Anxiety & Emotional Regulation Therapy
with Rachel Santellano, LSW
I help teens and young adults manage anxiety, emotional overwhelm, and constant self-pressure, especially during periods of change or uncertainty. Therapy focuses on normalizing what you’re experiencing, building regulation skills, and addressing the real-life stressors contributing to anxiety. This work is practical, supportive, and grounded in day-to-day functioning.
If It Feels Like Everyone Else Has It Figured Out
A lot of the people I work with don’t show up saying, “I can’t function.” They show up saying something more like, “I don’t know why this feels so hard when it seems like everyone else is doing fine.” On the outside, they’re getting through school, work, or daily responsibilities. On social media, it looks like everyone else is thriving — building careers, forming relationships, adjusting easily — while inside, they’re anxious, overwhelmed, or constantly questioning themselves.
I see how isolating that can be. Anxiety often convinces you that you’re the only one struggling this way, or that if you were just stronger or more capable, you wouldn’t feel like this. Therapy can be a place to slow that story down and look at what’s really happening, without judgment.
Holding It Together Can Be Exhausting
Many of the clients I work with are very good at keeping things together. They minimize how anxious they feel, avoid talking about it, or worry about burdening friends and family. Sometimes they’ve learned to mask — to appear calm, capable, and “fine,” even when their nervous system is constantly on edge.
Over time, that kind of emotional holding can lead to loneliness and burnout. Anxiety doesn’t always look like panic. It can show up as overthinking, irritability, perfectionism, emotional shutdown, or a constant sense of pressure. In therapy, I focus on creating a space where you don’t have to perform or explain things away — where what you’re feeling can be named, normalized, and understood.
Emotional Regulation Isn’t a Personality Trait
I often hear people describe themselves as “bad with emotions” or “too sensitive.” I don’t see it that way. Emotional regulation is something we learn over time, and it’s influenced by how we’re wired, what we’ve been through, and what’s happening in our lives right now.
If you’re navigating school, starting a career, moving to a new city, or adjusting to new responsibilities, your nervous system may simply be overloaded. Therapy isn’t about forcing calm or getting rid of anxiety altogether. It’s about understanding how your body and mind respond to stress and building skills that actually help you feel more grounded and in control.
Anxiety, Pressure, and the Need to Appear “Okay”
For many people, anxiety is tied to pressure — pressure to keep up, to make the right choices, to not fall behind. I often work with clients who feel responsible for holding things together, even when they’re overwhelmed inside.
In therapy, we look at how these patterns developed and what they’re costing you now. Accountability here doesn’t mean pushing harder. It means learning how to recognize when anxiety is trying to protect you and when it’s quietly running your decisions. That awareness alone can bring a lot of relief.
How I Work with Anxiety and Emotional Regulation
My approach is collaborative and practical. We work on understanding triggers, noticing how anxiety escalates, and building strategies that actually fit your life. Sessions may include emotional processing, nervous system regulation, and honest conversations about what is and isn’t working.
I work with teens, young adults, and adults, and I pay close attention to context. For some people, anxiety overlaps with neurodivergence. For others, it’s closely tied to life transitions — school, work, relationships, or major changes. I don’t assume there’s a single cause. We figure it out together.
What I Help With
- Ongoing anxiety and overthinking
- Panic symptoms and emotional overwhelm
- High-functioning or hidden anxiety
- Stress and burnout
- Masking and emotional shutdown
- Difficulty tolerating uncertainty
- Anxiety connected to school, work, or major transitions
Is This a Good Fit?
This work tends to resonate with people who are tired of pretending they’re fine when they’re not. If you’re looking for a space where your fears can be spoken out loud, understood, and put into perspective — without being minimized or turned into a diagnosis — therapy with me may be a good fit.
You don’t need to eliminate anxiety to move forward. Therapy can help you feel less alone, more grounded, and more confident in how you handle difficult moments.
Frequently Asked Questions About Anxiety Therapy
Is anxiety always related to trauma?
Not always. Trauma can play a role in anxiety, and I’m trauma-informed in my work. But I don’t assume that every anxiety issue is trauma-based. The brain is complex. Anxiety can be influenced by how your nervous system is wired, life stress, emotional skill development, and where you are in life. If trauma is relevant, we address it thoughtfully — but we don’t go looking for it unless it’s there.
Is this just about coping skills?
No. While we work on practical tools, therapy also focuses on understanding patterns, reducing self-blame, and creating lasting change.
Who do you typically work with?
I work with adolescents, young adults, and adults, adapting therapy to developmental stage and individual circumstances.
Is anxiety always related to trauma?
Not necessarily. I work from a trauma-informed perspective, which means we address trauma when it’s relevant, but I don’t assume all anxiety or emotional regulation challenges are trauma-based. Anxiety can be influenced by brain wiring, life context, stress, and transitions. If trauma is part of what’s driving symptoms, we’ll address it thoughtfully, but we don’t go looking for trauma where it isn’t needed.