How to Understand Anxiety: an Interview With Dr. Therese, Psy.d.

With an innate love for people, Dr. Therese Mascardo is passionate about identifying a person’s unique gifts as a means to help them create healthy relationships and live lives that are fulfilled and inspired. She believes that love is essential, relationships are the greatest source of health and healing, and that every person has the power to make the world a better place. I had the opportunity to talk with her about the similarities and differences between anxiety and depression, how to cope with them, outlets available for those of us experiencing mental illness, and much more. Throughout the mounds of wisdom I learned from her in our 45-minute conversation, perhaps one of my greatest takeaways is that we are all much more similar than we are different, and through honest expression and vulnerability toward mental health, we can come together to make our world a much safer place to live and love in.

What is the difference between depression and anxiety?

There are a lot of similarities and differences. They affect the same neurotransmitters. They are both affected by serotonin and dopamine and have to do with your feeling of peace and calm. Anxiety is oriented toward the future. Individuals may experience nervousness and worry about things that could happen. Physical symptoms include headaches, stomach aches, muscle tension, racing thoughts, increased heart rate, and/or sweating. The main emotion associated with anxiety is fear. Depression is oriented toward the past. Symptoms include sadness, worthlessness, hopelessness perhaps to suicidality, low energy, insomnia, loss of appetite, and/or loss of interest in things once enjoyed.

How can someone share what they’re experiencing in regards to mental illness?

A good way to share is first and foremost is to get educated yourself so that you feel a sense of the reality and justification of these illnesses. They’re measured scientifically. Similarly to if you break your leg, you wouldn’t tell someone to just keep walking on it. You wouldn’t tell a friend to get over it. You would understand that they need treatment so there’s no pain and they heal properly.

Understand, these are real illnesses.

Then, start off by telling people who you absolutely trust, who you can be vulnerable with. People can use labels in a way that isn’t always healthy. Not everyone will handle this condition tenderly. You might not tell everyone in the office, but you might start with a few really close friends.

According to the ADAA, only 36.9% of people get help for depression and anxiety. Why do you think that is the case?

It’s really unfortunate. I think it’s because the barriers to treatment are still way too high.

It takes extreme amount of emotional energy to get help when you’re going through something without even considering different cultures and stigmas against it.

It takes a lot of vulnerability. And that’s before it even starts! There’s also typically some level of financial contribution that can vary based on how good someone’s insurance coverage is. If you don’t have insurance, then you have to rely on community clinics that often have long wait lists.

We are moving in the right direction because people are gaining more access to help, but there is a cultural shift that needs a lot more to change. We need to normalize therapy. It needs to be part of a healthy regimen. Until we make mental health something that’s normalized, it’s going to be really hard for people.

A common question I hear is, “How do you find a good therapist?” It shouldn’t be so hard to do that. One of the things I’m working on is informational videos of how to find a good therapist. People can learn what anxiety is, how OCD works, etc. Once you have the information, you realize it’s not as complicated as you thought.

Can you explain the role of shame as it pertains to speaking out about our own anxiety and depression?

Shame comes up when someone believes that their symptoms are reflective of their unworthiness.

It validates their own underlying belief that their mental illness is deserved because they aren’t healthy enough. It affects people getting help because they’re afraid that people will suddenly realize that they’re unworthy or terrible. Shame is: “I’m not good enough.” The shift is: “What I’m going through isn’t good.”

To combat shame, remind yourself (or your loved one experiencing these) that anxiety and depression are real. They literally affect the biochemistry of your brain. Fifty percent of people in America will experience some form of mental illness over the course of their lifetime, which means, no one is alone in this struggle. Secondly, understand that being in a state of mental illness is a state, it’s not who you are.

This is like the #metoo movement. These issues have been around for years, but never had momentum until the last year. What was so powerful is the prevalence. It’s shifted the course of our culture. It increased awareness. Conversations happened that needed to happen. People saw feminism differently. It’s not, “that one woman who’s really vocal and loud.” It’s for everyone. The more people that are vocal about mental illness, the more we normalize it, and the better it is for everyone.

What type of help is available for those going through depression and anxiety?

To get started, take one small step toward something that will make you healthier. Start meditating and mindfulness. Get outside and get some sunshine. Work on your eating - processed sugars can impact moods negatively. Set up a really healthy routine where you go to sleep and get up at the same time everyday. These are great first steps.

Additionally, if therapy sounds overwhelming, you can share what’s going on with someone you trust. If you feel like you’re not quite ready to find a therapist, ask someone who cares about you to help you find 3 people who would be good for you. You could also do teletherapy over skype, so you’re able to do it from the comfort of your own homes.

How much does physical activity impact our growth toward mental health?

Harville Hendrix writes in Getting the Love You Want, “Self-discipline is self-love.” When you are self-disciplined, it is a statement about how you care about yourself. Even in the smallest of tasks, like making your bed in the morning. It’s one tiny act, but when you start to practice in any area, it starts to permeate every area of your life. You feel more of a sense of self adequacy.

My school of thought in psychology is that depression is strongly linked to physical inactivity. I always give clients this “prescription” on our first session: walk a little bit, sleep, and avoid sugar, alcohol, and processed carbs. Often people will heal so much from these simple actions that they don’t need medication. Plus, sunshine has a chemical effect on our brain. There’s power in taking a 10 minute walk in the sunshine every week.


Why are women twice as likely to experience anxiety than men?

It’s true that women are twice as likely to have anxiety than men. One in three women will meet the criteria for anxiety in her lifetime, and slightly less than one in four men (22%) will. We aren’t 100% certain why, but we do know that brain chemistry is different in men and women. While overall, women are more often diagnosed with anxiety, I would not say they are more “susceptible” to it, because I think that suggests that women are less able to combat anxiety.

One important factor to consider is that women may be subject to more physical and emotional abuse than men, and there is a connection between abuse and the development of anxiety disorders. I think the truth is that women and men cope with anxiety differently. Women are more likely to report their anxiety, seek social support for it, and seek counseling for it. These are excellent skills to help combat all sorts of psychological ailments.

What does someone who has never experienced depression/anxiety need to know in order to be there for someone who is going through these experiences?

They really don’t need to know a lot to be helpful. A mistake I see people make is that they try to give advice. Advice is not something people need. As a therapist, I do this very rarely. Being told what to do isn’t the same as experiencing someone’s love and empathy. When someone is in pain, they need love and support - so be empathetic. Repeat back what you’re hearing. Be able to tame your own anxiety to be there with them.

We have a habit of trying to minimize and fix, but the best thing to do is to make a person feel seen and known, instead of covering the issue up with a bandaid.

For someone who is seeking an entry point to getting help, where is the best place to start?

Psychology Today is a great resource where therapists are listed with profiles and background info. Pick 3-5 people you feel connected to just by their profile, and try to set up in-person meetings with a couple of them. Therapists often give a free consultation, because you should go to someone you trust and feel a connection with. If you have insurance, directly contact them for providers. If you don’t, find a clinic in your area. A lot of therapists have websites and personal reviews to help you decide what route will be best for you.

Photos by: Emily Steffen

Emily Schrems

Emily is a writer and professional nomad obsessed with the craft of storytelling. She is enamored by inspired conversation, diverse culture, and how a solid group of girlfriends and good coffee can heal nearly everything. A bold, “yes” is her mantra, especially in response to an outdoor adventure with her pup, a delicious cocktail and all things west coast. Visit her website,– to connect with her and read additional pieces of writing.