Meet Kathleen. She’s 21, a junior in college, and came to my clinic feeling stuck—lonely, unmotivated, and searching for meaning. When I asked what brought her in, she paused and said, “I don’t know where to start. I know I’m struggling with anxiety and depression, and I need some skills to help. But I’m also struggling with my relationships and my sense of purpose.” College, she hoped, would be the place to build lifelong friendships, but instead, she felt like “the chance to build a full and interesting life is slipping through my fingers.”
To understand Kathleen’s journey, we traced it back to a year prior, when she first visited her primary care provider (PCP). That day, she completed a self-report screener, answering these two questions:
- In the past two weeks, have you experienced little interest or pleasure in doing things?
(Kathleen’s answer: “Yes, several days”) - Have you been feeling down, depressed, or hopeless?
(Kathleen’s answer: “Yes, more than half the days”)
Her answers indicated a “positive screen,” signaling to her PCP that mental health concerns warranted a brief discussion. Her doctor followed protocol, mentioning her mood and offering a prescription for an antidepressant. In her medical chart, a new mood disorder diagnosis was added, ensuring the treatment and billing process moved forward—a significant milestone in healthcare’s efforts to recognize and reimburse mental health care.
But therein lies the problem. While the system’s evolution is laudable, it is far from comprehensive. Kathleen’s mental health care journey began and ended with two questions and fewer than five minutes of conversation. For an epidemiologist analyzing population data, this screening method is a success. For a real person, it can feel woefully inadequate—or even harmful. If I had a nickel for every patient with a similar story, I’d have enough to prove just how commonplace this is. In 2025, this is the standard of care for many, a process that often fails to truly engage with the complex realities of mental health.
For Kathleen, a moderate dose of an antidepressant failed to address her deeper struggles with existential, social, and spiritual disconnection. She eventually discontinued the medication and sat down in my clinic, searching for something better.
We started right then and there, introducing one simple but transformative idea: depression and anxiety are symptoms of suffering—a universal human experience that nearly 80% of people encounter at some point in their lives (Kessler et al., 2005). These symptoms are not necessarily indicative of a disease but rather signals pointing to deeper issues: struggles with relationships, purpose, and the meaning of life itself.
Suffering, we agreed, is unavoidable. But how we meet and respond to it is where we can find meaning, growth, and resilience. Together, Kathleen and I embraced the reality that flaws and struggles are part of being human. By accepting this, we began moving away from the pursuit of a “cure” and toward rational, joyful ways of finding meaning. It was the first step in a six-month journey that would change how Kathleen approached herself, her emotions, and her relationships.
A Six-Month Journey: Building Meaning, Connection, and Resilience
Kathleen’s therapeutic journey centered on aligning her actions with her values rather than her emotions, fostering meaningful connections, and building the skills to navigate anxiety as a barrier. This wasn’t about quick fixes or simply “feeling better.” It was about transforming how Kathleen understood herself and her role in the world.
Months 1-2: Laying the Foundation
The first month focused on exploring Kathleen’s values and understanding how her actions aligned—or didn’t—with them. In our initial session, we identified what mattered most to her: authentic relationships, personal growth, and finding meaning through service to others. We talked about how to evaluate her daily actions through a different lens—not based on how they made her feel in the moment but by whether they moved her closer to the life she wanted.
One of the biggest shifts for Kathleen was learning that she didn’t have to wait for relationships to feel perfect or for people to behave in a way she deemed “safe” or “good enough” before she could take action. Instead, the focus was on what she could control: her own behavior. Could she live up to her own values as someone who prioritized connection and meaning? Could she show up for others in ways that aligned with her goals? This framework allowed Kathleen to take responsibility for how she approached relationships without relying on external conditions.
We also reframed Kathleen’s experience with emotions like anxiety and sadness. Instead of seeing them as roadblocks, she began viewing them as signals—important but not always directive. Anxiety, for instance, often arose when she considered reaching out to friends. Instead of withdrawing, Kathleen learned to see that anxiety as a reminder of how much she cared about those relationships and what she stood to gain by engaging.
Months 3-4: Taking Values-Based Action
With a clearer understanding of her values, Kathleen began taking small, actionable steps that aligned with them. She set concrete goals, like reaching out to one friend each week or scheduling regular time with her family. These steps were manageable but also meaningful, helping her feel more connected without becoming overwhelmed.
We also worked on vulnerability—something Kathleen often avoided out of fear of rejection or judgment. Vulnerability, I explained, isn’t about oversharing but about showing up authentically in relationships. This might mean admitting when she felt lonely or simply being more open about her thoughts and feelings. For Kathleen, this shift was transformative. By focusing on how she showed up for others, rather than how they responded, she found herself more willing to take risks in relationships.
An important part of this phase was addressing anxiety as a barrier. Kathleen learned to observe her anxious thoughts without letting them dictate her actions. She practiced moving forward even when those thoughts were present, using her values as her guide. Over time, this made her more confident in her ability to navigate discomfort and still take meaningful action.
Months 5-6: Strengthening and Sustaining Change
As Kathleen began experiencing the rewards of values-based living, we focused on reinforcing her progress and preparing for future challenges. One key lesson was learning how to handle resistance or discomfort from others. Changing how you show up in relationships often disrupts established patterns, and it’s common for others to react in unexpected ways. We talked about how to stay grounded in her values, even when others didn’t respond as she hoped.
Kathleen also spent time reflecting on her progress. Revisiting the values she identified in our first session, she could see how far she had come in aligning her actions with what mattered most. She was reaching out to friends, engaging more openly, and finding fulfillment in living authentically. These reflections motivated her to keep going.
To ensure her progress continued, Kathleen created a plan for the future. This included continuing weekly actions aligned with her values, practicing the skills she had learned for managing difficult emotions, and envisioning the life she wanted to keep building.
Reflections on the Journey
By the end of six months, Kathleen had made significant strides. She no longer felt as though life was slipping through her fingers. Instead, she had taken the reins, guided by her values, and was actively building the connections and meaning she craved. Her anxiety and depression hadn’t disappeared, but they no longer defined her. They were signals—reminders of what she cared about—and she had learned to move forward despite them.
Kathleen’s story is a testament to the power of values-based action and the resilience that comes from embracing our shared human struggles. She learned that relationships, like life, don’t need to be perfect to be meaningful. By showing up for others in ways that aligned with her values, Kathleen found the connection and purpose she had been seeking all along.
***** Any names and stories in this video are simulated, drawn from thousands of hours of therapy. They do not represent any specific individual, and any resemblance to a specific individual person or persons is purely coincidental