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Anxiety does not always look like worry. For many people it shows up as a racing heart before ordinary situations, sleep that never quite settles, physical tension that has no obvious cause, or a persistent sense that something is wrong without being able to name what. Avoidance becomes a way of managing it, and over time the things you stop doing start to add up.
If any of that sounds familiar, a proper psychiatric evaluation can give you real answers and a clear path forward. Caroline Thiongo PMHNP-BC at Thrive Psychological Wellness provides anxiety evaluation and medication management at our Portland and Multnomah Village offices, with telehealth appointments available to patients anywhere in Oregon.
Not sure which type fits your situation? That is what the evaluation is for. Our PMHNP will work through it with you.
Feeling nervous before something stressful is normal. But when worry starts taking over, when concentration becomes difficult, when your body feels tense most of the time, or when you begin avoiding situations just to manage the fear, that is worth taking seriously. Anxiety at that level is not a personality trait or a phase. It is a clinical condition that responds well to treatment.
Caroline Thiongo PMHNP-BC can do things a therapist or GP cannot. She can identify the specific type of anxiety driving your symptoms, prescribe medication when that is the right call, and connect you with a therapist for talk therapy when that is part of the plan. You do not have to choose one or the other. Many patients do better with both working together.
Appointments are available at our Portland and Multnomah Village offices and through telehealth for patients anywhere in Oregon. No referral is needed to book.
Anxiety is not one condition with one presentation. There are several distinct anxiety disorders, and they do not all look the same. The type of anxiety you have shapes the treatment approach, which is why an accurate diagnosis matters before any medication or referral is considered. Here is what Caroline Thiongo PMHNP-BC commonly evaluates and treats at Thrive Psychological Wellness.
GAD involves chronic, wide-ranging worry that is hard to control. It often comes with physical symptoms like fatigue, muscle tension, and disrupted sleep. Many people with GAD have been anxious for so long they assume it is just their personality. It is not. It is treatable.
People with panic disorder have recurrent, unexpected panic attacks followed by persistent worry about having another one. The attacks themselves can feel like a medical emergency. They are not, but they are distressing and they respond well to treatment.
This goes beyond shyness. Social anxiety disorder causes intense fear in social situations, often centred on the worry of being judged, embarrassed, or humiliated. It can limit careers, friendships, and daily activities in ways that are hard to explain to people who do not experience it.
A specific phobia is a marked, ongoing fear of a particular thing or situation, out of proportion to any real danger. Heights, needles, flying, certain animals. Phobias lead to avoidance that can narrow someone's life significantly over time.
More common in children but also present in adults. Separation anxiety disorder involves excessive fear or distress when separated from key attachment figures. It can interfere with work, relationships, and independence.
Anxiety often does not travel alone. Depression, ADHD, insomnia, and substance use frequently co-occur with anxiety. A PMHNP can assess everything at once and build a plan that addresses the full picture rather than just the loudest symptom.
Thrive Psychological Wellness does not prescribe and send people on their way. Caroline Thiongo PMHNP-BC takes time to understand the full picture before any treatment decision is made. That means a proper psychiatric evaluation first, followed by a treatment plan built specifically around your symptoms, history, and what is actually going on rather than a generic protocol applied to everyone who walks in with anxiety.
A thorough review of your symptoms, history, triggers, sleep, physical health, and any prior treatment. We also look for conditions that sometimes run alongside anxiety, like depression or ADHD.
Using standard diagnostic criteria, we identify the specific anxiety disorder. We explain what that means and what we think the most effective treatment looks like for you.
Not everyone needs medication. When it makes sense, we start with the most evidence-backed options, at a low dose, and monitor your response closely over the following weeks.
Follow-up appointments let us track how treatment is working and adjust as needed. We also refer to therapists in the Portland and Multnomah area when talk therapy is part of the plan.
Sertraline, escitalopram, fluoxetine, paroxetine. First choice for most anxiety disorders. Taken once daily and generally well tolerated.
Venlafaxine and duloxetine. Effective for GAD and social anxiety, especially when depression is also present.
Non-habit-forming medication approved for GAD. Takes a few weeks to work but carries no risk of dependence, making it a good fit for long-term use.
Propranolol is sometimes used for situational anxiety, like fear of public speaking. It targets physical symptoms without affecting alertness.
Occasionally used short-term during acute anxiety or while waiting for other medications to take effect. Not recommended as a primary long-term treatment.
* Antidepressants are not prescribed on the first visit without a full evaluation. Bipolar disorder is screened for before any antidepressant is considered.
Here is what the process looks like from start to finish.
Call us or use the online form. We check your insurance before your appointment so you know what to expect cost-wise. No referral needed.
Before you come in, we send intake paperwork covering your history, current symptoms, sleep, medications, and anything else relevant to your care.
First appointments are 60 minutes. Your PMHNP goes through your history and current situation carefully. There is no rush.
By the end of the appointment you will have a diagnosis, a treatment plan, and if a prescription is appropriate, it will be sent to your pharmacy the same day.
Most people who come in for anxiety are dealing with something else at the same time. Depression is the most common pairing, but ADHD, insomnia, and substance use also frequently sit alongside it. When these conditions overlap, treating only one of them rarely gets very far.
Caroline Thiongo PMHNP-BC is trained to look at the full picture from the start. If anxiety is partly driven by untreated ADHD, for example, starting an anxiety medication without addressing that first is unlikely to produce much benefit. Getting the evaluation right at the beginning saves time, reduces unnecessary medication changes, and means the treatment you receive actually fits what is going on.
You do not need to be in Multnomah or Portland to get care here. We offer telehealth appointments for anxiety to patients anywhere in Oregon. The evaluation, medication management, and follow-up visits all work the same way. You just need a phone or computer with a camera. Prescriptions go directly to your pharmacy.
In-Person Offices
Multnomah Village, OR (Primary)
Portland, OR (Secondary)
Regional Areas
SW Portland, Lake Oswego, Beaverton
Gresham, Milwaukie, Clackamas
Anxiety rarely shows up on its own. If any of these sound familiar alongside your anxiety, we treat those too.
I had been dealing with panic attacks for two years before I found this practice. Within six weeks of starting the right medication I had not had a single one. I wish I had come in sooner.
As a rural Oregon patient, telehealth was the only realistic option for me. The PMHNP went through my history more thoroughly than anyone I had seen in person. That meant a lot.
I had been told for years it was just stress. The evaluation here found that I had both social anxiety and ADHD. Treating both at once made more difference than anything else I had tried.
Yes. Caroline Thiongo PMHNP-BC evaluates and diagnoses anxiety disorders and manages medications including SSRIs, SNRIs, and buspirone. Appointments are available at our Portland and Multnomah Village offices and through telehealth for patients anywhere in Oregon.
Not necessarily. After your evaluation, all options are discussed openly. Some people do best with medication alone, some with therapy alone, and many with a combination of both. The evaluation tells us which direction makes the most sense for your specific situation. We never recommend medication without first understanding the full picture.
Most medications for anxiety begin showing an effect within two to four weeks. Full benefit typically takes six to eight weeks at the right dose. Caroline checks in regularly during that period to monitor how things are going and adjusts the plan if needed. You are not left waiting without contact between appointments.
Yes. Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for anxiety to patients anywhere in Oregon. The evaluation works the same way as an in-person visit and prescriptions are sent electronically to your preferred pharmacy.
Caroline Thiongo PMHNP-BC treats generalised anxiety disorder, panic disorder, social anxiety disorder, specific phobias, separation anxiety disorder, and anxiety that occurs alongside depression, ADHD, PTSD, substance use disorders, and sleep disorders.
Yes. Most major Oregon insurance plans cover psychiatric care for anxiety disorders, including Oregon Health Plan. Thrive Psychological Wellness verifies your coverage before your first appointment so you know what to expect before care begins.
If anxiety has been getting in the way of your work, your sleep, or your relationships, it is worth getting a proper evaluation. We keep things straightforward. Book a time that works for you and we will take it from there.
Crisis line note below buttons: If you are in crisis, call or text 988. Cascadia Crisis Line: (503) 988-4888.