Anxiety Treatment Portland Oregon

Anxiety is a serious psychological condition that can affect a person’s ability to experience normal relationships or have a happy, productive life. If you or a loved one is suffering from this debilitating condition, Synergy Mental Wellness can help.

If you are not sure if you have anxiety, it can be helpful to understand the symptoms and treatment of the condition.

What is The Difference Between Fear and Anxiety?

Fear is a natural emotion. Your limbic system will be activated when you feel fear. This system is known as your emotional brain. When something or someone frightens you, your heart may pound, and you may have blurred vision. Fear is not something we consciously control. Fear prepares us to fight or flee in a dangerous situation.

For example, if you are walking down a dark street alone at night and you hear a deep voice behind you say stop, your heart will likely start beating faster. You need to decide quickly to either stop or run. Your breath may become short because your body is preparing to deal with danger.

Fear is a mechanism to keep people safe. It is what protected primitive people from walking into the jungle and being eaten by larger animals. It is what protects us when we are driving or hiking. If we did not have fear, we would have become extinct a long time ago.

Fear is a response to threats in our environment, but anxiety is a reaction to the emotions we experience. Anxiety is what prevents us from acting on our base emotions. To a certain extent, anxiety protects as well. Anxiety may be triggered by events in the past or happen when you are in certain situations. We often have too many emotions to manage. When you have therapy for anxiety, a psychiatric nurse practitioner can help you manage your reaction to your emotions. At Synergy Mental Wellness, we take a holistic approach to treating anxiety. Our trained psychiatric nurse practitioner, Michael Boas, can prescribe medication as well.

What Are the Symptoms Of Anxiety

Although fear and anxiety are closely related, there are certain physical symptoms you may experience with anxiety you would not experience if you were simply afraid. As with fear, you may have an increased heart rate and shortness of breath. You may even sweat or feel dizzy. 

However, you will also have more complex, long-lasting feelings, such as a feeling of doom. You may be unable to concentrate and have insomnia. 

If you live with anxiety long enough, you may end up with chronic feelings of insecurity. You may find yourself avoiding situations that could trigger your anxiety. People with anxiety often experience chronic gut problems. 

Different Types of Anxiety

There are five major types of anxiety disorders. When you have your initial appointment, we will examine you and give you a psychological assessment using the DSM 5. It is a detailed test used to determine different psychological disorders. It will allow us to pinpoint how we can best help you. 

Generalized Anxiety Disorder

If you find yourself feeling anxious for no reason, you may have generalized anxiety disorder. People with generalized anxiety disorder often find themselves worrying about everyday things excessively. They may worry about paying monthly bills, even though they are employed and have an income. They may worry excessively about if they have left the oven on or the door unlocked. 

Insomnia and restlessness are symptoms of generalized anxiety. You may feel irritable and have difficulties concentrating if you try to work or read.

We generally do not diagnose people with GAD unless they have been experiencing these symptoms for at least six months. 

This is a chronic condition that can be treated with medication and therapy. Symptoms tend to dissipate naturally as a person becomes older but will not go away completely without treatment.


The condition is thought to be genetic. People who have parents with the disorder are five times as likely to be affected by it. People who suffer traumatic experiences may also suffer from general anxiety. Many people who have this condition were abused or bullied.


There are several actions you can take to combat generalized anxiety disorder. People who smoke have intensified symptoms. If you smoke, you may consider quitting. Exercising regularly and reducing caffeine intake may also be beneficial. 

We always begin treating socialized anxiety disorder with psychotherapy. Cognitive behavioral therapy is generally used to treat GAD. However, our owner, psychiatric nurse practitioner Michael “Mike” Boas, believes in giving patients the treatment that is correct for them. He will include you in the decision-making process and discuss each kind of therapy we offer with you. This way, we can determine which method of treatment is correct for you. 

Antidepressants are often used to treat this disorder. Lexapro and Cymbalta are normally used to treat depression, but they have also been shown to treat patients with GAD.

Buspirone can also be used to treat anxiety. It is a selective serotonin reuptake inhibitor that changes the way certain chemicals in the brain interact with one another. Neurotransmitters relay messages from the nervous system to the rest of the body. Two of these neurotransmitters, dopamine and norepinephrine, control mood. Buspirone blocks the neurons from reabsorbing the chemicals they have released, causing dopamine and norepinephrine to work longer. 

Benzodiazepines are used to reduce anxiety on a short-term basis. They are sedatives and addictive, so they are typically prescribed on a short-term basis. 

Panic Disorder

When a person has repeated instances of intense fear accompanied by physical symptoms, they may have panic disorder. When a person with this disorder has a panic attack, they may sweat, have a racing heartbeat, or even feel faint. Their hands may shake, and they may throw up. In some severe cases, a person may feel as though they are not connected to their own body when they have this disorder. They may feel as though they are going to die.

A panic attack can last anywhere from 5 to 20 minutes. You may feel as if you are in danger, but it is not physically dangerous. Synergy Mental Wellness has helped many people with this condition.


It is unknown what causes a person to have panic attacks. However, it has been linked to an imbalance of neurotransmitters in the brain. It may also have to do with a traumatic event in a person’s past, such as grief over losing a family member. 


Unless panic attacks are severe, we will begin treating a patient with talk therapy. It is often helpful for us to recreate the circumstances that occurred during your last panic attack. This allows us to better understand how to treat it. Sometimes acting out the circumstances in which a panic attack took place can help illustrate the situation was not scary or anything to panic about. 

Selective serotonin reuptake inhibitors are generally prescribed for panic attacks. Benzodiazepines may be used for panic attacks, especially if they do not occur often.

Obsessive Compulsive Disorder 

OCD is an often misunderstood condition. In movies and on television, it is often portrayed as a comedic condition that causes a person to be obsessed with neatness and order.

In real life, people who suffer from OCD are constantly plagued by unwanted thoughts or images popping into their heads. They will repeat certain behaviors like counting objects or money, washing their hands, and cleaning. A person with OCD will often think if they perform these actions, they can make the thoughts go away. 

Sometimes OCD sufferers are afraid of very specific things. They may think they will get sick if they do not wash all their dishes ten times by a certain time of day. They may believe terrible things will happen if they do not perform certain rituals repeatedly. 

They may have unwanted or strange thoughts about religious themes or strange sexual fantasies. They may be afraid they will have the uncontrollable urge to yell obscenities in public.

Part of the myth of a person with OCD being very neat comes from the fact they are often obsessed with avoiding germs. It often comforts them to make everything orderly and symmetrical.

If a person with OCD does not receive treatment, they may be unable to work or function normally. 


Experts have been unable to determine what causes OCD. However, there is some evidence that brain abnormalities may cause the disorder. A person will normally start experiencing symptoms when they are a teenager or in early adulthood. 

Treatments for OCD

There are several different treatments for OCD. We will try psychotherapy first. Although we often follow up with medication, we want to understand how your thought process works. In the case of OCD, we have discovered there are a few specific types of therapy that are believed to work.

Exposure therapy involves exposing a person to whatever it is that troubles them. It has been used to treat people who are afraid to fly. It is also used for people who have various phobias, such as fearing dogs or cats. 

Therapy begins by having the person write down a list of their obsessions in order. They are then shown the object of their obsessions and told not to do what they feel like doing.

For example, if a person is obsessed with having all the pictures on an end table facing the same way, their therapist might have the person sit at a table with pictures that are in a complete state of disarray. 

Exposure therapy may be too intense for someone with severe OCD. Sometimes a therapist will begin with a picture of whatever the patient is obsessed with. If they are afraid of germs and dirt, a therapist may take a picture of a dirty table or a bathroom.

If the person is afraid to walk down the street without touching every lamppost, a therapist may make a videotape of themselves walking down the street without touching any lampposts. This type of therapy is normally a stepping stone to exposure therapy. 

Sometimes therapists will use habit reversal training to change a person’s behavior.

A person may be told to stand in front of a mirror or video camera while they are doing whatever activity they feel compelled to do. They will record any emotions they have while watching themselves. They will also document how they were feeling and what they were doing just before they had the urge to perform their ritual. They then make an effort to reverse the habit.


We often treat obsessive-compulsive disorder with medications. Anti-anxiety medications are typically used. Both Anafranil and Prozac are drugs used to treat this disorder. Why anti-anxiety medication works to treat OCD is unknown. Doctors initially experimented with Prozac to see if it would help people who have OCD, and it has proven to be effective in many cases.

Post Traumatic Stress Disorder

PTSD can develop after a person has experienced a traumatic event. People who have been in military combat often experience PTSD. Sexual assault victims also often suffer from PTSD. PTSD can also present itself in individuals who have experienced more common trauma, such as a car accident, or in individuals who have not experienced trauma but have the fear that they are in danger.  

PTSD can last for years. A person with this condition will relive the emotions they experienced during a traumatic event repeatedly. 

As we already discussed, when a traumatic event happens, and the limbic system is triggered, a person’s heart will race, they will experience shortness of breath, and their hands and knees may shake. A person with PTSD will relive those symptoms repeatedly. This is very dangerous because reliving those things repeatedly can cause heart complications. 

The symptoms may be triggered by nightmares or by flashbacks during the day. A rape victim may be triggered when they see someone who looks like their assailant. A person who has PTSD from military combat may be triggered when they hear noises similar to gunshots or when they see terrain reminding them of battle. 

Although a person may try to avoid thinking about the traumatic event, images of it continue to come back. A person with PTSD may have a distorted perception of the world. They may have trouble maintaining relationships with people and have suicidal thoughts. 

PTSD sufferers often become emotionally numb. They will be unable to enjoy the things they once did.

Treatment for PTSD

Some forms of cognitive behavioral therapy will be used when treating a PTSD patient. They will try to get the person to look at the triggering situation in an objective way. 

Prolonged exposure is often used in therapy. The therapist and the patient will gradually deal with memories of the inciting incidents. The therapist will talk to the patient about specific memories and the feelings those memories evoke. 

Medications for PTSD

Selective Serotonin Reuptake Inhibitors are used as a treatment for PTSD, just as they are used for every other anxiety category. The inhibitor known as Venlafaxine is being used to treat PTSD  often. It works as a serotonin reuptake inhibitor and norepinephrine reuptake inhibitor. 

Social Anxiety

When a person feels awkward and afraid in social situations, they may be suffering from social anxiety. In some cases, social anxiety may only take place in certain situations. A sufferer may only be anxious when they perform tasks in front of other people or when they go out on a date. In other cases, they may feel anxious all of the time when they are around other people.

A person with this disorder will constantly feel as though others are watching and judging them. It can affect work, as well as social life. A person with social anxiety may not have any friends or will only have friends on social media. They may have only surface relationships with people in real life. 

Social anxiety can make things such as public speaking, going to a job interview, or asking a question in class feel like torture. People fear being humiliated and judged the way other people would fear physical violence. 

Symptoms of this disease include turning red and feeling shaky. Their mind may go blank, and they might be unable to make eye contact with people around them. 

What Causes Social Anxiety?

A person with an appearance or medical condition that draws attention to them will often have social anxiety. People who have recently changed their lives in some way may experience social anxiety. For example, if a person has a new job in a new town, they may feel overwhelmed by all the changes in their life. It may cause them to be more reclusive than they would normally be.

Treatment For Social Anxiety

Cognitive behavioral therapy is considered the best form of treatment for social anxiety. A therapist can expose a person to a small group of people. In some cases, it may be a group therapy session.

You may be asked to participate in role-playing scenarios.  You will stand in front of a small audience of other people with anxiety and perform a skit with people who have a similar situation to yours.

Medication for Social Anxiety

As with every type of anxiety we have discussed, Selective Serotonin Reuptake Inhibitors are used to treat social anxiety. Zoloft is considered to be one of the most popular drugs for social anxiety disorder.

Social Anxiety is a more severe condition than people might think. If you feel scared going out in public or if you are having an event coming up you need to prepare for, therapy can help prepare you.

Our staff is looking forward to meeting you and helping you with any anxiety problems you might have. Give us a call today.