Pathways to Depression and Anxiety

The two most common presenting problems in therapy are depression and anxiety. In fact, I rarely see any psychological issue that does not contain aspects of depression or anxiety. Depression and anxiety are human reactions to psychological distress.

Although anxious and depressive feelings are common, there are unique ways of arriving at them. Two people may be depressed but for entirely different reasons. Person One may be depressed because they recently ended a relationship and worry that they will be alone forever. Person Two may be depressed because they are intensely self-critical and find fault with everything they do. These reasons are not incidental – they are the pathway.  In therapy, it important to explore the pathway into distress so we can chart a path out. If we focus just on the symptoms of depression – like low energy – the relief is usually short-term. Telling a depressed person to take a daily walk may provide an immediate boost. However, it rarely addresses the parts of the person’s psychology that led to depression/anxiety in the first place. Furthermore, most people have tried self-care techniques before speaking to a professional. If dealing with depression and anxiety were as simple as following a list of tips, no one would ever need therapy.

There is no one-size-fits-all when it comes to psychology. A therapist could be treating two people for depression using totally different interventions. In the example above, research has shown that Person One may need a different approach than Person Two. It goes without saying that no two people are alike; no two therapies should be, either.

Blatt, S. J. (2004). Experiences of depression: Theoretical, clinical, and research perspectives. American Psychological Association. 

Shedler, J. (2021). The personality syndromes. In R. Feinstein (Ed.), A Primer on Personality Disorders: Multi-Theoretical Viewpoints. Oxford: Oxford University Press.

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