Anxiety Therapy in San Francisco & Online across California
We help adults understand where their anxiety comes from, so they can stop reacting on instinct and start choosing differently.
Is Anxiety Affecting Your Daily Life?
Maybe you're the one everyone counts on, and no one knows how much you're actually carrying. Maybe you say yes when you mean no, replay conversations long after they're over, or feel your chest tighten before you even know why. If your mind rarely feels quiet — even when things are, on paper, fine — you're not imagining it, and you're not alone.
How Anxiety Can Show Up
Anxiety rarely looks like a textbook definition. More often, it shows up as:
Constant overthinking — replaying the same conversation or decision for hours
Difficulty relaxing — feeling unable to slow down, even when nothing's wrong
Panic attacks — sudden waves of fear that can come out of nowhere
Trouble sleeping — a mind that won't quiet down at night
Fear of disappointing others — over-giving, over-apologizing, or saying yes when you mean no
Burnout — pushing through instead of stopping, until you can't anymore
Physical symptoms — tension, a racing heart, or a stomach in knots with no clear cause
What We Work With
Generalized anxiety and chronic worry
Panic attacks
Social anxiety
Work and career stress, including burnout
Perfectionism and fear of failure
Anxiety tied to family expectations or relationships
High achievers and founders navigating pressure and high-stakes decisions
Immigrants and first-generation individuals holding two cultures at once
How We Approach Anxiety
Most anxiety therapy stops at Cognitive Behavioral Therapy (CBT) — a structured approach to noticing anxious thoughts and reframing them. CBT has its place, but it can stay at the surface: it teaches you to think differently about your anxiety without necessarily addressing why your body and emotions are producing it in the first place.
At Spiral Up Therapy, we work with approaches that go deeper — and pair them with practical tools you can use right away.
Cognitive Behavioral Therapy (CBT)
Once a pattern is named, CBT gives us concrete tools to restructure it —
catching an unhelpful thought in the moment and building a more accurate,
less punishing one in its place.
Acceptance and Commitment Therapy (ACT)
ACT teaches you to make room for anxious thoughts and feelings instead of fighting them, and to reconnect with your own values so your choices come from what matters to you, not fear.
Psychodynamic & Attachment-Informed Therapy
This is where we start: understanding your story, including your childhood experiences and your relationship with your parents or caregivers. Many of your earliest beliefs about safety, worth, and control were formed there — often before you had the words for them, and they're often still running the show. We help you name the specific thoughts and beliefs underneath your anxiety, trace where they came from, and recognize that many were genuinely helpful once. The work isn't to blame yourself for having them — it's to notice when they've become more harmful than helpful.
Self-Compassion Practice
Part of this work is learning to be an adult to yourself — steady and caring enough to catch an old belief in the moment and choose something different, instead of running the same script.
Your therapist draws from these approaches based on what you actually need — there's no one-size-fits-all protocol here. Most people notice some relief within the first three months, and we recommend ongoing support to continue exploring what's underneath.
Meet the Team
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Manali Deolalkar
Licensed Therapist
Individual Therapy - 210$/session
Couples Therapy - 230$/session
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Melanie Lei
Associate Therapist
Individual Therapy - 175$/session
Couples Therapy - 225$/session
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Meghna Das
Associate Therapist
Individual Therapy - 150$/session
Couples Therapy - 175$/session
What Sets Us Apart
Culturally Sensitive Therapy
South Asian Therapy
Immigrant Therapy
Inclusive Therapy
Frequently Asked Questions
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It depends on you. CBT and ACT are strong starting points for most anxiety; mindfulness helps regulate day to day; psychodynamic work helps when anxiety is rooted in longer-standing patterns.
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Most clients start weekly and see meaningful shifts within a few months, though this varies by person. We check in on progress and adjust together.
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Yes — online anywhere in California, plus in-person sessions in San Francisco
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We're out-of-network. Most clients pay directly and use a superbill for reimbursement — ask us about this during your consultation.
You Belong Here 🌟
Whether you’re the first in your family to seek therapy, or you’ve been on this journey for a while, we’re here to walk alongside you. Think of us as a mix of thought partners, compassionate guides, and cheerleaders—here to help you rewrite the story you want to live. Your culture, your struggles, and your dreams all matter—and we’re honored to hold space for them.