Therapy for anxiety and depression, when the worry will not switch off or the motivation will not switch on

Anxiety can look like

• A mind that will not stop: what if, what if, what if.
• Tight chest, racing heart, a knot in your stomach that is just always there.
• Trouble falling asleep, or waking at 3 a.m. with your brain already running.
• Avoiding things: the call, the drive, the event, the conversation.
• Irritability and a short fuse that does not feel like you.
• Overthinking decisions large and small, and then doubting the one you made.

Depression can look like

• Flat. Heavy. Tired in a way that sleep does not fix.
• Things you used to enjoy feel like effort, so you stop doing them.
• Pulling away from people, then feeling lonely and guilty about it.
• A critical voice that narrates everything you do wrong.
• Trouble concentrating, deciding, or getting started on anything.
• Going through the motions and wondering why nothing feels like much.

Many people have both at once, and many have been carrying this quietly for a long time while functioning well enough that nobody noticed. If that is you, nothing here is a verdict on your character. These are among the most common and most treatable things a person can go through.

Why this happens

Anxiety and depression come from a mix of biology, stress, history and habit, and the proportions are different for everyone. A hard year, a loss, a stressful job, a difficult family, a tendency toward perfectionism, or simply the way your nervous system is wired can each play a part. What keeps them going is more predictable: patterns of thinking, avoidance, and withdrawal that feel protective and quietly make things worse.

That is good news, because patterns can be changed. You did not choose this, and you can still do something about it.

How therapy helps

1. Understand what is happening. We map your specific anxiety or low mood: the triggers, the thoughts, the body sensations, and what you do in response. Clarity alone takes some of the fear out of it.
2. Calm the system. Mindfulness and breathing skills for the body, so the physical side of anxiety stops running the show. These are a core part of my practice.
3. Change the thinking. Cognitive behavioral tools for catching the catastrophic or self-critical thoughts and testing them against reality, until the new way of thinking becomes the automatic one.
4. Rebuild momentum. For depression, small deliberate actions that restart energy and connection. For anxiety, facing the things you have been avoiding in steps you can actually manage.
5. Protect the gains. A plan for the hard weeks, so a bad day does not become a bad month.

What working together looks like

Sessions are 50 minutes by secure video from anywhere in California. We usually meet weekly to begin. My style is warm and direct: you will feel heard, and you will leave with something concrete to do. If medication may help, I will tell you and coordinate with your physician if you wish.

I am in-network with Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Optum, United Healthcare and others. Private pay is $140 per session. See insurance and rates.