Medication management for anxiety by video, with a provider who looks at sleep, stress and your health as a whole — not just the next prescription. Flat cash-pay pricing and no benzodiazepines.
Tyler Patten, APRN, PMHNP-BC — board-certified psychiatric nurse practitioner
Book Now →Some anxiety is useful: it gets you to prepare for the meeting or double-check the stove. An anxiety disorder is different. The worry is out of proportion to the actual risk, it shows up most days, and it starts to cost you sleep, concentration, relationships or work. Often it shows up in the body first — a tight chest, a racing heart, a stomach that won’t settle — long before anyone calls it anxiety.
It is also one of the most treatable conditions in psychiatry. The hard part in this region is getting in the door. Utah, Idaho and Nevada all rank near the bottom of the country for psychiatric prescribers per person, and the gap is widest in rural areas, where the nearest psychiatric provider can be a half-day round trip. Many people end up with whatever their primary care office can offer, or nothing at all.
Telehealth closes most of that gap. Every visit with Affordable Psych is by secure video, so a first appointment doesn’t depend on how far you live from Salt Lake City, Boise or Las Vegas.
Worry that jumps from topic to topic most days, with tension, fatigue and poor sleep.
Sudden surges of fear with a pounding heart or shortness of breath, and the dread of the next one.
Fear of being judged that makes work, school or ordinary conversations exhausting.
Persistent worry about illness that reassurance and normal test results don’t settle.
A mind that won’t shut off at night, or waking at 3 a.m. already running through the list.
The two overlap more often than not, and the plan needs to address both.
I start with the whole picture, not just the anxiety score. Sleep, caffeine and alcohol, nutrition, gut symptoms, thyroid and other medical issues, and the stress load you’re carrying can all drive anxiety or make it harder to treat. When it’s useful, I order cash-pay lab work to rule out things like thyroid problems, low vitamin D or iron, or blood sugar swings that can mimic or amplify anxiety.
Medication is often part of the plan, and it should be when it helps. First-line options are SSRIs and SNRIs, which take a few weeks to work but treat the underlying pattern. Buspirone, hydroxyzine and propranolol each have a place for specific situations. I explain what to expect, including side effects, before you start anything.
I don’t prescribe benzodiazepines such as Xanax, Klonopin or Ativan, or any other controlled substance. They work fast but carry real risks of tolerance and dependence, and they don’t treat the anxiety itself. If you’re already taking one, we can talk about whether and how to taper.
You need to be physically located in one of these states during each video visit.
Along the Wasatch Front the problem is usually the wait for a new-patient appointment. In rural Utah it’s the drive. Either way, a video visit gets you seen from home.
Idaho has the fewest psychiatrists per person of any state, so anxiety is often managed in primary care for years. We see adults anywhere in the state, from the Panhandle to eastern Idaho.
Shift work and rotating schedules are a common anxiety amplifier in Nevada. Early and evening appointments make it easier to keep follow-ups whether you’re in Las Vegas, Reno or a rural county.
Further reading:
Book a 60-minute evaluation with Tyler Patten, PMHNP-BC. Most new patients are seen within two weeks.
Book Now →Questions first? Call or text (435) 625-3098 or email office@affordablepsych.org.