Conditions we treat

When Worry and Fear Have Taken Over: Anxiety Disorders We Treat in NYC

Everyone feels anxious sometimes. What brings people to us is something more persistent: the worry that doesn’t switch off at the end of the day, the physical tension that has become your baseline, the situations you’ve quietly started avoiding because the dread of them costs too much. Some people arrive knowing anxiety is the problem. Others come in for something else entirely, insomnia, irritability, difficulty concentrating,  and anxiety, turn out to be driving it.

Anxiety exists on a spectrum. There is the low-level, constant vigilance of Generalized Anxiety Disorder, which can make even ordinary days feel effortful and exhausting. There are panic attacks, which can be terrifying the first time they happen and are often misidentified as a medical emergency. There is the low-level, constant vigilance of Generalized Anxiety Disorder, which can make even ordinary days feel effortful and exhausting. Panic attacks are another common presentation — often terrifying the first time they happen, and frequently mistaken for a medical emergency. There is the social anxiety that slowly shrinks someone’s world, and the health anxiety that keeps a person in constant fear of what their body might be doing. The intrusive thoughts and rituals of OCD are also part of this spectrum — more common and more treatable than most people realize. Our post on recognizing anxiety and panic attacks is a useful place to start if you’re trying to understand what you’re experiencing. The National Institute of Mental Health also provides an overview of anxiety disorders and their prevalence.

We diagnose and treat

• Generalized Anxiety Disorder (GAD)
• Panic Disorder and recurrent panic attacks
• Social anxiety disorder
• Health anxiety and illness anxiety
• Obsessive-Compulsive Disorder (OCD)
• Agoraphobia and specific phobias
• Anxiety presenting as physical symptoms — chest tightness, GI distress, chronic tension

Treatment typically involves Cognitive Behavioral Therapy — which has one of the strongest evidence bases in psychiatry for anxiety — medication management, or a combination of both. The approach depends on how anxiety is showing up in your life and what has or hasn’t worked before.

When Your Mood Has Stopped Lifting

Depression is one of the most common reasons people come to us, and one of the most commonly misunderstood. It isn’t always sadness. Sometimes it’s numbness, a hollowness where feeling used to be. What replaces joy is often an inability to enjoy anything, a fatigue that sleep doesn’t fix, and a quiet but persistent belief that nothing is going to get better. Our overview of how psychiatrists approach depression treatment covers what evaluation and care actually look like.

When the Problem Is Mood Instability, Not Just Low Mood

Depression can also show up in the body — in chronic fatigue, unexplained pain, and digestive problems with no clear physical cause. The connection between inflammation, the body, and mood is something we pay close attention to in evaluation. Mood disorders as a broader category include conditions where the problem isn’t sustained low mood alone. Bipolar spectrum conditions involve periods of elevated or pressured energy alternating with depression.Getting the diagnosis right is essential. The treatment for bipolar disorder is meaningfully different from the treatment for recurrent depression. Some patients come to us with mood changes tied to food, body image, and eating. We evaluate and treat eating disorders as part of our broader mood and psychological care.

We diagnose and treat

• Major Depressive Disorder
• Persistent Depressive Disorder (dysthymia)
• Bipolar I and Bipolar II Disorder
• Cyclothymic Disorder
• Seasonal Affective Disorder (SAD)
• Treatment-resistant depression
• Eating disorders, including those presenting alongside depression, anxiety, or body image distress

Medication management and psychotherapy, particularly CBT and Dialectical Behavior Therapy, are the cornerstones of treatment and are frequently used together. Our psychiatrists take the time to understand the full picture before making any recommendations.

When You Can’t Focus, Keep Up, or Finish Anything

For adults with ADHD, the problem is rarely effort or intelligence. It’s that the brain’s systems for managing attention, regulating impulses, and executing tasks don’t work the way other people’s do — and this has often been true for most of their lives. The professional who loses track of conversations in meetings, the high-achiever who has managed through sheer force of will and is now running out of it, the person who starts every project with momentum and watches it stall: these are the patients we see regularly. Many of them have never been evaluated or diagnosed. Our detailed post on ADHD in adults also covers the frequently overlooked connection between ADHD and migraines.

Difficulty keeping up doesn’t always mean ADHD. Some people struggle with learning in specific ways, reading and processing written information, working quickly under pressure, retaining and recalling what they’ve studied, which reflect a learning profile rather than attention alone. A psychoeducational evaluation  clarifies exactly what is driving the difficulty. It can also produce the documentation needed for academic accommodations at universities, professional licensing exams, and workplace settings.

We diagnose and treat

• Adult ADHD and ADD
• Executive function disorders, including difficulty with planning, organization, task initiation, and follow-through
• ADHD co-occurring with anxiety, depression, or mood disorders
• Learning disorders in adults, including reading, processing speed, and written expression difficulties
• Giftedness with co-occurring learning challenges (twice exceptional)

Evaluation may involve a clinical interview, neuropsychological testing, or a formal psychoeducational evaluation. Treatment may include medication management, CBT adapted for ADHD, and Cognitive Remediation Therapy to rebuild specific cognitive skills.

When Your Thinking Changed After an Injury, Illness, or Medical Treatment

Some of the most disorienting experiences patients bring to us involve a clear before and after. Before the sports injury, before the accident, before chemotherapy, before the surgery, before COVID, and after, when something about thinking, memory, or mental sharpness is different and doesn’t seem to be resolving on its own.

The cognitive and emotional effects of a concussion or head injury are real and measurable even when brain scans look normal. Post-concussion syndrome can persist for months, producing difficulty concentrating, memory problems, irritability, sleep disruption, and a kind of mental fatigue that feels nothing like ordinary tiredness. Depression and anxiety frequently develop after injuries. Sometimes this is a direct neurological consequence. Other times it reflects the loss of function and identity that injury can bring. We take establishing a cognitive baseline seriously both for people who have been injured and for those who want a reference point before symptoms arise.

When the Cause Is Medical Treatment or Illness

Medical treatments can produce similar effects. Chemotherapy-related cognitive changes, often called chemo brain, and postoperative cognitive impairment significantly affect quality of life, yet many clinical settings fail to address them adequately. Long COVID has produced a recognizable pattern of persistent cognitive symptoms, mood changes, and fatigue in a meaningful portion of people who were infected. Our post on depression, inflammation, and the mind-body connection explores the biological overlap between these presentations. When memory and thinking changes are more gradual, the concern may involve mild cognitive impairment or early dementia. Careful evaluation is essential to distinguish between the two and determine the best path forward. Our post on understanding brain fog versus cognitive decline walks through how to tell the difference.