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It seems an often overlooked element involved with people who suffer from depression and anxiety is the trauma they were exposed to as a result of the experience. Often times, in my clients reports, I hear fear (separate from the anxiety and depression) about going to this low place again or this panicky space again. As a result, I see many people suffer from worry about "how bad will it be this time". I see this as a trauma response that is treatable. I have been successful in treating clients (more successful with clients not in the midst of extreme lows at the time of treatment) to significantly decrease the trauma response to these experiences of deep lows and extreme anxiety/panic. It seems highly useful at these times as well to offer education as to the function of depression and anxiety and the healthy reasons why we can experience such difficult feelings. Additionally, it has been very useful in my practice to illuminate circumstances in life that can mimic depression so clients can begin to recognize the difference between depression and every day experiences (IE exhaustion, fatigue, being overwhelmed with current circumstances as opposed to an independent chemical shift). Colleen Todd MA LPC CACIII