
- 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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Aug. 22, 2008
Bipolar isn't simple; there can be many sets of symptoms
By David Mrazek, M.D.
Bipolar affective disorder is a disorder of mood that involves a depressive phase and a nondepressed or manic phase.
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The specific set of symptoms is important as some medications, such as Lamictal, are better for a mixed bipolar episode. Medications used to treat bipolar (mood stabilizers) are different than medications used to treat depression.
The manic phase is characterized by elevated or irritable mood plus 3 to 4 of the following symptoms happening during the same time period (at least one week continuously):
- Decreased need for sleep (feeling refreshed on little sleep)
- Decreased appetite
- Grandiosity (inflated sense of self worth)
- Distractibility
- Excessive involvement in pleasurable activities that have a high potential for painful consequences (buying sprees, sexual indiscretion, foolish business ventures)
- Flight of ideas (talking and thinking that jumps from one topic to another-racing thoughts)
- Increase in activities involving school, work or social life
- Agitation
The person may also experience psychosis, which means being out of touch with reality. The manic phase is a change in previous life functioning that is not caused by drugs or alcohol. The manic phase alternates with a depressive phase.
The Mood Disorder Questionnaire (MDQ) is a self-screening tool that can be used in conjunction with a visit to a mental health provider. Mood swings alone do not mean you have bipolar. Borderline personality symptoms can look like bipolar and other mental illness, too. Time and accurate information help to make the correct diagnosis and provide the best treatment.
124 comments posted
September 8, 2010 12:43 p.m.
I have been suffering from Bipolar disorder since I was a teen. I tried to kill myself, but fortunately survived. The paramedics, came on time. They tried to place me in Camarillo Mental Hospital. I refused. I now have been on paxil for nearly 2 years. The mood swings has now been diminished. I could get along w-others. I have been in a realtionship for 9 years.. and my family is supportive of me..I recommend that everyone who is diagnosed be treated ASAP. before its too late..
- Unknown
July 19, 2010 2:14 p.m.
Bi-Polar I am. As hard as I try to peel back the layers that have overtaken me I am still Bipolar. I have found DBT to be great help in restoring enough of me to exist in the real world. Often times I wish I wasn't. I am truly Biploar - there is no doubt it in anyones mind including my own. I function day to day, but I am not who I appear to be any more. I can believe how much you are suffering.
- Vaughn
June 17, 2010 5:45 p.m.
You know what guys? I, too was diagnosed with bi-polar. Which I decided I wasn't. The Psychiatrist I have is excellent and does treat me for major depression and PTSD. But, the Bipolar diagnosis was making me seriously depressed, so I went off my Depakote and low and behold, I don't and have not had any moods swings for the past two years. So, either he was mistaken and I never was bipolar (just a quirk in my personality), OR if you really want to, it can be cured. I have felt 100% since deciding I wasn't bipolar. I have no ups or downs, just situational depression (due to mom's and dad's passing), and post-traumatic stress disorder.
- Nancy
June 16, 2010 10:41 p.m.
am suffering from biopolardisorder since 2 years treated with seroquel seroxat cipralex lamictal xanax useless medicament with no family and entourage support no one can believe how much am suffering
- No name given
June 15, 2010 6:19 p.m.
I am curious about how long these mood swings can last. I have been emotionally flat for months, but a year ago I felt normal, even like i was coming out of a cloud that i had been in for a period of months before. I have done some looking into my past and what struck me, and caused this curiosity, was a marked pattern of weight loss and gain, months where i feel great and loose weight. Then there are months where I am gaining and feel like its too much trouble to get off the couch. That cycle alone led me here, and I want some insight before I pursue this.
- Keisha
June 9, 2010 3:26 p.m.
I was recently diagnosed with bipolar. I had trouble sleeping and anxiety 2 months after my baby was born then lately i've been having serious depression. The have me on Zyprexa right now. They said it will help. I don't know why bipolar causes so much trouble sleeping. Could someone tell me?
- Jenn
June 4, 2010 11:36 a.m.
My boyfriend of a little over a year is currently on meds for manic depression. Upon finding this out I have begun researching so I can better understand what I'm dealing with. I struggle because he maintains a regular job (2 actually) is quite capable of watching his spending and has a good sense of responsibility. My issues surround his day-to-day behavior. He does several things that I can't determine if he has control over them or if they are part of his illness. Is it "normal" for a person with BP to not know the difference between affection and groping? Or when something stops being funny and becomes down right rude? What about incapable of hearing someone say "no"? I don't want to rule this guy out because of an illness. But I can't put myself in a situation where I will feel like I'm caring for another child (I have 2 small children). I care deeply for him but I need to understand what I'm getting into. Can anyone help?
- Leah
May 12, 2010 6:34 a.m.
LISSY I have Fibro, too. Get another Doctor or insist to the company Psych that you have Fibromyalgia. I have it too..take cymbalta,gabapentin for nerve pain and feel great with these....it took a year to get proper diagnosis from Jackson hospital at their Spine Institute in Miami, if you are near there... Further, you get that Doctor to change the letter to your "boss" which is NONE of his business or that could follow you everywhere, even get an attorney to write for you.
- Anne
May 7, 2010 8:31 a.m.
My wife of 48 years was diagnosed bi polar in 1989. She went through shock therapy early on and came out of that good, but had some problems about every 2 to 4 years until the last three years and now she has periods of ups and downs about every 3 months. She is on lithium 300 mg, effexor 150 mg, wellbutrin 150 mg, abilify 20mg, remeron 45mg! We like her doctor, but these cycles of ups and dowms are coming more frequently. I wish someone could offer something to make sense of all of this!
- Jim
April 17, 2010 1:54 p.m.
I am so tired of family members with psych problems that won't do anything about them. I suffered w/a widowed mom (meaning, no normal parent to turn to) with severe borderline personality per her symptoms and alcoholism, she's never been to a shrink. Result is her three kids all spend their lives in shrinks offices or on meds. Now my daughter is showing bipolar signs. I'm so tired of tiptoeing around these people, so they don't go off. My eventual grandkids will probably suffer from living with my daughter, as my sisters and I did from living with my mom. If you have one of these problems, get some help. Those perfect kids you have are just afraid of you, no kids are perfect without fear.
- Mary
April 7, 2010 7:53 p.m.
my friend's mom had bipolar disorder and she shows signs of cyclothymia, what would be a good teatment that she could do with out using drugs?
- wood
April 3, 2010 2:27 p.m.
I am at my wits end. I think my son is bi-polar but not sure. It is killing me. He only denies having any problem. How can I help him if he doesn't think he has a problem?
- Kathy
April 1, 2010 7:55 p.m.
I have been living next door to a woman for nearly 5 years that I believe is Bi Polar 1. I have endured endless conversations with the local PD, been cursed, threatened, stalked, harrassed and generally have my life made into a living Hell. I have tried to understand the why and how this disease effects my neighbor, but I am at the end of my rope. She was admitted to a local psych hospital after she told a local Judge that she felt like "committing suicide and committing homicide." I am terrified she will carry out her threats and kill me. If you can help me by suggesting how I might better cope with the merry-go-round of this woman's behavior, please do so. I can not sell my house and move. It is not an option.
- Carla
March 29, 2010 5:24 p.m.
I was diagnosed Bi/polar 1 in the 70,s after I tried to kill myself and was placed in a mental hospital.when I was released the mental help advocate came and brought me back to the town I lived in and I was pretty much left on my own.I did meet with a psychiatrist who placed me on lithium I was not diagnosed with borderline personality disorder until the late 80,s.In the early 90,s I became toxic on lithium and was placed on seroquel 300 mgs 10 to 12 at bedtime along with neurontin 300 mgs 10 at bedtime.I still had mania big time and I gained over 100 lbs.I was a runner I would take off to other states for no reason and it never worked out.Hence I made a very bad decision and paid a very high price because no mental health worker Psychiatrist knew what they were dealing with.I have been married 4 times and I was never happy or understood.Bi/polar runs through my entire family,mother,grandmother,aunts,uncles,My sister brothers all are bi/polar.And this condition is a difficult one to explain to those who befriend me.I have warned them what to look for while they are with me,But it has never worked out-as it scares the hell out of those who are NORMAL.When I was on a manic high I would spend alot of money which I did not have to spend! I wound up in jail more times than i can list.I have done alot of research on this God awful mental illness.My sister is a rapid cycler as I am and it is very scary to whatch her in her manic episodes.Because I now know what i act like allso.
- Rita
March 1, 2010 1:19 p.m.
bipolar is a terrible disorder because the meds wear off after a while, at least they have for me. So many times the depression is so very very bad that I wish for a manic stage. To those of you that have horrible manic stages I'm sorry. Mine are a full of spending sprees, some aggitation with arguements at times, and then some physical energy. With the depression, it's sadness, thoughts of my grandmother and dying to be with her, not being good enough because I didn't get my BA because of a Jackass Psychiatrist who put me on Haldol, Mellaril, and Thorazine and excluded Cogentine. This of course gave me Distonic Reactions which are seizures. To any who have walked in my shoes I know what it feels like to hurt. God bless you and don't let anyone misdiagnose you the way I let a stupid Dominican Republican do to me!! Walk with God. And seek the very best that you can find. Get references, find out all that you can about the Psychiatrists that you see--don't see just anyone on a insurance list!! I am now in good hands and he is taking away the meds that are not needed. So wish me well and say a prayer as I will say one for all of you!! It truly is a hard, long road to walk!!! I try to remember "Footprints in the Sand".
- renee
March 1, 2010 12:51 p.m.
I was diagnosed with bipolar, ptsd, md, and some episodes of borderline disorder. I take a multitude of meds such as: celexa,buspar,seroquel,pristiq,abilifyand then topomax for temporal lobe disorder. For sleep I take ambien and restoril. I am 50 years old this month and now have been bipolar since I was 15 years old. I can relate to so many of you. I have been seeing my psychiatrist for 21 years and he is a blessing, with exception to just putting me on too many meds. They have made me gain over 60 lbs. over this past year. I know about the crying, the aggitation, the talking and then getting angry and saying curse words. To the genleman taking 1200 mg of seroquel--please don't take all of that, it's too high of a dosage. I weigh over 250 and he gave me the max of 800mg and I was lethargic and out of touch with the world, as well as 281lbs. I am trying to get down to 175ibs for my build and frame. Wish me luck. I have a history of suicide attempts and one success that the hospital paddled me back and put me on a resperator for 4 days. Even today I still wish that sometimes I'd been successful. To those of you with manic shopping sprees, I can also relate. I've got 2 store credit cards and all I seem to do is buy, buy and pay them down and back up I charge. Being on disabily is a real pain. You feel like you can't catch up with anything. My mother helps me so that I can have a computer, my father gave me the laptop. I cannot drive because of all the meds.
- renee
February 27, 2010 8:57 a.m.
I’m 32 since my father die 5 years ago, I keep blaming my self for his death since them I been treated as having recurrent mayor depression and the doctor prescribe me different medication prozac then Zolof later Wellburin, 4 years ago I was diagnose by rheumatologist with Fybromialgy, and the past year I was hospitalized in a psychiatric institution because of to much stress in my work and with my family with suicidal symptoms anxiety and panics attracts there in the hospital three different psychiatrist give me the same diagnosis recurrent mayor depression but they change the medication to cymbalta this one really help and stabilize my mental condition, I take cymbalta twice a day 30 mg and 60 mg. clonazephan and lyrica 100 mg. This situation have affect my personal and work functionality my employer ask me to change psychiatrist to one they choose if I don’t follow their procedure the company will take my medical insurance off. So I change it this year to this new psychiatrist who has more than 20 years of experience and this have become very confusing to me, since my first appointment he diagnose me as Bipolar, but he didn’t change the medication and make a letter to my employer explaining the diagnose. Can someone help me is this normal o common what do I really have?
- lissy
February 19, 2010 7:34 p.m.
I have been diagnosed as depressed for years and just recently as bi-polar. For years I would use the same meds and IF they stopped working I'd just switch to something else. Now I just turned 60 and that just doesn't seem to work anymore. I took Effexor for 6 months and felt wonderful and then it just stopped working and I was suicidal. I can't seem to get off the Effexor because of the withdrawal affects, Lacmictal hasn't worked, I've tried Prozac, Paxil, Zoloft, Lexapro, etc.,etc. all had side effects I could not live with. I can't sleep or I go to sleep but wake up at 2-3AM. I've tried Keppra and Klonopin for sleep, now I'm using Xanax that is addicting and makes me feel drugged in the AM. Now the doctor wants to try Nuvigl a drug for sleep apnea (which he thinks I may have so I am having a sleep study). When I am manic I exercise and shop. But mostly I am depressed, overeating and avoiding social interactions at times. Most people do not know about this because my credo is "fake it till you make!' I JUST WANT A DRUG THAT WORKS so I can feel normal! But you have to just keep putting one foot in front of the other!
- Ellen
January 29, 2010 3:39 p.m.
I have been in an on again and off again relationship with a woman (26) who was just recently diagnosed with bipolar disorder, ptsd, ADD, ADHD, clinical depression, and borderline personality disorder. I am so thankful that she finally sought treatment. It had to get as bad as it had ever been in order for her to admit she has a problem and seek out treatment, but thankfully she did. She is paired with a wonderful psychologist, one of the best in my area, and is prescribed medication. She is seeing improvement in so many aspects of her life at this point. Although we are now apart (we were together just a couple weeks ago), I have faith in her being able to heal and that we will be together again in a loving relationship one day. Anyone either in a relationship with someone afflicted by these diseases or afflicted by these diseases yourself, I implore you to recognize the signs and symptoms and seek treatment from a professional as soon as you can. Do not deny what it may be. Accept that there may be a very real problem. There will be so much back and forth and so many terrible storms to weather. Be patient, compassionate, empathetic and as supportive as you can possibly manage without sacrificing yourself. Stop the vicious cycle and patterns associated with these horribly debilitating diseases. Debilitating not only to those afflicted, but to every loved one in their lives. Neither the afflicted or those in their lives asked for these diseases...be there for each other.
- Pete
January 20, 2010 11:27 a.m.
I have just left my fiance of a year who is bi-polar. He has been on Lithium for years and has felt stable (although he cannot hold on to any relationship). I was hopeful because I swa that he tried to take care of his physical health by working out and eating right. He was pretty good about it but every so often would binge on candy and junk food. Then I started noticing that about once every month, he would become irritable, withdrawn, depressed and angry. It was usually about something small, like my daughter singing in the car or things on the counter that he thgouht shouldn't be there (usually his stuff). He eventually went into such a deep depression that he finally called his doctor. Seroquel was added to his Litium and for a whole month, I saw a peaceful, calm, happy man. Then he decided to have some drinks (alcohol) for his birthday on Dec18. He wasn't the same man after that and has adopted the negative, self-serving side of his personality now. He swears that who he really is and although I agree that's a part of him, in everything I've read and everyone I've talked to, it's not him...it's his illness. He just doesn't want to manage it. He seems to think he is just fine and doesn't need anyone. I ahve tried being friends with him but this new attitude is hard on me and hurts. The saddest part to all this? The times when bi-polar did not take over his mind, we had a very loving, fun, compassionate and respectful relationship.... Laura
- Laura
January 2, 2010 5:58 p.m.
I tend to go through cycles that sometimes include the following excessive purchasing of certain items, usually certain clothing items but not limited to clothing it can be other items. Items which I do not need. Also these urges come in cycles with more urgentness certain times of the year as well. Along with these cycles I used to act out in certain ways especially during times when I took college classes. Maybe by wearing changing clothing habits,as well as to some degree personal hygene habits. Also I have had periods of time when I would isolate myself from friends whom I had been normally close to. Then eventually after awhile run into a new group of individuals whom I would befriend. During later years in college befriending guys who were usually not presently criminally active but had tendensies to talk about crime or other related. All the time I would swing back through prsonalities that allowed to to chair committeees in the community as well as perfessionally. Going through periods of exsessive exercise and strict dieting that would allow me to maybe loose thirty pounds and then later change and gain it back. Unable to focus to keep relationships. Dropping into moods where I allow myself to participate in risky behavior such as neglegent driving when I felt depressed. Maybe dressing like a guy down and out asking people for money. does anyone have any ideas how I fit into mania or maybe drugs for treatment
- jeff
December 22, 2009 8:58 p.m.
My girlfriend of 7 years (she is 43) was having mood swings that I just couldn't understand. She grew up in a home where alcohol played a major roll. Some if the behavior involved telling me that she didn't feel she was a good mother. She often was very irritable and arguementative. She has moved 7 times in the past 7 years often without any real explaination, she is in sales and although she seems to be able to concentrate on the deal at hand she has never been able to focus on much outside of work. She has taken on several extra projects recently that that she doesn't really have time for (becomming a board member on the condo association and becomming more involved in her church) She has become very social recently and does not display any or very much empathy for situations that are close to her. Her dad did pass away a year ago and recently her daughter had an episode where she tried to jump from a 2nd story window. She claims that she has IBS, she has a prescription for Zoloft has gained over 40 lbs over the past 2-3 years. Recently she had lost some weight during a period when she has felt VERY good about herself (manic?) wants to be very social and seems to function on very little sleep. I am guessing this is BiPolar...................she has been very difficult to understand and have a relationship with. How does anyone cope with this disease????????
- PMMSLM
December 18, 2009 2:09 p.m.
does a sympton include, for instance, strong need for neatness and order in simple or unimportant situations?
- carolyn
December 10, 2009 2:51 p.m.
I was diagnosed about 10 years ago being Bi Polar. I have experienced Super highs' and Super lows. I think this came out from combat in Vietnam. Its like I broke from my family and then broke from myself. My wife is taking the brunt of this,I can really get pissed about something small High Manic and then go into a Super Low like no big thing?. Iam on quite a few meds they are ok, but I still don't feel well
- Bob
December 4, 2009 9:10 p.m.
I've been Bi Polor for 28 years. Meds keep me someswhat polor but i still think I have rapid swings. Havent heard any one else mention one of the things that happens to me which is to flip very quickly into anger. I can just be in the middle of a converssation and someone says something I dont like, or I get frustrated, or think there stupid. And I just flip in a manner of seconds. I get out of control (with my mouth). I cannot control it and get really out of hand. It usually takes from several hours to several days for it to go away. Usually with meds and going to. The only way I can handle this situation at all is if I leave. This at least gets me out of the situation so i will not yel lat people or embarsis my self two much. any of you have this problem and what do you do. (sorry my spelling is so bad)
- Bipolor and Rage

124 comments posted