Anxiety, Depression & Life Transitions Therapy
Casen Psychology | Dr. Sara Casen, PhD.
When you're holding it together on the outside but running on empty inside
You're functioning. You show up, meet deadlines, do what's expected.
But underneath that, something feels off in a way that's hard to name. The anxiety that was manageable before is louder now. The depression isn't dramatic, just flat and heavy and persistent. The transitions, finishing school, starting a career, figuring out who you are outside the structures that used to define you, feel less like milestones and more like weight.
This is some of the hardest emotional terrain young adults navigate. Most people navigate it completely alone.
What you might be carrying
Anxiety can look like:
A mind that won't stop running worst-case scenarios, even when things are objectively fine
Over-preparing and still not feeling ready
Physical symptoms: tight chest, poor sleep, a low-grade hum of dread that follows you through the day
Depression often doesn't look like what people expect:
Less crying on the floor, more just muted
Things that used to feel meaningful don't land the same way
Getting through a day takes more than it should, and you're not sure why
Transitions carry their own weight:
Post-graduation, career changes, leaving home, ending a relationship: these are real losses even when they're chosen
Grief about what you're leaving and uncertainty about what's next can coexist in ways that feel destabilizing
The pressure to have it figured out compounds everything. When the people around you look like they're handling it and you're not, the internal narrative gets cruel.
What starts to shift
One of the first things that tends to change is your relationship with your own thinking. When you understand what's driving the anxiety, the thought patterns, the threat responses, the places your brain defaults under stress, it stops feeling like something is wrong with you. It starts feeling workable.
Depression lifts in layers, not all at once:
Early on it often shows up as slightly more energy
Small moments of engagement that weren't there before
Over time, a more stable baseline builds, not artificially positive, just less weighted
Transitions become more manageable when you have a real framework for processing them. That means grieving what you're leaving, getting honest about what you want next, and building daily structure that supports you rather than drains you.
How I work with you
CBT is a core part of how I work with anxiety and depression. We look directly at the thought patterns driving how you feel and work on shifting them with specific, concrete techniques. Not just talking about them.
I give homework. Real assignments between sessions that extend the work into your actual life.
Psychodynamic work runs underneath that. Where did this anxiety come from? What does this depressive period connect to in what you've been carrying for years? Understanding the deeper roots doesn't replace the practical tools. It makes them stick.
What to expect
The first session is a highlight reel of your life: the experiences, relationships, and patterns that feel relevant to where you are now.
From there, we build a treatment plan together with concrete goals and checkpoints at three, six, and nine months. You'll always know what we're working toward and roughly where you are.
Weekly sessions are standard
Twice weekly is available when things are more acute
Progress typically starts showing within the first few sessions, not resolution, but movement
Who this is a good fit for
This work is well suited for people in their late teens through mid-thirties who are:
Dealing with anxiety that's affecting sleep, focus, or relationships
Moving through depression that feels flat rather than dramatic
In a life transition that's harder than expected
You might be in the middle of grad school, newly out of it, changing careers, or just in a period where the life you're living doesn't match the one you thought you'd have by now.
If previous therapy felt too passive or open-ended, the more structured approach here tends to feel different. A willingness to do the work between sessions makes a real difference in how quickly things move.
Fees
My rate is $300 per session. A sliding scale is available for clients with genuine financial need.
Questions people ask before booking
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Yes, if it's affecting your quality of life. Therapy isn't reserved for crisis. If anxiety is costing you sleep, focus, or relationships, or if you're moving through your days feeling flat and disconnected, that's enough of a reason.
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Probably, yes. The approach here is structured and goal-directed, with specific techniques and between-session work. If previous therapy felt like venting without traction, this tends to feel more active.
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Most clients notice something shifting within the first few sessions, not full resolution, but a different quality to the work. Meaningful change in anxiety and depression typically takes several months of consistent effort.
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Yes. Transitions carry real emotional weight even when they're chosen and positive. Processing what you're leaving, clarifying what you want next, and building structure around a new chapter are legitimate things to work on.
If you've been waiting for things to get better on their own, it's okay to try something else
A free consultation call is available if you want to talk through whether this is the right fit. Schedule here.