What is anxiety? Albert Ellis, founder of Rational-Emotive Behavior Therapy, suggested that anxiety was a "crisis of the imagination." We can worry ourselves sick thinking about the potentially negative, or unpleasant, outcomes of a situation that hasn't happened yet. Anxiety is the uncontrolled rush of irrational thoughts that prevent us from thinking through situations. As a result we end up in a state of hyper-vigilance (fight or flight); very helpful in instances when our survival is threatened, not so much when we are standing in line at Trader Joe's.

Anxiety attacks, or panic attacks, can be triggered by any number of things (e.g., a licensing exam, a presentation, a dog, high places, etc.) and are scary because of the fact that we aren't usually aware of the irrational thoughts that precipitate them. The feeling suggests to us that we are in danger and can be very confusing if we cannot immediately identify any real threat. The body has the same response to a threat regardless of whether or not it was real or imagined. Untreated anxiety can evolve into a full blown phobia or other anxiety related disorder.

Therefore, therapy should focus on making us aware of our irrational thinking, providing us with evidence to challenge, or counter, our irrationality, and teach us skills to effectively reduce our anxiety and prevent it from becoming crippling.


Symptoms of depression often include fatigue, loss of energy, low motivation, weight loss or weight gain, insomnia or hypersomnia, excessive and inappropriate guilt, and feelings of worthlessness, hopelessness and helplessness. These symptoms are intensified if we have preexisting low-self esteem.

If this is the case, the behavior of others is often interpreted as confirmation of these negative feelings we have about ourselves. For example, if I've had a childhood in which I was neglected emotionally and psychologically, I will probably believe that I am no good, unworthy and undeserving. As a result when a benign event occurs, like an unanswered text, I will begin to have thoughts like: "I did something to upset the person," "they must not like me anymore," or "I'm a loser, no wonder they didn't respond." In a depressed state these thoughts become problematic as we begin to predict the inescapable continuance of a bad mood. Thoughts evolve to: "I'll never feel better," "my life will always suck," or worse, "I'd be better off dead."

Treatment of depression may consist of medication to lift the mood and traditional talk therapy to identify irrational core beliefs about oneself. The goal being to dispute this faulty thinking and replace it with thinking that moves us toward a more enjoyable and fulfilling life. In therapy we work to replace irrational interpretations of an unanswered text like, "they must not like me anymore," with rational ones like, "they might be busy and will respond when they're free."