Anxiety Treatment in Southlake, TX

Understanding Anxiety

Anxiety is one of the most common mental health conditions, yet it’s often misunderstood. It affects people of all backgrounds, ages, and genders. While anxiety can present differently across individuals, effective treatment is available for everyone.

It’s more than just feeling stressed or worried – anxiety disorders involve persistent, excessive fear or worry that interferes with daily life, relationships, and overall well-being. According to the National Institute of Mental Health, approximately 31% of US adults experience an anxiety disorder at some point in their lifetime, with roughly 19% experiencing an anxiety disorder in any given year.

When you encounter a threat or stressor, your body naturally activates the fight-or-flight response – a biological survival mechanism designed to protect you. This triggers the release of stress hormones like cortisol and adrenaline, increases your heart rate, and prepares your muscles for action. In a truly dangerous situation, this response is adaptive and life-saving. However, in anxiety disorders, this system becomes overactive. Your amygdala (the brain’s threat-detection center) sends alarm signals even when there’s no real danger, while your prefrontal cortex – the rational planning center – struggles to override these false alarms. Additionally, the hypothalamic-pituitary-adrenal (HPA) axis, which regulates your stress response system, can become dysregulated, keeping you in a heightened state of alert.

The key difference between normal stress and an anxiety disorder is persistence and impact. Normal stress typically feels manageable and resolves once the stressor is gone. Anxiety disorders continue even when the original trigger has passed, and the worry interferes with your ability to work, maintain relationships, enjoy activities, or feel at peace. At MindMED Behavioral Health, we believe anxiety is a human experience, not a personal failure. It’s a treatable condition, and with the right care, most people experience significant relief.

Types of Anxiety We Treat

Dr. Fredes provides comprehensive evaluation and treatment for the full spectrum of anxiety disorders:

• Generalized Anxiety Disorder (GAD) – Persistent worry about everyday matters – work, health, finances, family – that feels difficult to control and lasts at least six months. People with GAD often describe a constant “what if” mindset, anticipating problems that may never occur.
• Panic Disorder – Recurrent, unexpected panic attacks (sudden surges of intense fear) along with persistent fear of future episodes. Many people with panic disorder begin to avoid situations where they’ve had attacks, which can progressively limit their world.
• Social Anxiety Disorder – Intense fear of social situations and being judged, evaluated, or embarrassed by others. This extends beyond shyness and can make it difficult to work, attend social events, or maintain friendships.
• Health Anxiety (Illness Anxiety Disorder) – Excessive worry about having or developing a serious medical condition, even when medical evaluations come back normal. This often leads to frequent doctor visits or excessive health-related research.
• Specific Phobias – Intense, irrational fear of specific situations or objects (heights, flying, needles, animals) that leads to avoidance and can interfere with daily functioning.
• Agoraphobia – Intense anxiety about being in places or situations where escape might be difficult or where help wouldn’t be available if panic symptoms occur. People with agoraphobia may become housebound if untreated.
• Separation Anxiety – Excessive fear of being apart from attachment figures (spouse, parent, child), not just a childhood phenomenon. Adults with separation anxiety often struggle with independence and may experience panic when separated.
• Performance Anxiety – Fear and avoidance related to performing in front of others – public speaking, musical performance, athletic competition. The anxiety is specific to the performance situation and can significantly impact career and personal achievement.

Recognizing Anxiety Symptoms

Anxiety manifests differently for each person, but understanding the range of symptoms helps you recognize when anxiety has become a clinical concern. Symptoms typically fall into three categories:

Physical Symptoms: Racing heart or chest pain, shortness of breath, dizziness or lightheadedness, trembling or shaking, muscle tension and aches, fatigue or exhaustion, sweating, hot flashes or chills, nausea or stomach upset, difficulty sleeping or nightmares, frequent urination or diarrhea. These physical symptoms are real – they’re your nervous system in overdrive – but they’re not dangerous, even when they feel frightening.

Cognitive (Mental) Symptoms: Catastrophizing (jumping to worst-case scenarios), difficulty concentrating or mind going blank, racing thoughts, indecisiveness and difficulty making choices, persistent worry that’s hard to control, obsessive thoughts about potential dangers, memory problems. Your mind gets stuck in worry loops, replaying conversations or imagining future disasters.

Behavioral Symptoms: Avoidance of anxiety-triggering situations (which temporarily reduces anxiety but reinforces the cycle), reassurance-seeking from others, difficulty completing tasks, restlessness and pacing, procrastination, withdrawal from social activities or relationships, perfectionism or over-preparing, substance use to cope with anxiety. These behaviors often provide short-term relief but maintain the anxiety in the long term.

What Causes Anxiety Disorders?

Anxiety disorders typically result from a combination of biological, environmental, and psychological factors:

Genetics and Brain Chemistry: Anxiety tends to run in families, suggesting genetic vulnerability. Research shows that people with anxiety disorders may have differences in brain structure and function, particularly in neurotransmitter systems like serotonin, gamma-aminobutyric acid (GABA), and norepinephrine. These aren’t “chemical imbalances” in the moralistic sense – rather, they reflect how your brain is wired to process threat and stress.

Trauma and Adverse Experiences: Childhood trauma, abuse, neglect, or significant life stressors can sensitize your threat-detection system, making you more prone to anxiety. You may have learned that the world is unsafe, or that your feelings are unmanageable, and these beliefs persist into adulthood.

Medical Conditions That Mimic Anxiety: Thyroid disorders, cardiac arrhythmias, hypoglycemia, sleep apnea, and chronic pain can produce anxiety symptoms or trigger anxiety disorders. A thorough medical evaluation is essential to rule out these contributors.

Medications and Substances: Stimulant medications, certain blood pressure drugs, caffeine, and energy drinks can trigger or worsen anxiety. Conversely, alcohol and benzodiazepines can create dependency and worsen anxiety over time.

Life Transitions and Chronic Stress: Major life changes (new jobs, relationship loss, moving, health concerns), ongoing stress (work pressure, financial strain, relationship conflict), and accumulated daily stressors can trigger or intensify anxiety.

Our Approach to Treating Anxiety

We take an integrative approach that goes beyond simply prescribing medication. Dr. Fredes conducts a thorough initial evaluation (60–90 minutes) to understand your full picture – symptoms, medical history, family history, lifestyle factors, previous treatments, and personal goals. This comprehensive assessment is the foundation for an effective treatment plan.

Therapy Coordination: While MindMED provides psychiatric medication management and integrated psychotherapy, many people benefit from additional or specialized therapy. Dr. Fredes works collaboratively with your therapist, ensuring your medication plan supports your therapeutic progress. We have established relationships with excellent therapists in the Southlake and DFW area and can provide recommendations if you need specialized care like cognitive-behavioral therapy (CBT) or exposure therapy.

Evidence-Based Anxiety Treatments

The treatments we offer are supported by decades of research and clinical evidence:

SSRIs and SNRIs: Selective serotonin reuptake inhibitors (SSRIs) like sertraline, paroxetine, and escitalopram, along with serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine and duloxetine, are first-line medications for anxiety disorders. They work by increasing the availability of serotonin and norepinephrine in your brain, neurotransmitters involved in mood and anxiety regulation. Most people don’t notice improvement for 2-4 weeks, and full effects may take 6-8 weeks. It’s important to take these medications consistently even if you don’t feel immediate results.

Buspirone: This medication works differently from SSRIs, primarily affecting serotonin receptors. It’s often used for generalized anxiety disorder and is typically well-tolerated with fewer sexual side effects than SSRIs. It generally takes 2-3 weeks to become effective.

Benzodiazepines: Medications like lorazepam and alprazolam work quickly to reduce anxiety symptoms, making them valuable for acute anxiety or panic attacks. However, Dr. Fredes takes a cautious approach to benzodiazepines due to the risks of dependence and long-term use complications. When used, they’re typically prescribed for short-term relief (a few weeks to months) while longer-acting medications build effectiveness. They’re not recommended as a primary long-term solution for anxiety disorders.

Beta-Blockers: Medications like propranolol can be particularly helpful for performance anxiety and the physical symptoms of anxiety (racing heart, trembling). They block the effects of adrenaline on your body without affecting the emotional anxiety itself, making them useful for specific situations like public speaking or presentations.

Newer Options: Depending on your specific situation, Dr. Fredes may discuss other evidence-based options like hydroxyzine for situational anxiety or low-dose antipsychotics for severe anxiety, though these are reserved for specific clinical scenarios.

Living with Anxiety: What to Expect in Treatment

Timeline of Improvement: Most people notice some improvement within 4-6 weeks of starting treatment, though the first 2-3 weeks sometimes feel unchanged or even slightly worse before getting better. Full benefits often take 3-6 months, and for some, continued improvement occurs over a longer period. The rate of improvement varies based on the type of anxiety, how long you’ve had it, whether there are other medical conditions involved, and how consistently you engage in your treatment plan.

The First Few Weeks: You may experience initial side effects like mild headache, nausea, or sleep disruption, which typically resolve within 1-2 weeks. Some people describe feeling emotionally “flat” initially before emotional clarity returns. Anxiety itself may feel heightened at first – this paradoxical reaction is temporary and manageable. Dr. Fredes will monitor you closely during this period and adjust your plan as needed.

Consistency Matters: Taking your medication exactly as prescribed is crucial. Skipping doses or stopping abruptly can trigger anxiety rebound and make it harder for your medication to work effectively. If you experience side effects, always discuss them with Dr. Fredes before making changes – there are usually solutions that don’t involve stopping treatment.

When to Call Between Appointments: Contact the office immediately if you experience severe anxiety, panic that feels unbearable, thoughts of self-harm, or significant side effects that interfere with daily functioning. For routine questions about your treatment or mild side effects, these can be addressed at your next appointment or during a scheduled check-in. We’re here to support you through the process, and communication is key to success.

Insurance & Pricing

We accept major insurance plans to make quality psychiatric care accessible:

For patients without insurance coverage, we offer self-pay options with transparent pricing. We also provide superbills for out-of-network reimbursement. View full pricing details →

Why Choose MindMED for Anxiety Treatment?

• Board-certified psychiatrist – Dr. Fredes trained at Icahn School of Medicine at Mount Sinai and brings evidence-based expertise to every patient
• Integrative approach – We treat the whole person, not just symptoms, addressing biological, psychological, and lifestyle factors
• Unhurried appointments – Your initial evaluation is 60-90 minutes, allowing Dr. Fredes to truly understand your situation
• Bilingual care – Services available in English and Spanish to serve our diverse community
• In-person and telehealth – Convenient options for patients across Texas, New York, and Virginia
• Insurance accepted – Aetna, BCBSTX, Cigna, Oscar, and United Healthcare, with transparent pricing
• Dr. Fredes sees every patient herself – No physician assistants or nurse practitioners handle your care; you work directly with a board-certified psychiatrist from day one