Anxiety & Depression Therapy

Depression & Anxiety

On the surface, living with depression, anxiety, or bipolar disorder may look similar—moodiness, irritability, excessive worries, unhappiness, too much sleep (or too little), disrupted appetite (eating too much—or too little), dysregulated energy (too much energy—or, you guessed it, too little energy)… But, these are distinct disorders.

Depression is a mood disorder characterized by a prolonged sad mood lasting more than two weeks, low energy, and motivation, disrupted sleep, changes in appetite, anhedonia (losing joy in previously enjoyable activities), and sometimes suicidal thoughts. Anxiety, on the other hand, manifests as excessive worry, restlessness, fatigue, muscle tension, difficulty sleeping, and at times, panic attacks. Understanding these differences is crucial in recognizing and treating these conditions effectively, as each requires a unique approach to support and treatment.

Common questions

Is it anxiety or depression?

Often both, and they feed each other. Anxiety tends to show up as worry, restlessness, tension, and trouble sleeping. Depression tends to show up as low mood, low energy, and the loss of interest in things you used to enjoy. Telling them apart matters because each responds to a different approach, and that is part of what the first sessions are for.

What if I can’t name what I’m feeling?

That is more common than people think, and it is workable. Many of our clients grew up in families where feelings weren’t discussed, and learned to function without a vocabulary for them. Part of the work is building one.

Will I need medication?

Not necessarily. Many people improve with therapy alone. Our psychologists and therapists don’t prescribe, but if medication could help, we will say so and coordinate with your physician or a psychiatrist.

Does culture matter here?

Often, yes. How distress is expressed, what is allowed to be said, and whether asking for help feels acceptable all vary by culture and family. We work with that context rather than around it. See our page on Asian American and bicultural therapy.

I’ve tried therapy for this before.

Then you may already know the coping skills, and you may be here because they weren’t enough. We start underneath the symptom, with the patterns shaped by your family, your culture, and your history. Read When Therapy Hits a Wall.

What does the work look like?

We start underneath the symptom. Together we look at the patterns you’ve carried from your past into your present, the stories you tell about yourself, and the cultural dynamics that shaped both. Then we gently untangle and reweave the parts of your identity and experience that have been frayed by pain, shame, or trauma, so what’s left is a stronger, more durable sense of who you are.

Depending on what fits you, our clinicians draw on cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), psychodynamic therapy, and attachment-based approaches.