Anxiety and Depression

Anxiety often says, “Everything is unsafe! What if?” In my experience, anxiety is often tied to repression of useful emotions like anger or hurt; it is tied to perfectionism; and it is tied to a desire for certainty, which that then rubs up against the human conditions of uncertainty and unpredictable change.

And, depression is a fraternal twin sister to anxiety. It says, “You are hopeless and helpless. You will feel this way forever and never stop feeling this way, so you might as well do all the things that make you feel worse. And, it’s your fault that you now feel worse.”

With this in mind, this is my frame as a therapist: I’m listening for stories that color your interpretation of your current reality and that potentially reinforce cycles in your life of feeling hopeless, stuck, unheard, and broken.

Our job is to interrupt them at your pace and creating new stories together.

Here are some of the tools I use to do that:

  • Being nonjudgmental and frank about naming your patterns in therapy, such as apologizing repetitively or seeking reassurance. Usually these are ways you learned to survive real and scary and hurtful things; and, they’re usually what’s now keeping you anxious, distressed, obsessive, or traumatized

  • Being interested in the emotions, physical sensations, and memories that come up for you when you share with me

  • Radical acceptance of where and who we are, together

  • Providing psychoeducation to help you feel educated about your emotional patterns and what I observe with you in session

  • Helping you find coping tools from Somatic Experiencing Therapy, Acceptance and Commitment Therapy, and Dialectical Behavioral Therapy that work for you when you’re dysregulated emotionally

  • Identifying core values together that tell us about the life you hope to live

  • Challenging the extreme stories that fuel depression and anxiety - that this is life-ending, we are all-good or all-bad, that everything is our fault

  • Coaching you on interpersonal communication using tools from Dialectical Behavioral Therapy

  • Highlighting times that I see you grow in case you miss them

  • Encouraging the lifestyle pieces that are crucial to recovery - sleep, food, laughter, emotional connection, nature, and exercise

  • Validating where anxious and depressive symptoms are a healthy response to ongoing stress, boundary violations, and the state of the world, and signal the need for change 

Note: I refer out for moderate-to-severe substance use disorders and disordered eating, bipolar disorder, and schizophrenia and other psychotic disorders, in order to help clients move toward care from clinicians who have years of training and experience in these presentations.