Question: My anxiety/depression is very severe that I have a lot of physical presentations of it. I pace back and forth constantly many hours a day, my head shakes, both voluntarily and involuntarily. I have loss of concentration and confusion and it's very hard for me to make even the most simple decisions like what to eat or what to buy at a store. I know cognitive impairment and trouble with decisions is a normal part of depression, but this isn't just impairment, it is almost complete incapacity to make decisions many times. There are times when I change my mind several times on a decision in just a one second period. How severe are these symptoms and what should I do about them? I want to do Cognitive Behavioral therapy, but when I am this restless where I can't sit still, it doesn't seem to be helping. Should I focus on working with a psychiatrist and medication first? How can a psychologist help me right now when my anxiety is so severe?