Q: Existential anxiety and depression is main focus of my therapy for 3 years. I feel better for a while but always plummet. My therapist says it’s common but I’m fed up feeling miserable. Help?

A: You’re asking why relief never lasts, and that’s an important question.

Three years of therapy with temporary improvement followed by a familiar plummet points to something very specific: the surface distress is being managed, but the underlying structure that produces it hasn’t been questioned with radical honesty. Therapy is doing what it’s designed…