Specialty care
Anxiety & Burnout Therapy
Getting everything done on the outside while running on empty inside? Online therapy for high-functioning anxiety, burnout and perfectionism, for adults across Massachusetts and Rhode Island, with Ashti Mistry, LICSW.
BCBS · Optum · Harvard Pilgrim · United · Aetna · Cigna · Online in MA & RI
Something worth saying
What Are High-Functioning Anxiety and Burnout?
High-functioning anxiety is an everyday phrase, not a diagnosis. It describes people who keep meeting the demands of work and home while feeling anxious, restless or on edge underneath. Cleveland Clinic notes that someone with high-functioning anxiety may appear calm on the outside but feel very anxious internally. Burnout is the exhaustion that builds when stress goes on too long without real recovery. The World Health Organization describes job burnout as an occupational phenomenon, not a medical condition, marked by exhaustion, distance or cynicism toward work, and feeling less effective. Many people also use the word for the depletion that comes from parenting or caregiving.
You don't need a label to reach out. Therapy offers a steady space to slow down, understand what's driving the pressure, and find a pace you can actually keep. Ashti Mistry, LICSW, has been practicing since 2017 and offers secure online sessions for adults located in Massachusetts and Rhode Island.
What we work with
Does This Sound Familiar?
You might recognize one of these, or several at once. They're common experiences, not a checklist or a diagnosis.
Always On
Your mind keeps running through lists and "what ifs," even when you finally sit down. Rest feels like one more thing you're behind on.
Perfectionism & the Inner Critic
Good enough never feels good enough. You double-check, over-prepare and replay small mistakes long after everyone else has moved on.
People-Pleasing & Over-Responsibility
You're the one everyone counts on. Saying no feels uncomfortable, so your own needs keep sliding to the bottom of the list.
Running on Empty
Tired in a way a weekend doesn't fix. You might feel short-tempered, detached, or like you're going through the motions.
Stress You Feel in Your Body
Tight shoulders, a clenched jaw, trouble sleeping, an upset stomach or a racing heart before the workday starts. See how stress shows up in the body.
Pressure From Every Direction
Career demands, raising a family, caring for a parent, or all three at once, with little room left for you.
Who it's for
Do You Need Therapy if You're Still Managing?
You don't have to be falling apart to deserve support. Many people come to therapy precisely because they're still holding everything together and can tell it's costing them more than it should. It may be worth reaching out if:
- The stress no longer eases on weekends or vacations
- You feel irritable, numb or detached more often than you'd like
- Your sleep, health or relationships are taking the hit
- You're relying on pushing harder because slowing down feels unsafe
- People keep telling you you're doing great, and you feel like you're barely keeping up
If what you're feeling is mostly heaviness, low mood or losing interest in things you used to enjoy, our anxiety and depression therapy page may fit better. Not sure? A free consultation is a good place to talk it through.
Who we work with
People Who Look Fine on the Outside
Professionals and high achievers
Doing well at work, and quietly bracing for the moment it all slips.
People in a career change
A new role, a promotion, a pivot or a layoff can turn up anxiety, even when the change was your choice. Read when panic starts at work.
Parents holding the household together
Managing schedules, work and everyone's feelings while running low yourself. Babies and young children are welcome in online sessions.
Caregivers
Caring for a parent or loved one while keeping the rest of life going.
First-time therapy clients
If you've always been the one who handles things, asking for help can feel unfamiliar. You're welcome exactly as you are.
People who "have no reason" to feel this way
Things look good on paper, so you wonder whether you're allowed to struggle. You are.
Why it matters
How Therapy Can Help With Burnout and Anxiety
Rest, boundaries and good habits all matter, but they can be hard to put in place when anxiety is the thing running your schedule. Therapy looks at what's underneath: the beliefs, pressures and patterns that keep you pushing past your limits.
Understanding the pattern
Together we notice what drives the overworking, over-checking or over-giving, and how it shows up day to day.
Easing the inner critic
Compassion-based and mindfulness approaches can help you relate to yourself with less harshness, which can make change feel more possible.
Boundaries you can live with
We practice saying no, asking for help and protecting time for recovery, in ways that fit your real work and family life.
Reconnecting with what matters
Using values-based tools like the values bullseye, we look at where your energy is going and where you want it to go.
Our approach
Evidence-Based and Paced to You
We draw on research-supported approaches and adapt them to your goals, your pace and your life. Sessions feel like a collaborative conversation, not a script.
Cognitive Behavioral Therapy (CBT)
Notices the thought and behavior patterns, like perfectionism and catastrophizing, that keep anxiety going, and practices new ones.
Acceptance and Commitment Therapy (ACT)
Helps you make room for difficult thoughts and feelings while moving toward what matters to you.
Mindfulness
Builds present-moment awareness so you can notice stress building before it runs the day.
Compassion-Based Approaches
Softens self-criticism and builds a kinder, steadier inner voice.
DBT-Informed Skills
Practical tools for handling intense emotions and getting through hard moments.
Solution-Focused Therapy
Builds on your strengths and what's already working, one small step at a time.
What to expect
How Do You Get Started?
- 01
Free Consultation
A free 15-minute call to talk about what's been happening, what you're hoping for, and whether we're a good fit. No obligation. We're accepting new clients, and the typical wait is about a week.
- 02
Check Coverage
We're in-network with Aetna, Blue Cross Blue Shield, Cigna, Harvard Pilgrim, Optum and UnitedHealthcare. Private pay is also available, and limited sliding scale spots are offered; ask during your consultation. See Rates & Insurance.
- 03
Intake
A deeper conversation about what's on your plate, what's hardest right now, and what you'd like to feel or do differently.
- 04
Regular Sessions
One-hour sessions by secure telehealth, with flexible appointment times. We check in regularly and adjust as your needs change.
Common questions
Questions About Anxiety & Burnout Therapy
Is high-functioning anxiety a real diagnosis?
No. "High-functioning anxiety" is an everyday phrase, not a formal diagnosis. It describes people who keep up with daily life while feeling anxious underneath. You don't need a diagnosis or a label to start therapy; a free 15-minute consultation is a good place to talk through what you're noticing.
Can therapy help with burnout?
It can. Therapy can help you understand what's keeping you stuck in overdrive, ease self-criticism, and practice boundaries and recovery habits that fit your life. Progress looks different for everyone, and we'll check in regularly about what's helping.
How do I know if it's burnout, anxiety or depression?
They often overlap, and you don't have to sort it out alone. Burnout is usually tied to long-term stress, often at work. Anxiety tends to show up as worry and feeling on edge. Depression is more about persistent low mood or losing interest. If low mood is the main concern, see our anxiety and depression therapy page, or bring it to your consultation.
Do I need to be in crisis to start therapy?
No. Many people start therapy while they're still functioning well on the outside, because they can tell the pace isn't sustainable. Reaching out early is a reasonable choice.
Is online therapy for burnout available in Massachusetts and Rhode Island?
Yes. All sessions are by secure telehealth for adults located in Massachusetts or Rhode Island at the time of the session, so you can join from home or another private space without adding a commute to a full day.
Do you take insurance?
Often, yes. We're in-network with Aetna, Blue Cross Blue Shield, Cigna, Harvard Pilgrim, Optum and UnitedHealthcare, and your cost depends on your plan. Private pay is also available. See Rates & Insurance.
Can I bring my baby or young child to sessions?
Yes. Babies, toddlers and young children are welcome in online sessions, so you don't need to arrange childcare to get support.
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You Don't Have to Keep Holding It All Together Alone
A free 15-minute consultation with Ashti Mistry, LICSW, licensed in Massachusetts and Rhode Island. We'll talk about what's on your plate, what you're hoping for, and whether we're the right fit.
Online sessions for adults located in Massachusetts and Rhode Island.