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David Mrazek, M.D.
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David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
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Depression blog
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June 7, 2008
Personality disorders can be managed
By David Mrazek, M.D.
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Personality traits are a part of all of us and are influenced by our background and genetics. Sometimes a person will have an inflexible, maladaptive personality style. When this begins in early adulthood and results in significant impairment in functioning in life, it is termed a personality disorder. While these can be difficult to treat, recognition of a personality disorder is the first step in managing it. This is relevant to depression as this can impact depressive symptoms directly and can also impact the success of treatment.
There are many different personality disorders. We all may have some of these personality traits, but that doesn't mean that it meets the diagnostic criteria for a disorder. Types include: paranoid, schizotypal, schizoid, borderline, narcissistic, antisocial, dependent, obsessive compulsive (different than obsessive compulsive disorder or OCD) histrionic and avoidant.
Like other psychiatric disorders, the disorder's symptoms can range from mild to severe. When someone is under a lot of stress, the personality disorder can worsen. The person with the personality disorder will tend to blame everyone and everything else for their problems. Not having insight that their behavior affects their life is a hallmark of a personality disorder. You can easily see why an untreated personality disorder could negatively impact the successful treatment of depression.
For instance, borderline personality disorder is characterized by erratic mood swings, poor self-esteem and self-image, chaotic relationships, chronic suicidal ideation, suicide attempts, parasuicidal behavior, (such as cutting) impulsivity, paranoia under stress, hearing voices or seeing things (hallucinations) under stress, chronically feeling lonely and bored, being vulnerable to abandonment.
When reading this, one can see that some of the symptoms may appear to be similar to other psychiatric illnesses. For instance, paranoia under stress or hallucinations may make one think of schizophrenia. Severe mood swings may make one think of bipolar affective disorder. One symptom in isolation does not make a diagnosis as we have talked about before. The treatment for borderline personality disorder is a very specific kind of therapy call Dialectical Behavioral Therapy or DBT.
As always, a thorough evaluation by a trained professional is the best way to ensure proper diagnosis and treatment. Sometimes, symptoms will change or appear over time and the diagnosis may change. With insight, motivation and hard work, one can manage their personality disorder which in turn can help with successful treatment of depression.
36 comments posted
September 22, 2008 11:36 a.m.
Joni- There is no specific test for schizotypal personality disorder. A clinical exam is important and talk therapy is the treatment. I would contact your community mental health center-sometimes they have a sliding scale. You could also contact your county social services to ask what is available for help in you area. It is great that you have insight and are willing to accept help. Best wishes to you.
- MC.Com staff
September 17, 2008 1:28 p.m.
I suspect I have schizotypal disorder. I am 52 but this has been with me my whole life. Is there a test to find out? I have no insurance because I can't hold down a job for long.
- joni
September 2, 2008 5:01 p.m.
Gia, I would recommend you support your friend directly and recommend he get help for his drinking. You could go to Al-Anon yourself for support. You will not be able to change his fiancee'. She doesn't have any insight into her behavior and that is the hallmark of a personality disorder. It is difficult to see someone you care about suffering as well as being in the relationship you describe. He may not see the red flags in her that others see for many reasons. If you didn't already, try getting someone to help you and his family with an intervention without including her. Again, talk to someone at Al-Anon or AA. Good luck.
- Mayo Clinic .com Staff
August 30, 2008 12:01 a.m.
I suspect that my friend's fiancee suffers from schizotypal or borderline personality disorder. Last year, several family members and I reached out to her due to concerns for his health. We all suspect he is an alcoholic and wanted her help in an intervention. She has since decided that we are evil and trying to hurt him and does not want to have anything to do with us. When family members have tried to talk to her, she distorts the conversation and interprets it in a negative way. It seems that she looks at situations as black and white and if you cross a line, there is no getting back in her life. Recently I reached out to shake her hand at a black tie function, and she pulled her hand away from me in front of several people. This is causing a lot of anguish to my friend and his family. I also noticed that strange dress is a symptom. This woman has a habit of wearing inappropriate clothing, very often revealing underwear lines and plunging necklines. She appears to be an exhibitionist. I noticed that this is a sympton for Schizotypal disorder. This is a woman who is very caring to him and loves him, but cannot give an inch in forgiving his friends and family she believes are evil. Any comments or suggestions?
- Gia
August 12, 2008 7:35 p.m.
How do you find a reputable person for a dignosis? I am in the Macon area. Thank you a million
- Terry Parker
July 7, 2008 2:33 p.m.
For more on anxiety -see other links on our web site. This entry is meant to stimulate discussion on personality disorders and their effect on depression management.
- MC.com staff
June 26, 2008 12:49 p.m.
Anxiety is a range of disorders that includes Panic disorder, Generalized Anxiety Disorder, Post-Traumatic Stress Disorder (PTSD), phobias (for example, heights) to name a few. The diagnosis of Panic disorder is made when a person has recurring panic attacks accompanied by other specific symptoms and criteria. Therefore, a panic attack is a symptom of anxiety. A panic attack can include some or all of the following symptoms: sudden onset of extreme fear (panic), shortness of breath, a choking sensation, numbness or tingling in the fingers and/or toes, sweating, nausea and/or vomiting, and palpitations. (heart pounding) Many medical illnesses can cause the above symptoms, so seeing a professional is important for the right diagnosis. As said in an earlier entry, some people have depression and anxiety together.
- Mayo Clinic.com Staff
June 25, 2008 8:14 p.m.
I do wish someone would tell us the difference between a anxiety and a panic attack. I, too, have experienced palpitations, etc.
- Betty
June 19, 2008 8:03 a.m.
on and off i experience palpitations and and extreme sense of discomfort and helplessness. i cannot do anything but wait for it to pass. i am told i'm having panic attacks. but i experience no fear. what am i having?
- No name given
June 17, 2008 9:42 p.m.
How can I deal with depression from being a caregiver to my husband who has Parkinsons? I never have time to do anything I need time to do.
- lois
June 17, 2008 4:29 p.m.
what is the difference between an anxiety or panic attack. How should these be treated?
- Betty
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