Therapy for Anxiety and Depression
Support for persistent worry, low mood, exhaustion, and feeling disconnected from yourself or your life
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, or 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 contributing to distress, recognize what is already helping, 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 uncertain situations, seek reassurance, overprepare, 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, reduce uncertainty, or maintain control. Some of these patterns may have helped you manage difficult circumstances in the past even if they are now interfering with your life. Understanding what anxiety is doing, rather than simply treating it as something that needs to disappear, can help us determine what kinds of changes may actually be useful.
Depression Does Not Always Look Sad
Depression may involve sadness, but it can also feel like emptiness, numbness, exhaustion, irritability, disconnection, or loss of interest in things that once mattered. Some people withdraw from daily life, while others continue working, caring for others, and meeting expectations despite feeling depleted internally.
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
Depression can develop alongside prolonged stress, difficult experiences, health concerns, loss, major transitions, isolation, or other circumstances. It can also make the things that might ordinarily help feel much harder to begin. 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, decisions, or responsibilities. Avoidance can provide temporary relief while increasing isolation, self-criticism, unfinished responsibilities, or hopelessness. Depression may then reduce the energy or motivation needed to address situations contributing to anxiety, making them feel even more overwhelming.
These cycles are not personal failures. They can develop through stress, difficult experiences, health concerns, relationships, environmental pressures, learned patterns, or attempts to cope with circumstances that have felt unmanageable. Therapy can help us understand how the cycle operates for you and experiment with different responses without expecting you to change everything at once.
How Therapy May Help
Therapy for anxiety and depression is individualized. We can begin by exploring what you are experiencing, how it affects your life, what may be contributing to it, what you have already tried, what strengths and resources you bring with you, and what you hope will become different. Depending on your needs and goals, our work may involve:
understanding patterns among thoughts, emotions, behaviors, relationships, and physical responses
developing different ways of responding to worry, rumination, and self-criticism
learning emotion 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 values and identifying actions that reflect what matters to you
strengthening mindfulness, self-compassion, and psychological flexibility
developing practical 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 becoming more capable of responding to them, participating more fully in your life, understanding yourself differently, reconnecting with meaningful activities, or making choices based more on what matters to you than what anxiety or depression demands in the moment.
An Individualized and Integrative Approach
My approach is humanistic, person-centered, strengths-based, trauma-informed, collaborative, and integrative. Therapy is something we do together 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.
Depending on your experiences and goals, our work may draw from person-centered therapy, MI, CBT, DBT, ACT, CFT, MBCT, EMDR, mindfulness, somatic and mind-body practices, behavioral strategies, and other evidence-based and research-informed approaches. I may explain why I am recommending something, discuss the theory or evidence behind it, and give you an opportunity to decide whether you want to explore it.
No single intervention is right for everyone. We can try different approaches, pay attention to what happens, and use what we learn to guide what comes next. Something that helps can tell us more about what supports you. Something that does not help can also give us useful information about what may not fit.
For some people, anxiety and depression are connected to difficult or traumatic experiences. When relevant, we can explore those connections and determine together whether trauma-focused work may be appropriate. Therapy does not need to move into deeper processing before you feel prepared to do so.
Anxiety, Depression, and Physical Health
Mental and physical health can influence one another. 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, concentration, motivation, and the ability to manage medical care.
Living with ongoing health concerns can introduce additional challenges, including uncertainty, changes in functioning, medical appointments, treatment decisions, and adjustments to personal expectations. Therapy can support the emotional, behavioral, relational, and practical aspects of living with physical or mental health concerns while recognizing that physical symptoms and limitations are real and may not be within your control.
Therapy does not replace medical evaluation or treatment. Coordination with other healthcare professionals may be considered when it would support your care and when 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.
These are possibilities, not assumptions. Therapy is adapted to the individual rather than based on what someone of a particular age or life stage is expected to be experiencing.
Online Therapy for Anxiety and Depression
Appointments are provided through secure video for clients located in Oklahoma, Florida, South Carolina, and Idaho. Online therapy can make care more accessible when work, school, caregiving, transportation, health concerns, mobility, geography, or limited access to an appropriate therapist nearby make office-based care difficult.
You must be physically located in a state where I am authorized to provide psychotherapy 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, and 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 can influence one another. Therapy can address the ways they interact rather than requiring your experiences to be separated 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 another 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 can revisit your goals and progress throughout therapy.
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. People can continue working, studying, maintaining relationships, caring for others, and meeting expectations while experiencing significant 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 you are experiencing, assess safety, identify protective factors and supports, and collaboratively determine appropriate next steps.
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?
Not always. Some people may need in-person treatment, specialized assessment, more frequent support, intensive outpatient care, partial hospitalization, residential treatment, emergency care, or another level of support. We can discuss whether online outpatient psychotherapy appears appropriate for your current needs.
Related Resources for Anxiety and Depression
Explore additional coping skills and therapeutic practices that may help you respond to difficult emotions, strengthen self-compassion, and reconnect with meaningful activities.
Self-Compassion Break:
A mindfulness practice for responding to difficult emotions and self-criticism with kindness and understanding.
Check the Facts:
A DBT skill for examining whether your emotional reactions fit the facts of a situation.
Pleasant Event Scheduling:
A practical way to make room for enjoyable or meaningful activities when motivation or energy is limited.
For additional strategies to manage worry, respond to difficult emotions, and reconnect with everyday activities, explore the Coping Skills & Exercises library.