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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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Depression blog
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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 28, 2008 11:22 a.m.
I have panic disorder and have researched the web site. The U of Iowa is developing a genetic blood test for this disorder which I believe means there must be a biological cause...if this were strictly a behavioral problem it would not show up on a genetic blood test. Also the National Institue of Health is doing alot of research and has already discovered that the serotonin levels in the brains of people who suffer from this are one-third lower in three key areas of the brain. I have provided this information to my mayo psychologist and now because I don't want to believe that this is strictly a behavioral disorder...that there is definitely a biological trigger point for this disease.,,my doctor wants me to see someone else. At this point I feel my doctor has totally given up on me...that I have made my doctor upset because of the information that I researched. I know that the doctors are very educated and have studied this for many years but I have lived with this illness for years. This disease is not just being a little stressed or anxious...I feel like I am short circuiting...like the wires in my brain just are not connecting properly...and to describe this feeling to doctors is almost impossible. All I really want to say is if doctors really want to learn about this disease listen to your patients. We can teach you more about panic disorder than any textbook.
- No name given
October 27, 2008 12:53 p.m.
MJ, We would recommend you talk to your provider. I am very sorry to hear about your daughter. Anxiety can be normal during stress but you should be evaluated to assess both your anxiety and depression. We cannot predict if you will have another episode, so following closely and monitoring your active symptomsis important. Our thoughts and prayers are with you! Lilly, We would recommend that you discuss all of the risks, benefits and alternatives with your care team. If ECT is their number one recommendation, that doesn't mean that you have to. Ask what their reasoning is for not trying the other medication first. Have all of your questions answered and then you'll be better equipped to make a decision with your loved ones. Best wishes and we hope you feel better soon. MC.Com Staff
- MC.Com Staff
October 25, 2008 3:26 p.m.
I have had GAD for about 15 years now with three major depression episodes sprinkled in just for fun! Five years ago I watched my mother die a very slow death from leukemia. We were best friends. Now my other best friend, my 28 daughter has been diagnosed with an inoperable brain tumor. While she may live a long life, just recently when she visited, I experienced the same anxious feelings being with her as I did being with my mom the last year of her life. It took the joy out of our visit. Is this normal or do I need to worry about heading for another depressive episode?
- MJ
October 21, 2008 9:06 p.m.
Has anyone been treated for anxiety/depression by ECT in less than 2months? The Hospital we are at is pushing ECT before trying an old drug that worked in the family. Should we try medicine first before jumping into ECT treatment?
- Lilly B.
October 17, 2008 6:02 p.m.
I wanted to thank you Val for your post. I feel the same way about the hardest thing being that I'm watching myself act in ways that are not the real me. No one understands that - its destroyed my relationship with my husband and he has the "your tougher than that, its a choice so make it" attitude. It felt so good to know that I'm not alone. Thank you.
- Kel
October 15, 2008 10:11 p.m.
I HAVE HAD IT CAN SOME ONE GIVE ME SOME ADVICE ON WHAT MEDS ARE THE BEST AFTER 15 LONG YEARS IM AT THE END OF MY ROPE IM GOING ON MEDS
- mike
October 13, 2008 10:25 a.m.
Please do not put in personal information such as full name, e-mail address or phone number. We do encourage you to help each other but have found that providing specific personal information is not a good idea. Thank you.
- Mayo Clinic.com Staff
October 12, 2008 3:06 a.m.
i have had anxiety all my life i am 27 now and i have trowed all my medication away and have learned to deal with it i am a severe hyperconderiac and i still worry constanly about my health but i do not have a problem with anxiety anymore but i know how you all feel i was there going on no sleep i still sleep with the light on thinking if i shut it off i will have some kind of symptoms that i will not be able to see in the dark and i used to run the ER everytime i thought i was dyeing but no more and i cannot tell you how i did because i dont know how i did it but i have all the same problems all of you are haveing if my chest starded hurting i whould run to the ER thinking i was haveing a heart attack and i have so bad of panic attacks that it felt like i had a electric shock in my tounge i passed out everytime i have a panic attack but i decided one day i am tired of the doctors useing me as a guiney pig i throwed all my meds away and delt with it i am telling you that you have to that meds might work for you but they did not work for me
- chris
October 9, 2008 9:18 p.m.
i have had anxity,panic,depression for over 15 years at one time i did not leave the house for 3 years im at the end of my rope do i go on med's. on the net all you here is horror stories i no you say you read all of these post but i would like a answer please if you can help it would be a blessing i no god will work through this post so i can get back to liveing life.
- mike
October 2, 2008 1:14 p.m.
I have been taking an SSRI for depression and anxiety for a month now and the depressive moods are gone. But I still have anxiety. Also, the medication appears to have increased my insomina. I have been depending on a sleep aid to sleep but I still feel sleep deprived and stressed. I cannot even take an afternoon nap. I feel fatigue and tired all the time. From my readings, it appears that all SSRIs have insomnia as a side effect. How can i get around this chronic insomnia? I eat right and exercise already.
- Maria Goretti
September 29, 2008 11:53 a.m.
Jim, You need to discuss your physical symptoms with your primary care provider or the person that prescribes the prednisone. Yes, prednisone cause anxiety and mood symptoms. The symptoms usually go away after tapering the prednisone.
- MC.Com Staff
September 25, 2008 12:13 p.m.
Following a 6wk bout with cluster headaches; I've developed persistentanxiety and numbness in my left hand/forearm and feet. In addition I frequently feel "woozie." I'm wondering if this could be related to the prednisone I used for a month? I have gone through the usual blood tests etc.noting shows up, but I'm left with the adrenaline in my stomach. jim
- jim
September 21, 2008 11:39 p.m.
This is to everyone, My son just returned from the Mayo-amazing experience! We are now finally on the right track. I agree fully with ap Relief, peace and reasearch. I will add hard work and support from family and friends. I hope you all find your way.
- mom
September 20, 2008 9:38 p.m.
My depression and anxiety comes from a bad divorce that is still raging. I get lonely and think there is something wrong with me. I have tried meds, they are not working. I have been trying to occupy my time by doing a lot of volunteering and working extra jobs. It would be nice to find something that would help.
- R.C.
September 12, 2008 2:47 p.m.
Im precribed to alprazolam, and propanolol,for panic attacks.I had night terrors or panic attacks in my sleep as a child not only would i wake up in fear but the fear would make me try to run without any control of where i was going.Im 26 now and i still have them and it becomes over bearing somtimes i wont say anything to antbody and i will just get in my truck and leave work it will eventually cost me my job.so any herbal supplements or books or tapes you guys can suggest to me would be greatly appreciated. I cant drink or take to heavy of a pain pill nore do any street drugs.
- chris
August 21, 2008 5:50 p.m.
I have just returned from the ER at my local hospital with all of the symptoms of Anxiety/Panic. I am seeing a specialist who has referred me to an Endocrinolgist - many panic/anxiety symptoms can be from other conditions and are not isolated. Do not forget to review the OTC drugs that you take. I have been taking an antacid and in reviewing possible side effects - many of them are eactly what you experience in an anxiety or panic attack. I have been diagnosed with OCD and I do take clonazepan. This does help turn down the symptoms but does not stop or cure the problem. I tend to think that a bad mix of perscription and otc drugs can be a huge part of the problem. Stress and what's going on at home and at work contributes. Yoga helps. Walking helps. Get adequate rest and hydrate with water. Stop caffeine, tobacco and keep alcohol to no more than one drink. Stop all street drugs. Watch your diet - get a well balanced diet with adequate protein, fibre and fruits and vegetables. Gastro-intestional progblems can have many of the same symptoms. So can Thyroid and andreanl fatigue. You need a good doctor to sort this out with you - you can't do it on your own. Rule out physical problems as well as mental health problems. I think if medication keeps you sane until the pieces of the puzzle are put together then by all means take them responsibly under the supervision of a doctor. Be honest with your health care providers - if you're smoking drugs-adds to the proble
- Adele
August 10, 2008 6:51 a.m.
I have anxiety daily. I also have panic attacks when I feel like I am going to die. It onset when I was 25, now I am 42. I have a Ph.d from a reputable university and have managed to function highly. Wellbutrin has helped me, with depression. Valium has helped me with anxiety, though I refuse to take it more than two days in a row. Right now it is hard to leave the house and I am struggling to keep my job. In my opinion this country lacks mental health parity coverage. If I could move to a Scandinavian country I would do so in an instant.
- AT
August 8, 2008 7:32 a.m.
anxiety is major factor causing depression and taking anxiolytic drugs helps in reducing it so you should control it
- -amit yadav
August 7, 2008 9:49 a.m.
I bought a book on practicing mindfulness. I do not want to mention the name of the book I read to avoid looking like I am pushing something. . My life has been changed dramatically from the practice. Look into it as an alternative to anxiety that works.
- Don D.
July 22, 2008 4:06 p.m.
Hello- Thanks for your interest and we are glad that you are helping each other out! Your individual experiences are important. We do not have the capacity to publish summary notes, journals, etc. from individuals. If we did this for one person, where would we draw the line? Thanks for understanding. We definitely recommend David Burns, MD material and Mind Over Mood by Greenberger/Padesky-both are excellent resources for cognitive behavioral therapy. (CBT)
- MC.Com Staff
July 21, 2008 8:49 p.m.
I am being treated for anxiety and panic attacks and my counselor suggested that I read Dr. Burns book. I have started it this past week and I think it may help me also. I too worry about all the medications that I have been taking.I would like to read Rick Beatty's summary notes. Is that possible?
- CK
July 20, 2008 7:03 a.m.
Dr Burns book is available in book stores.Try the self help sections
- sam
July 19, 2008 11:23 a.m.
Thank you to all who have shared their experiences. I don't feel so alone. My story is similar to most of yours and I suppose one of the hardest things is to see and feel myself acting in ways that are not really me. Which in turn, is slowly distroying all my relationships, because I simply can not trust anyone anymore. I don't want to be this way. I read and educate myself as much as possible so that I can find a way to be the real me again. Is Dr. David Burn's book "Feeling Good" still in print? Thank you again to eveyone who has the courage to reach out. Namaste.
- Val
July 17, 2008 12:13 a.m.
Will your notes fit on this blog? I'd be very interested in seeing them. My counselor keeps advising against cognitive therapy, but I keep seeing it recommended as the best approach to anxiety. Thanks, Greg
- Greg
July 16, 2008 12:01 p.m.
Like many others who have commented upon this article, I too suffered from anxiety and panic attacks for 20 years before they culminated into Clinical Depression. My anxiety and panic attacks were miss-diagnosed by the medical profession for 20 years. During my panic attacks my chest muscles would contract so tightly that I could not breath and felt like an elephant was standing on my chest. Doctors told me to relax and excersise more to reduce the frequency of these attacks? Then they gave me the same simple advice that appeared in your recent article entitled "Recover from Depression One Step at a Time". These simple panaceas did not help me one iota. The long term cure for anxiety and clinical depression is set out in the book by Dr. David Burns entitled "Feeling Good" the New Cognitive Therapy. I read and summarized the contents of this book and then attended a Cognitive Therapy Clinic sponsored by a hospital (part-time) over six weeks. I no longer suffer from either anxiety or clinical depression but continue to rely on Cognitive Therapy daily to challenge and dismiss those automatic negative thoughts that caused my anxiety/panic attacks and immobilized me in a state of clinical depression. Please let me know if there is a way I can send you a copy of my Summary Notes on Dr. Burn's book "Feeling Good", so that others may share my experience. Thank you.
- Rick Beatty
61 comments posted