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Anxiety and Depression

Anxiety and Depression Management | Cohesive Therapy NYC | Find a Therapist

When anxiety and depression take over your mind and body, they not only change how you view yourself and the world around you, they also have a deep impact on your overall quality of life. Whether it’s due to what you experienced during childhood, a difficult life transition, or health issues, dealing with anxiety or depression can create a vicious cycle of frustration, insecurity, and an ongoing compulsion to keep trying to control your environment.

Anxiety and depression can become nothing short of exhausting. We’re here to help you break the cycle and take back control of your life.

Some of our focus areas include:

  • Social Anxiety
  • IBS and GI-Related Anxiety
  • Panic Attacks
  • Insomnia
  • Cultural and Social Norm Roles
  • Stress Management
  • SAD (Seasonal Affective Disorder)

For some people, anxiety comes in the form of discomfort or awkwardness in social, intimate, workplace, or family situations. Individuals with social anxiety may feel the urge to hurry out of parties early or simply freeze up during conversations. Social anxiety manifests differently for everyone.

Many people worry excessively about pleasing their peers or about what others think, causing distressful emotions that are hard to escape. These social concerns can even lead to a self-fulfilling prophecy by which a person with ordinary social skills begins to see their social abilities deteriorate.

The first and foremost thing to understand about unhealthy anxiety is that it LOVES to make you avoid things and seeps into other parts of your life. For example:

If you have anxiety about social situations, it eventually gets you to “rationalize” that going out is a really bad idea, which can easily turn into isolating yourself from friends and family.

If you have a chronic illness that changes the way in which you see yourself, you may begin to avoid reaching out to the people who might be able to provide you with the support that you need because you worry that others will see you as weak.

Over time, this pattern of avoiding and worrying creates the Cycle of Avoidance, illustrated here:

The Cycle of Avoidance | Anxiety Management | Cohesive Therapy NYC

As time goes on, the cycle becomes more and more ingrained in your mind and habits and eventually, it becomes a “go-to” way of coping with distressful situations.  Now, you might be asking yourself, why is it so much easier to use avoidance in order to cope with anxiety- triggering circumstances? The reason is because the act of avoidance or avoiding provides a momentary (and very temporary) relief that is brought on by avoiding the fearful situation (Phew, I avoided it, I’m safe now!).

Let’s be clear – keeping your distance is not the only strategy that we use to cope with anxiety. Avoidance wears many hats and understandably, people tend to use the hat that provides the quickest relief.  For example, many people avoid by pretending that something is not happening (denial) and may then find themselves focusing on trying to control things that are actually beyond their control. Others may find themselves using alcohol or drugs in order to escape from anxious feelings.

Psychotherapy, and in particular, Cognitive Behavioral Therapy (CBT) for social anxiety, can help you reframe social situations and learn some of the social skills you may have lost or missed out on. Relationships are crucial to well-being and happiness, and your social life deserves to bloom.


For those struggling with anxiety-related digestive disorders, your levels of frustrations can be compounded by the well-meaning but unhelpful advice to “just relax!” We get your concerns – it’s not as simple as just relaxing.

Chronic health issues such as IBS, IBD, Crohn’s disease, ulcerative colitis, and other digestive issues can take a toll on multiple areas of your life. You may find yourself battling financial troubles, canceling social engagements, or avoiding certain situations entirely. On top of your frequent discomfort and worry for your future health, you may feel guilty about impacting the lives of those around you.

You may find yourself in an ongoing battle with your anxiety, never quite knowing what tools you have – if any – to come out on the winning side of it. No matter how hard you try to stay calm or tell yourself “it’s going to be okay,” your mind and body disagree, making it almost impossible for you to manage those anxious feelings. If any of this sounds all too familiar, you are not alone.

The mind and body are deeply connected. Anxiety can often lead to health issues such as IBS, and the impact of health challenges often results in further anxiety, creating a cycle that’s difficult to break. Your well-being is important, and we want to help you:

  • Understand your cycle of avoidance and disrupt the pattern
  • Gain new insight and perspective
  • Change unhelpful ways of thinking
  • Accept life’s uncontrollable stressors
  • Regain a sense of control and confidence
  • Use personally-tailored coping strategies that actually work

Together, we will work to break the cycle so you can move on with your life in a healthy, productive, and meaningful way. It’s important for you to find a therapist who understands your situation and cares deeply about your struggles, and we want you to know that we’re here.


Perhaps you’ve experienced recent bouts of shortness of breath, shakiness, or brain fog that you cannot explain. You might have been in the middle of an activity you enjoy when all of a sudden, a sense of fear or dread washes over you. When these physical symptoms or frightening feelings happen often or during inopportune times, they can impact your quality of life.

Panic attacks may get in the way of your ability to leave your home, feel comfortable on a date, perform on stage or even to get your job done. In some cases, panic attacks may even affect your ability to sleep restfully. You may have been unable to discover the cause of your panic attacks, and it may have been easier for you to simply avoid triggers – if you have been able to find the source of your anxiety at all.

Through therapy, you’ll learn how to understand your triggers and confront your fears with confidence. Together, we’ll work to identify the specifics of what is causing you the greatest distress and then move towards achieving your goals. We’ll also discuss any major life stressors you may have recently experienced, such as the birth of a new child, a move, or the death of a loved one. Due to the sensitivity of the subjects that may come up, we know how important it is for you to find a therapist who you can confidently place your trust in. Your comfort and peace of mind are invaluable, and we’re committed to helping you achieve your goals. You deserve to have a better quality of life, and we want to be there to see you through it.


With anxiety, you might experience constant “what ifs” and self-doubt that become a source of sleep deprivation. As these thoughts, worries, and fears keep you awake at night, your concentration and focus are also affected, impacting your work and how you spend time with loved ones. Your body’s ability to re-energize and regenerate decreases, impacting your health.

In some cases, you may not worry while you lie in bed at all. You may feel “wound up” for no obvious reason, unable to get the sleep you need to effectively function.

Together, we’ll investigate possible causes for your insomnia and discuss lifestyle changes that may help with your inability to sleep. When you experience insomnia, other areas of your life may need attention, as well, and we would love to help you address them. During our time together, you will also learn how to tell if you are focusing on helpful worries vs. unhelpful worries so that you can shift your focus if necessary. You’ll also learn how to “re- train your brain” so you are able to deal with negative thoughts or situations by learning how to look at situations with a different, less intimidating, and less fearful perspective. Little by little, you’ll begin to build a coping “toolbox” that you’ll continue to add to and choose from.

We’ll also:

  • Educate you on normal sleep patterns and the factors that affect sleep
  • Guide you through skills to manage stress and calm the mind
  • Teach you how to diminish negative thoughts and feelings that result in loss of sleep
  • Review how to cope with the effects of insomnia and maintain daytime functioning
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Perhaps you or a loved one hold beliefs about certain cultures, races, or genders that have gotten in the way of your well-being. Or maybe you have been on the receiving end of discrimination or harassment, or have been affected by social stereotypes. As a result of your experience, you may have had an argument, faced the judgment of your peers, or even lost your job, causing you to call your understanding of cultural and social norms into question.

You may even find yourself asking if you really do need to conform to others’ expectations of you, leading to deep insecurity that causes your stress and anxiety to swell.

The feelings of loneliness associated with navigating cultural and social norms can be daunting, and you may feel defeated as a result. When you find a therapist that is culturally sensitive, culturally aware and culturally curious, who also thoroughly listens to your concerns and helps you consider your situation from multiple angles, you will be in a better position to manage the emotional challenges that come with social norms. We are here for you – you don’t have to go through it alone.


We often use the word “stress” to describe how we are feeling when under pressure. Many times, it is used interchangeably with “anxiety”, a word that describes the result of a worry.  But, what is stress vs. anxiety, and how do they affect each other?

Stress is your body’s way of responding to any kind of demand or threat. When you sense danger—whether it’s real or imagined.  the body’s defenses kick into high gear in a rapid, automatic process known as the “fight-or-flight” reaction or the “stress response.” The stress response is the body’s way of protecting you, but without good coping strategies, the body may not be “helping” in the most beneficial of ways.

People are not always aware of their body’s stress response, and if they are used to being “stressed” most of the time, they may become unable to identify when their bodies have kicked their responses into high gear. In fact, it is not uncommon for people who suffer from GI symptoms such as IBS to say “I don’t feel stressed”, even though their body’s symptoms are pretty obvious.

Anxiety is a “motivational response” to stress, and a little anxiety can actually be helpful. Some people approach our practice with the statement “I want to get rid of my anxiety!” and our response to that, “well… let’s re-think that and see how you can perhaps dial it down instead.”

So, how can anxiety be helpful? For example, you might have a work deadline coming up, or perhaps you’re planning a surprise party for someone important to you. If you’re a student, you might feel anxious about getting a poor grade in school, and so your anxiety spurs you to study more and work harder or find an alternative way of studying.

In these cases, anxiety can be helpful in motivating you to be proactive or creative so that you can achieve your goals. Anxiety would have a direct impact on what you want that party to look like or to ensure that you are meeting deadlines at work or securing good grades on your exams.

Unfortunately, many people struggle with what is commonly referred to as unhelpful anxiety or unhelpful worries.  As the word “unhelpful” implies, this type of anxiety or worry causes your mind and body to react in ways that cause distress and often leave you feeling overall miserable.

With the right combination of skills and tools, it is possible for you to conquer your stress-related anxiety and come out on that winning side of it. There is no reason for you or a loved one to continue to struggle with anxiety. We’ll guide you through approaches that will help you to cope with stress, including lifestyle changes, relaxation techniques, and reframing through Cognitive Behavioral Therapy (CBT). You deserve to take a breath and enjoy your life without stress absorbing your thoughts. Let’s be in touch to see if therapy is the right next step for you.


When you feel sad during the darker days of fall and winter, you might tell yourself that it’s because you miss the warm summer breeze and balmy outdoor activities.

Or, you might even feel down as winter turns to spring and summer, unable to feel the joy that some others do when the warmer, sunnier seasons arrive.

However, if you also notice that you don’t get enjoyment out of life (anhedonia), sleep far too much or too little, or have trouble maintaining your relationships, career, or home, it could be seasonal affective disorder, also known as seasonal depression. Seasonal affective disorder (aptly abbreviated “SAD”) is a temporary depression, but it can leave a huge impact on your life and even lead to feelings of anxiety.

SAD is a commonly triggered during the fall and winter months, when our days become shorter. Some people are able to feel better through the use of antidepressant medications, but for others for whom medication is either not an option or a choice, therapy can be a very helpful way to combat this type of depression.

During our sessions together, you will come to understand what seasonal affective disorder truly is and what steps you can take to cope with the depression and then conquer it. We’ll discuss possible underlying causes for your anxiety and depression, as well. First acknowledging that you may be struggling with seasonal depression is a huge step, and you have already taken an important step towards wellness!


In order to eliminate some of the travel issues that are sometimes involved with living in New York, we offer therapy for anxiety and depression through a completely confidential online platform called Telehealth (like Skype, but secure!), as well as in-person office visits for those who prefer to work in person.

Ready to chat? Contact us today to learn more about how therapy for anxiety and depression can help make things better, and to find a therapist who understands the unique challenges that you face.

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