What this guide covers
Depression and anxiety are common. The National Institute of Mental Health (NIMH) estimates that 21.0 million U.S. adults, 8.3% of the adult population, had at least one major depressive episode in 2021, and that about a third of U.S. adolescents and adults experience an anxiety disorder at some point in their lives. Behind those numbers are people who are still going to work, raising children and looking after others while feeling flat, exhausted or constantly on edge.
This guide is written for adults who are wondering whether what they feel is depression, anxiety, both or neither, and for people who care about them. It does not diagnose anyone. It aims to give clear, sourced information so you can think about what is happening and decide what to do next.
It is a general guide for the Charlotte area. If you live in Polk County or the foothills, the anxiety and privacy in a small town guide covers anxiety with a local focus.
Recognizing it
The first group of articles is about noticing what is going on. Signs of depression walks through the symptoms NIMH lists, from loss of interest and fatigue to sleep changes and guilt, and explains why a questionnaire such as the PHQ-9 is a screening tool rather than a diagnosis. Signs of anxiety covers the thoughts, physical sensations and avoidance that anxiety brings.
Some people keep everything running while feeling empty inside. High-functioning depression explains what that informal phrase means, why it is not a diagnosis, and how it relates to persistent depressive disorder. And because the two so often overlap, when depression and anxiety come together looks at the research on why they travel together and what that means for getting help.
Living with it
The second group looks at the day-to-day experience. Depression and motivation explains why depression drains the drive to do things and how behavioral activation, a well-studied approach, uses small planned actions to rebuild mood. Overthinking and worry covers rumination and worry, and techniques with research behind them.
Depression also looks different across seasons and stages of life. Seasonal depression covers the pattern that comes and goes with the darker months. Depression in men explains why it often shows up as anger, irritability or drinking rather than sadness. Depression and anxiety in midlife and later life looks at how both can change with age, health and loss.
Getting help
The last group is about what help looks like. Therapy for depression and anxiety explains the main talking therapies and what happens in sessions. Therapy, medication or both for depression sets out how people usually think about that choice with their doctors. When to get help for depression or anxiety covers the signs that it is time to talk to someone and the signs that it is urgent.
The practice's shorter articles when low mood will not lift and when anxiety becomes the default are a good place to start if you want a brief read first.
Where counseling fits
NIMH describes psychotherapy, medication or both as the usual treatment for depression and for anxiety disorders, and names cognitive behavioral therapy and interpersonal therapy among the evidence-based talking therapies for depression. Many people start with their primary care doctor, who can also check for physical causes such as thyroid problems.
Laura Bass is a psychotherapist in Charlotte, North Carolina, who works with adults, and depression and anxiety are among the concerns she works with in individual counseling. She works with the whole person, mind, body and spirit, and clients choose what their sessions focus on. You can read more about psychotherapy and counseling with Laura.
Laura does not diagnose by checklist and does not prescribe medication. Questions about antidepressants or anti-anxiety medication belong with your physician or a psychiatric prescriber, and counseling can work alongside that care. Contact Laura to ask whether working together could help.
If you need help right now
This guide is not crisis care, and nothing on the site is monitored for emergencies. If you are in immediate danger, call 911. If you are having thoughts of suicide or are in emotional crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline at any hour, or chat online. If you are worried about someone else, you can call 988 for guidance too.
Common questions
How do I know whether I have depression or anxiety?
Only a clinician can assess that, and many people have features of both. The articles on signs of depression and signs of anxiety describe what NIMH lists for each. If symptoms have lasted more than a couple of weeks, are getting in the way of work, relationships or sleep, or are getting worse, talk to your doctor or a therapist.
Does Laura Bass prescribe medication for depression or anxiety?
No. Laura Bass is a psychotherapist and does not prescribe. Medication is a decision to make with a physician or psychiatric prescriber, such as your primary care doctor or a psychiatrist. Many people use counseling alongside medication, and many use counseling on its own; NIMH describes psychotherapy, medication or both as the usual approaches.
Do I need a diagnosis before starting counseling?
No. You can start counseling because you have been feeling low, worried, flat or overwhelmed, without knowing what to call it. Part of early work is understanding what is going on. Seeing your doctor is still a good idea, both to talk about mood and to check for physical causes that can mimic depression or anxiety.