Yes, your primary care physician (PCP) is the appropriate first point of contact for symptoms of anxiety. Anxiety disorders are among the most common mental health concerns, and PCPs routinely diagnose and manage these conditions. Starting the conversation with a doctor you already know and trust can make seeking help more accessible and less intimidating than going directly to a specialist. Your PCP is equipped to conduct a thorough initial evaluation, initiate treatment, and coordinate any necessary specialized care.
Initial Assessment and Diagnosis
When you visit your PCP with concerns about anxiety, the first step is an investigative process to understand the full scope of your symptoms. This assessment involves two main components: ruling out underlying physical conditions and formally evaluating the anxiety itself. Because physical symptoms of anxiety, such as a rapid heart rate, sweating, and shortness of breath, can mimic other medical issues, your doctor will perform a physical exam and likely order laboratory work.
Common physical conditions that can present like anxiety include hyperthyroidism, which causes nervousness and heart palpitations, and certain cardiac irregularities. Low blood sugar (hypoglycemia) and anemia can also cause shakiness, dizziness, and fatigue that overlap with anxiety symptoms. Blood tests, such as a complete blood count (CBC) and thyroid-stimulating hormone (TSH) test, help exclude these biological causes before a mental health diagnosis is finalized.
Once physical causes have been addressed, your PCP will move to a preliminary mental health screening. They often use standardized, evidence-based questionnaires like the Generalized Anxiety Disorder 7-item scale (GAD-7). This tool assesses the severity of your anxiety based on symptoms experienced over the past two weeks. The score from this screening helps the PCP determine the severity of the condition and guide the initial treatment plan.
Treatment Options Your PCP Can Provide
A significant number of anxiety cases can be successfully managed within the primary care setting using a multi-modal approach. Your doctor is authorized to prescribe first-line pharmacological treatments for anxiety disorders. These commonly include Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). These medications work by helping the brain better utilize neurotransmitters like serotonin and norepinephrine.
Examples of these first-line medications include sertraline, escitalopram, and venlafaxine. Your PCP will typically start you on a low dose to minimize potential side effects. While other medications like benzodiazepines can offer short-term relief for acute anxiety or panic, PCPs use them sparingly due to concerns about dependence and sedation. They may be prescribed in limited quantities for use only while waiting for the daily SSRI or SNRI medication to become effective, which can take several weeks.
Beyond medication, your PCP will integrate non-pharmacological recommendations into your treatment plan. They will discuss lifestyle modifications, which can significantly reduce anxiety symptoms. This includes ensuring adequate sleep hygiene, incorporating regular physical exercise, and discussing dietary changes. They may also introduce simple stress management techniques and recommend self-help resources or digital therapeutics.
Understanding Referral to a Mental Health Specialist
While primary care is well-suited for initial management, there are specific circumstances where your PCP will transition your care to a mental health specialist. Referral is necessary if the anxiety is severe, presents with complex co-occurring mental health conditions, or is resistant to first-line treatments. If symptoms are not improving after trying a couple of different medications or if your GAD-7 score remains high, a specialist’s expertise is warranted.
The specialist your PCP refers you to will depend on the type of care needed. A psychiatrist is a medical doctor specializing in mental health who provides intensive medication management, especially for complex cases or when multiple medications are required. Conversely, a licensed therapist, counselor, or psychologist specializes in talk therapy, offering treatments like Cognitive Behavioral Therapy (CBT) or Exposure Therapy. PCPs often recommend combining medication management and specialized therapy for the most comprehensive outcomes.
How to Prepare for Your Appointment
Taking a few proactive steps before your visit can make the appointment more efficient and productive. Start by documenting your symptoms for several days or weeks, noting their frequency, severity, and any specific triggers. This detailed information will help your PCP accurately assess your condition.
You should also compile a list of all medications and supplements you currently take, including dosages. Be prepared to discuss any recent life stressors or major changes, as these can directly impact your mental health. Finally, write down specific questions for your doctor to ensure all your concerns are addressed during the appointment.