Support for persistent worry, low motivation, and negative thinking
Anxiety can make it difficult to relax, while depression can make it difficult to find the energy or motivation to move forward. When they occur together, you may feel caught between constant worry and a sense that even ordinary responsibilities require too much effort.
Your world may begin to feel smaller. You might withdraw from people, avoid situations that make you anxious, or lose interest in activities that once mattered to you.
Dr. Irwin Rosenfarb provides anxiety and depression therapy in San Diego and online across California for adults who want to understand these patterns and develop more effective ways of responding to them. His approach combines compassion, collaboration, and empirically supported treatment.
When Anxiety or Depression Affects Daily Life
Anxiety and depression can influence much more than mood. They may affect sleep, concentration, motivation, relationships, work, physical health, and your ability to enjoy everyday life.
Depression may lead you to focus on what feels wrong while making positive experiences harder to notice. Anxiety may keep your attention fixed on possible dangers, mistakes, or uncertain outcomes. Together, they can create a cycle in which worry leads to avoidance, avoidance increases isolation, and isolation makes it harder to reconnect with meaningful activities.
Seeking therapy does not mean that you are weak or should have been able to handle everything alone. It offers an opportunity to better understand what you are experiencing and begin making manageable changes.
Symptoms of Anxiety
Anxiety involves more than occasional stress or worry. When it becomes persistent, it can interfere with your ability to rest, make decisions, focus, or feel present in your life.
Common symptoms may include:
- Excessive or difficult-to-control worry
- Restlessness or feeling constantly on edge
- Difficulty relaxing
- Irritability
- Trouble concentrating
- Muscle tension or physical discomfort
- Fatigue
- Difficulty sleeping
- Avoiding situations that create anxiety
- Headaches, nausea, sweating, or digestive problems
Symptoms of Depression
Depression does not look the same for everyone. Some people experience persistent sadness, while others primarily notice exhaustion, irritability, withdrawal, or a loss of interest in activities.
Symptoms may include:
- Sadness, emptiness, or hopelessness
- Loss of interest or pleasure
- Low energy or persistent fatigue
- Difficulty concentrating or making decisions
- Changes in sleep or appetite
- Feelings of guilt, worthlessness, or helplessness
- Irritability or restlessness
- Pulling away from relationships and activities
- Difficulty completing everyday responsibilities
- Thoughts about death or suicide
If you are experiencing thoughts of suicide or believe you may be in immediate danger, call 911 or go to the nearest emergency room. You can also call or text 988 to reach the Suicide & Crisis Lifeline. This practice does not provide emergency or crisis services.
When Anxiety and Depression Occur Together
Anxiety and depression often reinforce one another. Worry and fear may lead you to avoid situations, responsibilities, or relationships. That avoidance can provide temporary relief but may eventually contribute to isolation, lowered confidence, and depressed mood.
These concerns can also affect relationships. Depression may make it difficult to express affection or stay connected. Anxiety can contribute to irritability, reassurance-seeking, or difficulty being fully present with a partner or family member. Therapy can help you understand these interactions and develop healthier ways of responding.
How Therapy Can Help
The goals of treatment depend on your symptoms, circumstances, and priorities. In anxiety therapy in San Diego and online across California, you may work on understanding persistent worry, approaching situations you have avoided, and becoming more comfortable with uncertainty.
In depression therapy in San Diego and online across California, treatment may focus on recognizing negative thinking, increasing daily activity, reconnecting with meaningful experiences, and developing more balanced ways of viewing yourself and your circumstances.
Therapy may help you:
- Recognize thoughts and behaviors that maintain anxiety or depression
- Develop practical coping strategies
- Increase motivation and daily functioning
- Respond differently to worry and avoidance
- Improve emotional awareness and regulation
- Reconnect with relationships and meaningful activities
- Develop healthier responses to stress
Progress does not always happen all at once. Therapy provides a structured place to understand what is keeping you stuck and practice changes that can become more manageable over time.
CBT and ACT for Anxiety and Depression
Dr. Rosenfarb uses well-researched approaches, including Cognitive Behavioral Therapy and Acceptance and Commitment Therapy.
CBT can help you identify patterns of negative or unhelpful thinking, examine how those thoughts affect emotions and behavior, and develop more balanced responses. Treatment may also involve gradually changing behaviors that reinforce anxiety, withdrawal, or depressed mood.
ACT can help you change your relationship with difficult thoughts and emotions. Rather than making the elimination of every uncomfortable feeling the goal, ACT can help you clarify what matters to you and take meaningful action that reflects your values.
An Experienced San Diego Psychologist
Dr. Rosenfarb is a licensed psychologist with more than 40 years of experience. He is also the former Director of the Clinical Psychology PhD program at Alliant University, San Diego, and is currently Professor Emeritus in the Clinical Psychology Ph.D. program at CSPP/Alliant University. He has served as principal investigator on an NIMH research grant and authored more than 100 publications and presentations.
His work is grounded in evidence-based treatment and the belief that meaningful change develops within a compassionate therapeutic relationship. Treatment is collaborative and shaped around your individual concerns rather than a one-size-fits-all process.
Therapy in Scripps Ranch, Sorrento Valley, and online across California
Dr. Rosenfarb provides anxiety and depression therapy at offices in Scripps Ranch and Sorrento Valley serving adults from throughout San Diego. He also offers anxiety and depression therapy online for clients throughout California.
You do not need to have everything figured out before contacting a therapist. You only need to recognize that something is not working as you would like and be willing to explore whether change is possible.
Contact Dr. Rosenfarb to schedule an introductory phone conversation and learn whether anxiety or depression counseling in San Diego or online may be right for you.