High-Functioning
Anxiety & Depression
You're functional. That's part of the problem.
Many of the clients I work with are high-functioning. From the outside, nothing looks wrong. But inside, they feel a persistent hum of worry that doesn't quiet, or a flatness that makes everything feel like it's happening behind glass.
Anxiety and depression in high-functioning people are particularly insidious because the coping mechanisms work well enough to keep things going. As a result, the problem gets managed rather than addressed, sometimes for years.
Anxiety shows up as physical vigilance, anticipatory dread, the exhausting work of managing how you come across while also managing everything else. It's 3 a.m. spirals. It's difficulty being present in your own life.
Depression can look like the absence of color — a muted, flattened version of a life that looks fine on paper but doesn't feel like much from the inside.
I work with adults experiencing anxiety and depression that is entangled with their history, their relationships, and the specific pressures of their lives. Using CBT and ACT, we'll build practical skills for interrupting patterns that aren't working. Using modern psychodynamic approaches and EMDR where relevant, we'll address the experiences that drive those patterns.
The goal here isn't indefinite symptom management. It's understanding and reworking the patterns driving those symptoms.
What you can expect:
A space to stop performing "fine," and figure out what's underneath it
EMDR to address experiences underneath the patterns, not just the symptoms
Support for high-functioning anxiety that doesn't look like a crisis from the outside
FAQ
1. How do I know if what I'm experiencing is "bad enough" to warrant therapy?
If you're asking the question, it probably is. High-functioning anxiety and depression are particularly easy to talk yourself out of addressing because from the outside (and sometimes from the inside) things look fine. But the fact that things aren't falling apart doesn't mean something isn't wrong. The people I work with most often come in not because everything has collapsed, but because they're tired of how much energy it takes to keep everything from collapsing. That's a legitimate reason to be here.
2. Do I have to take medication?
No. I am not a prescriber, and I will never push or require you to take medication. The decision is yours, not mine. What I can do is help you think it through: what you're weighing, what you've heard, what your concerns are — and refer you to a psychiatrist if you want a qualified opinion on the options. That said, medication is rarely a clean either/or. For some people, especially with more severe or entrenched symptoms, it can lower the intensity enough to make the underlying work in therapy more accessible — not a substitute for that work, but something that supports it. For others, therapy alone is plenty.
3. What if I've tried therapy before and it didn't help?
It's more common than you'd think, and it doesn't mean therapy doesn't work for you. A lot of people with high-functioning anxiety and depression have done some version of therapy that stayed pretty surface-level — tracking thoughts, building coping skills, managing symptoms. That work has value, but it doesn't always touch what's actually underneath. If you've left therapy before feeling like you got tools but not answers, that's worth paying attention to. What I do here is oriented toward understanding the patterns driving your experience, not just managing the output. That's a different kind of work, and for a lot of people it's the version that actually moves something.
4. How long does therapy for anxiety and depression usually take?
The honest answer depends on what you're bringing in; how long it's been running, how entrenched the patterns are, and what you're hoping to walk away with. Some people notice a shift within a few months. Deeper pattern work takes longer. We'll talk about this openly as we go, and you won't be left wondering whether we're making progress.
Additional Resources
A few places to learn more between sessions, or if you're not ready to reach out yet.
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Anxiety and Depression Association of America: Background on symptoms, treatment options, and current research
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NIMH: Federal research summaries on anxiety and depression