Dr. Daniel B. Nicholas
January 27, 2013

There are many types of Anxiety and Depressive Disorders. You can experience either one or both of these disorders at any given time. In fact, 25% of all American adults, experience some form of anxiety, depression or other mental disorder, in any given year (National Institute of Mental Health).

Some of these disorders can be chronic or you could have been worried or sad for a long time. Other anxious and depressive disorders can be a reaction to a variety of stressful situations like work, family, financial, marital, divorce, relationship, death of a loved one, trauma, life transitions, or health conditions. Depressive and anxious reactions to stressful situations can develop quickly and become quite debilitating.


Typical anxiety and depression concerns can involve, but are not limited to, the following areas:

  • Feeling panicky, jittery, restless, worried, etc. These emotional states often occur with repeating distorted thinking in which we imagine worse case scenarios.
  • Obsessive thoughts plus compulsive behavior or avoidance.
  • Specific fears or phobias.
  • Distressing physical sensations and symptoms that have no identifiable physical cause.
  • Uncomfortable physical sensations can cause us to want to engage in safety seeking behaviors like avoiding things, seeking reassurance and/or distraction. These behaviors can contribute to the problems.
  • Sleeping problems. These issues can relate to having difficulty going to sleep and/or staying asleep, as well as oversleeping or not wanting to get up.
  • Loss of interest in things.
  • Feeling sad, down, irritable, angry or guilty. Negative thoughts towards the self, future or others are not uncommon.
  • Feeling hopeless and helpless.
  • Thoughts of suicide or death.
  • Lack of appetite or overeating.
  • Lack of energy and motivation or too much energy.
  • Concentration problems. Difficulty focusing can cause functional and emotional difficulties.
  • Feeling Stressed. Feeling overwhelmed at work and/or dealing with job loss or insecurity. Financial factors, family problems and relationship issues can also take a physical and emotional toll.
  • Sex drive can seem way down or absent. Also, extreme sex drive that you can’t seen to turn off.
  • Social Concerns. These issues can cause extreme anxiety (social anxiety). Withdrawing or avoiding social situations is common in different types of anxiety and depressive conditions.
  • Behavioral issues like alcohol, drug, eating and gambling abuse and addiction often occur in reaction to underlying depression and/or anxiety.Many research studies have validated that specific forms of psychotherapy and certain treatment methods can be effective at reducing or eliminating the signs and symptoms of various types of anxiety and depression.Our clinical staff includes Licensed Clinical Social Workers, Clinical Professional Counselors, and a Clinical Psychologist. They all have been trained in a variety of different, scientifically validated, treatment strategies for anxiety and depression, as well as other clinical conditions.There are several evidence-based types of psychotherapy that are effective specifically for depression— including cognitive-behavioral, interpersonal and psychodynamic, etc. Also, research supported methods are available for treating symptoms that can be present in both disorders like negative self-talk and behavioral avoidance. Indeed, specific cognitive and exposure therapy approaches, can be designed for each type of anxiety disorder. These techniques will help you to manage your distressing internal sensations without having to avoid things and/or seek reassurance from others.


    Plan to experience a thorough Initial Evaluation during your first session. This will involve sharing a good deal of information, and learning more about your condition. You and your therapist will also begin the process of developing a good relationship.

    After a good deal of information is considered, a working diagnosis will be developed. A customized treatment plan will then be formulated. The treatment plan that your therapist recommends will involve techniques from one, or a combination of several types, of evidence-based, psychotherapy treatments.

    The selection of the therapeutic strategies will be based on your specific symptoms, diagnosis, and your characteristics and preferences. The diagnosis and treatment plan will be discussed with you and you will be asked to help develop therapy goals . It is a collaborative process and there will be homework assignments!

    Psychological testing may provide another useful source of information to aid in the development of both an accurate diagnosis and a customized treatment plan. I am the clinical psychologist at PCS, if testing is needed.


    Release the Anxiety and DepressionEvidenced-based psychotherapy techniques help you recover from anxiety and depression. You will learn many skills, some of which are presented below:

  • Identify past and present triggers and situations that make symptoms worse.
  • Expand insight or awareness about how past experiences have affected our behavior, outlook, and relationships.
  • Identify automatic negative thoughts (ANTS – Read More on This Topic) and your specific type(s) of distorted thinking patterns that contribute to anxiety and depressive symptoms. Learn to gradually stop your safety seeking behaviors.
  • Examine other maladaptive ideas and behavior that may contribute to the anxiety and/or the depression.
  • Learn skills that will increase your sense of control, build your distress tolerance, reduce your stress, and improve your ability to enjoy your life. In addition, these skills will help you to make your thinking more objective, be more productive, and to be more effective in your relationships and social interactions.
    You may also learn how to more mindful or conscious of the present moment, to be less reactive to your thoughts, emotions, and physical sensations. In short, you will learn to be more calm, self-confident and to stop avoiding behaviors. More meaning and positivity in life is attainable, after negative states have been reduced and/or removed!


    Many forms of anxiety and depressive conditions can be effectively treated with therapy alone. However, some anxiety and depressive conditions are most effectively treated with a combination of psychotherapy and medication.

    Your therapist will discuss with you if a medication evaluation with your physician and/or psychiatrist is merited based on the type of anxiety or depression that you are experiencing. When a medication evaluation is recommended or you are currently taking medication for your condition, your therapist can periodically consult (with your consent), with your physician or psychiatrist, to coordinate your care. This type of collaborative relationship can help to better manage your care and help you feel better more quickly.

    In an ongoing effort to make coordination of care and joint treatment convenient for our patients, an independent, board certified, psychiatrist is available at our office location, for medication evaluation and monitoring.

    Dr. Nicholas thanks the American Psychological Association for many of the ideas that are outlined in this post.