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Elevating Psychiatric care What We Treat


Anxiety is a normal and temporary human emotion in response to a perceived, sometimes identifiable stress or threat. A deadline like getting your taxes done or a performance like taking a test can create anxiety, worry, and stress. This occasional anxiety will resolve with completion of the task or performance. When anxiety is more than temporary when your thoughts and fears become intrusive and negatively affect your day-to-day life, it is time to get help.

Anxiety disorders are common and are classified into different disorders which share similar characteristics of fear and excessive anxiety, and lead to disturbances in behavior. Anxiety disorders often co-occur with depression, substance abuse, and panic disorders. Women are diagnosed with GAD more often than men.

Clinical anxiety is chronic, exaggerated feelings of anxiety and unease, dread and worry, insecurity, and agitation, that lasts over six months. It is usually generalized and unfocused in reaction to a situation that is only subjectively seen as menacing.

The most common form of anxiety is Generalized Anxiety Disorder (GAD) a frequent and highly disabling condition affecting about 6% of the population during their lifetime. Someone experiencing GAD feels constant, excessive worry and tension without cause, about issues and situations that occur normally every day and lasts longer than six months.

GAD is diagnosed when at least 3 of the key symptoms are uncontrollable on more days than not for at least six months. All symptoms are related to uncertainty. People with GAD try to control situations to prevent symptoms.

The key symptoms include:

  • restlessness
  • easily fatigued, feeling weak and tired
  • difficulty concentrating or a mind that goes blank
  • irritability
  • muscle tension
  • sleep disturbances

Other symptoms can include nervousness, chest pain, a racing heart, rapid breathing, the inability to stop thinking about the worry (rumination), gastrointestinal problems, and panic, with or without panic attacks. Sometimes a person with GAD will develop maladaptive behaviors to cope which can negatively impact functioning and increase symptoms. It is often partly recognized in children and adolescents. Untreated GAD can lead to panic disorders and episodes of major depression later in life.

Treatment can help people with GAD function better in society and have meaningful lives and gainful employment.

Panic disorder

Panic disorder is panic attacks that are sudden episodes of intense fear, discomfort, and a sense of losing control, even without a trigger. Symptoms of a panic attack include a racing heart, sweating, trembling, chest pain, feeling out of control and impending doom. In response people with panic disorder try to control situations to prevent another attack by avoiding people, places, and situations.

Social anxiety disorder

Social anxiety disorder is intense, persistent fear of social situations and fear of being judged by others. The fear feels uncontrollable and lead to avoiding social situations such as work, schools, and everyday activities. Symptoms include blushing, sweating, racing heart, stomachaches, difficulty making eye contact, and feeling self-conscious.

Phobia related disorder

A phobia is an intense fear of objects or situations. Specific phobias are a fear of flying, fear of heights, fear of spiders, dogs or snakes, fear of receiving injections, fear of blood.


This is fear of being in public or enclosed spaces.

Separation anxiety disorder

Separation anxiety can affect children and adults. The fear is of being separated from someone to whom they are attached and that something bad will happen to their attachment if they aren’t together.

  • genetics
  • brain chemistry
  • stressful life events
  • a history of drug or alcohol abuse
  • medical conditions that can cause anxiety symptoms including heart, lung, and thyroid disorders.

  • A history of mental disorders like depression
  • A history of shyness as a child
  • Severe chronic illness or caring for someone with a severe or chronic illness
  • Substance abuse
  • GAD may be more likely in people who have a history of:
    poverty, physical or emotional trauma, PTSD, childhood abuse and neglect, divorce, separation and being widowed, and low self-esteem.

Dr. Poulakos will review your medical history asking about the physical conditions you have and the medications you take because some medical conditions and some medications can cause anxiety. He will review your family history for depression and anxiety. He may conduct a physical exam and may order a blood test to rule out physical conditions, such as hypothyroidism, that could be the cause of your anxiety.

Dr. Poulakos will ask you to complete a questionnaire about your symptoms, how they began, how long they last, how severe they are, whether you have had previous episodes of anxiety and whether you have previously treated for anxiety, depression, and other psychological conditions. There are also several other psychological conditions that could be related to or accompany your anxiety including but not limited to PTSD and eating disorders. You will have a conversation with Dr. Poulakos and discuss his diagnosis and potential treatment options.

Dr. Poulakos offers evidence-based, individualized treatment using medication and psychotherapy, and state-of-the-art treatments. He is a caring and compassionate doctor who will work with you to find solutions that meet your unique needs. Contact him at his New York, New York office to schedule an appointment to receive the correct diagnosis and all your treatment options.

At a Glance

Dr. Paul Poulakos

  • Attending Psychiatrist at Mount Sinai Beth Israel Medical Center
  • Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai
  • Past Clinical Assistant Professor of NYU Langone Medical Center
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