East Bay Area Psychiatrist Center for Anxiety ADHD Depression
Dr. Alex Anastasiou - Psychiatrist

Dr. Alex Anastasiou - Psychiatrist

Psychiatry doctor located near Pleasanton, Livermore, Dublin, San Ramon, Danville, East Bay, San francisco Bay Area, CA


Generalized Anxiety Disorder


  • Common condition defined as chronic anxious excessive worry for at least 6 months that causes distress or impairment.
  • At least 3 key symptoms out of a possible 6 are required to make a diagnosis: restlessness or nervousness, easy fatigability, poor concentration, irritability, muscle tension, or sleep disturbance.
  • It is in part a diagnosis of exclusion: medical conditions, medications or substances, and other mental disorders should be ruled out as a primary cause.

Physical examination and laboratory studies are generally normal if no coexisting medical problems or substance abuse issues exist.

  • Treatment is with either pharmacotherapy, psychotherapy, or a combination.



Panic Disorder - Anxiety Attack


  • Characterized by recurring cued or uncued panic attacks, worry about future attacks over a 1-month period, and changes in behavior as a consequence of the attacks.
  • Higher risk among first-degree relatives; onset of attacks triggered by stress; often comorbid with other anxiety, mood, and substance-use disorders.
  • Assessment is made through ruling out organic causes; self-report; clinical interview; and behavioral observation.
  • Selective serotonin-reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and cognitive behavioral psychotherapy are first-line treatments
  • Long-term management includes relapse prevention after treatment discontinuation.



Social Anxiety


  • Characterized by an excessive fear of social and performance situations where the individual is afraid of being embarrassed or negatively evaluated by others.
  • One of the most common and impairing mental disorders with a high risk for comorbid anxiety, depressive, and substance-use/abuse-related disorders.

Assessment is based on self-reporting, clinical interview, and behavioral observation.

  • Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and cognitive behavioral therapy are considered the first-line treatments.
  • Long-term clinical management and monitoring are typically required, as patients are prone to relapse following discontinuation of acute treatment.


What Are Anxiety Disorders?

Everyone feels anxious now and then. It’s a normal emotion. Many people feel nervous when faced with a problem at work, before taking a test, or making an important decision.

Anxiety disorders are different, though. They can cause such distress that it interferes with your ability to lead a normal life.


This type of disorder is a serious mental illness. For people who have one, worry and fear are constant and overwhelming, and can be disabling. But with treatment, many people can manage those feelings and get back to a fulfilling life.


What Are the Causes of Anxiety Disorders?

The exact cause of anxiety disorders is unknown, but anxiety disorders -- like other forms of mental illness -- are not the result of personal weakness, a character flaw, or poor upbringing. As scientists continue their research on mental illness, it is becoming clear that many of these disorders are caused by a combination of factors, including changes in the brain and environmental stress.


Like other brain illnesses, anxiety disorders may be caused by problems in the functioning of brain circuits that regulate fear and other emotions. Studies have shown that severe or long-lasting stress can change the way nerve cells within these circuits transmit information from one region of the brain to another. Other studies have shown that people with certain anxiety disorders have changes in certain brain structures that control memories linked with strong emotions. In addition, studies have shown that anxiety disorders can run in families, which means that they can at least partly be inherited from one or both parents, similar to the genetic risk for heart disease or cancer. Moreover, certain environmental factors -- such as a trauma or significant event -- may trigger an anxiety disorder in people who have an inherited susceptibility to developing the disorder.


How Are Anxiety Disorders Diagnosed?

If symptoms of an anxiety disorder are present, the doctor will begin an evaluation by asking you questions about your medical history and performing a physical exam. Although there are no lab tests to specifically diagnose anxiety disorders, the doctor may use various tests to look for other medical illness as the cause of the symptoms.


How Do You Know When Worry Turns To Anxiety That Needs Treatment?

If no other medical illness is found, you may be referred to a psychiatrist, or another mental health professional who is specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for an anxiety disorder.


The doctor bases his or her diagnosis on the patient's report of the intensity and duration of symptoms -- including any problems with daily functioning caused by the symptoms -- and the doctor's observation of the patient's attitude and behavior. The doctor then determines if the patient's symptoms and degree of dysfunction indicate a specific anxiety disorder.


How Are Anxiety Disorders Treated?

Fortunately, much progress has been made in the last two decades in the treatment of people with mental illnesses, including anxiety disorders. Although the exact treatment approach depends on the type of disorder, one or a combination of the following therapies may be used for most anxiety disorders:


Medication: Drugs used to reduce the symptoms of anxiety disorders include many antidepressants, certain anticonvulsant medicines and low-dose antipsychotics, and other anxiety-reducing drugs.


Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their disorder.


Cognitive-behavioral therapy: This is a particular type of psychotherapy in which the person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.


Dietary and lifestyle changes


Relaxation therapy


Can Anxiety Disorders Be Prevented?

Anxiety disorders cannot be prevented; however, there are some things you can do to control or lessen symptoms:


Stop or reduce consumption of products that contain caffeine, such as coffee, tea, cola, energy drinks, and chocolate.


Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.