A lot of people tell me their anxiety got worse after they moved to San Francisco. Most of them assume something is wrong with them.
Often it is not. Some of what they are feeling is coming from the city itself, and they have not named it yet.
That distinction matters more than it sounds like it should. If you believe the problem is you, you try to fix yourself. If you can see the pressure you are actually living under, you have something you can work with.
Everything here moves fast. People are optimizing something at all times, whether it is a career, a workout, a side project, or a weekend. You absorb that even if you never agreed to it.
Your nervous system starts treating an ordinary Tuesday like there is something to keep up with. Nothing is wrong. Nothing is due. You still feel behind.
In my work with clients, this is usually the first thing we untangle. People describe feeling rushed with no deadline attached to it. That is not a character flaw. It is what happens when the pace around you becomes the pace inside you.
Rent here is high. Groceries are high. A normal month costs more than it would almost anywhere else. That creates a low hum of financial pressure running quietly in the background.
Most people do not think of that as anxiety. They think of it as math. But your body does not separate the two. When money is a standing concern, you stay a little more alert than you otherwise would, and that baseline stress adds to everything else you are carrying.
I see this in people who are, by any outside measure, doing fine. Good job, stable income, no crisis. They still describe a tightness they cannot account for. Often the explanation is that they have never had a month here where money was not a variable.
San Francisco concentrates high achievers. You work near them, live near them, and read about them. Your brain quietly measures you against them all day, whether you ask it to or not.
This one is worth naming clearly. Comparison to others wears on you even when nothing in your life is actually going wrong. You can have a good week and still feel like you are falling behind, because the reference point keeps moving.
This comes up constantly in my practice, especially with people working in tech. The standard they hold themselves to is not their own. It is assembled from everyone around them. That is also why so much of it stays hidden behind a life that looks successful from the outside.
Naming the source is the first step, and it does more than it sounds like it does. Anxiety with a cause feels different from anxiety that seems to come from nowhere.
From there, a few things tend to matter. Getting specific about which pressure is yours and which belongs to the environment. Deciding what you are actually optimizing for, rather than defaulting to whatever the people around you are optimizing for. Protecting time that is not productive on purpose. These are also the habits that keep tech burnout from building quietly.
None of that changes the rent. It does change how much of the city you are carrying on your own.
If the city is part of what is wearing you down, you do not have to sort it out alone. The therapists at Good Therapy SF work with adults across San Francisco on anxiety, stress, and burnout. Reach out for a free consultation to learn more.
About the Author
Dr. Tom McDonagh, PsyD, is a licensed clinical psychologist and the founder of Good Therapy SF. He trained at Vanderbilt and completed a postdoctoral fellowship at Kaiser Permanente. He works with adults on anxiety, stress, and burnout, and much of his practice is with people working in tech. Good Therapy SF is located at 870 Market Street, Suite 617, San Francisco, CA.
