Come As You Are: My Approach to Anxiety, Stress, Trauma, & Perinatal Mental Health Therapy

Written By: Abby DeRoche, APSW

My own experiences with anxiety, mental health, and going to therapy myself helped shape me into the therapist I am today. They also led me toward practicing perinatal mental health therapy, anxiety therapy, and trauma therapy here in Madison, WI. My own experiences also taught me the importance of and need for extra support when individuals are going through life transitions. At the center of my work is a simple philosophy: come as you are.

My Own Mental Health Journey

My mental health journey began during my freshman year of college, when I found myself overwhelmed by intense anxiety. At the time, I didn’t have the language for what I was experiencing. I remember thinking I was “irrational or crazy,” not realizing that what I was feeling had a name and an explanation.

Entering therapy for the first time, I learned what anxiety was and realized it had been present throughout most of my life. Having words to describe my feelings and reactions felt deeply validating.

With a better understanding of my mental health came a sense of empowerment. I learned that I could rewire my thoughts, build coping skills, and integrate them into my daily life.

I also learned a truth that many people don’t talk about: healing is not easy, and therapy is not a quick fix.

Seeking help can feel uncomfortable, vulnerable, and unfamiliar. This is why I believe asking for support and practicing getting comfortable with being uncomfortable is incredibly brave. I decided that I wanted to be there for people who want to take that brave step into self-exploration.

My “Come As You Are” Approach to Therapy

In my work as a therapist, I hold a “come as you are” philosophy. Come with the awkwardness, the discomfort, the messiness, because I have been there myself.

I know what it feels like to walk into a room unsure of how you are going to show up, and I want my clients to know that all parts of them are welcome.

It is my privilege to hold space for the stories and the traumas that feel heavy. I approach each person with a tailored, client-centered lens, honoring your strengths, your pace, and the wisdom you already carry.

Whether you’re navigating life transitions, sorting through anxiety or stress, healing from trauma, or exploring who you are becoming, I believe you are the expert of your own life. My role is to walk alongside you, helping illuminate what feels confusing, tender, or unfinished while supporting the resilience that’s already present within you.

Why Perinatal Mental Health Matters to Me

My interest in perinatal mental health began with my diagnosis of PCOS (WHO, 2025). I was not given much information at the time, and the guidance I did receive was confusing or unhelpful. I later learned that PCOS can be correlated with anxiety and depression (Dokras, 2012; WHO, 2025).

As I continued researching, I discovered how little attention and funding exist for women’s mental and physical health (Kulkarni, 2014; Rodin & Ickovics, 1990)

Combining my interest in gender studies with my commitment to mental health led me to the field of reproductive and perinatal mental health, where my heart has stayed ever since.

My passion for gender and women’s studies allows me to support those navigating hormone vulnerability, perinatal mental health, perinatal loss, reproductive trauma, and the complex emotional experiences that come with these transitions.

A Little About Me Outside the Therapy Room

Outside of work, you’ll usually find me on a walk, listening to podcasts, watching reality TV, or doing something active like cycling, Pilates, or hot yoga. I’m in the process of learning Spanish, and I love to travel. I get excited about fashion and interior design, and I can spend way too long curating a mood board for any occasion.

You Don’t Have to Show Up Put Together

In my therapeutic work, I often remind people to be however they need to be in the moment.

In my space, you do not need to be put together when you walk through the door. Bring your struggles, your tenderness, your strength, your exhaustion. I am here to support you and to honor the resilience that already exists within you.

 

About the Author: Abby DeRoche, APSW, is a client-centered, strengths-based therapist at HEART Counseling who supports teens, young adults, and adults navigating perinatal mental health, life transitions, trauma, anxiety and stress, and identity exploration. Abby brings a humanistic, trauma-informed approach to therapy and believes healing happens through connection, curiosity, and creating space for people to reconnect with what is meaningful and resilient within themselves. 

 

References

Dokras, A. (2012). Mood and anxiety disorders in women with PCOS. Steroids, 77(4), 338–341. https://doi.org/10.1016/j.steroids.2011.12.008

Kulkarni, J. (2014). Women’s mental health: Still not a priority, still not good enough. Australian & New Zealand Journal of Psychiatry, 48(8), 701–704. https://doi.org/10.1177/0004867414541684

Rodin, J., & Ickovics, J. R. (1990). Women’s health: Review and research agenda as we approach the 21st century. American Psychologist, 45(9), 1018–1034. https://doi.org/10.1037/0003-066X.45.9.1018

World Health Organization. (2025, May 7). Polycystic ovary syndrome. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome