Anxiety Treatment in Michigan — Telehealth Psychiatric Evaluation & Medication Management
If anxiety is affecting your ability to work, sleep, maintain relationships, or function day to day — psychiatric evaluation and medication management may be the level of care you need.
Skye Mental Health provides telehealth psychiatric evaluation and medication management for anxiety disorders in adults and teenagers across Michigan. Both providers — Dr. Jennifer Sam, DNP, PMHNP-BC and Darla Dane, PMHNP-BC — are board-certified Psychiatric Mental Health Nurse Practitioners with extensive clinical experience evaluating and treating anxiety at the psychiatric level. New patients are typically seen within approximately 3 days.
All appointments are conducted by video via Zoom across Michigan.
What is an anxiety disorder — and how is it different from everyday anxiety
Everyone experiences anxiety. It is a normal neurological response to perceived threat — it sharpens focus, motivates action, and prepares the body to respond. An anxiety disorder is something different. It is anxiety that is disproportionate to the situation, persistent rather than situational, and significant enough to impair daily functioning in ways that do not resolve on their own.
The distinction matters clinically because anxiety disorders are not a personality trait, a weakness, or a response to stress that will improve with lifestyle changes alone. They are neurochemical conditions involving dysregulation of the brain's threat-detection systems — primarily the amygdala and its relationship with the prefrontal cortex — and they respond to psychiatric treatment including medication in the same way that other neurological conditions do.
At Skye Mental Health, anxiety is evaluated and treated at that level of clinical depth — not dismissed as stress, not addressed with generic advice, and not managed with a prescription written after a 15-minute appointment.
Who this is for:
Adults and teenagers ages 12–17 experiencing anxiety disorders in Michigan
Provider: Dr. Jennifer Sam, DNP, PMHNP-BC and Darla Dane, PMHNP-BC
Appointment type: Telehealth video via Zoom
New patient wait: Approximately 3 days
Insurance: Most major Michigan plans accepted (see complete list here)
Self-pay: $200 initial evaluation | $100 follow-up
Types of anxiety disorders Skye Mental Health evaluates and treats
Anxiety presents differently depending on the person, the underlying neurological pattern, and whether other conditions are present. Skye evaluates and treats the following anxiety disorders:
Generalized Anxiety Disorder (GAD) Persistent, excessive worry about a wide range of everyday situations — work, health, finances, relationships — that is difficult to control and disproportionate to the actual likelihood of the feared outcome. GAD is often accompanied by physical symptoms including muscle tension, fatigue, difficulty concentrating, and sleep disruption.
Panic Disorder Recurrent, unexpected panic attacks — sudden surges of intense fear accompanied by physical symptoms including racing heart, chest tightness, shortness of breath, dizziness, or a sense of unreality — followed by persistent worry about future attacks or significant changes in behavior to avoid them. Panic disorder is frequently misidentified as a cardiac or respiratory condition before the psychiatric origin is recognized.
Social Anxiety Disorder Intense fear of social situations in which scrutiny, judgment, or embarrassment is possible — to a degree that causes significant avoidance of work, school, relationships, or daily activities. Social anxiety disorder is not shyness. It is a clinical condition that causes measurable impairment and responds to psychiatric treatment.
Agoraphobia Fear and avoidance of situations where escape might be difficult or help unavailable in the event of a panic attack — including crowded places, public transportation, being outside the home alone, or being in open or enclosed spaces. Agoraphobia frequently develops as a consequence of untreated panic disorder.
Specific Phobias Intense, irrational fear of a specific object or situation — heights, flying, medical procedures, needles, certain animals — that is out of proportion to the actual danger and causes significant distress or avoidance. When specific phobias begin to interfere meaningfully with daily functioning, psychiatric evaluation is appropriate.
Illness Anxiety Persistent preoccupation with having or developing a serious illness despite medical reassurance and minimal or no physical symptoms. Illness anxiety involves significant health-related checking behaviors, avoidance of medical settings, or constant reassurance-seeking that consumes substantial mental energy and time.
10 signs your anxiety may need psychiatric-level care
Many people with anxiety disorders have lived with their symptoms for so long that they have normalized them. Others have tried therapy or lifestyle changes without sufficient improvement. These ten signs suggest that a psychiatric evaluation — rather than continued self-management or therapy alone — is the appropriate next step.
1. Your anxiety is present most days regardless of what is happening in your life Situational anxiety resolves when the situation resolves. An anxiety disorder does not. If you are anxious most of the time, across a wide range of situations, including situations that objectively do not warrant that level of concern, the anxiety itself has become the problem — not the situations triggering it.
2. Physical symptoms are a consistent part of your anxiety Racing heart, chest tightness, shortness of breath, muscle tension, headaches, gastrointestinal distress, dizziness, and trembling are all common somatic expressions of anxiety. When anxiety lives in the body as much as the mind — when you feel it physically before you can even name what you are anxious about — it is typically a sign of a clinically significant anxiety disorder rather than ordinary worry.
3. You are organizing your life around avoiding things that trigger anxiety Turning down opportunities, avoiding social situations, not driving on highways, not going to medical appointments, working from home because the commute triggers panic — when your world is quietly shrinking around your anxiety, avoidance has become the primary coping strategy. Avoidance maintains and reinforces anxiety over time. It does not reduce it.
4. Sleep is consistently disrupted by anxious thoughts Lying awake with racing thoughts, catastrophizing about the next day, or waking in the early hours unable to return to sleep because your mind is already running — chronic anxiety-related sleep disruption compounds every other symptom and significantly impacts quality of life, cognitive function, and physical health.
5. Concentration and cognitive function are affected Anxiety consumes working memory and cognitive bandwidth. If you find it difficult to concentrate, finish tasks, retain information, or think clearly because your mind is running threat scenarios in the background, anxiety is affecting your cognitive performance — not just your emotional state.
6. Your relationships are being affected Irritability, emotional reactivity, reassurance-seeking, avoidance of social situations, and withdrawal are all ways anxiety damages relationships. If the people closest to you are noticing changes in your behavior, or if your anxiety is creating conflict or distance in important relationships, it has crossed the threshold of clinical significance.
7. You have panic attacks A panic attack is not simply feeling very anxious. It is a discrete episode of intense physical and psychological fear — heart racing, difficulty breathing, chest pain, dizziness, tingling, a sense of impending doom or of dying — that typically peaks within 10 minutes. If you are having panic attacks, psychiatric evaluation is appropriate regardless of how infrequently they occur.
8. Therapy alone has not been sufficient Therapy — particularly cognitive behavioral therapy — is an effective treatment for anxiety disorders. But for many people with clinically significant anxiety, therapy alone does not provide adequate relief because the neurochemical component of the disorder is not being addressed. Medication and therapy work better together than either does alone for moderate to severe anxiety.
9. You are using alcohol or other substances to manage anxiety Using alcohol to take the edge off social situations, to sleep, or to get through high-anxiety periods is one of the most common ways untreated anxiety disorders progress. Substance use as an anxiety management strategy consistently worsens both conditions over time and is a clear signal that the underlying anxiety requires proper clinical treatment.
10. You have had anxiety for years and accepted it as just how you are This is perhaps the most important sign. Many people with anxiety disorders have never sought treatment because they have normalized their symptoms — assumed that constant worry, avoidance, and physical tension are simply their personality. They are not. Anxiety disorders are among the most treatable psychiatric conditions. Years of unnecessary suffering is not inevitable.
How Skye Mental Health treats anxiety
Skye's approach to anxiety treatment begins with a comprehensive 60-minute psychiatric evaluation. The goal of that evaluation is to understand the full clinical picture — the nature, pattern, and severity of your anxiety, any co-occurring conditions that may be contributing to or maintaining it, your history with anxiety, and any previous treatments you have tried.
Anxiety disorders rarely exist in a vacuum. They frequently co-occur with depression, and each condition can drive or worsen the other. They sometimes co-occur with trauma or PTSD, where the anxiety is rooted in unprocessed threat responses from past experiences. Understanding what is driving the anxiety — not just that anxiety is present — is what makes the treatment plan that follows more precise and more effective.
Medication options for anxiety
Skye prescribes a broad range of psychiatric medications for anxiety, selected based on your specific diagnosis, symptom pattern, history, and individual clinical picture. Options include:
SSRIs (Selective Serotonin Reuptake Inhibitors) First-line medications for most anxiety disorders including GAD, panic disorder, social anxiety disorder, and illness anxiety. SSRIs build therapeutic effect over 2–6 weeks and provide sustained anxiety reduction without the dependency risks associated with older medication classes. Common options include sertraline, escitalopram, fluoxetine, and paroxetine.
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) Effective for GAD and panic disorder, with the added benefit of addressing the physical symptoms of anxiety — muscle tension, fatigue, and somatic pain — through norepinephrine pathways. Common options include venlafaxine and duloxetine.
Buspirone A non-habit-forming anti-anxiety medication particularly effective for GAD. Buspirone works differently from SSRIs and SNRIs — it acts on serotonin and dopamine receptors — and is a strong option for patients who have not responded well to SSRIs or who prefer to avoid them.
Beta-blockers Used situationally for performance anxiety and specific phobias — situations involving public speaking, medical procedures, or other discrete high-anxiety events. Beta-blockers address the physical symptoms of anxiety — racing heart, trembling, flushing — without sedation.
Hydroxyzine A non-habit-forming antihistamine with significant anxiolytic properties, effective for acute anxiety and as a sleep aid for anxiety-related insomnia. Used as a standalone treatment or alongside SSRIs during the initial weeks before the SSRI reaches therapeutic levels.
Benzodiazepines Prescribed selectively and carefully for acute anxiety and panic. Benzodiazepines provide rapid relief but carry dependency risk with long-term use and are not appropriate for every patient. When prescribed at Skye, they are used at the lowest effective dose with close monitoring and a clear treatment plan.
Ongoing medication management Anxiety treatment is not a one-appointment process. After the initial evaluation and prescription, follow-up appointments of 30 minutes or longer are used to assess your response, adjust dosing, manage any side effects, and ensure the treatment plan is working over time. Most insurance plans cover follow-up visits.
Why your primary care doctor may not be the right clinician for anxiety treatment
Primary care physicians treat anxiety, and for mild presentations that is often appropriate. For moderate to severe anxiety — anxiety that is significantly affecting your functioning, that has not responded to initial treatment, or that co-occurs with depression, trauma, or other psychiatric conditions — specialist-level care provides a meaningfully different level of evaluation and treatment.
Depth of evaluation A standard primary care appointment does not provide enough time to distinguish between GAD, panic disorder, social anxiety, and illness anxiety — each of which has a different treatment approach. A 60-minute psychiatric evaluation does.
Psychopharmacology expertise Board-certified PMHNPs have specialized training in psychiatric medication that goes beyond what primary care training provides. This matters when first-line medications do not work, when side effects need to be managed, or when anxiety co-occurs with another condition that complicates the medication decision.
Co-occurring conditions Primary care providers often treat the most visible symptom. A psychiatric evaluation assesses the full picture — identifying depression, ADHD, trauma, or other conditions that may be driving or worsening the anxiety and that require a coordinated treatment approach.
Frequently asked questions about hormonal psychiatry at Skye Mental Health
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Anxiety is a normal emotional response to stress or perceived threat. An anxiety disorder is anxiety that is persistent, disproportionate to the actual situation, and significant enough to impair daily functioning — work, relationships, sleep, or the ability to engage in normal activities. Anxiety disorders are neurochemical conditions that respond to psychiatric treatment including medication. At Skye Mental Health, anxiety is evaluated and treated at that clinical level.
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Yes. Both Dr. Jennifer Sam and Darla Dane evaluate and treat anxiety in patients ages 12 and older. Dr. Jennifer Sam is the dedicated teen specialist at Skye and sees patients ages 12–17. For adolescents, anxiety frequently co-occurs with ADHD, depression, or trauma — Dr. Sam's evaluations assess the full picture rather than treating the most visible symptom in isolation.
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Skye Mental Health prescribes a broad range of psychiatric medications for anxiety including SSRIs, SNRIs, buspirone, beta-blockers, hydroxyzine, and benzodiazepines where clinically appropriate. Medication selection is based on your specific anxiety disorder, symptom pattern, history, and individual clinical picture — not a one-size-fits-all approach. Your provider will discuss all options at your initial evaluation.
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No referral is required. You can schedule directly at skyementalhealth.com/get-started. New patients are typically seen within approximately 3 days. If you have prior records, previous diagnoses, or a list of medications you have tried, you are welcome to share them — but they are not required to get started.
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Skye Mental Health focuses specifically on psychiatric evaluation and medication management — not standalone long-term talk therapy. Therapy, particularly cognitive behavioral therapy, can be a highly effective complement to psychiatric medication for anxiety disorders. If therapy is appropriate for your situation, your provider can discuss referral options for therapists in Michigan who specialize in anxiety.
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Yes. Skye Mental Health accepts most major insurance plans in Michigan including Blue Cross Blue Shield of Michigan, Blue Care Network, Aetna, Cigna, United Healthcare, Optum, MESSA, and Oscar. Self-pay rates are $200 for the initial evaluation and $100 for follow-up sessions. HSA, FSA, and FRA cards are accepted.
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If your anxiety medication is not providing adequate relief, your provider will assess this at follow-up appointments and make evidence-based adjustments — changing the dose, switching to a different medication class, or adding a complementary medication. Anxiety treatment often requires some titration and adjustment before the optimal regimen is established. Follow-up appointments at Skye are 30 minutes or longer, giving your provider enough time to properly assess your response rather than simply renewing the prescription.