Many of the calls we receive at the OC Anxiety Center begin with “I’m anxious and depressed and I need help.” While anxiety and mood disorders are often co-occurring, treatment goals differ significantly resulting in different approaches to treatment. One question to ask yourself is “What’s the bigger problem right now?” or “If I had a magic pill that could get rid of one problem, would it be for my anxiety or depression?”. This helps us understand what the presenting problem is, and therefore what needs to be addressed first. If treatment isn’t done in the correct order, it may not be effective:
If depression is primary, and anxiety is secondary
- If I’m so depressed that I can’t get out of bed, so low energy that I can’t focus on treatment (or even get to the office), I’m too overwhelmed to address my anxiety. As a more extreme, if I have suicidal thoughts or actions, clearly those need to be addressed before we can begin treatment on the anxiety issues.
If anxiety is primary, and depression is secondary
- If I’m so anxious that I can’t focus on treatment (distracted by many worry “what if” thoughts, my body so tense I can’t calm down), then focusing on depression treatment will not be effective.
At the OC Anxiety Center, we begin with a phone screen to make sure that those who come in have an anxiety disorder as a primary issue: if depression is the primary issue, we typically refer out to a depression specialist. This is followed by a thorough 2-3 hour assessment (a semi-structured interview and usually a few additional written measures) to obtain a detailed clinical picture that allows us to create a structured treatment plan based on research protocols, tailored to each individual, as each anxiety disorder is treated differently as well. “Anxiety” in of itself is not a diagnosis, it’s a category of issues, much like saying “cancer”.
Our goal is to ensure the highest level of care for each individual, even if it means referring the person to another provider. While we receive many calls, and we refer out approximately 50% of the people to other providers as we want to make sure they receive the care that is appropriate to their needs. We often say ‘best services, be it us or someone else.” As you investigate treatments, think about what the primary issue you are experiencing that you would like addressed: if it’s anxiety issue, give us a call at 949-689-5892 or send an email directly to me at hsia@ocanxietycenter.com, as we would be happy to see if we’re a good fit for your needs – or be able to refer you to someone who is.