Therapy for Anxiety and Depression

When Anxiety or Depression Begins Affecting Your Life

Anxiety and depression can appear separately, occur together, or shift over time. You may experience periods of intense worry followed by exhaustion and withdrawal. You may feel restless but unable to begin anything. You may also continue meeting your responsibilities while struggling internally.

These experiences can affect concentration, sleep, energy, motivation, relationships, physical health, and your ability to enjoy life. Even ordinary decisions may begin to feel overwhelming. You may know that something needs to change without knowing where to begin.

Therapy offers a place to understand what is happening, identify patterns that may be keeping you stuck, and explore ways of responding that fit your needs and circumstances.

Anxiety Does Not Always Look Anxious

Anxiety can involve fear, nervousness, or panic, but it can also appear in less obvious ways. You may feel compelled to plan for every possibility, replay conversations, avoid situations, seek reassurance, or remain constantly busy so that difficult thoughts cannot catch up with you.

Experiences associated with anxiety may include:

• persistent worry or overthinking

• difficulty relaxing or feeling safe

• irritability, restlessness, or feeling on edge

• fear of making mistakes or disappointing others

• avoidance of situations that feel uncertain

• perfectionism or excessive self-criticism

• difficulty concentrating or making decisions

• physical tension, digestive changes, headaches, or disrupted sleep

• panic attacks or sudden periods of intense fear

Anxiety often develops as an attempt to anticipate danger, prevent mistakes, or maintain control. These patterns may have helped you manage difficult circumstances in the past even if they are now limiting your life.

Depression Does Not Always Look Sad

Depression may involve sadness, but it can also feel like emptiness, numbness, exhaustion, irritability, disconnection, or a loss of interest in things that once mattered. Some people withdraw from daily life. Others continue working, caring for others, and meeting expectations despite feeling depleted.

Experiences associated with depression may include:

• low mood, hopelessness, or emotional numbness

• loss of interest or pleasure

• fatigue or difficulty beginning tasks

• changes in sleep or appetite

• difficulty concentrating or remembering things

• withdrawal from relationships and activities

• guilt, shame, or feelings of worthlessness

• irritability or frustration

• feeling disconnected from yourself or your future

• thoughts about death or not wanting to be alive

You do not have to wait until depression becomes unbearable before seeking support. Therapy can be appropriate when something feels different, daily life has become harder, or the strategies you usually rely on no longer seem to help.

When Anxiety and Depression Occur Together

Anxiety and depression frequently reinforce one another. Worry and fear may lead you to avoid activities, relationships, or responsibilities. Avoidance can provide temporary relief, but it may also increase isolation, self-criticism, and hopelessness. Depression may reduce the energy needed to address the situations causing anxiety, which can make those situations feel even more overwhelming.

These cycles are not personal failures. They are understandable patterns that can develop through stress, difficult experiences, health concerns, relationships, environmental pressures, or efforts to cope with circumstances that have felt unmanageable.

Therapy can help you recognize these cycles and experiment with new responses without expecting you to change everything at once.

How Therapy May Help

Therapy for anxiety and depression is individualized. We will begin by exploring what you are experiencing, how it is affecting your life, what may be contributing to it, and what you hope will become different.

Depending on your needs and goals, therapy may involve:

• understanding patterns among thoughts, emotions, behaviors, and physical responses

• developing ways to respond to worry, rumination, and self-criticism

• learning emotional regulation and distress tolerance skills

• gradually approaching situations that anxiety has led you to avoid

• rebuilding routines, relationships, and meaningful activities

• exploring difficult experiences that may influence current reactions

• clarifying your values and deciding what matters to you

• strengthening self-compassion and psychological flexibility

• developing coping strategies that can be used outside therapy

• identifying environmental, relational, or practical changes that may support your well-being

Progress does not require eliminating every difficult thought or emotion. It may mean feeling more capable of responding to them, participating more fully in your life, and making choices based on what matters rather than what anxiety or depression demands in the moment.

An Individualized and Integrative Approach

My approach is humanistic, person-centered, strengths-based, and trauma-informed. Therapy is collaborative rather than something that is done to you. You are encouraged to ask questions, disagree, identify what does not fit, and participate actively in decisions about your care.

Our work may draw from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Dialectical Behavior Therapy, mindfulness-based approaches, self-compassion practices, somatic awareness, and other evidence-based interventions.

No single method is imposed on every person. We will consider your experiences, identities, relationships, physical health, environment, strengths, preferences, and goals as we determine what may be useful.

Anxiety, Depression, and Physical Health

Mental and physical health can influence each other. Sleep disruption, pain, chronic illness, hormonal changes, medication effects, disability, and other health concerns may affect mood and anxiety. Anxiety and depression can also influence energy, physical tension, sleep, appetite, and the ability to manage medical care.

Therapy does not replace medical evaluation or treatment. It can provide support for the emotional, behavioral, relational, and practical effects of living with physical or mental health concerns. Coordination with other healthcare professionals may be considered when appropriate and authorized by you.

Therapy Across Different Stages of Life

I work with adolescents age 13 and older, adults, and older adults. Anxiety and depression can take different forms across the lifespan.

Adolescents may be navigating school pressure, identity development, changing relationships, family stress, social expectations, or uncertainty about the future. Adults may be balancing work, relationships, caregiving, health concerns, financial pressure, or major transitions. Older adults may be experiencing grief, retirement, changes in health or independence, caregiving responsibilities, or questions about meaning and purpose.

Therapy is adapted to the person rather than based on assumptions about age or life stage.

Online Therapy for Anxiety and Depression

Appointments are provided through secure video. Online therapy can make care more accessible for people managing work, school, caregiving, transportation barriers, health concerns, or limited access to an appropriate therapist nearby.

You must be physically located in a state where I am authorized to provide therapy at the time of your appointment. Visit the Online Therapy and Telehealth page for current availability and information about how virtual sessions work.

Frequently Asked Questions

Do I need a diagnosis to begin therapy?

• No. You do not need to determine whether you have anxiety, depression, or another diagnosis before reaching out. We can begin by discussing what you have been experiencing. A formal diagnosis may be required when insurance is used. Any diagnosis will be discussed as part of your care.

Can therapy address anxiety and depression at the same time?

• Yes. Anxiety and depression often overlap, and therapy can address the ways they interact. Treatment does not have to separate your experiences into isolated categories.

Do you prescribe medication?

• No. As a licensed clinical social worker, I do not prescribe medication. If medication evaluation or management may be helpful, you can speak with a physician, psychiatrist, or another qualified prescriber. Coordination with a healthcare professional can occur when appropriate and authorized by you.

How long will I need therapy?

• The length of therapy varies based on your concerns, goals, circumstances, preferences, and response to treatment. Some people seek focused support for a particular concern, while others benefit from longer-term work. We will revisit your goals and progress throughout the therapeutic process.

Can I seek therapy even if I am still functioning?

• Yes. You do not have to be in crisis or unable to manage daily responsibilities to benefit from therapy. Many people appear highly functional while experiencing significant anxiety, depression, exhaustion, or distress internally.

What if I experience suicidal thoughts?

• Suicidal thoughts can occur alongside depression and other forms of distress. You can discuss these experiences honestly in therapy. We can explore what the thoughts mean, assess safety, identify protective factors, and develop an appropriate plan for support.
  
  Therapy with Z is not an emergency or immediate crisis-response service. If you are in immediate danger or unable to remain safe, call 911, go to the nearest emergency department, or call or text 988 in the United States.

Is online therapy appropriate for everyone?

• Online outpatient therapy can be helpful for many people, but it is not appropriate for every situation. Some people may need in-person treatment, more frequent support, intensive outpatient care, partial hospitalization, residential treatment, or emergency services. We can discuss whether this practice appears appropriate for your current needs.

Begin Therapy for Anxiety and Depression

You do not need to have everything figured out before contacting me. If you are experiencing anxiety, depression, or a combination of both, you are welcome to reach out with questions or request an appointment.