The first thing I did was start seeing a therapist. My therapist was recommended by my doctor. She had an office in the same building as him and they knew each other, so it worked out quite well. Its important to note that she is a therapist and counselor, not a psychiatrist. As such, medication is not part of her toolkit, which is just the way I wanted it.
Initially, I was going twice a week as I was still in the grip of 5 months of serious anxiety and depression and I needed lots of help. First, we had to "stop the bleeding", so for the first month or two we focused primarily on making me functional again - learning to relax and knock down the panic and anxiety. I had already learned much about abdominal breathing and other basic relaxation techniques, but having someone to work with was a big help in actually putting them to good use. Slowly, I began to regain mastery of my anxiety and panic and I was back among the living (even if I was pretty shaky and close to the edge most of the time).
We also worked on strategies I could use to help change my thinking. The first step was understanding that I could control my thoughts. The most powerful cognitive weapon in my arsenal to this day is one simple idea - "This is just a thought. If I don't like it, I can choose to have a different thought". I'll never forget my first few days working on that as I tried to go about my daily activities. It was absolutely exhausting as my mind was constantly "racing", but it worked. I was starting to feel a difference. When I stopped fearing my thoughts, things became easier on me.
One of the first tasks she made me to was to make a list of things that made me happy. I had to make that list, and keep it with me at all times. In the state I was in, it was often difficult to feel joy, so imagining things that made me happy was a challenge. She was a huge help, explaining that I didn't need to swing for the fences all the time. She asked me if there was anything in particular that I liked about the car I was driving at the time. Well, I guess I liked the fact that it had heated seats. Bingo. There was item number one on my list. I remember laughing out loud because it seemed so silly and simple, but I had the idea. Within a week or so, I had a decent list that ranged from the mundane to the sublime. My job was to keep adding to the list as things popped into my head, and to physically look at that list any time I needed to intercept a "bad" thought and turn it into a "good" thought.
I kept that list on my Palm Treo until the day I sold it. Guess what? The list got transferred onto my iPhone and remains there to this day.
After a couple of months, I went from twice-a-week sessions to once-a-week. I was improving and I didn't need her as much. We kept working on the coping skills and cognitive behavior stuff, and also started working on larger life issues like the fear of failure, having unrealistically high self-expectations and resolving interpersonal conflicts in a more productive manner. We talked some about the fact that my parents divorced when I was 10 years old and how that may have contributed to my problems later in life. We chatted about things that were bothering me at home and about how I could take a healthier approach to my professional life that would help minimize stress. It was all good stuff.
By the summer of 2006, I was doing great. I was actually going days at a time without any notable anxiety. My depression and obsessive thinking were gone. My mild agoraphobia was gone too. I was out and driving around.
By August I think we had gone to every-other-week sessions. By Christmas she had closed her office on Long Island and my initial journey through therapy and counseling was over. Mission accomplished and it was an experience that will serve me for the rest of my life.
I've maintained contact with her since then, and we've done a couple of face-to-face sessions when she's been out in my neck of the woods. We've done some work over the phone too, when I needed it, most recently in the last 6 months or so when my anxiety and panic returned, brining the mild to moderate agoraphobia with it.
I'll talk more about that down the road ...
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