Anxiety & insomnia · Washington telehealth
Care for anxiety, in the day and through the night.
Persistent worry, tension, and nights that don’t feel restorative.
Start with the pattern, not just the symptom.
Worry and sleep difficulties can overlap. Your experience might be daytime tension, repeated checking, panic, trouble falling asleep, or waking and struggling to settle again.
I ask about a typical day and night, how long this has been happening, and what you have tried. We also review caffeine, alcohol, medications, medical concerns, and changes in mood.
Anxiety is not only a sleep problem
It may show up in anticipation of a meeting, while making a decision, in a crowded place, or when nothing seems obviously wrong. I ask what you fear will happen, what you do to manage that feeling, and what it is keeping you from doing. Your own examples help us understand the pattern.
Sleep deserves its own assessment
Insomnia is not always explained by anxiety. Snoring, breathing interruptions, shift work, or other sleep problems may call for evaluation beyond psychiatric care. We discuss when primary care or a sleep specialist should be involved.
Cognitive behavioral therapy for insomnia, called CBT-I, is generally a first treatment option for long-term insomnia. Medication may be considered after an individualized discussion; being sedated is not the same thing as resolving a sleep disorder. Read the NHLBI overview of insomnia treatment.
What this practice provides
Psychiatric evaluation and medication management, with attention to the rest of your treatment. I do not provide a stand-alone course of CBT-I, and can discuss finding that care if appropriate.
Controlled medications are within my scope when clinically indicated. I do not start them at a first visit or prescribe them on request. Continuing an existing prescription requires a fresh diagnostic review, a Prescription Monitoring Program review, a treatment agreement, and regular follow-up.
Read about anxiety and the sleepless night
Common questions
Will you prescribe something to help me sleep?
Not before an assessment. We first look at your sleep pattern, anxiety, physical health, medications, and substances. CBT-I is generally a first treatment option for long-term insomnia. If medication is considered, we discuss the specific target, possible benefits, and risks.
Do I need a diagnosis before contacting you?
No. We can begin with what you have noticed and what you want help with. The free consultation checks fit; a paid psychiatric evaluation is where assessment and treatment planning take place.
How do fees and insurance work?
The first conversation is free, for 15 minutes by video or phone. Insurance participation is not yet active. If you hope to use insurance for future care, you can join the insurance interest list. For appointments before participation is active, see current fees and payment details.