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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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July 3, 2008
Managing depression by understanding anxiety
By David Mrazek, 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.
112 comments posted
January 31, 2012 11:05 a.m.
what can you do to help distress?
- love123
January 29, 2012 6:02 p.m.
Depression needs understanding from love ones, especially the family.
- Doctorate of occupational theraphy
January 19, 2012 9:23 a.m.
It seems that nobody can escape the wrath of anxiety at least at some stage of their lives. Many millions of us also suffer with panic attacks and in many cases end up suffering with depression as a result.
- Athena
September 18, 2011 8:15 p.m.
Faye I also have PTSD and all the things that go a long with it .If you find an answer to your question ,please write .I would be interested about anything you find on PTSD.Good luck .
- kam
September 16, 2011 3:18 a.m.
This is one of the better articles I've seen in regards to understanding the psychosomatic process involved in a panic or anxiety attack. Well done!
- Serene
September 14, 2011 5:05 p.m.
Response to Paula - Yes!! Prickly skin!! I get this on my arms when I feel myself starting to get stressed. I use it as an "early warning system" for what could turn into an anxiety attack. As soon as I feel it coming on, I step back from the situation (physically or mentally), take a deep breath, relax and take a new approach. Works most of the time to stop the anxiety from overtaking me.
- Sue
September 14, 2011 4:59 p.m.
In response to Debbie - Depending on your age, the hot feelings you are experiencing may be related to menopause. My hot flashes got worse after my period stopped. Also, fatigue is common in menopause. Making some small changes to your routine may help -- wear lighter clothing while riding, ride during the cooler parts of the day, that sort of thing. Hope this helps.
- Sue
September 11, 2011 11:36 a.m.
Clair I wanted to respond to you. I too have grown up with severe sexual, physical and mental abuse from birth! I feel so alone and have battled severe depression all my life. I have tried to commit suicide many times. Everyday is fight to just keep living. I have been on meds most of my life and thru therapy but am still depressed. I have a hard time enjoying anything in life. I just feel dead inside. I drink to drown out the horrible feelings but that doesn't help it just causes new set of problems. I am in my 50's now and was hoping it would get better with age. no luck there lol. I wish you the best as I know how it feels...
- Cindy
August 26, 2011 8:07 a.m.
I do have anxiety and stress, but according to Doc, my blood work is O.K. What I am having is the feeling of being hot. Worst when I first get up in morning, and then bouts of it during day. Also if I ride my bike I feel I don't have enough energy to get back home . Help me please
- Debbie
August 24, 2011 10:17 p.m.
dear clair: i'm glad u wrote in, welcome to the blog, i 2 have treatment resistant depression & have been thru alot of meds. & r still looking 4 the right combo after 35 long yrs. (20 yrs. of nardil) that med. worked great & then stopped when i started with the "wonderful" menopause lol, have u tried nardil (it's a MAOI medication)?? it has all 3 of the neurotransmitters in it, have u tried any alternative supplements ex. SAMe, 5-HTP, St. John's Wort, etc. there's always ECT treatments 2, there's a blood test CYP 450 that tells your dr. which meds. would be suited for you personally, good luck & hope this helped, write back & let me know how you're doing
- denise
August 22, 2011 7:31 p.m.
Treatmaent resistant. OK, long history of panic attacks and depression since childhood. Severe sexual, physical and emotional abuse. Meds and therapy since late teens. Full understanding of condition and causes. Tried EVERYTHING incl. meds, anti dep. (venlaf the best) anxiolytics,(Diphenhydramine the best) some antipsycotics, lamactil, vits, etc. Some help but condition still really disabling. Any ideas?
- Clair
August 14, 2011 9:05 a.m.
Is there any councing that help with Panic attacks with ptsd
- faye
July 9, 2011 8:24 p.m.
I am a caregiver to my mother and enrolled in a clinical pastoral education unit (CPE) at a Christian hospital. Last year while I was at work, and while my mother was at home alone, she experienced a panic attack (a sudden state of fear) and fleed. She was found by the ambulance hal unconscience in a nearby street. I have received the following suggestions from a local behavorial health therapist and from my CPE Supervisor: 1. reflect back on life for anytime of abandonment (leaving a biological parent to live with a step parent)or any type of mild to severe abuse that one may have experienced in life and be prepared to come to terms with it by either confronting it, putting it to death (figuaratively speaking). For example, because of my mother's up bringing in a country where voodoo is highly practiced she believes that the cause of her panic attacks are voodoo based. In respond to that came up with a saying when she experiences a panic attack "This shall pass in the name of the Lord." I have yet to invite a pastor a good friend who is a nurse to prayer over my mother and excorcise the deamons out of her and reliquish the authority for my mother to do the same if another panic attack occurs. 2. Explore and implement relaxation techniques: regular excercise program (walking), music, reading, prayer etc; 3. avoiding stimulants such as caffine. Nontheless, we have yet to know if the panick attacks have ceased for good, but if they return we have somewhat of
- Moe
July 5, 2011 2:01 p.m.
When I feel anxiety, it actually helps me to breathe. Sounds elementary, but when I breathe in deeply, count to four, then breathe out through my mouth slowly, it helps. I concentrate on my belly moving in and out. Before I know it, I calm down. It's the distraction away from the source of the anxiety that helps me refocus. Usually, I can come back to the situation in a calmer state of mind.
- Wayne
July 4, 2011 10:30 p.m.
I've never had a panic attack but I have a friend who said she suffers from them. This was reminds me of my blog that I posted the other day on a person who suffered from panic attacks.
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July 3, 2011 3:05 p.m.
"I get apanic attacks when I drive on the interstate are driving over a bridge'How can I over come this feair'I love to drive but'How can I over come Thia'
- Charles:
July 2, 2011 3:19 p.m.
dear Luc I too have tryed so many different drugs Iwas ready to give up .I am now taking Lexapro and just a few weeks a go was given Lamotrigine. I always have so many side effects from all my meds .Not this one .I take them together in the morning .It was only a matter of days before the fog lifted .It sure doesnt make everything go away .For the first time in 4 years and many attemps at so many drugs I feel like I can think a little clearer .
- kam
June 27, 2011 11:24 p.m.
Friends, I’ve read on the Internet that the use of Pristiq can exacerbate anxiety. So my anxiety might be a natural occurrence of taking that particular medication. I also read that it can take up to eight weeks or even more to get the full benefits of an antidepressant. However, I’ve been on these medications for two decades now, and none of them have been effective so far! I’ve learned about a genetic test that could help discern if my body metabolizes well the antidepressants I take to help my condition. I don’t know if this test is available in Canada, however? Any way I look at it, depression is martyrdom all along! Cordially, Luc
- Luc
June 26, 2011 2:09 a.m.
Doctor, There would be considerable risks of using Seroquel: tardive dyskinesia, fever, 'diabetes', somnolence and cataracts. I still find it very difficult to get rid of the symptoms of depression, along with a terrible anxiety in the morning. It is martyrdom! The good effects of Pristiq were imaginary or short term? I do not know. However, my anxiety disappears when I'm standing. But my depressive symptoms come and go, incessantly. I read that it would serve no purpose to increase the dose of Pristiq, because it would only exacerbate the side effects of that particular drug. Anyway, I am faced with extreme anxiety [about money, although I can wrap my income] in the morning. It's unbearable! I still want to give Pristiq a chance to act, but if things are getting worse, I will take an appointment with my doctor. We will then assess the risks of using Seroquel or Cymbalta. Regards, Luc
- Luc
June 20, 2011 11:00 p.m.
Thanks for sharing your thoughts! Depression sometimes lead to suicidal actions that's why it is important as early as possible if you are finding yourself in the middle of stress or depression to consult to an expert. Remember an ounce of prevention is a liter of cure! :)
- Scott
June 18, 2011 10:46 p.m.
dear Pershing: i'm glad u wrote in, i'm not a professional but just a person that suffers from depression & anxiety, i can't say that i have suffered from any panic attacks, but if u go on-line under "panic attacks in children" there's a web-site that will help you & your family in the meantime, while ur waiting 2 c a psychiatrist, write back & let me know how all of you are doing, you're in my prayers
- denise
June 18, 2011 11:17 a.m.
Our daughter has panic disorder. She has panic attacks about once a week. She has all the typical symptoms. She is currently under a physicians care...but we are waiting until the beginning of July (when ins. will pay for it) to make an appointment with a psychiatrist. What can we do, as parents, to enable her recovery or lessen its impact.
- Pershing
June 16, 2011 3:45 p.m.
There are many effective ways to deal with depression, including exercise, talk therapy, medication, natural supplements, and lifestyle choices. Learning about the treatment options will help you decide what measures are most likely to work best for your particular situation and needs. There are no quick fixes or instant cures, but if you're willing to work on yourself and stick with treatment, you'll find yourself out from under depression's shadow sooner than you think.
- Jenny
June 3, 2011 11:31 p.m.
Hi everyone, I am sad and i am not sure what to do at this point in my life,I am a real person and life just sucks at this point,i have been talking to all the professionals and they all get paid and i am still depressed,so what the hell is up this,medicate,medicate,thats all the the professionals want to do,well guess what i wll not to be able to afford to be swept under the carpet,all people want these days is to get there degree and live the high life on us people that really need help,I have been to so many over the years,and its all about the money...,no more hearts out there in helping,it all goes back to old America,We help each other,not anymore,so i need help and i cant get,i cant afford welfare ,i make to much money,But i have insurancs,but no one to really help me,I have been depressed all my life,and have so many bad things happen,and everyone has been paid but me.
- Patty
April 29, 2011 9:06 p.m.
Hi Terri, I simply wanted to respond to your post because I have the exact same thing. My anxiety/depression is mild to moderate, but 1-4 days before my period I experience seriously deeper darkness. I am now thinking of going the antidepressant route for the first time. Previously I could depend on the herb St. John's Wort. It doesn't do enough now mostly due to these several days around my period. I also wish I knew what the hormone situation was. I just feel like whatever it is, all of the serotonin is drained from my body. I wish there was a bit more clarity here too. I have been to several doctors and they can't find anything. So next it's on to the psychopharmacologist. Best wishes to you.
- Samantha
112 comments posted