
- With Mayo Clinic psychiatrist
Gabrielle J. Melin, M.D.
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Gabrielle J. Melin, M.D.
Gabrielle J. Melin, M.D.
Dr. Gabrielle Melin, board certified in general psychiatry and psychosomatic medicine, is looking for ways to empower patients and families dealing with chronic mental illness. She encourages patients to commit to working together with their physicians and health care teams.
Dr. Melin completed medical school at the University of Minnesota. She completed both her psychiatry residency and consultation-liaison fellowship at Mayo Clinic before joining the Mayo Clinic staff in 2001. She is medical director of Mayo Clinic Psychiatry Emergency Services in Rochester, Minn. She has special interests in emergency psychiatry, adult psychiatry and addiction psychiatry.
"Instilling hope is one of the most important things we can do for patients and families. Mental illness can be chronic and significantly impacts lives. Our goal is to provide the best treatment and education so that patients can manage their symptoms more effectively," she said.
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July 3, 2008
Managing depression by understanding anxiety
By Gabrielle J. Melin, M.D.
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Depression can be a challenge to manage. Anxiety and depression may occur together but certainly not always. Be assured that if anxiety accompanies depression, it can be treated.
Anxiety may manifest itself in a multitude of ways including fear, helplessness, a feeling of panic, feeling that something bad may happen, as well as possible physical symptoms. We wouldn't be human if we didn't experience anxiety.
Anxiety is a general term. Anxiety disorders include a number of different specific disorders that includes panic disorder (panic attacks plus other symptoms), generalized anxiety disorder, post-traumatic stress disorder (PTSD), phobias (for example, heights, flying, needles), 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 cluster of symptoms that signify anxiety. A panic attack can include some or all of the following symptoms: sudden onset of extreme fear (panic), shortness of breath, dizziness, feeling hot/cold, a choking sensation, numbness or tingling in the fingers and/or toes, sweating, nausea and/or vomiting, and palpitations or a sensation of heart pounding.
Panic attacks typically last for a few minutes, reach a peak intensity, and then resolve with time. If you do have panic attacks, here are a couple of basic self-management tools:
- Although you may feel completely powerless, anxiety is nothing more than an exaggeration of normal body reactions to stress.
- Tell yourself in a positive tone of voice that this will pass and it is not dangerous.
- Refrain from escalating your panic with frightening thoughts about what is happening and where it will lead ("what if").
- Don't fight the feeling of panic, accept it. Get as comfortable as possible without fleeing. You could sit or lean on something.
Many medical illnesses can cause anxiety symptoms, so seeing a professional is important for the right diagnosis.
Finally, we want you to know that we do read through all of the comments you send, but cannot answer all of them. Our goal is to provide accurate information and stimulate conversations amongst visitors. Thanks for visiting our blog and have a great week.
61 comments posted
October 21, 2009 1:51 p.m.
Hello All: I read your comments and pray for a measure of grace for us all. I have Crohn's disease and developed an anxiety disorder after what was a normal Crohn's surgery followed by a gaggle of complications. I also have a hugely traumatic event from my teen years, 34 years ago, that recently has bubbled up after having dealt effectively with it for over 20 years. MY QUESTION: Does anyone else get anxiety symptoms without the worry or dread? Please understand I'm not minimizing the way many are suffering, but I've described it as panic attacks without the panic. I'm currently in therapy and don't outwardly seem to have any of the emotional component to anxiety (which sounds a little like being sad without feeling bad...it just doesn't make sense somehow). I experience chest heaviness (not heart problems, we've checked), throat tightening, the urge to tense all my muscles (like a physical case of "the willies"), resulting muscle ache, difficulty concentrating. Presently managing with nortriptyline and xanax, and using relaxation exercises (thank you "Relaxation Response" book!). Anyone else out there trying to manage this? Any thoughts are appreciated. Rusty
- Rusty
September 27, 2009 10:06 a.m.
..this is continued .. at present iam 59 years old this oct 11 as i was born in 1950. i am presently adddicked to xanax and can t live without them. i take 6-8 mgs a day to "bring me down to where i can sorta function to at leastdrive side streets to work n maitain my ownn home. My wife of 26 year "left me.. n my 3 grown children -dont talk to me.. they all moved away or moved "on' I live alone with 3 German Sheppards.. My jobs a hard one,, I ve bbeen lifting weights since 16 years old to relieve the stress. Gee I can bench 255 lbs on a 45 incline bench and dead lift 330 lbs..I at one time single arm pressed 145 in my 20s.. my best bench press 'prone was 330.. best dead lift 410 best miltary press 225 still "going.. til i have a stroke or die from overexertion. Never took street drugs ,only "doctos drugs,, been hooked as a teen on 12 different drugs . Was Never cured I am longterm chronic.. but stll try everday to be normal..
- Greg postted sept sept 27th at 9:50 am here see thatfirst
September 27, 2009 9:50 a.m.
Hello from Greg,... to Anyone reading this. Gee Most here are recent su\ffering people .thst may have been panic disorder for a few years. Does 43 years break a record?. Mine started out as a child. I 'always felt afraid" of..= life. Movies scared me isoalton scared me.. lage open ares scared me. riding in cars ,,nothing ade me feel.."safe" I wound up seeing doctors in my 14 year old days .. They told me nothing. Back then they tested you n dissmised anything,,of a disorder save for GAD. well I "talked suicide ,,never really tried that.. but was "detained in a mental facillity at 15 for 2 months on a "locked ward with "adults trying to sexually violate me. My parents we re not educated, they never finished high school. My dad Died on me 2 weeks before my 15th birthdy,, He had polio all his life but nevergave me any atention as his child. My mom made him move out the year earlier.. He died shortly after ,,He gave up on /life.. I had felt he actually died from a broken . We n my mom were his life. Well I was let out of that ospital after 2 months they did more harm than good. Now I was stimatized. everyone knew about me I had no girlfriends.. I stayed in my room at home most the time. I "painted n sculpted and wrote poems. I lost a year of high school and repeated.2nd yr, high school. I had a lower 90 s avg, in grammer school 8th grade.. and my teacher
- Greg
July 4, 2009 7:47 p.m.
I was found out last October 08' that I have diabetes. During my education classes for diabetes I found out that it comes with depression. Right now I feel so very alone and that my family and co-workers are against me. This is causing me to have more anxiety attacks. I'm under my dr's care for this but there seems to be times that the meds don't work as well as others. My dr gave me a 2nd pill to take during the time I feel an anxiety attack coming on me. I feel like some members of my family are trying to "fix" me. That I'm "broken". My grandmother now treats me as if all things lead back to the depression. I know I still have enough grasp on reality to know that not all of it leads back to the depression. It's the sterotype placed on those of us who have depression. I think the two main co-workers I work with have depression too but they are not seeking help. One is extreamly hateful to me. So much so that our boss made them apologize to me. So I know it's not all in my head. What more can I do to stop the attacks esp at work?
- ChristineE
July 2, 2009 8:05 p.m.
I AM 56 YEARS OLD AN HAVE BEEN DEALING WITH MAJOR DEPPRESSION FOR THE LAST 20 YEARS. I STARTED ON PROZAC AND TOOK IT FOR 10 YEARS. IT WORKED GREAT AND THEN IT STOPPED WORKING. THE LAST 10 YEARS HAVE BEEN NEW MEDICATIONS LASTING 2 YEARS EACH. I AM THROUGH MENOPAUSE AND WONDER IF MY PROBLEMS WITH DEPRESSION AND ANXIETY COULD BE HORMONAL. WHAT DO YOU THINK?
- judy
June 28, 2009 12:51 a.m.
i tell you i feel like the most alone person but reading this is incredible iam not suffering alone and neither are you guys it is the most isolating feeling of dome and despair ever i have gone threw it all the meds therapy grat quite times without the meds away from therapy and back it comes again worse and trickier than ever there has to be better way and the worst is why do people label us i have a feeling we are truly so intelligent that we dont realize how strong and great we are...imagine how powerful we could all be if we could channel this energy but where is the trick i tell you there has to be a better way even if its meds therapy or what???everyone i have spoken to says the lucinda basset tapes really work... and these people mentioned it to me and the by the way i suffer also comes out.. why is there such a label until people suffer they dont understand it is truly a humbling experience..l.
- debbie
June 18, 2009 12:34 p.m.
Hi, I'm new to this. I wanted to know if there is a chatroom out there for panic attacks. Sometimes during an attack, it would really be great to have someone to talk to during it. I can go months without one. Then I have a panic attack and mentally I a set back. I feel like a loser, failure, weak, like I can't handle what others can. I have no support in this area. Most people look at you and asks whats bothering you? just relaxs. Ok I'm sleeping and I get anymore relaxed than that? and waking up gasping for air and terrified. I would like to know if there is a chatroom where others can share thoughts, suggestions or even ideas that have been positive for them in handling there panic attacks. I have listen to meditation cd, talk visualization and read so many books and articles but all this information, doesnt help me during a PANIC ATTACK! it's like I forget it all and am so fearful I am going to die, I make it worse or last even longer. I need to talk to people who experience it and are living with this disorder and understand what I am going through. Thanks
- Phillie
June 18, 2009 12:22 p.m.
Anthem, you may want to give your know medication a chance. I have a problem with the dosage thing myself. I take 0.25 xanax up to 3 times a day as needed. But what do I do? take it only when I have a panic attack and usally then it's too late. I have been taking one a day now. I am not aware of my stress I fool myself into believing I am handling it. Sounds like your a natural worrier. Have you tried talk therapy? sometimes it can be a release and they Dr may uncover things your not aware of. Keep strong, and don't give in or up! Begin with some positive thining. you are aware that you are a negative thinker, work on changing that behavior. Good Luck!
- Phillie
June 18, 2009 12:14 p.m.
I have been having panic attacks for almost 10 years. I get numbness in my face at time or my ears too. It's normal and part of the panic attack.
- Phillie
June 6, 2009 8:45 a.m.
Does anyone experience feeling hot all the time with no fever (many times dizziness) and no explantion for it? Doctors have just laughed it off and say I am too young for menopause, but I have been dealing with this since a young age....It is very annoying.
- Jennifer
June 4, 2009 5:00 p.m.
Has anyone ever been treated with EMDR. It's a type of Eye Movement therapy for anxiety & depression. My therapist wants me to try it and I'd feel better if I could talk to someone who has experienced it before. Lisa
- Lisa
June 3, 2009 1:12 p.m.
I have been diagnosed with Panic and Anxiety disorder. Congitive therapy has done wonders for me but I still have unexpected attacks. Is it normal to have your stomach, hands, feet, parts of face go numb or tingle with pain? I have been to every specialist but my therapist says only my hands and feet should feel that way. Is there anything else I should get checked out?
- Anna
May 28, 2009 2:09 p.m.
Working towards the purpose of your life actually signifies that your subconscious ness is in harmony with the actions taken. You will actually be surprised to see how you feel after you start implanting your plan. Thanks for the great article.
- Debra Trotter
May 22, 2009 1:59 a.m.
I am very thankful that I have found this site. I have recently been diagnosed with adjustment disorder. I am a teenage single mother who has been through alot throughout my life. It took 18 years for the right doctors (of CAMH) to diagnose me with the appropiate diagnosis. Growing up, the other doctors, all just considered my stress "adolescent stress".
- Mary
May 12, 2009 2:57 p.m.
Is it possible to have General Anxiety Disorder sort of..subliminally? I have hot flashes everyday, sometime more than once per day and excessive night sweats! Going on over 3 months now - it's torture! I'm 36 with 2 small children and it effects my daily living in a very negative way. I've been checked by my primary physician thoroughly - blood test; urine tests; MRI; EKG; have been to the Endocrinologist, etc. I'm Healthy! Great! We've been discussing anxiety and although I am a very busy person and have a lot of my plate, I live a wonderful life and no real cause I can pinpoint for anxiety. I've been on Zoloft for about a week now and it has helped reduce the severity of the hot flashes, they are not completely gone. I cannot help to think something else may be going on. My family and friend think I discount the amount of stress in my life, but it the amount isn't much more than I've handled most of my adult life. Any advice?
- Jill
April 14, 2009 12:35 p.m.
Dear Bloggers, Please do not write in with comments such as "never take medication" or "never go to therapy." Different treatments work for some and not others. We want to encourage readers to share experiences. We do not want to discourage people from seeking treatment. Thank you for your continued interest!
- MayoClinic.com Staff
April 6, 2009 7:59 a.m.
Hi. I have had symptoms now for a little over a month, the basics, anxiety attacks, panic attacks and while trying to fight them off I will get exhausted and then a slight bout of depression sets in. Lots of guilt, fear, and feeling of doom. I know that i have no reason to feel like this, I have a good job and a loving/supporting wife & extended family. Im just sick of these feelings. I have tried things suck as Omega-3 fish oil, changing my diet, trying to exercise etc. I pray everyday for God to remove this, and I know He is working with me. I have been taking Buspar now for about 3 days with really no improvement, I dont want to get on any heavy type meds for this. Basically I know its all in my head, I take something positive and make it negative then allow fear to creep in, if I could just think the opposite. Im so tired of this crap and I want to defeat it.
- Anthem
March 4, 2009 12:29 p.m.
Yes, there is medication available that effectively treats anxiety. Work with your provider to get an accurate diagnosis as well as to know the benefits and side effects of the medications. Anxiety can be treated successfully with therapy as well as medication, so keep an open mind if therapy is recommended. Best of luck!
- MC.Com Staff
February 25, 2009 9:22 p.m.
Hi i just wanted to know why i get anxiety every time i go to a public place or sometimes when im talking to someone that i dont really know is it my age im 31years old.I use to be able to control my panic attacks when i was 25 but,now it seems like its getting worst now i get anxiety with the panic attacks is there any kind of medication for this.
- ej
February 12, 2009 1:47 p.m.
Hi, I wanted to respond to the person that said they have a fear of swallowing. I also have this. When I was about 11 or 12 I almost choked on food. Even though this event did not immediately affect my eating habits, later on in my adult life I became afraid of choking. People think I don't like to eat.I do but I take forever eating and never gain the weight that I want to. Does anyone know of any resources that can help me. This problem has caused much depression. I also have a slight stuttering problem that is related to anxiety problems, that I can control the majority of the times. My friends and family do not know of these problems. I don't want to be on any medications, I know that behavior modification should be effective. I am a mess and I really need help. Thanks.
- hope
December 31, 2008 10:38 a.m.
Mike this e-mail is for you. I also suffer from panic disorder and know how horrible it is. Most doctors that treat this disorder have never suffered from it and have no idea the suffering we are going through. The good news is that the U of Iowa has developed a genetic blood test for panic disorder. This disease is not all in your head...there is a genetic basis for it. However at this time the treatment for this disease remains the same...medication and cognitive behavioral therapy. I have chosen group therapy rather than medication because I have heard that there are so many serious side effects from the medications and coming off of them can be extremely hard to do. However if you should choose to discontinue your medications you need to do this very slowly and under your doctors supervision. I can not emphasize this enough. If you go off the meds too quickly you could suffer major complications and this would only make matters worse. If you have not tried group therapy I would recommend it. It's not a quick fix by any means but you will be with others who are going through the same thing and you will have a safe place where you can talk about your attacks and no one will laugh at you...and the added bonus is you will make 5 or 6 brand new friends...and that in inself is wonderful. God knows what you are going through also. Pray and ask Him to help you. He will bring you comfort. I hope this information will help you. Take care.
- No name given
December 22, 2008 12:13 p.m.
I feel at times that i can't swallow my food.. i fear that i am going to choke.. has anyone ever felt that way??
- bp
December 10, 2008 3:08 p.m.
I HAVE HAD DEPRESSION FOR A LONG TIME BUT NEVER AS BAD AS KNOW IT DOES'NT MATTER WHAT I TAKE NOTHING SEEMS TO WORK. IT REALY GOT BAD ABOUT 5 YRS AGO WHEN I HAD SHOULDER SURGERY AFTER THAT SURGERY I STOPPED TAKING HORMONES. COULD THAT HAVE MADE IT THIS BAD? I'M 59 NOW.
- EDIITH
December 4, 2008 10:49 p.m.
if there is some one that can help me i have been taken xanax for 12 years 1 mg for about 7 years and 1 and 1/2 mg for adout 3 years and 1 and 3/4 mg for 2 year. for anxity / panic/ depression . im gonig to stop it c/t i have had all i can take if there is some one that can give me some advice it would be nice the mental disorder is bad but im so tired of all this. this will be the last time i post a comment if i dont get a repley i do not take antideperession med if you think they will help i would like to no i have tried every thing self help /threapy/all what do i do next i think if i get off the xanax i might not fill down all the time but if ther is something else that might work i would like to no thanks.
- mike
November 24, 2008 8:42 p.m.
help i would like some one out there to give me some advice on do med work or not after 15 long years of panic/anxity/de pression i just dont no what to do next do i just got to live this way or not??
- mike
61 comments posted