Therapy is a science. So is the process that creates mental health challenges. We often think about anxiety and depression as just a way that we feel, or even a part of our personality, but they’re actually changes in chemical balances and brain activities that are altered by some of the things going on in our lives.
These conditions alter our reality. They make us feel like what we’re thinking and feeling “is how it is,” and that it’s an accurate representation of the world and our place in it. Yet, what people are really experiencing is the way that chemicals in the body affect the way we think and feel.
That is why it is important to really understand both what is happening to create anxiety and depression, and also what therapy can do about it. While each person’s experience is different, these conditions tend to emerge through identifiable biological and psychological mechanisms that follow a predictable chain of events.
The Initial Stress Response
First, a note: Keep in mind that some conditions can occur without a clear cause, and some may be based on genetics more so than the process we will describe here. Still, it’s important to understand that even in cases where anxiety/depression are caused by genetics, it is still treatable with therapy.
Most cases of anxiety and depression begin with what we’ll call “sustained stress activation.” When a person encounters something that feels threatening – such as a demanding job, loss, or relationship conflict – the brain’s amygdala sends an alert to the hypothalamus. The hypothalamus then triggers the pituitary gland to release signals that activate the adrenal glands, producing stress hormones such as adrenaline and cortisol.
This is known as the “fight-or-flight” mode. Heart rate increases, attention narrows, and the body prepares for action as if you’re experiencing an actual, physical conflict rather than an emotional one.
In healthy situations, this system turns off when the stress passes. But when the stressor is ongoing – financial pressure, emotional trauma, or prolonged uncertainty – the body continues to release cortisol long after it’s needed.
This prolonged exposure begins to interfere with normal brain chemistry. Cortisol suppresses serotonin and dopamine production and damages neurons in the hippocampus, which regulates emotional memory. The longer the stress continues, the more the brain’s emotional regulation centers struggle to return to balance.
From Temporary Stress to Persistent Anxiety
When the body’s alarm system remains switched on, the amygdala becomes hypersensitive, meaning it begins to trigger the stress response even when no immediate threat exists. Everyday situations – emails, minor disagreements, or unfamiliar settings – start to feel tense or unsafe.
Meanwhile, the prefrontal cortex, which normally evaluates whether a threat is real, begins to lose efficiency. Its ability to override emotional impulses diminishes, allowing worry and tension to dominate thought.
As a result, anxiety develops as a learned biological habit: the brain associates ordinary experiences with danger, producing automatic fear or worry even when the logical mind knows there is no reason for alarm.
How Prolonged Stress Leads to Depression
If chronic stress continues without relief, the brain shifts from hyperarousal (anxiety) to fatigue and shutdown (depression). For some people, it may even skip the hyperarousal part altogether. After months or years of cortisol overproduction, the body begins to conserve energy. The stress system becomes blunted, reducing the release of both cortisol and the neurotransmitters responsible for motivation and pleasure – especially dopamine and norepinephrine.
This creates the physical foundation for depression. Activities that once brought enjoyment no longer produce reward responses in the brain. The dopaminergic pathways that signal satisfaction and purpose grow less active, while the default mode network – the part of the brain involved in self-referential thought – becomes more dominant. This shift increases rumination, self-doubt, and hopelessness.
At the same time, serotonin levels may fall, further reducing mood stability and increasing irritability. Sleep becomes disrupted as the body’s natural rhythm between alertness and rest loses coordination. Over time, this pattern reinforces itself: fatigue leads to reduced activity, which lowers dopamine and serotonin even further, deepening the depressive cycle.
The Role of Inflammation and Physical Health
Chronic stress also triggers inflammatory pathways. When cortisol remains high for long periods, immune cells release cytokines – chemical messengers that promote inflammation throughout the body. These cytokines can cross into the brain, altering neurotransmitter activity and reducing neuroplasticity.
Inflammation disrupts the function of serotonin-producing neurons and decreases the growth of new neural connections in the hippocampus. This helps explain why people experiencing ongoing physical illness, poor sleep, or poor nutrition often see increases in anxiety or depressive symptoms.
The body’s immune and stress systems are directly influencing brain chemistry, and vice versa.
When Brain Circuits Begin to Reinforce Each Other
As these chemical and structural changes take hold, the brain’s circuits begin to reinforce maladaptive patterns. The amygdala remains overactive, the hippocampus loses regulatory control, and the prefrontal cortex has less capacity to intervene. Thoughts become repetitive and self-critical because the neural networks that process threat and negativity are firing more frequently and with less inhibition.
This is why anxiety and depression can feel self-perpetuating. The brain’s chemistry, structure, and thought patterns are all reinforcing the same message – that something is wrong and cannot be changed.
You’ll hear someone tell you that mental health is self-sustaining, and this is why. When left untreated, it becomes a cycle that affects both a person’s thoughts and behaviors in ways that increase anxiety and negativity.
How the Process Can Be Reversed
Fortunately, the same neurobiological systems that create anxiety and depression can also recover. When stress levels decrease, when therapy helps regulate thought patterns, or when medication helps restore neurotransmitter balance, neuroplasticity allows the brain to form new pathways.
Therapy (such as CBT, ACT, or mindfulness-based approaches) strengthens the prefrontal cortex’s ability to regulate emotion and reduces the amygdala’s hyperactivity.
Exercise and improved sleep increase serotonin and dopamine production and lower inflammation.
Antidepressant medication, when used appropriately, can normalize neurotransmitter activity and help the brain respond more effectively to positive experiences.
These interventions do not simply mask symptoms – they directly influence the underlying biological processes that created the problem.
Anxiety and Depression Are Biological Learning
In essence, anxiety and depression represent the brain’s attempt to adapt to prolonged stress. The brain learns to remain alert, cautious, or disengaged as a survival mechanism. What begins as a protective response becomes maladaptive when it no longer matches current circumstances.
By recognizing this, we can change our perspective of what it is and how it’s treated. These are not failures of character or perspective, but the result of identifiable neurochemical and structural patterns that can change with proper support.
The same biology that allowed anxiety and depression to form is the same biology that allows recovery. Through consistent care, therapy, and behavioral change, the brain can restore balance and rebuild resilience – proving that even the most deeply learned stress responses can be unlearned.
It is objectively accurate to say that we live in a political climate with a lot of anxiety. This is not politics as usual, and – regardless of one’s political side – it is becoming increasingly challenging to stay connected to what is going on in the world and still feel like your mental health is in a good place.
It is also becoming more and more common for people to seek therapists because of this political anxiety. Though they may or may not recognize that their anxiety is directly related to politics, often in conversation it becomes clear that there politics is directly affecting their mental health.
If you are also struggling, maybe it’s time for you to think about whether or not it might help to work with a therapist to process politics, your role in it, and what you can do to still lead your best possible life without compromising your passions or values.
Therapy for Politics
You don’t have to disengage. You don’t have to pretend that the world is fine when it isn’t. You also don’t have to – as many people recommend – act as though the people with different politics from you are all fighting for the same thing. Political anxiety exists because we are not all working towards the same goals as a country, or as a world.
You are allowed to feel.
In therapy, the goal is to create a space where you can safely explore these reactions without judgment. A therapist can help you identify the emotions that come up when you read the news, engage in discussions, or think about societal change, and then work with you on how to respond in a way that protects your mental health.
What Political Anxiety Can Look Like
Political anxiety does not always appear as anger or fear. It can present itself through physical tension, insomnia, fatigue, or emotional burnout. Many people find that they are:
Constantly checking or avoiding the news
Feeling hopeless or cynical about change
Experiencing conflict in relationships because of political differences
Struggling to focus on personal goals or responsibilities
Feeling disconnected or powerless in their community
These feelings are not signs of weakness or disengagement — they are natural responses to a prolonged sense of uncertainty and – perhaps even more importantly – overstimulation.
How Therapy Helps You Regain Balance
Working with a therapist provides structure and tools to manage emotional reactions to political events. Rather than suppressing how you feel, therapy helps you understand those feelings and decide how to respond to them more effectively. Together, you and your therapist might:
Establish boundaries around media exposure and social interactions.
Address issues like digital overload.
Determine how to avoid social media algorithm-related distress.
Identify triggers that heighten your stress or anger.
Practice emotional regulation and grounding techniques.
Develop strategies for staying informed without becoming consumed.
Explore your values and identify meaningful, realistic ways to take action.
Through this process, therapy allows you to engage with the world intentionally, not reactively – maintaining your commitment to your beliefs while preserving your emotional stability.
Reclaiming a Sense of Control and Wellbeing
Political awareness does not have to mean living in a constant state of anxiety. With the right therapeutic support, you can reconnect with a sense of agency, compassion, and perspective. Therapy can help you shift from feeling powerless in the face of conflict to feeling grounded, thoughtful, and capable of contributing to change in a sustainable way.
If the weight of the current political climate feels too heavy, reaching out to a therapist may be one of the most meaningful ways to take care of yourself – not by tuning out the world, but by learning how to navigate it with strength and balance. Reach out to Flourish Psychology today to learn more.
This week is OCD Awareness Week. It is a time when our goal – as therapists and as a society – is to talk more about obsessive compulsive disorder and help people understand what it is, who it affects, and why seeking treatment is worthwhile.
We’ve touched on this topic in the past, but in honor of OCD Awareness Week, it’s discuss OCD in a way that is simple, easy to understand, and helps people see why many struggle with OCD without realizing it.
Obsessions and Compulsions
Let’s start by talking about “obsessions” and “compulsions.”
Before we can talk about them, we have to first forget what the words mean in normal conversation. In normal conversation, an “obsession” is a desire. We use the term endearingly to talk about people or things that we love.
In the mental health world, an “obsession” is something entirely different. It is a recurring, intrusive thought – one that we do not want, and one that we cannot stop. It is an “obsession” because our brain cannot stop thinking about it no matter how much we want it to.
Because these are thoughts we *do not want*, they cause us to feel distress.
Because we cannot stop these thoughts, we feel distress over and over and over again.
Eventually, we find that some behavior provides some relief from the thoughts. Examples include:
Contamination Obsession – If someone has obsessions about germs or illness, they may wash their hands to feel relief.
Sin/Hell/Religious Obsession – If someone has obsessions about sinning or ending up judged by God, they may pray often.
Perfectionism Obsession – Someone that has an obsession with perfectionism may organize things or be constantly cleaning.
Compulsions can occur entirely organically. If a person has a harm obsession, and finds that they get relief from that thought when they make a noise or touch their knee, they may continue to do so to get some relief. Other times, it relates back to the obsession, like in the case of hand washing.
When these behaviors are visible, some people are encouraged to get help.
But they’re also not always visible.
The Hidden Struggles of Some OCD Types
OCD is also not always easy to see or diagnose.
One of the most common types of “compulsions” is what’s known as “checking.” Checking is where a person physically or mentally tests the obsession to make sure it’s not true. For example, a heterosexual person that has obsessions about being homosexual (again, remember that this person is likely not homosexual, it is just a recurring intrusive thought) may “check” to see if they’re homosexual by thinking about men in sexual encounters, and trying to determine if they’re aroused.
These types of checking behaviors occur entirely internally, which makes them both hard for others to notice and create a sense of extreme distress and self-judgment. People can have these obsessions about sexual violence, causing harm, causing self-injury, and more, and their “checking” behavior is imagining thoughts about it in order to see if it is real.
Not only do obsessions cause distress, but many people also worry that these obsessions mean something negative about themselves. For example, a person may have an “obsession” over sexual violence. Keep in mind that this person is typically *not* a sexually violent person, which is why the obsession causes such distress.
Internally, not only is this person experiencing distress at the obsession, but they may – because of the recurring thought – think they are a sexually violent person and be afraid to tell others. They may not seek help, worried about being branded or judged for these thoughts. Over time, it can be more and more destructive to their mental health and self-esteem.
OCD is Out There – But Not Always Seen or Understood
There was a time when obsessive compulsive disorder was not well known. Most people were unaware how many types of obsessive compulsive disorder exist or how they manifest.
Now, people are more familiar with the term “OCD” but rarely truly understand it. They may even say it as a descriptive tool. For example, they may organize a shelf a specific way and say “I’m a little OCD about this.”
True obsessive compulsive disorder can be very distressing, damaging, and challenging to those that experience it. It can also cause people to feel shame, further anxiety, depression, and more.
This OCD awareness week, it’s important to truly be aware of OCD – what it feels like, what it looks like, and what it means. The more we as a society really understand OCD, the better position we will be in to address it.
Often, when a couple seeks out couples counseling, it is because they are fighting often. They’re arguing, they’re resentful, they’re making snide comments – they see aggression and disgust in ways that cause harm in their relationship, and they want to see if there is a way to solve those issues and make the relationship work.
Still, every couple is made up of two individuals, each one that has their own desires, their own needs, their own wants, and their own feelings. While this has the potential to create frequent conflict, that conflict – while not desirable – is not always a sign of a relationship that’s struggling. While frequent conflict can be upsetting, conflict itself is something that can happen when two distinct people try to make a partnership work.
The Problem is Not Necessarily Conflict – It’s How You Reconnect After
What matters is not necessarily the conflict itself, which is going to occur now and then even in the most loving, most successful of relationships. What often matters more is how you make up afterwards.
One term for this is “Rupture and Repair.” Conflict puts distance between two partners. Repair is how you fix the problem.
It is the “Repair” portion where many struggling couples have the most problems. Most people know how to argue. They don’t always know how to make up. To be successful, couples need to be able to navigate their challenges, listen, learn, grow, and heal. Most couples that are struggling, however:
Give up
Ignore it
Grow resentful
Hold grudges
Argue until they “win”
Rather than trying to understand their partner, they simply allow the issue to linger until it is forgotten, or hold onto it to use it again in the future.
Successful and happy couples, on the other hand, try to navigate these things together. They try to build emotional attachment with each other. They try to heal. Even if they still disagree or they can’t fix anything, they intend to at least understand each other more and feel heard.
This process – this “Repair” – not only helps solve part of the conflict but makes couples stronger. It:
Grows emotional trust and attachment.
Helps provide immediate stress reduction.
Prevents more frequent future conflict.
Often, the strength of a relationship improves considerably when you learn how to connect after in a healthy way. Conflict still arises, but how you solve that connection has real benefits on your ability to feel close, intimate, and in love.
Learning to Repair a Relationship the Right Way
Those that feel they’re really struggling in relationships benefit greatly from learning how to repair relationships more effectively. This involves truly listening and trying to understand what your partner is saying, even if you disagree, taking responsibility for your own role in the conflict, offering reassurance on the relationship, and more.
It’s a process, but it’s an effective one. In that sense, couples counseling isn’t necessarily designed to stop all conflict. Couples in love are still going to have disagreements. But, if you address them in the right way, you can heal from it and maybe even grow closer as a result. Reach out today to learn more.
Couples counseling is the best approach we have for addressing issues in an existing relationship. Couples therapy methods, like Gottman, have been extensively searched and are proven to be effective at supporting a couple that is going through challenges or feels stuck at some stage in their relationship.
But what if you’re single?
Many relationship challenges “start” before a person has even gone on the first date. From patterns to traumas to attractions, a person can learn how to have a deeply committed relationship with a partner long before they have met that person.
Here at Flourish Psychology, we encourage those that are single or dating to also consider whether or not they might benefit from *individual relationship counseling* – counseling that is focused on how to help you find and maintain a fulfilling, happy relationship and love yourself in the process.
If you’re interested in singles counseling in New York City, give us a call and let’s connect you to a therapist that is ready to address your needs.
Benefits of Singles Therapy
Often the success of a relationship starts before you’re even in one. Everything from your relationship habits to the people you choose to date to the love you have for yourself are all affected by how we are when we’re single. The more we’re in a good place psychologically, the easier it is to have more successful, committed relationships with a partner that we’re really connected with – and also to do so in a way where we are not dependent on the relationship for us to be happy.
That is why, while couples counseling is a great way to address the issues of an *existing* relationship, singles therapy is a great way to find a better relationship in the first place. This type of counseling can provide many benefits, such as:
Ability to Address Patterns of Behavior – Rather than wait to repeat a pattern, you can focus on how to address it before it starts, talking to your therapist about habits and issues that recur in relationships. This allows you to start the next relationship without those patterns present.
Ability to Address Patterns in Relationship Choice – We tend to be attracted to the same type of people over and over again, even if those people are not the best for us. Through therapy, we can help determine who you’re really meant to be with and help make sure you’re growing attracted to people that are right for you.
Learning to Love Yourself – People have more successful relationships, and are more likely to find a relationship, when they love themselves. They also are more likely to find happiness from any direction when they are also fine being alone. Indeed, you’re more likely to find someone that’s right for you when there is less pressure to be in a relationship. All of this comes from loving yourself, which is something we can work on in therapy.
Addressing Existing Mental Health Challenges – It’s hard to manage a relationship of any kind when you’re already struggling with mental health issues. If you have anxiety, depression, or something else, therapy can help address it before you’re in a relationship so that it’s not a barrier to finding happiness.
Gaining More Self-Awareness – Relationships often require truly knowing and understanding yourself and your actions. But self-awareness is hard, and many people that are single for a long time become more hardened in their ways. Therapy can help people build the ability to be more self-aware, resulting in the ability to be objective about behaviors in the relationship.
Prepping Your Relationship Skills – You don’t have to be in a relationship to work on things like attachment issues, communication skills, how to open yourself up to intimacy, and more. Those can all come beforehand, as you learn more about yourself.
The idea behind relationship therapy is to have a more successful relationship. But there is no rule that you have to currently be in a relationship to benefit. If anything, the best relationships start when you’re at a place in your life where you feel your best about yourself.
If you are single or dating, and feel like you’re ready for something more, consider singles therapy with Flourish Psychology. Reach out today to learn more.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
Manage Consent
By clicking “Accept”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.
Functional
Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
