
- With Mayo Clinic psychiatrist
David Mrazek, M.D.
read biographyclose windowBiography of
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
April 19, 2011 7:44 p.m.
What effect do hormones have on depressive symptoms? My depression has been very black for 1 -2 days sometime before my period but I haven't figured out just when. I know stress triggers my body - I have autoimmune diabetes, thyroiditis and dermatomyositis - as well as some major depressive episodes recently. Just wondered what hormones exacerbate depression?
- Terri
March 30, 2011 12:39 p.m.
I want to know if anyone has prickly skin with their anxiety. I have had this around my one arm for a long time-sometimes it is there & other times it is better.
- Paula
February 23, 2011 9:31 p.m.
Panic attacks are controllable. Please do not let this horrifying experience impact your life.
- Will
February 20, 2011 6:33 p.m.
I have had Hypothyroidism since aug 2010. I have depression,anxiety,panic. Have taken mind altering drugs. Can not take them. am taking Vistral now 25mg. Is there anything I can do, this is terrible. I dont feel like I will ever be myself again. Anybody have any ideas that might help?
- pam
January 21, 2011 2:54 p.m.
I usually engage in at least 30 minutes of meditation before each visit to the dentist. Visiting the dentist is one of my least favorite thing to do, yet it is a necessity if we plan to live healthy lives. Consider deep meditation, visualization and relaxation techniques the next time you have to engage in something that causes you anxiety. It has helped has helped me tremendously. I list some other helpful techniques at: Cures for Panic Attacks
- Clay
January 12, 2011 1:47 a.m.
I am a psychologist in Perth, Western Australia. I have developed an online therapy program which deals with managing depression and anxiety. If anyone's interested please see my website.
- Psychologist Perth
January 3, 2011 5:42 a.m.
Thank you Dr Mrazek for your self-management tools. The worst thing for me is the panic attacks that intensify in the first several weeks after starting medication (cipralex). I had to reduce it from 10 mg a day to half that because I was in such a state, shaking, teeth chattering, waking up with dread and fear that I was dying, a pounding heart, and blood pressure shooting up to 190 over 110. I think the trouble is partly with my brain escalating the panic, as you say, particularly if it is a weekend and I feel isolated from health services (I live on an island). I calm down when I talk to a reassuring doctor. Do you have any advice for dealing with the high blood pressure issue which is what I think scares me the most? Thank you all for the postings, it helps to know you are all there (sorry, wish you weren't).
- Daphne
December 8, 2010 1:56 a.m.
Can depression and anxiety cause asthma attacks and trouble breathing. I am coughing and panting the drs say its all in my head ,nothings wrong. Pleas help me. Thanks
- Elaine
November 1, 2010 8:55 a.m.
Yes I agree that depression can be a challenge to manage, but at the same time it's all about the individual because that's where it all starts. We as human beings all handle depression in different types of ways, because what works for one person may not work well for the other. That just goes to show how different we all are, so if anyone really want to get over depression - it all starts with You. Even though a loving & helpful supporting cast would be very beneficial, sometimes we have to do it on our own.
- Daniel
October 16, 2010 11:21 a.m.
Great article! Thanks for the info. If anyone (including the author) would please be so kind as to read and reflect on my article on panic relief it would be much appreciated.
- Mark
October 10, 2010 3:57 p.m.
I have PTSD, depression and anxiety...definitely feel it doesn't help to be post menopausal (women of coursej) but men also go through hormone changes as they age...so don't discount this!! Be good to yourself, don't kick yourself for what's happening, life is tough but we're tougher. Try meditation, be sure you're getting enough B1, B6 and B12 (be careful on dosage of these), get plenty of VITAMIN D from the sun, at least 10-15 minutes a day if possible. Listening to sages help me a lot, I like Wayne Dyer, and love watching Joyce Meyer and JOel Osteen and their "spiritual" teachings. I have PTSD pretty bad, so I know of what I speak......talk to a psychologist if you can, or a friend who will not judge you who has an idea of what TRUE anxiety is....God Bless. HANG IN THERE, U R A GOOD PERSON....AND DESERVING OF GOOD THINGS AND LOVE!! HUGS TO YA!!
- Betty
August 4, 2010 8:04 a.m.
I want to support all of you who suffer of anxiety. For me the helpful thing was a good doctor, a great pychologist and somebody who teached me meditation an relaxation teqniques to get a grib on my anxiety. It's hard work, but you can fight it! So have much courage!
- No name given
July 28, 2010 1:24 p.m.
As a teacher of the Alexander Technique, I am convinced that lessons in AT can be valuable in conjunction with treatment options. Since the Alexander Technique is education rather than therapy, it is not appropriate as a replacement for therapy. However, there is a long history of beneficial effects of lessons in sub-clinical anxiety such as stage fright or other performance anxiety as well as fear of heights. Teachers of the Technique can be found in many major cities. For an overview, see my site: the-amazing-alexander-technique.com
- Forrest
July 6, 2010 12:37 p.m.
I have sufferred from depression for years along with anxiety. I have for the past year being sufferring from dibilitating fatigue. I take Effexor XR 150 mg, Klonipin 1 mg, and at night I take Ambiien CR 12 and Remeron. Any suggestions on what will help with my fatigue. I tried Wellbrutrin but did not tollerate it too well as well as Cymbalta. Those make me feel more anxious. Any comments?
- Lynn
June 28, 2010 2:57 p.m.
I read all the comments and don't see my sanity-saving drug, Ativan (lorazepam). Just reading all the side effects from anti-depressant drugs, is enough to freak me out. Ativan is the one thing that lets me get a good night's sleep and I don't wake up feeling like my brain is in a fog.
- Miranda
June 27, 2010 9:48 a.m.
This is my second contribution. I am no better after taking the medication. Have memory problems as well as general anxiety & depression. Am seeing a therapist next week. Am nervous about it. Any advice from anyone? hmPVqf
- JO
June 6, 2010 6:40 a.m.
Wow, how many of us struggle with anxiety & depression. I've had all of the symptoms, insomnia, panic attacks (nocturnal too) I thought I was going through early menopause & insisted that the doctor check my hormone levels. I've always lead a very healthy life-style & managed without any meds or therapy until I hit 40!! I thought that if I exercized, prayed & "did the right thing" that it would just "go away" The mind, body, spirit connection is so fragile, all need to work in unison for us to be healthy. Anyway, I accepted that I need help & am currently taking Lexapro. With the meds & therapy I'm doing okay. We take pills for a headache or other ailments but when it comes to taking medication for mental disorders we beat ourselves up. I've learned not to and to accept that I need to take medication along with dealing w/ life. I just want to encourage all of you to stay on your meds, find a good therapist & stay focused being healthy.Dont beat yourselves up, lift yourselves up!!!
- Liz
May 8, 2010 12:23 a.m.
I have a history of depression. And then came anxiety. And then came menopause. So know I'm confused. Are my insomnia, hot flashes, chills, numb feet and arms, panic attacks a symptom of only depression or does menopause figure into this? I was seeing a doc but just making the appt. gave me so much anxiety I didn't make the appt. Now out of meds.
- Cindy
April 22, 2010 11:11 a.m.
Hi, I have just seen my family doctor & she has put me on Pristiq and promices that this will put an end to my dependence on Atavan - I have had ongoing depression and anxiety with sleeplessness, tingling in my hands and night sweats. tried at least 4 drugs which were supposed to help with the depression, but none of them worked. I live alone (by choice) and have a lot of anxiety about that. Am a "geriatric patient with three kids some of whom know what I am going thru.
- jo
March 29, 2010 8:30 p.m.
Hi,All! I JUST found this site on a friends computer & I'm amazed by how many of us suffer from depression / panic-anxiety disorder; it often makes you feel like you're all alone no one else "GETS" what your'e going thru.I have struggled w/ this for over 30 years but it got more severe about 15 yrs. ago. MY "stress" hits me MOSTLY in my stomach; with pain, bowel problems, nausea, but also (to JILL) have hot flashes/severe nite-sweats, (I sometimes have to get up & change my sheets & p.j.s because they are soaked.) And to "ANNA", I also get numbness in hands & feet BUT ALSO sometimes in my back/shoulders/ face, so I "GET" that too. I get OPTIC migraines, which make me see white spots/flashes/waves & that's kind of scarey. I get palps, chest pains, tremors but mostly, MY panic/anxiety hits me stomach the most (daily). Those who DON'T have depression, etc. are totally clueless as to WHAT we go thru, sometimes on a daily basis. My mom suffered from this illness & so do 2 of my sisters- & neices as well. My third sister however does NOT have it... & she tells me things like- "Oh, just STOP thinking about it'' OR "You just need to get out more & take your mind off of it." (?!?) Yeah, RIGHT! I've had tests, been poked, probed & prodded for a "physical" reason for my symptoms & thay found I DO have chronic irritable bowel syndrome & CFS but can't find anything MAJOR, al
- Sandra C.
March 21, 2010 9:46 p.m.
I just found this blog.I think it was put here for me .I have PTSD,Anxiety ,panic disorder ,sleep disorder.Depression.and often have a very hard time going out of my home .I see a therapist weekly .Am on many meds.I have had suicide issues.Several days ago my therapist sent me to the ER because I was haveing a very hard time coping .They told me to take more meds and sent me home ..Dont know what to do next.
- K
January 27, 2010 2:53 p.m.
Hi all, I suffer with anxiety and depression,Anxiety came first. What scares me is it comes out of no where tingling in my head hot feeling from toes to my head .Worried its a stroke, so now I am taking paxil 20 mg.First time on it was 10 years ago,for a year. Life stresses brougth me back . With therapy and paxil and God ..I will be my new self again..If these head aches would just go away. pax in llatin means peace, peace of mind. Thank you all for listing
- Lorraine
January 15, 2010 1:47 a.m.
About 10 years ago, I was diagnose to have Panic and Anxiety disorder. After reading thru I guess mine is a minor Panic disorder. I only had attacks when I feel trapped,,like inside a lift ,or even stucked in a traffic jam.I was given Xanax to be taken only when neccessary. Well, after 12years, I do have recurrance attacks and as during all these years, I have kinda learn how to cope with it to a certain extend.Like all pro advice, like saying to yourself it is only in my mind and it will go away soon. Stay calm and focus. I must say the Buddhist meditation class I learned came in handy if not 100% but at least 50 %. I really wish I will be totally cured,..soon... I am 51 now.
- Richard
January 6, 2010 5:43 p.m.
I had a "nervous break down" in 2006 due to aggrevated anxiety and depression and am still struggling with the after effects. As I had a severe reaction to anti-depressant meds, I decided to visit a naturopath who put me on 5-HTP. This medication works wonderfully and takes the edge off. However, I am still suffering from severe body shakes, tingling and needle sensations in my hands and feet to the point of feeling numb in my toes. - Recently, I started EFT (Emotional Freedoms Technique), to deal with my emotional issues that stem from my child hood, and hopefully, this will help me. As I am in a lot of pain due to the nerve pain in my hands and feet I am wondering if you wonderful readers have any suggestions. Thank you.
- Jassie
December 29, 2009 8:13 a.m.
I had a breakdown associated with depression and anxiety 15 years ago. I started out on Zanex but could see that it wore off fast and could be addictive so I took Serzone for a year, but developed an allergy to it that mimicked Lupus. So, my psychiatrist put me on Doxipen. That drug seemed to be a good fit for me as it calmed my anxiety and my body shake, helped me sleep (as I went 2 weeks with no sleep whatsoever) and helped my depression. As my body started calming down, I was able to work through some of the issues I needed to deal with. I could not afford counseling so I went through many self-help books to try to deal with my negative thoughts, self hatred, fear/control issues, and anger issues that I continually had in relationships. The thing I discovered is that you can never recover unless you deal with your issues. The drugs are wonderful because they help your body relax and you can get back to ‘normal life’ while you deal with your issues. But, they should never be the answer and the ‘end all’. After YEARS of self help books the one that helped me the most was, “Battlefield of the Mind” by Joyce Meyer. Depression and anxiety is not only a ‘chemical’ thing, but a behavioral thing. With a combination of drugs and changing the way I think…I am now drug free and living a good life. I am praising my Lord!
- Pam

112 comments posted