SPECIALTY
Anxiety & depression, when both are loud.
Therapy when worry and the flat, heavy piece show up together. Telehealth across New York State.
If overthinking is the main thing you want help with, and you're searching specifically for anxiety-focused therapy by telehealth, that page goes deeper on the NYC-shaped version of this work.
These often come together:
01 WHAT IT ACTUALLY LOOKS LIKE
Anxiety keeps you keyed up. Depression keeps you drained. Somehow, you're both.
Your mind won't stop moving, and your body won't get off the couch. You're anxious about everything you're not doing, and too depleted to do any of it. People who only have one or the other don't quite get how you can be this wired and this tired at the same time.
Maybe you can't sleep because your thoughts are looping, and then you can't get up in the morning because nothing feels like it matters enough to bother. Maybe you're anxious about being anxious, and low about being low — an exhausting loop with no edges to grab onto.
Sometimes it's both. At the same time. Fun.
Most people who come to me for this don't lead with "anxiety" or "depression" first. They say things like:
- “I’m anxious about how depressed I am, and depressed about how anxious I am.”
- “I want to do everything and I can’t make myself do anything.”
- “I’m exhausted, but if I stop moving, the anxious thoughts catch up to me.”
- “Some days I’m wired and can’t sit still. Other days I can’t get off the couch. I never know which one I’m getting.”
- “I feel guilty for being tired when I’m supposed to be anxious, and guilty for being anxious when I’m supposed to be tired.”
- “I used to think I had to pick one to explain to people. Neither one alone was ever the whole story.”
Some of this is straightforwardly anxiety and depression, running together the way they usually do. Sometimes there's a third thing underneath both: ADHD that never got named, where years of unmanaged executive dysfunction curdled into anxious hypervigilance on one side and demoralized burnout on the other. If a late diagnosis is part of your story, the late-diagnosed ADHD page goes into that connection.
And then there's the NYC of it. The pace that doesn't let you slow down. The financial anxiety that runs in the background 24/7. The pressure to be crushing it professionally, socially, personally, all at once, all the time.
02 WHY WHAT YOU'VE TRIED ISN'T WORKING
You're not failing at either one. Treating them separately is why neither one moves.
You've probably had two different toolkits — something for the anxiety (breathing, grounding, a worry journal) and something for the low mood (exercise, routine, gratitude lists) — used on different days, like they're unrelated problems. Maybe one provider treated the anxiety and referred you out for the depression. Maybe medication helped one piece and left the other exactly where it was.
Treat them as two separate problems, and you clear space for whichever one you're not treating to get louder. Anxiety and depression running together aren't really two conditions taking turns — they're one nervous system stuck between two settings, alert and shut down, with no calm middle ground in between.
“You're not lazy and you're not fragile. You're running two systems that are both maxed out, and they're feeding each other.”
03 HOW WE'D ACTUALLY WORK ON THIS
Not one at a time. Whichever is loudest, first.
The first thing we'd do is figure out what's actually happening on a given day, because anxiety and depression don't take turns politely. Some days the worry is loud and the flatness is quiet underneath it. Other days it flips. We'd track that pattern together instead of treating "anxious and depressed" as one blurry state.
From there we'd work on how the two feed each other: the way worry keeps you keyed up long after your energy's gone, and the way the flatness makes even the anxious thoughts feel too heavy to argue with. Treating just one usually leaves the other one running the show.
I won't ask you to pick which one we're "really" working on. We'll follow whichever is loudest on a given day, and slowly build back the parts of you that both of them have been quietly wearing down.
04 WHAT YOU MIGHT NOTICE
“What clients tend to notice first isn't that one of them lifts. It's that the order starts to make sense.”
The anxiety usually shifts before the flat feeling does. Which is strange — for a while, you have more energy to feel the worry, and that can feel worse before it feels better. Then small things start coming back. A preference about what to eat. A song you want to hear twice. A text you actually want to send.
The flat layer is slower. It doesn't lift, exactly. It thaws. You catch yourself making a plan and meaning it. You do a hard thing and it doesn't cost the entire day. The voice that says what's the point gets quieter, not gone — and eventually, less interesting than it used to be.
You stop bracing for the morning before it starts. That's usually the one people notice last and remember first.
If this feels familiar, we can talk“For a while I felt more anxious not less, and I almost quit. She told me that was actually a sign things were moving. I didn't believe her until like three months later.”
Client, 27 · Anxiety & Depression · 15 months
Testimonials shared with permission. Identifying details changed.
05STARTING
If this sounds like the right fit, let's talk.
The 15-min consult is where we figure out if we're a good match. No commitment. If I'm not the right person, I'll help you find someone who is.
Free 15-minute consult, no pressure. Private pay $160/session. Insurance accepted; what is covered depends on the exact plan.
You send a note.
Takes a minute. Tell me what’s bringing you in, or just say “hi, I want to talk.” No intake form, no questionnaire.
We do a 15-min call.
No cost, no commitment. We see if it’s a fit. If it’s not, I’ll help you find someone it is.
We book a first session.
Evenings and weekends available. Telehealth from anywhere in New York State.
Or email Angela@nystateofmindtherapy.com