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Anxiety Treatment Should Begin by Understanding What Anxiety Is Effective anxiety treatment starts with a basic question that is often skipped: what is anxiety actually doing? Many patients come into treatment believing that anxiety itself is the disease and that successful treatment means finding some way to stop feeling it. That makes sense when anxiety has become miserable, intrusive, or disabling, but it misunderstands why the human brain produces anxiety in the first pla

Depression Treatment Should Begin With a Better Question When someone is suffering from depression, the obvious question is, “How do we treat it?” I think there is an important question that needs to come first: Why is this particular person depressed? The diagnosis tells us what they are experiencing, but it does not automatically tell us which treatment they need. Two patients can meet the same diagnostic criteria for major depression while having very different problems un

Learn what therapy does beyond venting and coping skills: understand root causes, change repeating patterns, and improve how you feel and function.

Antidepressants Can Work Even Though the Old Explanation Was Too Simple Do antidepressants work if depression is not caused by a chemical imbalance? Yes. Those two ideas are not contradictory, but for years patients were often given an explanation that made them sound contradictory. Many people were told that depression happened because the brain did not have enough serotonin and that an antidepressant corrected the problem by replacing or restoring that missing chemical. It

Medical Causes of Depression Matter Because the Symptoms Can Look Identical When a patient tells me they are depressed, I take that seriously. But one of the most important things I learned during medical and psychiatric training is that the word depression tells me what the patient is experiencing; it does not automatically tell me why they are experiencing it. Low motivation, fatigue, poor concentration, sleep problems, changes in appetite, brain fog, loss of sexual desire,

Depression Recovery Does Not Have to Wait Until Life Is Fixed One of the cruelest things depression does is convince people that they cannot feel better until all of their problems are solved. If the marriage is struggling, they think they will feel better when the marriage is finally repaired. If they hate their career, relief seems impossible until they have a new job. If they are lonely, they assume happiness has to wait until meaningful relationships appear. When several

Learn how medication management considers your goals, health history, daily routines, response, and side effects to support your best functioning.

The Five Areas of Life Give Us a Better Map Than “Are You Happy?” When someone tells me they are depressed, anxious, overwhelmed, or simply feel like something is missing from life, one of the least useful questions I can ask is, “Are you happy?” That question is too broad. A person may be happy with their children and miserable professionally. They may have a successful career while feeling completely alone in their marriage. They may have wonderful friends but no idea what

Depression Is Not Always About Being Sad When people think about depression, they usually think about sadness. Sadness can certainly be part of depression, but many patients describe something different. They tell me that life feels empty, that they are going through the motions, that they no longer feel connected to the people around them, or that they are working hard without feeling as though anything they do actually matters. Others have stopped accomplishing things altog

Confidence and Anxiety Are More Connected Than Most People Realize Confidence and anxiety are closely connected because anxiety is affected not only by how dangerous something appears, but also by how capable we believe we are of handling it. Two people can look at the same challenge and have very different emotional reactions. One person may think, “This is going to be difficult, but I can probably figure it out.” The other may think, “There is no way I can handle this.” The

How to Overcome Anxiety Starts With Understanding Avoidance Learning how to overcome anxiety often begins with understanding one of the most powerful traps anxiety creates: avoidance makes you feel better right now while often making anxiety stronger later. This is one of the reasons anxiety can become so confusing. The behavior that appears to help in the moment may be the same behavior teaching the brain that more things need to be feared in the future. Imagine that you bec

Depression and Anxiety Are Different, but They Often Travel Together Depression and anxiety are different experiences, but it is extremely common for the same person to struggle with both. Someone may begin by describing constant worry, panic, tension, or fear and then gradually become discouraged, withdrawn, exhausted, and depressed. Another person may begin with depression, low motivation, poor sleep, and reduced functioning, only to find that ordinary responsibilities beco

What Causes Anxiety Is Easier to Understand Than Most People Think What causes anxiety? Most people describe anxiety as fear, worry, racing thoughts, tension, panic, or the feeling that something bad is about to happen. Those descriptions are accurate, but they describe what anxiety feels like more than they explain why it is happening. To understand anxiety, it helps to start with a very simple idea: the brain is constantly watching for things that could potentially harm us

What Causes Depression Is a More Important Question Than It Sounds What causes depression? That question sounds simple, but it may be one of the most important questions we ask in mental health care because depression describes what a person is experiencing more than it tells us why they are experiencing it. Two people can meet the same criteria for depression and have completely different causes underneath the symptoms. One person may be struggling because their thyroid is n

Part 4 of a 4 Part Trauma Therapy Series. Click here for part 1 Why Breaking the Abuse Cycle Requires Compassion and Accountability Breaking the abuse cycle requires holding two truths at the same time. First, people who were harmed deserve compassion for what happened to them. Abuse, neglect, fear, shame, emotional volatility, intimidation, abandonment, or chronic unpredictability can teach a person distorted lessons about relationships, safety, power, vulnerability, and sel

Part 3 of a 4 Part Trauma Therapy Series. Click here for part 1 Is Neglect Abuse? Why This Question Matters Is neglect abuse? The answer is simple in some situations and more nuanced in others. When a child or dependent person is not given essential care, safety, food, shelter, medical attention, supervision, emotional responsiveness, or other basic needs, neglect is a recognized form of harm. In those situations, the problem is not only what someone actively does, but what s

Part 2 of a 4 Part Trauma Therapy Series. Click here for Part 1 Why the Abuse Cycle Is Not Just About the Incident The abuse cycle is often discussed as though the abusive incident is the only part that matters, but the harmful abuse episode is usually not where the pattern begins. Long before someone explodes, attacks, intimidates, humiliates, withdraws, neglects, or causes harm, tension has usually been building. Something uncomfortable has entered the relationship. A hard

Porn Recovery Should Not Mean Fear of Sexuality Porn recovery is often misunderstood because many people assume the safest path is to shut down sexual desire completely. When someone has struggled with unwanted pornography use, secrecy, compulsive patterns, or values-discordant sexual behavior, it can feel frightening to allow any sexual desire back into life. The person may begin to treat desire itself as dangerous, as though every sexual thought or feeling is a warning sign

Why Postpartum Depression Treatment Has to Look at the Whole Person Postpartum depression treatment is often misunderstood because people look for one simple explanation when the postpartum period is rarely simple. A mother may be told that her symptoms are just hormones, just lack of sleep, just stress, just breastfeeding, just anxiety, just the transition into motherhood, or just the normal difficulty of caring for a newborn. Each of those explanations may contain part of t

Part 1 of a 4 Part Trauma Therapy Series. Click here for Part 2 Why Trauma Therapy Has to Distinguish Discomfort From Abuse Trauma therapy often has to begin by helping people separate ordinary discomfort from actual harm. In many families and relationships, people become confused because they have been incorrectly taught that any discomfort, disagreement, criticism, or accountability means someone has wronged them. That belief can make healthy relationships impossible, becau