You came looking for help with depression. Or maybe anxiety. But the more you think about it, the less those categories make sense. You’re exhausted and wired. Hopeless about the future and worried about everything in it. Some days you can’t get off the couch; others you can’t stop your mind from racing.

If this sounds familiar, you’re not alone. Between 60-90% of people with depression also experience significant anxiety symptoms. The conditions feed each other—anxiety depletes your energy, depression makes everything feel pointless, and the combination makes it hard to imagine things getting better.

At Therapy Group of DC, we specialize in treating depression and anxiety together. We understand that what you’re experiencing isn’t two separate problems—it’s one interconnected pattern that requires an integrated approach. Our therapists help you address both the low mood and the constant worry, so you can stop managing symptoms and start reclaiming your mental health.

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Is Depression and Anxiety Therapy Right for You?

You might benefit from therapy for depression and anxiety if you:

• Feel exhausted but can’t turn off your mind
• Experience persistent worry alongside feelings of hopelessness or emptiness
• Notice your mood affecting your work, relationships, or daily life
• Have trouble concentrating, sleeping, or making decisions
• Feel like you’re functioning but not actually living
• Wonder whether what you’re experiencing is “bad enough” to need help
• Have tried addressing one condition only to have the other get worse

What to know:

• Anxiety disorders co-occur with major depressive disorder more often than not—you’re not unusual, and you’re not imagining the connection
• Mental health treatment that addresses both conditions simultaneously is more effective than treating them separately
• Many people experiencing anxious depression have tried therapy or antidepressant medications that only targeted one piece—integrated treatment works differently
• With the right treatment approach, both anxiety and depression symptoms can improve significantly

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Understanding Depression and Anxiety Together

Depression and anxiety are the two most common mental health conditions—and they rarely travel alone. Among anxiety disorders, generalized anxiety disorder appears alongside depression most frequently, but panic disorder, social anxiety disorder, and other anxiety disorders also commonly co-occur with depressive disorders. When these conditions overlap, they create challenges that neither causes on its own.

Why They Happen Together

The relationship between anxiety and depression isn’t coincidental. They share biological pathways, respond to similar life circumstances, and can trigger each other in a feedback loop. Chronic worry depletes your emotional resources until hopelessness sets in. Depression’s fatigue makes it harder to cope with stress, amplifying anxious responses.

This overlap is so common that mental health professionals increasingly recognize anxious depression as a distinct pattern—not simply depression plus anxiety, but a specific presentation with its own trajectory and treatment needs. Talk therapy remains the foundation of effective treatment for most people with both anxiety disorders and depressive disorders.

What Anxious Depression Looks Like

The exhausted worrier. You lie awake at night cycling through everything that could go wrong, then wake up too depleted to face any of it. The anxiety drives the overthinking; the depression strips away your confidence that you can handle what you’re worried about.

The high-functioning struggler. You’re still showing up—still performing at work, still maintaining relationships—but internally you’re drowning in emotional distress. Others might not know anything is wrong. You might not even fully recognize it yourself, because you’ve gotten so good at pushing through both the low mood and the constant stress.

The stuck-in-your-head pattern. You can’t stop thinking, but the thinking goes nowhere. Rumination about past failures blends with worry about future catastrophes. Decision-making feels impossible because depression says nothing matters and anxiety says everything could go wrong.

People with anxious depression often tell us they feel “tired but wired”—exhausted to their core but unable to rest. This isn’t a contradiction. It’s the hallmark of a nervous system stuck between shutdown and overdrive.

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Depression Symptoms vs. Anxiety Symptoms: How They Overlap

Understanding how depression and anxiety symptoms interact helps explain why treating them together matters.

Core Depression Symptoms

Major depressive disorder—sometimes called major depression—involves persistent changes in mood, energy, and functioning. Depression symptoms include:

• Persistent sadness, emptiness, or hopelessness
• Loss of interest in activities you once enjoyed
• Fatigue and low energy, even with adequate sleep
• Difficulty concentrating or making decisions
• Changes in appetite and sleep patterns
• Feelings of worthlessness or excessive guilt
• In severe depression, suicidal thoughts or thoughts of death

Core Anxiety Symptoms

Anxiety disorders involve excessive worry and physiological arousal. Symptoms of anxiety include:

• Persistent worry that feels difficult to control
• Restlessness or feeling on edge
• Muscle tension, headaches, or physical discomfort
• Difficulty concentrating due to racing thoughts
• Sleep disturbances, particularly trouble falling asleep
• Irritability and emotional reactivity
• Avoidance of situations that trigger intense anxiety

Where They Converge

Notice the overlap: concentration problems, sleep disturbances, fatigue, and difficulty functioning appear in both conditions. When you’re experiencing both anxiety and depression, these shared symptoms intensify. The cognitive symptoms—negative thoughts, difficulty concentrating, rumination—become particularly pronounced.

Generalized anxiety disorder, social anxiety, and other anxiety disorders commonly co-occur with depressive disorders. The persistent negative thoughts characteristic of depression combine with the worried predictions of anxiety disorders to create a relentless internal critic. When both mental health conditions are present, the specific combination shapes which treatment approaches work best.

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Why DC Professionals Are Particularly Affected

Washington DC’s professional culture creates conditions ripe for anxious depression. High-stakes work, constant evaluation, and pressure to always perform takes a predictable toll on mental health.

Achievement-driven environments reward pushing through symptoms rather than addressing them. You’ve built a career on being capable—admitting you’re struggling feels like failure.

Competitive work culture normalizes chronic stress. When everyone seems equally overwhelmed, it’s easy to dismiss your experience as part of the job.

Transient population means many people lack support networks that buffer stress. You may have moved here for work and never built the friendships that help people weather difficult periods.

We see this pattern constantly: successful professionals managing anxiety and depression symptoms for years, assuming this is what ambition costs. It doesn’t have to be.

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How We Treat Depression and Anxiety

Effective mental health treatment for depression and anxiety addresses both conditions as an integrated whole—not by treating depression first and hoping anxiety resolves, or vice versa.

Psychodynamic Therapy

Psychodynamic therapy explores the underlying emotional patterns, often rooted in past experiences, that shape how you relate to yourself and others. For people who experience depression and anxiety for years, or who notice recurring patterns despite trying various treatments, psychodynamic work helps uncover the deeper roots of these experiences.

This approach is particularly valuable when anxious depression connects to early experiences, attachment patterns, or long-held beliefs about yourself and your worth. Rather than just managing symptoms, psychodynamic therapy helps you understand why you developed these patterns—and that understanding creates lasting change. Many clients find this depth-oriented approach helps improve mood in ways that feel more fundamental than symptom management alone.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy—also spelled cognitive behavioural therapy—is one of the most well-researched treatments for both anxiety and depression. CBT helps identify and change the negative thought patterns and behavior patterns that maintain both conditions. You learn to recognize catastrophic thinking, challenge distorted beliefs, and develop new responses to difficult situations.

For anxious depression specifically, CBT addresses the cognitive overlap—the rumination, the negative self-talk, the tendency to interpret ambiguous situations as threatening or hopeless. Through this structured form of talk therapy, you develop practical coping strategies and coping skills that work for both the worried mind and the depleted mood.

Interpersonal Therapy (IPT)

Interpersonal therapy focuses on improving relationships and communication patterns that contribute to depression and anxiety. IPT recognizes that mental health conditions don’t exist in isolation—they affect and are affected by your connections with others.

For people whose anxious depression involves relational difficulties—conflict with family members, isolation, grief, or life transitions—this approach addresses the interpersonal roots directly.

Mindfulness-Based Approaches

Mindfulness-based cognitive therapy (MBCT) and other mindfulness practices help you develop a different relationship with difficult thoughts and emotions. Rather than getting caught in rumination or fighting against anxiety, you learn to observe thoughts without being controlled by them.

Research shows mindfulness-based approaches reduce both depression symptoms and anxiety symptoms while building resilience against relapse.

Additional Approaches

Our therapists also draw on:

• Acceptance and Commitment Therapy (ACT) — Builds psychological flexibility and helps you take action aligned with your values, even when difficult emotions are present
• Dialectical Behavior Therapy (DBT) skills — Particularly useful for emotional regulation, distress tolerance, and interpersonal effectiveness when both anxiety and depression affect your functioning
• Problem-solving therapy — A structured approach to addressing specific issues that contribute to anxiety and depression; problem-solving therapy helps you develop concrete strategies for real-life challenges
• EMDR — When trauma underlies or intensifies anxiety and depression, EMDR therapy can help process those experiences

We match the treatment approach to what you’re actually dealing with—not a generic protocol, but therapy tailored to your specific pattern of symptoms, history, and goals.

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What to Expect in Treatment

Assessment and Treatment Planning

The treatment process begins with understanding your specific experience. We assess depression symptoms, anxiety symptoms, how long they’ve been present, what you’ve tried before, and how they’re affecting your life. This helps us develop an approach that addresses your actual needs.

We’re attentive to other factors—whether there’s underlying trauma, whether substance abuse is playing a role, whether other mental disorders need attention. An accurate diagnosis shapes everything that follows, and finding the right treatment starts with understanding what you’re actually dealing with.

The Process

Early sessions focus on stabilization and skill-building. You’ll learn coping strategies for managing both anxiety and depression symptoms in daily life. We help you understand what you’re experiencing and why—many clients arrive convinced they’re uniquely broken, when what they’re dealing with is common and treatable.

Middle-phase work goes deeper. Depending on the approach, this might involve challenging negative thoughts, processing difficult experiences, changing behavior patterns, or exploring how your history shapes your present. This is where lasting change happens.

Later sessions consolidate gains and prepare you for maintaining progress independently. You’ll know what warning signs to watch for and what coping skills work for you.

Timeline

Most people see meaningful improvement within 2-4 months of regular therapy. More severe or longstanding presentations may take longer. We’re focused on helping you build the skills to manage your mental health on your own.

We know seeking help is hard, especially when depression tells you nothing will work and anxiety tells you everything is dangerous. You don’t need to arrive with confidence that therapy will help. You just need to show up.

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Our Depression and Anxiety Therapists in Washington DC

Our therapists bring specialized expertise in treating depression and anxiety together. They understand DC’s professional culture and work with clients navigating high-pressure careers alongside mental health challenges.

Dominique Harrington, MA.Ed., LPC, NCC

Dominique uses relational and narrative therapy approaches to help clients explore the experiences that shape their depression and anxiety. View Dominique’s full profile →

Dr. Tyler Miles, Psy.D.

Dr. Miles specializes in anxiety, depression, and stress using ACT, client-centered therapy, and cognitive behavioral therapy. View Dr. Miles’s full profile →

Dr. Dana Treistman, Ph.D.

Dr. Treistman uses Cognitive Behavioral Therapy and mindfulness practices to help adults manage depression and anxiety. View Dr. Treistman’s full profile →

 

Dr. Kevin Isserman, Psy.D.

Dr. Isserman draws on client-centered and psychodynamic approaches—particularly valuable when depression and anxiety involve harsh self-criticism. View Dr. Isserman’s full profile →

Dr. Paul Rizzo, Psy.D.

Dr. Rizzo uses client-centered, existential, and humanistic approaches to help clients navigate anxiety, depression, and life transitions. View Dr. Rizzo’s full profile →

Dr. Michael Burrows, Ph.D.

Dr. Burrows draws on psychoanalytic, psychodynamic, and relational approaches for clients with longstanding depression and anxiety. View Dr. Burrows’s full profile →

Xihlovo Mabunda, MS, LPC

Xihlovo integrates EMDR and psychodynamic therapy. When trauma underlies anxiety and depression, her training helps address root causes. View Xihlovo’s full profile →

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Begin Depression and Anxiety Therapy in Washington DC

You’ve been managing this alone for long enough—the low mood, the constant worry, the exhaustion of fighting yourself on two fronts.

Treatment at Therapy Group of DC offers a path forward. Our therapists understand anxious depression and provide evidence-based treatment that addresses both conditions as the interconnected pattern they actually are.

You don’t have to choose between addressing depression or anxiety. You don’t have to keep pushing through and hoping things improve on their own. Effective treatment exists, and our integrated treatment approach works.

Schedule an Appointment →

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Frequently Asked Questions

What is the best therapy for anxiety and depression?

The best therapy depends on your specific situation. Cognitive behavioral therapy has the strongest research base for both anxiety and depression and is often a first-line treatment. IPT is particularly effective for depression with relational components. For people with anxious depression, integrated approaches that address both conditions simultaneously tend to work better than treating them separately. Our therapists will help determine which approach—or combination—fits your needs.

Do anxiety and depression go together?

Yes. Depression and anxiety co-occur more often than they appear alone. Studies show 60-90% of people with depression also experience significant anxiety symptoms. The conditions share biological pathways, respond to similar stressors, and can trigger each other. When someone has both, mental health professionals often describe this as anxious depression—a distinct pattern requiring integrated treatment.

How to help with anxiety and depression?

Effective mental health care typically includes therapy with a mental health provider trained in evidence-based approaches like cognitive behavioral therapy, psychodynamic therapy, or interpersonal therapy. Self-care practices—regular exercise, adequate sleep, social connection—support treatment but usually aren’t sufficient alone. For some people, antidepressant medications prescribed by a medical doctor or psychiatrist complement therapy. The key is addressing both conditions together rather than hoping that treating one will resolve the other.

What kind of therapist helps with depression and anxiety?

Psychologists, licensed professional counselors, and clinical social workers can all provide effective mental health care for depression and anxiety. More important than credential type is whether the mental health provider has specific training and experience with your presentation. Look for a therapist who works regularly with both depression and anxiety, uses evidence-based approaches like CBT or interpersonal therapy, and takes an integrated approach rather than treating them as separate issues.

Can depression and anxiety be treated at the same time?

Yes—and treating them together is usually more effective than addressing them separately. Because depression and anxiety share mechanisms and influence each other, treatment that targets their common elements often improves both simultaneously. CBT, for example, addresses the negative thought patterns that maintain both conditions. An experienced mental health professional will develop a treatment plan that accounts for how your specific depression symptoms and anxiety symptoms interact.

How long does treatment take?

Most people notice meaningful improvement within 2-4 months of weekly treatment. More severe depression, long-standing anxiety disorders, or complex presentations may take longer. We’re focused on helping you develop lasting change, not keeping you in treatment indefinitely.

What about exposure therapy for anxiety?

Exposure therapy is an evidence-based treatment for anxiety disorders that involves gradually facing feared situations. Research supports exposure therapy for specific phobias, panic disorder, and social anxiety—exposure therapy works by helping people learn that feared situations are more tolerable than anticipated.

However, our practice emphasizes psychodynamic and relational approaches that address the underlying roots of anxiety rather than focusing primarily on behavioral exposure therapy techniques. We find that for many clients—especially those with anxious depression—understanding why anxiety developed matters as much as learning to face fears. Exposure therapy has its place, but it’s not our primary modality. If you’re specifically seeking structured exposure therapy, we can discuss whether our approach fits or help you find a specialist.