, anxiety can become more manageable, allowing individuals to feel grounded, focused, and emotionally balanced.
Birch Grove Mental Health – Anxiety Treatment
Creative Tools for Calmer Living
Science-based personalized support
Frequently Asked Questions for Anxiety
What’s the difference between anxiety and panic attacks?
Anxiety is a steady feeling of worry that builds over time, while panic attacks are sudden bursts of intense fear that come and go quickly. Our clinicians work with patients to identify triggers, teach coping skills, and develop personalized treatment plan goals for anxiety.
Is social anxiety considered a disability?
Social anxiety can be considered a disability when it significantly limits daily life or work. At Birch Grove Mental Health, we provide compassionate care and structured therapy programs that help individuals rebuild confidence and ease the challenges of social interaction.
Why does my anxiety feel worse at night?
Anxiety often feels worse at night when the mind becomes quieter and worries start to surface. Our team helps patients develop calming nighttime routines and cognitive strategies to manage overthinking, tension, and sleep disturbances more effectively.
How can I relieve chest tightness or tension caused by anxiety?
Chest tightness is a common physical response to anxiety and shallow breathing. Through guided breathing exercises, Cognitive Behavioral Therapy, and relaxation practices, we help individuals release tension and restore a greater sense of calm and control.
Supportive care can help individuals reconnect with what matters most.
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
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
Blog post…
Recognizing Adult ADHD
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 Treatment
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 Treatment
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
MA, NH, RI, VT
Psychiatric Nurse Practitioner

Natasa Ristivojevic
MA, NH
Psychiatric Nurse Practitioner

James Quackenbush
MA, NH
Psychiatric Nurse Practitioner

Juliana S Pires
MA, NH, RI, VT
Psychiatric Nurse Practitioner

Erin Savage
MA, NH
Psychiatric Nurse Practitioner
Sunami Gurung
Psychiatric Nurse Practitioner
Approach
- Person-centered approach
- Tailored treatment plans
- Evidence-based medication management & psychotherapy
Clinical interests
- Depression & Anxiety
- Bipolar disorder
- OCD
- Trauma & PTSD
- ADHD
Languages
- English
- Nepali
- Hindi
Locations
- MA, NH, RI, VT
Salma Trainor
Psychiatric Nurse Practitioner
Approach
- Passion for supporting others
- Empathic relations is foundational
- Collaborative and inclusive
Clinical interests
- OCD
- Depression
- Anxiety
- Bipolar disorder
Languages
- English
Locations
- MA & NH
Natasa Ristivojevic
Psychiatric Nurse Practitioner
Approach
- Wholistic approach prioritizing human connection
- Evidence-based interventions
- Judicious medication management
Clinical interests
- Psychotic disorders
- Mood disorders
- Substance use
Languages
- English
- Serbian
Locations
- MA & NH
James Quackenbush
Psychiatric Nurse Practitioner
Approach
- Collaborative focus on goals and you
- Evidence-based planning
- Empowering you toward well-being
Clinical interests
- Depression & Anxiety
- PTSD
- Borderline
- Personality disorder
- Bipolar disorder
- Schizophrenia
Languages
- English
- French
Locations
- MA, NH
Juliana S Pires
Psychiatric Nurse Practitioner
Approach
- Medication management
- Coping skills development
- Empathic listener, genuine, honest
Clinical interests
- Depression & Anxiety
- Bipolar disorder
- Schizophrenia
- Trauma & PTSD
- ADHD
Languages
- English
- Portuguese
Locations
- MA, NH, RI, VT
Erin Savage
Psychiatric Nurse Practitioner
Approach
- Compassionate & empathic listening
- Tailored treatment to goals
- Utilize cognitive behavioral therapy & coping skills development
Clinical interests
- Depression & Anxiety
- Bipolar disorder
- schizophrenia
- Trauma
Languages
- English
Locations
- MA, NH
Insurance, Costs, Payments
Massachusetts
Aetna
Blue Cross Blue Shield
Cigna
Harvard Pilgrim
Mass General Brigham Health
Tricare
Tufts
UHC – Optum
New Hampshire
Blue Cross Blue Shield
Carelon Behavioral Health
Cigna
Harvard Pilgrim
Tricare
Tufts
UHC – optum
Rhode Island
Aetna
Blue Cross Blue Shield
Cigna
UHC – Optum
Vermont
Blue Cross Blue Shield
Cigna
UHC – Optum
Costs
15 min Consultation – Free
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 treatment, 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
Get Started Today
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 mental health concerns can Birch Grove Mental Health support?
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 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, ADHD, OCD, Bipolar Disorder, Panic, Thought Disorders, Trauma