Karen Sussan, LCSW, LMHC logo Karen Sussan LCSW, LMHC
Karen Sussan's therapy office in Suffern, New York

Anxiety and Depression

I work with adults in Suffern, NY and via telehealth throughout New York State and Florida, drawing on approaches including EMDR, DBR, CBT, talk therapy, and relational work to address anxiety and depression and the issues that may be contributing to them.

Anxiety and depression are common. So is the stress that major life transitions and changes can bring. Not every hard season is a disorder. But when certain emotional states persist and begin affecting how you function or how you feel about yourself, it is worth paying attention.

Anxiety and depression rarely look the same from one person to the next. One person may constantly brace for something to go wrong. Another may have been going through the motions for so long that they no longer remember what it feels like to care about what they are doing.


Recognizing It

What Anxiety Feels Like Beyond Panic Attacks

Many people associate anxiety with panic attacks, but anxiety can be quieter and more constant. It may show up as:

Worry that will not switch off
Trouble sleeping, or waking with your mind already racing
Ruminating or replaying conversations, past events, or possible future situations
Feeling vulnerable or unsafe when nothing obvious is wrong

Anxiety may be connected to current stress, other conditions, earlier experiences, or some combination.

Recognizing It

What Depression Feels Like Beyond Sadness

Sadness can be part of depression. For many people, though, it is not the most noticeable part. Depression may include:

Low energy that sleep does not fix
Loss of interest in things you used to enjoy
Difficulty getting started or making small decisions
Feeling hopeless or stuck
Harsh self-criticism
Withdrawing from people
Feeling numb or empty
People who are depressed often describe this as not feeling like themselves. That description can be more accurate than any list.
How They Interact

When Anxiety and Depression Happen Together

Anxiety and depression frequently occur together, which can be confusing to experience. You can be restless and exhausted at once, or worried about everything yet feel hopeless about changing any of it.

Anxiety can wear a person down while depression can make anxiety harder to manage. Over time, the two may reinforce each other, and the cycle can become a problem in its own right, separate from whatever started it.

Karen's Approach

Looking at What Is Underneath

Symptom relief matters and can be an excellent starting point for treatment. Sometimes it takes a while to understand the whole picture: both the more obvious symptoms and the issues that may be contributing to them. Those may include:

Current stress
Coping strategies
Grief
Childhood experiences and attachment wounds
Relationship difficulties
Unresolved trauma
Chronic pain
Long-standing negative beliefs about yourself
Nervous system responses that continue after stress has reduced
Why Insight Alone May Not Shift It

Understanding It May Not Be Enough

Many people come to therapy with an idea of why they feel the way they do. They can name stressors and trace related history and patterns. Despite that understanding, they may still find that their body stays on alert and their feelings do not shift.

You may struggle to feel emotionally safe even when you know you are safe. You can understand that a harsh belief about yourself is inaccurate while still experiencing it as true.

Insight is useful, but for some people it is not sufficient on its own. That can be the point when considering a different approach becomes relevant.

How I Work

Treatment Approaches for Anxiety and Depression

We begin by understanding what you are experiencing and what may be contributing to it. Depending on what is going on for you, treatment may include:

Talk therapy and relational work
Cognitive Behavioral Therapy (CBT), for interrupting anxious thought patterns and behavioral cycles
Experiential and present-moment work, mindfulness, and grounding
Attachment-informed therapy, when early relationship patterns are part of the picture
EMDR, when unresolved trauma or distressing experiences are contributing
Deep Brain Reorienting (DBR), when earlier experiences may be connected to deeper nervous system responses

Not everyone needs all of this. The approach should fit what is going on with and for you.

A Possible Connection

When It Is Connected to Trauma

Anxiety and depression often arise without any trauma history. For some people, however, they may be tangled up with unresolved experiences, chronic conditions, or early attachment wounds. Signs that may point in that direction include reactions that seem out of proportion to what is happening now, emotional shutdown under stress, persistent shame with no clear source, and behavior or relationship patterns that do not change no matter how well you understand them.

If this describes your experience, my pages on trauma therapy and childhood trauma and attachment wounds may be worth reading.

What to Expect

What Change Can Look Like

Change often looks less dramatic than “getting your life back,” and it can be much more useful:

Feeling less controlled by anxiety, even when it is present
Recognizing what sets off a reaction before it takes over
More flexibility in how you respond rather than one automatic setting
Energy and interest returning, often gradually
Having a choice where there did not seem to be one
This tends to accumulate rather than suddenly appear. People often notice it first in retrospect.
Is This a Fit?

Is This Work Right for You?

This work tends to fit adults who want to understand troubling experiences and the factors that may be contributing to them, while also working toward more effective ways of coping with daily life and more lasting relief from symptoms.

If you are currently in an acute mental health crisis, need intensive addiction or crisis stabilization services, or are court-ordered to attend therapy, a different setting will serve you better right now.

If you are in immediate danger or thinking about harming yourself, please call or text 988 to reach the Suicide and Crisis Lifeline, or go to your nearest emergency room.

Getting Started

Ready to talk?

You do not need to figure out on your own whether what you are experiencing is anxiety, depression, trauma, or something else. Sorting that out with a mental health professional is part of what the first conversations in therapy are for.

I offer a free phone consultation. You can reach me at 845-202-9774 or through the contact page.

I am a therapist in Suffern, NY offering in-person and telehealth therapy for anxiety and depression to clients across New York State and Florida.

Curious if this feels like the right fit?

I invite you to start with a consultation. There is no pressure, just a conversation to see whether working together makes sense.