Anxiety is one of the most common mental health concerns among adults, but it doesn’t always look like panic attacks or constant worry. It often shows up as fatigue, stomach discomfort, irritability, or trouble sleeping. In primary care, we see patients every day whose anxiety is affecting their blood pressure, digestion, and even their ability to lose weight.
The good news? Primary care providers are trained to spot these signs early and to treat anxiety with the same focus we bring to any physical condition. If you’re in Vienna, Arlington, or anywhere in Northern Virginia, Heale Medical Primary Care is here to support your whole wellness, including your mental health.
What Actually Triggers Anxiety?
Anxiety rarely has a single cause. It’s typically a combination of internal and external stressors, and it looks different for everyone. That said, there are some common triggers we see time and again in our primary care practice:
1. Chronic Stress from Work or Family Life
Constant deadlines, caregiving responsibilities, and lack of sleep all pile up. When there’s no time for recovery, your body can stay in a fight-or-flight mode, leading to generalized anxiety.
What We See In Primary Care
- Elevated blood pressure or heart rate
- Insomnia or early waking
- Fatigue that doesn’t go away with rest
2. Poor Nutrition and Gut Health
What you eat, and how your body processes it, can directly affect how your brain functions. The gut-brain axis is well-studied, and imbalances in gut microbiota are associated with increased anxiety and depression.
Supporting Evidence
A 2021 meta-analysis published in General Psychiatry confirmed that probiotics and balanced diets significantly reduced anxiety symptoms in several randomized controlled trials.
3. Substance Use (Caffeine, Alcohol, THC)
Caffeine and alcohol can be double-edged swords. While they may offer short-term relief (or stimulation), they often worsen anxiety over time, especially in sensitive individuals.
Example From Clinic
We frequently see patients experiencing anxiety symptoms tied to daily energy drink use or THC edibles disrupting their natural sleep cycles.
4. Unrecognized Hormonal Changes
In women, especially, hormonal shifts during perimenopause, pregnancy, postpartum, or even untreated thyroid issues can trigger new anxiety symptoms.
5. Medical Conditions and Medications
Anxiety can also be a side effect of an underlying health issue. These include:
- Hyperthyroidism
- Sleep apnea
- Vitamin B12 deficiency
- Medications like corticosteroids or ADHD stimulants
This is why it’s so important to involve a primary care provider early.
Table: Medical vs Lifestyle Anxiety Triggers
| Trigger Type | Examples | Primary Care Role |
| Biological | Thyroid issues, sleep apnea, nutrient deficiencies | Diagnostic blood work, treatment referral |
| Hormonal | PMS, perimenopause, postpartum changes | Symptom tracking, medication adjustments |
| Behavioral | High caffeine, skipped meals, sedentary lifestyle | Lifestyle coaching, referrals |
| Emotional | Grief, trauma, burnout, and relationship stress | Screening, therapy referrals, and medications |
| Environmental | Noise, clutter, poor lighting, and a lack of natural exposure | Patient education, stress reduction tips |
Why See a Primary Care Provider for Anxiety?
You don’t need to wait for a mental health crisis before getting help. Your primary care physician is your first, and often most accessible, line of defense when anxiety symptoms show up.
Here’s what we do at Heale Medical Primary Care
1. We Screen for Anxiety Early
At every annual wellness visit and many follow-up appointments, we use standardized tools like the GAD-7 (Generalized Anxiety Disorder scale) to detect symptoms early, even if you didn’t come in for mental health.
2. We Rule Out Underlying Medical Causes
Because anxiety symptoms can mimic or mask other issues, we typically run labs to check:
- Thyroid function (TSH, Free T3/T4)
- Vitamin levels (especially B12 and D)
- Hormonal markers (for women)
- Inflammatory markers (CRP)
3. We Offer Medication Options If Needed
We may recommend short-acting or long-term medications, such as:
- SSRIs (e.g., sertraline, escitalopram)
- SNRIs
- Buspirone (a non-sedating anti-anxiety medication)
- Beta-blockers for situational anxiety (e.g., public speaking)
These are prescribed only after a thorough discussion and follow-up plan.
4. We Refer to Mental Health Specialists
For patients needing therapy, we work closely with local therapists, psychologists, and psychiatrists. Referrals are often faster and more effective when coordinated through your PCP.
5. We Focus on Whole-Body Wellness
Anxiety doesn’t exist in isolation. If you’re also dealing with weight concerns, fatigue, or sleep problems, we address these together. Our approach includes:
- Weight loss therapy and medications (like semaglutide or tirzepatide)
- Nutrition guidance
- Stress management and exercise planning
When Anxiety Impacts Weight and Metabolism
One thing we often see is how anxiety blocks progress in weight loss efforts. Stress increases cortisol levels, which can:
- Promote fat storage (especially abdominal fat)
- Disrupt insulin sensitivity
- Lead to emotional eating or skipped meals
At Heale Medical, we combine weight loss therapy with anxiety care when the two are connected. This might include:
- GLP-1 receptor agonists (like semaglutide) to control appetite
- Addressing emotional eating patterns
- Sleep and circadian rhythm regulation
- Hormonal evaluation (especially for women in their 30s–50s)
Anxiety in Women: A Closer Look
Women are twice as likely as men to be diagnosed with anxiety disorders. And many symptoms are brushed off as “normal stress” when they actually indicate something more profound, especially during hormonal transitions.
Common Patterns We See
- Late 30s/early 40s irritability, sleep disruption, anxious ruminating
- Postpartum intrusive thoughts, physical tension, and fear of harm to the baby
- Perimenopause heart palpitations, feeling “on edge,” low mood
In each of these stages, we assess hormone levels, evaluate for underlying conditions, and coordinate care that includes both physical and mental support.
Practical Wellness Strategies We Recommend
Sometimes what patients need most is a grounded, manageable plan, not more overwhelm. Here are five evidence-backed strategies we often suggest alongside other treatments:
| Strategy | Why It Works |
| Consistent daily routine | Reduces cortisol spikes and helps regulate circadian rhythm |
| Regular movement | Aerobic exercise lowers anxiety scores across all age groups |
| Cutting caffeine by 50% | Reduces physical symptoms like heart palpitations |
| Time outdoors | Sunlight increases serotonin, helps regulate melatonin |
| Sleep hygiene focus | Anxiety often starts with disrupted sleep, not vice versa |
We don’t expect perfection. We help patients select one or two habits to begin with and build from there.
How to Start the Conversation
You don’t need a mental health diagnosis to bring up anxiety with your doctor. In fact, some of the best outcomes happen when patients mention a slight shift early, like, “I’ve been feeling more restless lately,” or “I just can’t shut my brain off at night.”
That’s often enough to trigger the proper screening, support, and treatment.
Primary Care is a Starting Point, Not a Last Resort
If anxiety is interfering with your sleep, mood, relationships, or health goals, it’s time to talk to your doctor.
At Heale Medical Primary Care, we treat anxiety with the same seriousness and attention as any other medical issue. We consider the entire picture, from thyroid lab results to workplace stress, and develop a care plan tailored to your life.
We’re here for you in Vienna, Tysons, Fairfax, Great Falls, Falls Church, Arlington, Ballston, Annandale, and DC, whether you’re managing anxiety, navigating weight loss, or just trying to stay well.
Ready to Get Support?
Schedule your first visit or wellness check-up at www.healemedical.com.
Let’s take a proactive, thoughtful approach to your anxiety, together.
