How PMHNPs Treat Anxiety and Panic Disorders

A PMHNP discussing a treatment plan with a patient
A PMHNP discussing a treatment plan with a patient

Anxiety disorders affect tens of millions of people in the U.S., making them the nation's most common type of mental disorder. This was true even before the COVID-19 pandemic began, but the last few years have accelerated anxiety in Americans of all ages. Simultaneously, there has also been a rise in mental health awareness. Ninety percent of U.S. adults say that America is facing a mental health crisis. Between 2019 and 2021, U.S. adults receiving mental health treatment rose from 19.2 percent to 21.6 percent. 

Simultaneously, the U.S. faces a significant mental health care provider shortage. As more people seek treatment for anxiety and try to find a primary care provider who can help them, they may wonder:

  • Can a nurse practitioner diagnose anxiety? 
  • What is the role of a primary care provider in treating anxiety? 
  • Who can establish and monitor treatment plans for mental health conditions?

A Psychiatric-Mental Health Nurse Practitioner (PMHNP) can play a vital role in identifying, assessing, diagnosing and treating mental health conditions such as anxiety and panic disorders. As primary care health professionals on the front lines of treating anxiety and panic disorders, PMHNPs are essential to individual and community health in a nation that is suffering from overwhelming rates of stress and mental health conditions. Nurses who want to make a difference in the world by identifying and treating anxiety may wish to consider licensure as a PMHNP. 


Understanding the Widespread Nature of Anxiety

The Anxiety and Depression Association of America reports that annually, anxiety disorders affect over 19 percent of the American population aged 18 and older. The National Institute of Mental Health also estimates that nearly 32 percent of American adolescents suffer from an anxiety disorder. Between 2016 and 2020, the percentage of American children struggling with anxiety or depression jumped from nine percent to 12 percent, according to the Annie E. Casey Foundation.

While mental health conditions like anxiety are highly treatable by a professional such as a psychiatric mental health nurse practitioner (PMHNP), most people suffering from such a condition go untreated. The results of this can be dangerous. People with anxiety disorders are three to five times more likely to seek medical attention, often due to physical symptoms of anxiety, and six times more likely to be hospitalized for psychiatric disorders than those without anxiety disorders. 

Anxiety disorders may arise from a confluence of causes and risk factors , including:

  • Medical problems: heart disease, diabetes, thyroid problems, chronic pain, respiratory disorders 
  • Substances: drug misuse or withdrawal, alcohol or medication withdrawal, medication side effects
  • Personality 
  • Trauma and/or stress 
  • Family history 

At the end of 2022, 37 percent of Americans rated their mental health as fair or poor, up six percentage points from the end of 2021. While one in five Americans expected increased stress in the year to come at the end of 2021, now more than one in four anticipate greater stress heading into 2023. 

Nearly a third of American adults are making resolutions related to their mental health. That means many people are ready for precisely the type of support, guidance and treatment that a PMHNP can provide.


Can a Nurse Practitioner Diagnose Different Forms of Anxiety? Yes!

There are several types of anxiety disorders, including:

  • Generalized Anxiety Disorder
  • Obsessive-Compulsive Disorder
  • Panic Disorder
  • Post-Traumatic Stress Disorder
  • Social Phobia (or Social Anxiety Disorder)

To form a diagnosis for a patient who seems to be suffering from an anxiety disorder, PMHNPs will screen for risk factors and may use tools such as questionnaires or self-assessments in which patients rate the frequency at which they experience various symptoms. PMHNPs may also conduct physical exams and order diagnostic testing to rule out other or contributing medical conditions. They will likely consider how the use of caffeine, substances and prescription medications affects the patient’s life. 

Understanding the nuances of the five most common anxiety disorders listed above empowers PMHNPs to provide the proper screening tools and form an accurate diagnosis and treatment plan. 


How Does a PMHNP Treat These Anxiety Conditions? 

Depending on the state in which a PMHNP practices, they may need to establish a collaborative practice agreement or protocol with a physician to engage their full scope of practice. In states where nurse practitioners have a full scope of practice, they can prescribe, diagnose and treat patients without physician oversight. NPs in reduced practice states can diagnose and treat patients without physician oversight but will need physician oversight to prescribe medications. Those in restricted practice states must have physician oversight for prescribing, diagnosing and treating patients. 

As long as state regulations are followed regarding physician oversight, PMHNPs can develop treatment plans for individuals with anxiety or panic disorders that include:

  • Prescribing medications
  • Conducting individual, family and group therapy sessions
  • Making referrals
  • Monitoring treatment outcomes and overall patient well-being

The American Association of Nurse Practitioners provides the following information about practice scope in Virginia, Maryland, the District of Columbia and nearby states:

State or District



Restricted Practice


Full Practice

Washington, D.C. 

Full Practice

West Virginia

Reduced Practice


Full Practice


Reduced Practice

North Carolina

Reduced Practice


How to Become a PMHNP

The first step to becoming a PMHNP is considering whether or not you have a passion for helping people with mental health issues. The career of a PMHNP is enriching and can also be rewarding as these professionals encounter people who are struggling daily. Determining if you have a sustainable desire to help people with mental health conditions is a great place to start. 

If you determine that you are ready to become a PMHNP, becoming a registered nurse is the next step. You will then need to pass the NCLEX-RN examination. Then, apply to accredited PMHNP programs and complete the course of study and the requisite 500 faculty-supervised clinical hours. Upon completion of the program and clinical hours, you must pass the PMHNP exam administered by the American Nursing Credentialing Center (ANCC) before applying for state-specific PMHNP certification.

Nurse practitioners are in very high demand. In fact, the Bureau of Labor Statistics projects a 40 percent growth in roles for NPs between 2021 and 2031. That’s eight times faster than the projected growth rate for all occupations. The median salary for nurse practitioners in 2021 was $120,680, compared to a median salary of $77,600 for registered nurses (without advanced practice degrees).


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  • An on-campus residency
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  • 100% online courses on topics like Research and Evidence-Based Practice

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If you want to become an RN, contact one of our student advisors to discuss if this program is right for you.


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