Generalized anxiety is constant worry or discomfort. People with generalized anxiety usually end up feeling worn out, tense, irritable, restless, and have trouble sleeping. The worry is not usually limited to one thing, but is more pervasive and includes many things large and small.

Generalized anxiety can be treated effectively with Cognitive Behavioral Therapy where the patients learn to relax and control their thoughts. In addition to one-on-one sessions in the office, patients are usually assigned homework to work on from the comfort of home. We understand that changing the way that you feel and think is not an overnight task, and we are here to offer the support you need to accomplish this goal.

Obsessive-Compulsive Disorder (OCD) is associated with worries about bad things that could happen. This causes so much anxiety that the person with these thoughts tries to make the anxiety go away or prevent the dreaded event by repeatedly checking things or performing routines and behaviors.

The thought is called the obsession. Examples of obsessions are thoughts of things being dirty or things not in the right order. What the person does to make it the anxiety go away or to prevent the dreaded outcome is usually referred to as the compulsion. Examples of compulsions include excessive cleaning, counting, washing or repeating things.

There are also other types of obsessions including but not limited to thoughts about harming oneself and loved ones, performing sexual acts or otherwise tabooed thoughts. Sometimes the OCD can be so persistent as to prevent normal daily activities and cause distress. Many OCD patients can also feel isolated, depressed and even suicidal. OCD is most effectively treated with exposure and response prevention (ERP) or medication. We consider ERP to be crucial and include it in every patient’s treatment.

Post-traumatic stress disorder (PTSD) is a series of intrusive recollections of a traumatic event that was experienced either directly or observed. Many people who observe or have a traumatic event happen will experience some symptoms. These often include intrusive recollections: unwanted thoughts, vivid images, nightmares. People may have similar emotional and physical reactions to trauma. Some people will develop PTSD and some will not. For example, millions of people saw the World Trade Center collapse on TV. There were some gruesome images. Not all of the people who saw it on TV developed PTSD. Many people were able to talk it out and reassure themselves in a way that prevented them from developing PTSD. Others who knew people working in the building, were there at the site or had a predisposition to develop this disorder might have PTSD today.

PTSD sufferers often experience intrusive dreams, flashbacks, hypersensitivity to similar situations (like the person who has experienced gunfire or explosions will hit the deck when a car backfires), irritability, withdrawal from others, and persistent feelings that life will not move forward.

Patients with PTSD can benefit from carefully designed and executed exposure exercises, as well as Cognitive Behavioral Therapy, both of which are offered at our practice.

Panic attacks are bouts of extreme anxiety or fear that lead the person to think that they may be having a heart attack, losing control or going crazy. Sometimes, the panic attacks happen by chance in the same place several times, which could cause the person to start associating the location with the attacks. Avoidance happens when the person stays away from the place to prevent panic attacks. More extreme avoidance is called Agoraphobia.

We use Cognitive Behavioral Therapy (CBT) and exposure exercises which have been proven to be effective in treating Panic disorder and Agoraphobia.

People avoid things because they fear them. This avoidance is called a phobia. In children these are normal developmental fears which children grow out of (a fear of strangers or animals). Sometimes these fears persist or worsen into adulthood. People can also develop phobias in adulthood. An example would be a child traumatized by a dog bite and then finds that they are now avoiding dogs, get scared around all dogs, and feel anxious even hearing the barking of a dog.

Frequently phobias that were manageable by avoidance, become unmanageable. For example, if you feared flying but never had a need to, it wouldn’t be a problem. Then your child decides to get married in the south of France. Now your phobia of flying may become a problem. Phobias are very treatable with Cognitive Behavioral Therapy.


Depression presents itself in different ways. There are gradations and variations in the types of depression people experience. At one end is Dysthymia, which usually has fewer symptoms than other forms of depression, but can still cause just as much suffering. Mood Disorders is more severe and may come once or recur many times during a person’s life. Manic episodes are times when a person feels the opposite of depressed - irrationally high, with excess energy and a feeling that they are “on top of the world”. This can alternate with depressive episodes. When this happens, we say there is a case of bipolar disorder. In adolescents, anger, acting out and truancy may sometimes be the primary symptoms.

The depressed person hates feeling bad, so much so that they sometimes hate themselves for feeling this way. They feel that other people all seem to be enjoying life but they are not. In fact, depression can lead people to lay in bed because they do not have the interest or energy to get out. The activities they used to do are no longer enjoyable. Depression can lead to pains in the body, olfactory hallucinations, hearing things, impairments of memory, concentration, sleep, and thoughts of suicide. Depression is treatable with Cognitive Behavior Therapy and/or in combination with medications.