Anxiety treatment that takes the full picture seriously.
Anxiety is the most common category of psychiatric illness — and one of the most frequently undertreated, misunderstood, and inadequately managed. At Wave Psychiatric Group, our board-certified psychiatrists provide comprehensive, individualized anxiety treatment in West Los Angeles and via telehealth throughout California, drawing on the full range of evidence-based pharmacological and psychotherapeutic approaches to address not just the symptoms of anxiety, but its roots.
Understanding anxiety
Anxiety, in its most basic form, is not pathological. It is a fundamental feature of human neurobiology — an evolved system designed to detect threat, mobilize a response, and protect against danger. The problem arises not when anxiety exists, but when it becomes decoupled from actual threat — firing in the absence of genuine danger, at an intensity disproportionate to the situation, or in ways that have become self-reinforcing and disabling.
Like depression, anxiety disorders are best understood not as the product of a single biological mechanism but as the result of a complex interaction between biological vulnerabilities, psychological patterns, and social and environmental factors. Neurobiologically, anxiety disorders involve dysregulation of threat appraisal and fear extinction circuits, altered activity in the amygdala and prefrontal cortex, disrupted stress response systems, and in many cases significant overlap with inflammatory and autonomic processes. Psychologically, they are sustained and amplified by patterns of avoidance, catastrophic thinking, hypervigilance, and the various ways in which the anxious mind attempts to manage uncertainty and perceived threat. Socially and environmentally, they are shaped by early relational experiences, ongoing stressors, the quality of social support, and the particular demands and pressures of a person's life.
Understanding which of these dimensions is driving the presentation — and in what proportion — is central to developing a treatment plan that actually works.
Anxiety is not a single condition. It is a family of related but clinically distinct disorders, each with its own presentation, its own evidence base for treatment, and its own particular challenges. Our psychiatrists treat the full range of anxiety disorders in adults, including the following.
Generalized anxiety disorder
Generalized anxiety disorder is characterized by persistent, pervasive worry across multiple domains of life — work, health, relationships, finances, the future — that the person finds difficult to control and that is accompanied by physical symptoms including muscle tension, fatigue, difficulty concentrating, irritability, and sleep disturbance. The worry in GAD is not focused on a specific feared object or situation but is diffuse and wide-ranging, and it tends to follow the person across contexts and circumstances. GAD frequently co-occurs with depression and other anxiety disorders, and the combination requires careful diagnostic attention.
Panic disorder
Panic disorder is characterized by recurrent, unexpected panic attacks — discrete episodes of intense fear or physical discomfort that peak rapidly and are accompanied by symptoms including palpitations, chest tightness, shortness of breath, dizziness, sweating, trembling, and a sense of impending doom or unreality. The disorder is maintained not simply by the attacks themselves but by the anticipatory anxiety and avoidance that develop in response to them — the fear of the fear. Panic disorder is highly treatable, but it is frequently mismanaged, particularly when the somatic symptoms lead patients and their physicians to focus on cardiac or other medical workup while the underlying psychiatric condition goes unaddressed.
Social anxiety disorder
Social anxiety disorder — also called social phobia — involves intense fear of social or performance situations in which the person expects to be scrutinized, judged, or humiliated. It goes well beyond shyness or ordinary social discomfort. It is a clinical condition that can profoundly restrict a person's professional development, relationships, and quality of life, and it frequently goes unrecognized and untreated for years before a patient seeks help. Social anxiety disorder has a strong evidence base for treatment with both CBT and pharmacotherapy, and in many cases the combination produces better outcomes than either alone.
Specific phobias
Specific phobias — intense, disproportionate fear responses to particular objects or situations — are among the most common anxiety presentations and among the most responsive to targeted psychotherapeutic intervention. Exposure-based therapy, in which the feared stimulus is approached gradually and systematically in a safe clinical context, is the treatment with the strongest evidence base and the most durable outcomes.
Health anxiety
Health anxiety — formerly called hypochondriasis — involves persistent preoccupation with the possibility of having a serious medical illness, despite medical evaluation and reassurance. It is a genuinely distressing condition that is frequently frustrating for both patients and the physicians who treat them, and it responds best to psychotherapeutic approaches that address the underlying anxiety rather than repeated medical reassurance, which tends to provide only temporary relief and can inadvertently reinforce the cycle.
Obsessive-compulsive disorder
OCD involves intrusive, unwanted thoughts, images, or urges — obsessions — that generate significant distress, and compulsive behaviors or mental rituals performed in an attempt to neutralize that distress. It is classified separately from anxiety disorders in current diagnostic systems but shares meaningful overlap with them and is treated at Wave. Exposure and Response Prevention — a specific form of CBT in which the patient confronts feared stimuli while refraining from compulsive responses — is the gold standard psychotherapeutic treatment for OCD and has the strongest evidence base of any intervention for this condition.
Anxiety in the context of trauma
Anxiety frequently arises in the aftermath of traumatic experiences, and the relationship between anxiety disorders and trauma is pervasive and clinically important. Post-traumatic stress disorder, which involves anxiety, hyperarousal, avoidance, and intrusive re-experiencing of traumatic events, is addressed in detail on our PTSD and Trauma page. Many patients with anxiety disorders carry trauma histories that have not been adequately addressed and that are maintaining their anxiety in ways that standard anxiety treatment does not fully reach.
Anxiety disorders we treat
Our approach to anxiety treatment
Wave's approach to anxiety is individualized, comprehensive, and grounded in a formulation that accounts for the biological, psychological, and social dimensions of the presentation. We do not apply a single protocol to every anxious patient. We begin with a thorough diagnostic evaluation, identify which anxiety disorder or disorders are present and what is maintaining them, and develop a treatment plan that matches the intervention to the clinical picture.
Medications have a meaningful role in anxiety treatment, particularly for moderate to severe presentations, for patients who have not responded adequately to psychotherapy alone, and as an adjunct to psychotherapy in the early phases of treatment when anxiety is too intense to allow effective therapeutic engagement.
SSRIs and SNRIs are first-line pharmacological treatments for most anxiety disorders — not because they correct a serotonin deficiency, but because they produce changes in fear circuit activity, stress system regulation, and neuroplasticity that reduce the biological substrate of anxious arousal over time. They require several weeks to reach therapeutic effect and are intended as medium to long-term treatments rather than acute interventions.
Buspirone is a non-sedating anxiolytic with a favorable side effect profile that is useful in generalized anxiety disorder, though it requires several weeks to reach full effect and is not effective for acute anxiety.
Benzodiazepines are effective for acute anxiety reduction but carry well-established risks of dependence, tolerance, and cognitive side effects with regular use. Our psychiatrists prescribe them judiciously — for specific, time-limited indications — and are direct with patients about their limitations and risks. They are not a long-term solution for anxiety disorders, and we do not use them as one.
Beta-blockers have a limited but genuine role in performance anxiety and situational anxiety where somatic symptoms — palpitations, tremor, flushing — are prominent and disabling.
For most anxiety disorders, psychotherapy is the treatment with the strongest evidence base and the most durable long-term outcomes — not because medication is ineffective, but because the mechanisms that maintain anxiety are largely psychological and behavioral, and addressing them directly produces change that persists beyond the duration of treatment.
Cognitive-Behavioral Therapy is the most extensively researched psychotherapeutic approach for anxiety and is a first-line treatment across virtually every anxiety disorder. Its core mechanisms — identifying and modifying catastrophic thinking patterns, building tolerance for uncertainty, and systematic exposure to feared situations — directly target what keeps anxiety going rather than simply reducing its intensity in the short term.
Psychodynamic psychotherapy addresses the deeper psychological structures underlying chronic anxiety — the early experiences, relational patterns, and internal conflicts that generate vulnerability to anxious states across the lifespan. For patients whose anxiety has not responded adequately to symptom-focused approaches, or who are seeking a deeper understanding of why they experience the world as they do, psychodynamic work offers a different level of engagement with the problem.
Intensive Short-Term Dynamic Psychotherapy is particularly effective for anxiety that is rooted in underlying emotional conflicts and relational patterns — cases where the anxiety is not primarily about specific feared situations but about deeper psychological experience that has been walled off by the anxious defenses themselves. Dr. Lyu has dedicated training in ISTDP and uses it with patients for whom this model is clinically appropriate.
The role of avoidance
One of the most important clinical points about anxiety treatment — and one that is frequently not communicated clearly to patients — is that avoidance is the primary mechanism by which anxiety disorders are maintained and worsened over time. When a person avoids the situations, experiences, or internal states that trigger their anxiety, the anxiety is temporarily relieved — which reinforces the avoidance. But the feared situation remains unfaced, the feared consequence remains unchallenged, and the anxiety system learns nothing new. Over time, avoidance tends to expand, and the life of the anxious person tends to contract around it.
Effective anxiety treatment, regardless of modality, must ultimately involve some form of engagement with what has been avoided — whether that is a feared situation, a physical sensation, an emotion, or a thought. This is not a reason to be cavalier about how that engagement is approached. It requires careful clinical preparation and support. But patients who understand why exposure is central to recovery — rather than experiencing it as an arbitrary demand — tend to engage with it more effectively.
Integrative approaches to anxiety
Several integrative interventions have meaningful evidence as adjunctive treatments for anxiety.
Mindfulness-based approaches — particularly Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy — have a solid evidence base for anxiety and are particularly well-suited as tools for building the capacity to tolerate anxious experience without immediately acting to suppress or escape it. This is directly complementary to the exposure-based work at the core of effective anxiety psychotherapy.
Exercise has demonstrated anxiolytic effects in both experimental and clinical research, with mechanisms involving stress system regulation, autonomic nervous system balance, and neuroplastic processes. It is a meaningful adjunctive intervention that our psychiatrists discuss and encourage as part of comprehensive treatment planning.
Sleep optimization is clinically important in anxiety treatment — the relationship between sleep disruption and anxiety is bidirectional and substantial, and addressing sleep as a target in its own right frequently produces meaningful reductions in daytime anxiety.
Caffeine is worth mentioning specifically. It is a potent anxiogenic compound that directly activates the sympathetic nervous system and exacerbates anxiety symptoms across all anxiety disorders. Many patients with significant anxiety disorders are consuming quantities of caffeine — through coffee, energy drinks, pre-workout supplements, and other sources — that are meaningfully contributing to their symptom burden. This is a simple, modifiable factor that is frequently overlooked in clinical practice.
What to expect when you come to Wave for anxiety
Your first appointment is a comprehensive diagnostic assessment with a board-certified psychiatrist — 50 minutes dedicated to understanding your presentation fully before any treatment decisions are made. Your psychiatrist will take a complete psychiatric, medical, and social history, assess which anxiety disorder or disorders are present, explore the psychological and social factors maintaining the presentation, and develop a formulation that accounts for the full picture.
At the end of your initial evaluation, your psychiatrist will share their diagnostic impressions and work with you to develop an individualized treatment plan. You will leave with a clear understanding of what the plan is, why it is structured the way it is, and what to expect as treatment progresses.
Insurance and fees
Wave Psychiatric Group accepts Aetna, Optum / UnitedHealthcare Behavioral Health, Meritain Health, Oxford Health Plans, ComPsych, UC SHIP, and others for diagnostic assessment appointments. Self-pay rates are also available.
Call us at 323-688-6380 or complete our intake form and our team will verify your benefits before your first appointment.
Frequently Asked Questions
What is the difference between anxiety and an anxiety disorder?
Anxiety itself is a normal and necessary human experience — a biological response to threat or uncertainty that serves an important protective function. An anxiety disorder is present when anxiety becomes persistent, disproportionate to actual circumstances, and disabling in ways that significantly impair functioning or quality of life. The distinction is not simply about intensity — it is about the degree to which anxiety has become self-sustaining and is restricting the person's life. A psychiatric evaluation is designed to make this assessment carefully and accurately.
Do I need medication for anxiety?
Not necessarily. For many anxiety disorders, psychotherapy — particularly CBT and exposure-based approaches — has the strongest evidence base and the most durable outcomes. Medication is an important tool for moderate to severe presentations, as an adjunct to psychotherapy when anxiety is too intense to allow therapeutic work to proceed effectively, and for patients who have not responded adequately to therapy alone. Whether medication is appropriate for your situation is a clinical decision made collaboratively based on your specific presentation, your history, and your preferences.
Are benzodiazepines safe for anxiety?
Benzodiazepines are effective for acute anxiety reduction but are not appropriate as a long-term treatment for anxiety disorders. With regular use, they carry real risks of physical dependence, tolerance — meaning progressively less effect at the same dose — and cognitive side effects including memory impairment. They also do not address the psychological mechanisms that maintain anxiety disorders and can in some cases interfere with the exposure-based work that is central to effective psychotherapy for anxiety. Our psychiatrists prescribe them for specific, time-limited indications and are direct with patients about their limitations and risks.
How is OCD related to anxiety?
OCD shares significant overlap with anxiety disorders — intrusive thoughts generate intense anxiety, and compulsions are performed in an attempt to reduce it — but it is classified separately in current diagnostic systems because its specific mechanisms and optimal treatments differ from those of other anxiety disorders. The gold standard treatment for OCD is Exposure and Response Prevention, a specialized form of CBT that targets the obsession-compulsion cycle directly. Our psychiatrists assess for OCD as a routine component of anxiety evaluations and treat it when present.
Can anxiety be treated via telehealth?
Yes. The evidence base for telepsychiatry in anxiety treatment is strong, and virtually all of the treatments we offer for anxiety — including diagnostic evaluation, medication management, CBT, and other psychotherapy modalities — are available via secure telehealth video for patients anywhere in California.
Is anxiety treatable, or is it something I will always have to manage? For many patients, anxiety disorders are highly treatable — meaning that with appropriate treatment, symptoms remit substantially and functioning returns to baseline. For others, anxiety is a longer-term condition that requires ongoing management rather than a one-time cure. The distinction depends on the specific disorder, its severity, its duration, the presence of comorbid conditions, and individual factors that your psychiatrist will assess carefully. What is consistent across the literature is that untreated anxiety disorders tend to worsen over time, while treated anxiety disorders — particularly those addressed with evidence-based psychotherapy — show durable improvement. Early and adequate treatment is associated with significantly better long-term outcomes.