Finding a Therapist for Anxiety and Depression: What You Need to Know

When you're dealing with both anxiety and depression—what clinicians sometimes call "comorbid" conditions—it can feel like you're trapped in an exhausting feedback loop. The anxiety keeps you wired and restless, while the depression drains your energy and hope. One moment you're spiralling with worry; the next, you're too flat to care about anything at all.

If this describes your experience, you're far from alone. Research suggests that around 60% of people with depression also experience significant anxiety, and vice versa. The two conditions often intertwine, each amplifying the other in ways that can feel overwhelming.

The good news? You don't need two separate therapists or two different courses of treatment. The right therapeutic approach can address both conditions simultaneously, helping you understand the patterns that fuel them and develop more effective ways of responding.

This guide will walk you through what to look for in a therapist when you're managing both anxiety and depression, which approaches tend to work best, and how to make sure you're getting the integrated support you need.

Table of Contents

• Why Anxiety and Depression Often Co-Occur
• Do You Need a Specialist in Both Conditions?
• Therapeutic Approaches That Work for Both
• What to Look for in Your Therapist
• Questions to Ask in Your Initial Consultation
• What Treatment Might Look Like
• When to Consider Additional Support
• Frequently Asked Questions

Why Anxiety and Depression Often Co-Occur

Understanding why these two conditions so frequently appear together can help you make sense of your own experience—and reassure you that what you're feeling makes complete sense given how these states interact.

The Exhaustion Cycle

Chronic anxiety is draining. When your nervous system is constantly activated—always scanning for threats, replaying worries, bracing for disaster—it burns through your physical and emotional resources. Over time, this sustained state of hypervigilance can tip into depression as your system essentially runs out of fuel.

You might recognise this pattern: weeks or months of high anxiety followed by a crash into a depressive episode where you can barely function. The anxiety hasn't necessarily gone away; it's just been overlaid with profound fatigue and hopelessness.

The Rumination Connection

Both anxiety and depression involve particular styles of thinking that keep you stuck. Anxiety tends toward "what if" thinking—anticipating future threats and catastrophes. Depression involves rumination about the past—replaying failures, losses, and perceived inadequacies.

These thought patterns often feed each other. You might start by worrying about the future ("What if I never feel better?"), which triggers depressive thoughts about the past ("I've always struggled, nothing ever changes"), which then fuels more anxiety about your future prospects. Round and round it goes.

Shared Biological Pathways

From a neurobiological perspective, anxiety and depression share common features. Both involve dysregulation in neurotransmitter systems (particularly serotonin and noradrenaline), disrupted stress response mechanisms, and changes in brain areas that process emotions and threats.

This biological overlap is why you might notice your symptoms blur together: the restless agitation of anxiety mixing with the heavy flatness of depression, creating a confusing state that's neither purely one nor the other.

Life Circumstances That Trigger Both

Often, the same life situations can provoke both conditions. Prolonged stress, relationship difficulties, work pressures, health problems, or past trauma can simultaneously fuel anxiety (about what might happen next) and depression (from feeling overwhelmed, helpless, or depleted).

Do You Need a Specialist in Both Conditions?

Here's a question many people ask: do I need to specifically find someone who advertises "anxiety and depression" expertise, or will any competent therapist do?

The honest answer: most qualified, experienced therapists regularly work with both conditions. Anxiety and depression are among the most common presentations in therapy, and any BACP-registered counsellor or UKCP-registered psychotherapist will have training and experience addressing them.

That said, there are some things worth considering:

Experience Matters More Than Labels

Rather than searching specifically for someone who lists both conditions on their website, look for evidence of solid training and several years of practice. Someone who's been working with mental health difficulties for five years will inevitably have extensive experience with the anxiety-depression overlap, even if they don't explicitly market themselves that way.

Approach Matters More Than Specialism

The therapeutic approach someone uses matters more than whether they specifically advertise dual diagnosis expertise. As we'll explore below, humanistic therapies, psychodynamic approaches, and integrative methods all offer effective pathways for working with these interlocking difficulties.

Trust the Initial Consultation

Most therapists offer a brief initial consultation (often 15-30 minutes, sometimes free). Use this to explain that you're experiencing both anxiety and depression. A competent therapist will immediately recognise this as a common presentation and be able to articulate how their approach addresses both. If they seem confused or suggest you need two separate types of help, that's a red flag.

Therapeutic Approaches That Work for Both

Different therapeutic approaches offer different pathways through the anxiety-depression tangle. Here's what the evidence and clinical experience tell us works well:

Humanistic and Person-Centred Therapy

Humanistic approaches like person-centred therapy, Gestalt, and integrative humanistic counselling work with both anxiety and depression by addressing the underlying patterns that fuel them: self-criticism, disconnection from your authentic needs, and the burden of internalised "shoulds."

These approaches don't treat anxiety and depression as separate problems to fix. Instead, they create a space where you can explore what these states are communicating. What is your anxiety trying to protect you from? What is your depression telling you about needs that aren't being met?

Over time, the core conditions of humanistic therapy—unconditional positive regard, empathic understanding, and congruence—help reduce the self-judgement that often intensifies both conditions. You learn to respond to yourself with the same compassion your therapist offers you.

Best for: People who want to explore the deeper patterns and meaning behind their struggles, prefer a relational and exploratory approach, and want to work at their own pace without external pressure.

Cognitive Behavioural Therapy (CBT)

CBT is the most widely researched approach for both anxiety and depression, with strong evidence for effectiveness. It focuses on the relationship between thoughts, feelings, and behaviours, helping you identify and challenge unhelpful thought patterns that maintain distress.

For anxiety and depression together, CBT helps you recognise the specific thinking styles that fuel each (catastrophising for anxiety, negative self-assessment for depression) and develop more balanced perspectives. Behavioural elements include activity scheduling to counter depression and exposure work to reduce anxiety.

Best for: People who want a structured, time-limited approach with clear techniques and homework, prefer working on specific symptoms, and like having a collaborative but therapist-guided treatment plan.

Psychodynamic and Attachment-Based Therapy

Psychodynamic approaches explore how past experiences and relationships shape your current patterns. For many people, anxiety and depression have roots in early attachment experiences or unresolved conflicts that continue to influence how you relate to yourself and others.

This approach can help you understand why certain situations trigger particular responses, how your internal critic developed, and what your symptoms might be protecting you from confronting.

Best for: People curious about how their past influences their present, willing to explore deeper and sometimes uncomfortable territory, and interested in longer-term work focused on lasting change rather than quick symptom relief.

Integrative Approaches

Many therapists, particularly those trained in humanistic traditions, work integratively—drawing on multiple models as appropriate to what you bring. They might combine person-centred relational foundations with Gestalt experiments, Transactional Analysis insights, or CBT techniques when specific skills would help.

This flexibility can be particularly valuable when working with anxiety and depression together, as different moments might call for different interventions: sometimes you need empathic space to process feelings; sometimes you need practical tools to interrupt rumination; sometimes you need to understand long-standing patterns.

Best for: People who want a flexible, responsive approach tailored to their unique needs rather than a one-size-fits-all protocol.

What to Look for in Your Therapist

Beyond therapeutic approach, here are key qualities to look for when choosing a therapist to support you with anxiety and depression:

Professional Registration and Qualifications

In the UK, check that your therapist is registered with the BACP (British Association for Counselling and Psychotherapy) or UKCP (UK Council for Psychotherapy). Registration indicates they've met rigorous training standards (typically a minimum of Level 4 Diploma, though many hold degrees or postgraduate qualifications), engage in regular supervision, and adhere to ethical frameworks.

Experience with Complexity

While you don't need someone who exclusively treats anxiety and depression, you do want someone comfortable with complexity and capable of holding both experiences simultaneously. During an initial consultation, notice whether they seem to understand the interplay between the two conditions or whether they're trying to separate them out artificially.

Attuned Rather Than Prescriptive

Pay attention to whether the therapist listens carefully to your specific experience or immediately launches into what "should" happen in treatment. The best therapeutic relationships involve the therapist attuning to your unique presentation—your particular flavour of anxiety and depression, your history, your resources—rather than applying a generic protocol.

Comfortable with Both Emotional Depth and Practical Support

Different moments in therapy require different responses. Sometimes you need space to feel and express difficult emotions; sometimes you need practical strategies to get through the week. Look for someone who can move fluidly between emotional depth and practical support rather than offering only one or the other.

Warm but Boundaried

The therapeutic relationship should feel safe and containing. You want someone who's genuinely warm and present, but also maintains appropriate professional boundaries. This combination creates the security needed to explore difficult territory without the relationship itself becoming a source of anxiety or confusion.

Questions to Ask in Your Initial Consultation

Most therapists offer a brief initial conversation to see if you're a good fit for each other. Here are questions that can help you gauge whether this person can support you effectively:

"How do you work with someone experiencing both anxiety and depression?"

This open question lets you hear how they conceptualise the problem and their approach. Listen for answers that acknowledge the complexity and describe an integrated rather than fragmented response.

"What's your training and approach?"

Understanding their theoretical orientation helps you assess fit. If they say "person-centred and integrative," you might ask what they integrate. If they say "CBT," you might ask how they tailor it when someone presents with multiple concerns.

"How long might we work together?"

Some approaches are time-limited (typically 6-20 sessions for CBT); others are open-ended (common for humanistic and psychodynamic work). There's no right answer, but you want clarity about their usual way of working so you can decide if it suits your needs and budget.

"Do you have experience working with...?"

If there are other relevant factors—for example, you're LGBTQ+, dealing with a chronic health condition, navigating work stress, or have experienced trauma—ask directly whether they have experience working with these contexts. You want someone who can hold the full picture of your life, not just isolated symptoms.

"What happens if we don't feel like a good fit?"

This question reveals professionalism and flexibility. A good therapist will acknowledge that fit matters and be comfortable discussing how to handle it if the relationship isn't working, including helping you find an alternative.

What Treatment Might Look Like

While every therapeutic relationship is unique, here's a general sense of what working with anxiety and depression together might involve:

Early Sessions: Building Understanding

The first few sessions typically focus on building a safe relationship and developing a shared understanding of your experience. Your therapist will want to know about your history with anxiety and depression, what triggers flare-ups, what your daily life looks like, and what you're hoping therapy can offer.

During this phase, many people report immediate relief simply from being listened to without judgement and having their experience validated as making sense.

Middle Phase: Exploring Patterns and Developing Resources

As the work deepens, you'll likely explore the patterns that maintain your difficulties: thought habits, behavioural cycles, relationship dynamics, unmet needs, historical influences. Simultaneously, you'll develop new resources: ways of soothing yourself when anxious, strategies for staying engaged when depressed, practices for self-compassion.

The balance between exploration and skill-building depends on your approach and your needs in any given session. Some weeks might be intensely focused on processing a difficult event; others might involve learning specific techniques for managing panic or motivation.

Navigating Setbacks

Progress with anxiety and depression is rarely linear. You'll likely have better periods and worse periods. A skilled therapist helps you navigate setbacks without catastrophising them, using relapses as opportunities to understand your patterns more deeply and refine your coping strategies.

Later Phase: Integration and Consolidation

As things improve, therapy often shifts toward consolidating gains, building confidence in your ability to manage difficulties independently, and addressing any remaining stuck points. You might start spacing sessions out—moving from weekly to fortnightly to monthly—as you need less intensive support.

When to Consider Additional Support

Sometimes therapy alone isn't enough, and you might benefit from additional support:

Medication

Antidepressants (particularly SSRIs) are often prescribed for both anxiety and depression and can be used alongside therapy. Some people find medication helpful for stabilising their mood enough to engage meaningfully with therapy; others manage well with psychological treatment alone.

This is a personal decision best made in consultation with your GP or psychiatrist and your therapist. There's no shame in using medication if it helps—therapy and medication can work synergistically.

Crisis Support

If you're experiencing thoughts of self-harm or suicide, it's important to access crisis support. Contact your GP, call the Samaritans (116 123, available 24/7), or go to A&E if you're in immediate danger. Let your therapist know as well—they can help you create a safety plan.

Group or Peer Support

Some people find group therapy, peer support groups, or online communities valuable alongside individual therapy. Connecting with others who understand what you're experiencing can reduce isolation and provide different perspectives.

Lifestyle Factors

While therapy addresses the psychological dimensions of anxiety and depression, physical health matters too. Sleep, nutrition, movement, social connection, and routine all influence mood. Your therapist might help you think about these factors, but you might also benefit from support from a GP, nutritionist, or exercise professional.

Frequently Asked Questions

Can one therapist really help with both anxiety and depression?

Yes, absolutely. In fact, treating them together with one therapist is usually more effective than trying to address them separately. A skilled therapist will understand how these conditions interact in your particular situation and help you work with both simultaneously.

How long does therapy for anxiety and depression take?

This varies widely depending on the severity of your symptoms, how long you've been struggling, your circumstances, and the approach you choose. CBT typically runs 12-20 sessions. Humanistic and psychodynamic approaches are more open-ended, often involving several months to a few years of work. Many people notice initial improvements within 6-8 weeks, with deeper change unfolding over time.

Will therapy cure my anxiety and depression?

Therapy isn't about "curing" mental health difficulties so much as helping you develop more effective ways of managing and responding to them. Many people do experience significant symptom reduction or even complete remission. Others learn to live with fluctuating moods in a way that no longer dominates their life. The goal is meaningful improvement in quality of life and functioning, rather than perfection.

What if I can't afford private therapy?

NHS counselling services are free, though waiting times vary significantly by region (typically 6 weeks to 6 months). Your GP can refer you, or you can self-refer through NHS Talking Therapies (search "NHS Talking Therapies" plus your area). Alternatively, many private therapists offer reduced-fee spaces for students or people on low incomes—it's worth asking.

Should I try therapy or medication first?

For mild to moderate anxiety and depression, psychological therapy is often recommended as a first-line treatment. For moderate to severe symptoms, a combination of therapy and medication often works best. Discuss options with your GP, and remember you can always start with therapy and add medication later if needed, or vice versa.

What if therapy doesn't work?

If you've been in therapy for several months without improvement, have an honest conversation with your therapist about it. Sometimes switching approaches or therapists makes sense. Sometimes adjusting medication, addressing other factors (sleep, relationships, work stress), or adding complementary support helps. Occasionally, the timing isn't right and taking a break before trying again is appropriate.

How do I know if my therapist is any good?

You should feel listened to, understood (even if not always agreed with), and safe enough to explore difficult territory. You should notice some improvement within the first 2-3 months, though change is often gradual. If you feel consistently judged, misunderstood, or pressured, or if there are boundary violations, trust those concerns and consider finding someone else.

Can I do therapy for anxiety and depression online?

Yes. Video counselling (via platforms like Zoom) is now standard practice and research shows it's as effective as in-person therapy for most people. The quality of the therapeutic relationship—not the medium—is what matters most. Some people prefer the convenience and accessibility of online work; others value the ritual of attending sessions in person. It's entirely your choice.

Finding Your Way Through

Living with both anxiety and depression can feel like an impossible puzzle—too wired to rest, too exhausted to function, caught between states that seem to fight with each other whilst somehow making each other worse.

But these conditions, while challenging, are also deeply treatable. The right therapeutic relationship provides both the compassionate space to understand your patterns and the practical support to develop more effective responses. Over time, you can shift from being controlled by anxiety and depression to having a more balanced, grounded relationship with your internal experiences.

The first step is simply reaching out. You don't need to have everything figured out before starting therapy. You just need to find someone qualified, experienced, and committed to walking alongside you as you find your way through.

If you're looking for humanistic therapy for anxiety and depression in London, particularly South West London areas like Fulham, Chelsea, or Putney, contact Kicks Therapy to arrange an initial consultation. We offer both in-person and video sessions, working integratively to address the unique ways anxiety and depression show up in your life.

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About the Author: This article was written by the Kicks Therapy Content Team, with clinical input from BACP-registered therapists experienced in working with anxiety, depression, and co-occurring mental health conditions.

Further Reading:

• Signs You Need Anxiety Therapy
• Depression Therapy: How It Helps
• How to Find the Right Therapist in London
• Understanding Humanistic Therapy

Expert Sources:

• National Institute for Health and Care Excellence (NICE). (2022). Depression in adults: treatment and management. https://www.nice.org.uk/
• British Association for Counselling and Psychotherapy (BACP). (2024). Anxiety and depression: what works. https://www.bacp.co.uk/
• Kessler, R. C., et al. (2015). Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys. Epidemiology and Psychiatric Sciences, 24(3), 210-226.