Anxiety and burnout therapy for adults who look fine on paper

You are still showing up. Still delivering. Still the person other people describe as “so together.” And underneath that, your chest is tight most mornings, you cannot remember the last time rest actually worked, and you are running a background process that never shuts off. Performing well and being okay are two different things.

Anxiety, stress and burnout are not the same thing

They get used interchangeably, and that is part of why people stay stuck — the wrong name leads to the wrong plan. Distinguishing them is usually the first useful thing we do together.

• Stress is a response to demand. It rises when the load rises and it settles when the load lets up. Stress is not a disorder; it is information about your circumstances.
• Anxiety is what happens when the alarm keeps sounding whether or not there is a current demand. It shows up as anticipation, rumination, over-preparation, physical tension, trouble sleeping, and a mind that rehearses conversations that have not happened yet.
• Burnout is depletion, most often related to prolonged occupational or caregiving demand. It tends to look like exhaustion, cynicism or emotional distance, and a drop in your sense of effectiveness — which is especially disorienting for people whose competence has always been reliable.

They also overlap. Chronic stress can maintain anxiety; burnout can produce symptoms that resemble depression. Sorting out which is doing the most work in your particular life is clinical work, not a quiz, and it changes what we actually do next.

Why more rest hasn't fixed it

Because rest addresses depletion, and a lot of what you are carrying is not depletion — it is vigilance, over-responsibility, and a set of standards you never consciously agreed to. A vacation pauses the demand. It does not change the part of you that believes slowing down is a risk. That is the part we work on.

What we actually do

We start with an honest map: what is happening in your body, what is happening in your schedule, and what beliefs are keeping the whole arrangement in place. Then we get practical — regulating the physical alarm, interrupting the rumination loop, renegotiating the commitments that are quietly costing you the most, and rebuilding a version of rest that actually restores something.

My approach is psychoeducational and direct. I explain what I am seeing and why, because people who understand the mechanism stop needing me to hand them a script for every situation.

When ADHD is part of the picture

For some adults — particularly those diagnosed late or never diagnosed — years of compensating for attention and executive-functioning difficulties produces real anxiety and real exhaustion. If that is your history, treating the anxiety alone can feel like mopping while the tap runs. It is worth looking at both. Read about ADHD therapy for adults, or bring the question to the consult and we will sort out what is worth exploring.

Practical details

Sessions are virtual and available to adults located anywhere in Texas — see how online therapy in Texas works. Fees and the insurance plans currently accepted are listed on the fees and insurance page, and the FAQ covers the rest.

Related: depression and life transitions · therapy for helping professionals · therapy for high-achieving women

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