Conditions we treat › Generalized anxiety disorder
- Anxiety and GAD · Evaluation and medication management
Online anxiety and GAD treatment in Maryland
Thrive Telepsychiatry provides online anxiety treatment for people anywhere in Maryland, with a focus on generalized anxiety disorder (GAD). A board-certified psychiatric mental health nurse practitioner (PMHNP-BC), licensed in Maryland, evaluates your symptoms by secure video. If medication is right for you, they prescribe and manage it with regular follow-ups. There’s no office visit and no benzodiazepines. Thrive accepts Blue Cross Blue Shield, Johns Hopkins EHP and self-pay, and you pay nothing upfront.
- Board certified PMHNP-BC
- Licensed in Maryland
- No upfront payment
Medically reviewed by Alicia Reed, PMHNP-BC, Founder · Last reviewed: November 2026
What is generalized anxiety disorder (GAD)?
Generalized anxiety disorder (GAD) is a long-term condition in which worry is hard to control and shows up most days, about many different things. That worry comes with symptoms such as restlessness, tiredness, irritability, trouble concentrating, muscle tension and poor sleep. To be diagnosed with GAD, the symptoms need to have lasted at least six months and to get in the way of work, school or relationships.
GAD is common. About 2.7% of US adults have GAD in a given year, and 5.7% will have it at some point in their lives. It is almost twice as common in women as in men (NIMH). It is a medical condition, not a personality flaw, and it often responds well to treatment.
What GAD can feel like
Constant worry
Overwhelming worry about daily life, even when things are okay.
Physical symptoms
Fatigue, headaches, and muscle tension.
Fear and nervousness
Persistent feelings that interfere with work, relationships, and daily tasks.
It’s often linked to ongoing stress, difficult past experiences or a family history of anxiety, and it can also appear without a clear cause.
Get your anxiety treatment plan online
Book a video evaluation with a Maryland-licensed provider and leave with a clear plan for managing your anxiety. You pay nothing upfront.
Signs it may be time for an online anxiety evaluation
GAD often builds slowly, so it can feel like “just how you are”. Signs include worry you can’t switch off, feeling on edge, poor sleep, tight muscles and trouble focusing. If these have shown up most days for six months or more, an evaluation is a good next step.
General Anxiety Disorder Symptoms
Common symptoms of GAD include:
Constantly feeling anxious about different things, even when there’s no real reason to worry.
Feeling uneasy or unable to sit still, often described as “on edge.”
It is hard to focus on tasks because your mind is overwhelmed with worry.
Difficulty falling asleep, staying asleep, or feeling rested after sleeping.
Feeling tightness or discomfort in your muscles, especially in the neck, shoulders, and back.
Getting frustrated or annoyed more quickly than usual.
Feeling tired constantly, even if you get enough sleep.
If several of these sound familiar, a short evaluation can tell you whether it’s GAD or something else, such as a thyroid problem or another anxiety disorder.
Signs of GAD in teens (13 to 17)
Thrive sees teens aged 13 to 17. In teens, GAD can be hard to spot, because they don’t always say how they feel. Signs can include:
They may constantly think about things like school, friends, or the future, even when everything is okay.
Children and teens might avoid school, social events, or new experiences because they feel too nervous.
They may have difficulty falling asleep or wake up often at night due to racing thoughts.
Frequent stomach aches, headaches, or feeling unwell without an apparent reason can be a sign of anxiety.
They might get frustrated or emotional over small things and find it hard to calm down.
Asking the same questions repeatedly to feel safe or seeking constant approval from parents and teachers.
Anxiety can make it difficult to pay attention in class or finish homework on time.
Parents can book for their teen through Get Started by choosing “My teenager, 13 to 17”.
General Anxiety Disorder Causes and Signs
General anxiety disorder causes can be different for everyone, but several common factors may contribute to its development. Some of the possible causes include:
Anxiety can run in families, so if a parent or close relative has experienced it, there is a higher chance of developing it.
Ongoing stress from school, work, or personal relationships can build up and lead to anxiety over time.
Some people naturally tend to overthink or worry more, making them more likely to experience anxiety.
Events such as bullying, accidents, or the loss of a loved one can trigger anxiety and make it hard to cope with daily life.
Chronic illnesses, hormonal imbalances, or other medical problems can sometimes lead to feelings of anxiety.
Drinking too much caffeine or alcohol or using certain drugs can make anxiety symptoms worse.
Differences in brain chemicals that control mood and emotions may play a role in causing anxiety.
Anxiety medication options at Thrive
Medication can reduce worry and the physical symptoms of GAD, so daily life feels more manageable. Thrive’s provider prescribes non-controlled medications and adjusts them at follow-up visits. Thrive does not prescribe benzodiazepines, such as Xanax, or any other controlled substances. Most anxiety medications take several weeks to work fully, so early follow-ups matter.
Educational only. Whether medication is right for you, and which kind, is a decision you make with your provider during your evaluation.
SSRIs and SNRIs (first-line)
Often the first choice for GAD. Escitalopram and paroxetine are FDA-approved for GAD. They help regulate serotonin to ease worry over time.
Duloxetine and venlafaxine XR are FDA-approved for GAD in adults. They work on serotonin and norepinephrine. Duloxetine and escitalopram are also approved for GAD in children and teens aged 7 and older.
Other options
Thrive does not prescribe benzodiazepines such as Xanax or Ativan. They are controlled substances that carry a risk of dependence, so Thrive focuses on longer-term options.
FDA-approved for anxiety disorders. It works gradually over a few weeks, is not a controlled substance, and usually doesn't cause drowsiness.
| Option | How fast it works | Controlled substance | Considered at Thrive |
|---|---|---|---|
| SSRIs (escitalopram, paroxetine) | Several weeks | No | If appropriate |
| SNRIs (duloxetine, venlafaxine XR) | Several weeks | No | If appropriate |
| Buspirone | A few weeks | No | If appropriate |
| Benzodiazepines (Xanax, Ativan) | Often within an hour | Yes (Schedule IV) | No |
Safety: SSRIs and SNRIs carry an FDA boxed warning about a higher risk of suicidal thoughts and behaviors in children, teens and young adults (under 25). Your provider explains side effects before you start and checks mood and side effects at every follow-up.
How Thrive diagnoses GAD online
Your first visit is a one-hour video evaluation with a Maryland-licensed PMHNP-BC. Your provider looks at your symptoms, health and history to work out whether it’s GAD, another anxiety disorder or something else, and then explains your options.
Detailed Symptom Discussion
Your provider asks what you worry about, how often, and how it affects work, sleep and relationships.
Diagnostic criteria
Your provider checks your symptoms against the DSM-5-TR criteria for GAD, including excessive worry on more days than not for at least six months.
Medical screening
Thyroid problems, caffeine, some medications and other health issues can mimic anxiety. Your provider may ask for recent lab results or suggest tests with your primary care doctor.
Psychological Assessment Tools
Standardized screening questionnaires, like the GAD-7, help measure the severity of your anxiety and how it affects your daily activities.
Medical and family history
Your provider reviews past conditions, current medications, and any family history of anxiety or other mental health conditions.
Online anxiety treatment options in Maryland
Online anxiety treatment at Thrive combines a full psychiatric evaluation with anxiety medication management online. You get both from one Maryland-licensed provider by secure video. Follow-ups every 2 to 4 weeks keep your plan on track while medication is started or adjusted.
Evaluation
A one-hour video evaluation of your symptoms, history and health, using validated tools such as the GAD-7.
Medication management
If it’s right for you, your provider prescribes a non-controlled medication and adjusts it at each follow-up.
Self-Help Strategies
Practical steps such as sleep routines, less caffeine, regular exercise and breathing exercises, built into your plan.
Why Marylanders choose Thrive for anxiety care
Thrive is a Baltimore-based practice that has focused on telepsychiatry since 2015. You get your evaluation, diagnosis and medication plan from the same provider where possible, without travel or a waiting room. If you also see a therapist, your provider can coordinate with them.
Ready to start? Book your online anxiety evaluation or call 855.805.9015.
Board-certified provider
Care from a PMHNP-BC licensed by the Maryland Board of Nursing.
Personalized plan
Your plan is built around your symptoms, health and schedule.
No benzodiazepines
A focus on longer-term, non-controlled medications.
Ongoing follow-up
Regular check-ins to adjust your plan as you improve.
Treatment follows the same four steps
- No upfront payment
Book online
Choose a provider and a time that suits you.
Meet by video
A full evaluation from home, on any device.
Start your plan
A prescription to your pharmacy, if it is right for you.
Follow up
Every 2 to 4 weeks to begin with, then as you need.
Online anxiety care across Maryland
Thrive’s providers are licensed by the Maryland Board of Nursing. Since October 2015, Maryland nurse practitioners have been able to practice without a collaborating physician, so a PMHNP can diagnose GAD and prescribe medication independently.
You can attend from Baltimore, Columbia, Silver Spring, Rockville, Frederick, Annapolis, the Eastern Shore or anywhere else in the state. The only requirement is that you are in Maryland at the time of each visit.
How online care works in Maryland
Secure video
Visits run on Tebra, a HIPAA-compliant platform in your browser. Nothing to download.
Teens and adults
Care for ages 13 and up who are in Maryland at the time of each visit.
Local pages
Baltimore · Columbia · Silver Spring · Rockville
Panic attacks too? See online panic disorder treatment.
What online anxiety treatment costs
Thrive accepts insurance and self-pay, and you pay nothing upfront. You only pay after each session. Insurance: Blue Cross Blue Shield and the Johns Hopkins Hospital Employee Health Plan (JHH EHP). Coverage varies by plan, so check your benefits before your first visit. See plans and pricing.
First evaluation: $250
1 hour, self-pay, with a board-certified PMHNP-BC.
Follow-up: $175
30 minutes, self-pay, for ongoing medication management.
$0 upfront
No payment until your session is complete, with insurance or self-pay.
Online anxiety treatment in Maryland: FAQs
Quick answers to the questions people ask most about online anxiety care at Thrive.
Can anxiety be diagnosed online in Maryland?
Yes. A Maryland-licensed PMHNP can diagnose GAD and other anxiety disorders through a structured video evaluation. Your provider reviews your symptoms, history and health, uses validated tools such as the GAD-7, and checks for medical causes that can look like anxiety.
Does Thrive prescribe Xanax or other benzodiazepines?
No. Thrive does not prescribe benzodiazepines or any other controlled substances. Your provider may consider non-controlled options such as SSRIs, SNRIs or buspirone, which are not considered addictive. Stopping some of them suddenly can cause discontinuation symptoms, so any changes are made with your provider.
What medication is used for generalized anxiety disorder?
SSRIs and SNRIs are usually tried first. Escitalopram, paroxetine, duloxetine and venlafaxine XR are FDA-approved for GAD, and buspirone is approved for anxiety disorders. Your provider recommends an option based on your symptoms, health history and any other medications you take.
How long do anxiety medications take to work?
SSRIs and SNRIs usually take several weeks to reach their full effect, and some people notice changes sooner. Your provider checks in every 2 to 4 weeks at first to adjust the dose and watch for side effects.
Does Thrive offer therapy for anxiety?
Thrive focuses on psychiatric evaluation and medication management. If you also see a therapist for approaches such as CBT, your provider can coordinate your care with them.
How much does online anxiety treatment cost at Thrive?
Self-pay is $250 for the first one-hour evaluation and $175 for each 30-minute follow-up. With insurance, you pay your plan’s usual copay or coinsurance. You pay nothing upfront.
Who can be seen for online anxiety treatment at Thrive?
Teens and adults aged 13 and up who are in Maryland at the time of each visit. Every visit is by secure video.
What if I'm in crisis?
Thrive is not an emergency service. If you are in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911.
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Ready when you are
Choose a provider, meet online, and pay after your session is completed. No upfront payment.