Anxiety, Panic & Social Anxiety Treatment in New Hampshire

What Anxiety Actually Looks Like

Anxiety disorders are a group of conditions marked by excessive fear or worry that’s difficult to control and interferes with daily life — including generalized anxiety disorder, panic disorder, and social anxiety disorder. Anxiety can look very different from person to person: for some, it’s a constant undercurrent of worry that makes it hard to relax or focus; for others, it’s sudden panic attacks that feel like a medical emergency, or social anxiety severe enough to limit career and relationships. What these presentations share is that they respond best to treatment that starts with a careful, specific evaluation — not a one-size-fits-all approach.

Some anxiety symptoms trace back to a specific traumatic experience; Dr. Narlesky also evaluates and treats trauma and PTSD as a distinct area of care on the Trauma & PTSD page.

Anxiety Conditions Evaluated and Treated

Dr. Narlesky evaluates and treats a range of anxiety-related conditions, including:

• Generalized Anxiety Disorder (GAD) — persistent, excessive worry across multiple areas of life, often accompanied by muscle tension, restlessness, and difficulty sleeping
• Panic Disorder — recurrent panic attacks, sometimes with anticipatory anxiety and avoidance behavior that can progressively narrow a person’s life
• Social Anxiety Disorder — intense fear of social or performance situations that goes beyond normal shyness and leads to avoidance of work, school, or interpersonal situations
• Trauma and PTSD — Dr. Narlesky also evaluates and treats trauma and PTSD as a distinct area of care. Visit the Trauma & PTSD page for more detail.
• Adjustment Disorders — significant anxiety or distress in response to a life change or stressor that interferes with daily functioning

These categories overlap more than most people realize. Many patients present with features of more than one, and prior clinicians may have focused on the most obvious symptoms without exploring the broader pattern.

Anxiety can also be a symptom of obsessive-compulsive disorder (OCD), involving intrusive thoughts and compulsive behaviors or mental rituals. Dr. Narlesky evaluates the full symptom pattern to distinguish OCD from a primary anxiety disorder and guide treatment recommendations.

How Dr. Narlesky Approaches Anxiety Treatment in New Hampshire

Anxiety is an area where a careful initial evaluation makes the most significant difference. The wrong treatment — or the right treatment applied to the wrong diagnosis — can stall progress for months or years.

Dr. Narlesky’s evaluation includes:

• A detailed history of anxiety symptoms: when they started, what triggers them, how they’ve evolved
• Assessment of whether panic, trauma, social anxiety, or generalized worry is the primary driver — or whether multiple patterns are at play
• Review of prior treatment, including what’s helped and what hasn’t
• Medical history review to rule out conditions that mimic or worsen anxiety — thyroid dysfunction, cardiac arrhythmias, medication side effects, caffeine sensitivity, and others
• Assessment for co-occurring depression, which frequently accompanies anxiety disorders
• Functional impact — how anxiety is affecting work, relationships, sleep, and daily life

This is not a fifteen-minute intake. It’s a real clinical conversation designed to produce an accurate formulation and a treatment plan that targets the right things.

Anxiety Treatment

Treatment depends entirely on what the evaluation reveals. Options may include:

Medication, when appropriate, selected based on the patient’s specific symptom profile, medical history, and prior treatment response. Dr. Narlesky takes the time to explain the reasoning behind any medication recommendation — what it targets, what to expect, and what the plan is if adjustments are needed. The goal is to treat the underlying condition effectively, not to simply blunt the symptoms.

Therapy recommendations when talk therapy is indicated. Dr. Narlesky does not provide therapy directly but frequently coordinates with therapists and can help identify the right type of therapy for a given presentation — because the approach that works well for generalized anxiety may not be the best fit for social anxiety or panic disorder.

Ongoing monitoring through follow-up visits that include clinical conversation, symptom tracking, and treatment adjustment. Anxiety treatment often requires fine-tuning, and follow-up appointments are structured to allow for that.

When to Consider a Psychiatric Evaluation for Anxiety

Many patients with anxiety have managed it on their own for years before seeking help — or have received treatment that helped partially but never fully resolved things. A psychiatric evaluation is worth considering if:

• Anxiety is interfering with work, relationships, or the ability to enjoy daily life
• You experience panic attacks or periods of intense physical anxiety
• You’ve been in therapy but feel like something biological might also be going on
• A primary care doctor started you on medication
• You carry the effects of past trauma — Dr. Narlesky also evaluates trauma and PTSD as a distinct area of care; visit the Trauma & PTSD page for more detail.
• You’ve been told “it’s just stress” but it feels like more than that

You don’t need a referral and you don’t need to be in crisis. You just need to feel like what you’re currently doing isn’t working well enough.

What to Expect From a New Hampshire Anxiety Psychiatrist

Your first appointment is typically 60 minutes, conducted via secure video from anywhere in New Hampshire. Dr. Narlesky will take a thorough history, assess current symptoms, and begin developing a treatment plan specific to the patient’s situation. Patients who have never seen a psychiatrist before may want to read more about what to expect at a first psychiatric appointment.

Follow-up visits include ongoing clinical assessment and medication management when applicable. The pace of treatment is guided by how the patient is responding — not by a rigid schedule.

Who This Practice Serves

This practice provides ongoing outpatient psychiatric care for adults 18 and older located in New Hampshire. It is not equipped for acute psychiatric crises, frequent or recurring safety-related needs, inpatient or intensive outpatient-level care, benzodiazepine management, forensic or disability evaluations, standalone psychotherapy, or addiction treatment as a primary concern. Full details are available on the Disclaimer and FAQ pages.

If you’re in crisis, call or text 988, or call 911 or go to your nearest emergency room.

Accepting New Patients Across New Hampshire

If you’re looking for a psychiatrist in New Hampshire who understands anxiety and takes the time to evaluate it carefully, new patient appointments are available on a rolling basis.

In-network with Anthem BCBS, Aetna, Cigna, Carelon Behavioral Health, Point32 Healthcare, and Providence Health Plan. An estimated session cost based on your insurance benefits will be provided before your first appointment.