
- 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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Feb. 13, 2009
Repeat episodes of depression: Look for warning signs
By David Mrazek, M.D.
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Just as it's important to know that depression is a treatable disease, it's worth knowing that having had an episode of depression increases your risk down the road for more episodes. That shouldn't discourage you because proper treatment can make a huge difference. But it's important to watch for warning signs of repeat episodes of depression.
What's an episode of depression you ask? An episode is a period of time. For example, depression (formally called major depression, major depressive disorder or clinical depression) is diagnosed by having at least two weeks duration of five or more of the following symptoms:
- Depressed mood
- Decreased enjoyment in pleasurable activities
- Sleep disturbance (increased or decreased)
- Appetite disturbance (increased or decreased)
- Excessive or inappropriate guilt or feelings of worthlessness
- Decreased energy
- Concentration difficulties or indecisiveness
- Change in your daily activity. You may feel slowed down, or sped up; increased to the point of feeling fidgety
- Recurrent thoughts of death
These symptoms need to present almost all day nearly every day. In addition, the symptoms also need to cause significant concern or difficulty in all areas of one's life. Finally, the symptoms can't be due to a medical illness or feelings of grief, such as with the loss of a loved one.
Please see your health care provider for additional information about depression, evaluation for depression and options for treatment. If you have suicidal thoughts, contact your provider or seek care at the nearest medical center. Another resource for help is the National Suicide Prevention Lifeline, 1-800-273-TALK (8255).
54 comments posted
February 2, 2012 10:34 a.m.
(CONT. from last post): Dreams of marraige and children seem far-fetched for me. I distrust most men and I am coming up on 35, making conceiving a child risky, soon. Great... My life for the past few years has been a series of disappointments. I am finally tired and bitter. I know I should have faith and it is best and that God is not CAUSING these things, but my faith is waning. Effected by all the downs. I often feel worthless and even have discovered that I really truly feel i have no purpose in life. I am a visual artist by study and have had success in that, but mild success. That on top of every setback I mentioned leaves not much hope for me. I wonder if I even should be on this earth since thinngs fail fme so easily and since I am feeling like such a 32 yr old loser. I am always angry, lacking energy or drive to do much and I have even cracked up a few times. I have had suicidal thought and read about death. I used to cut w/ razors. No matter how happy and grateful i try to be, no matter how many good things do occur in my life, trouble is ALWAYS around the corner. Always a step away. I feel like my life is going nowhere. This is deadend and this really is the end. I am afraid this is all there is: no decent job ever, will never move out, will never have a family. Just will never be happy ever. My life is over.
- Callie
February 2, 2012 10:26 a.m.
(CONT. from last post): I am stuck @ home nearly everyday/allday. I live with my mother @ 32 yrs old. At 32 yrs old, a woman wants her own place and even a family, a car and a job. Not living @ home w/ a mother still trying to monitor me and even planning out my future and even planning for me to live w/ my ill (he is in remission) father and sister. I do not think i am being selfish when I say I am tired of living w/ family. I have never lived away from them nor been out on my own. Everyone needs to fly, but I feel caged. My mother is a good person, but everything she (and anyone really) does irritates me as I have less tolerance for anyone/thing now. She criticizes me alot. My father hates me and calls me names. My sister is a very good person, but she does not necessarily act like anolder sister. My brother is older, too, but treats us all like we don't exist. Bitter about things that did not happen. He cut us all off. I have had romantic relationships, but they have all been wrong. My 1st boyfriend in college drifted away and had a girlfriend back home in Philly i only later found out about. My 2nd boyfriend nagged me to have sex (we didn't), my 3rd was in love w/. He was deployed for a year and to show his thanks for me waiting on him and being faithful, he cheated less than 2 months after his return and got the girl pregnant while we were still a couple. So now he is married to her and I keep having disappointing relationships or none at all. Dreams of marraige and chil
- Callie
February 2, 2012 10:14 a.m.
I know that I have many things to be grateful for. I have a relationship w/ God and He is ever-present. Still, I am not happy in my life overall. Whether it is from things I have done to myself or things that happened out of m control that I did not ask for or expect. These negative things have snowballed and created a big mess inside of me. Sometimes I explode in anger. Throughout my working years, I have been laid off 3 times (2 of those positions taken from me due to my race; I had more on the job experience than my Caucasian co-worker, but I was the one given the boot). Where I live jobs are very scarce in this crappy economy and due to that, I want to move out of state. Problem w/ that is when I had the money to move, things did not pan out and I started pinching off the money I tried so hard to save to pay bills. Now I have no money. I am literally broke until I hopefuly get a refund w/out student loans and an old hospital bill taking it. I also thought I could fix my laptop w/ part of my savings. That was thrown on the floor in a spiteful fit by someone I know. Busting the screen. I have no cash to fix that now. And when I thought I did, that drained out for bills bills bills. So now I have no laptop until Maybe 2 wks from now. Bills are an incessant part of my life: student loans, personal loans and more. I have no car due to an accident w/ my tire. That was my fault. W/out a car it is hard to get around. And unless i go out w/ friends every so often, I am stuck @ hom
- Callie
January 17, 2012 7:27 p.m.
I am divorcd still living with my ex. Disabled and have undergone 3 spine surgeries in 18 months. Worked 26 years and live in poverty. Debt ratio is to high for me to move, my copays medicare is to expensive. When I move I will lose my transportation as I will not be able to afford the payment or insurance. My pain is chronic and exhausting. Have been treated for bipolar (anxiety and depression) for more than a decade. I am 52 and was married 22 years. This was my second marriage and i have not been loved for the last 19 years. There is no transportation system in Michigan so if I lose my car I will not be able to get to my psychiatrist or pain doc or back doc. I am allowed 16 dollars a month for food, an since my ex lets me live here he does not get me food I need to eat to keep my weight in control. Tired of living worrying crying being blown off by apathetic mental health and physical health doctors. Tired of struggling to survive, not being loved and not being able to trust anyone. There are good things in my life and I do not enjoy them due to pain. I eat stuff that does not require work cuz I dont feel like cleaning. It is so hard to groom due to pain and the time it takes cuz I move slow cuz of pain, just wanna sleep watch tv. Live in my bedroom cuz my ex thinks I am sexually attracted to him, I hide from bill collectors my kids, friends, obligations, social networks and myself. Have 2 plans to kill myself just a matter of timing.
- Suzanne
October 13, 2011 9:49 p.m.
I feel like i am having a nervous breakdown. I am a full time student, mother of two children, and in a very verbally, mentally and physically abusive relationship. I have been through so much hurt and pain from this my day to day functions are not normal. I cry all the time, Im angry at my kids cant concentrate, dont want to do anything. I want to get out of this relationship but cant afford to leave. I feel worthless, lonely and unloved. I have had a number of suicide thoughts and even of killing him, and if i dont get away for this I will act on one of them.I pray and ask God to help me, and restore my mind because I need it before I really snap. I cant take it anymore.
- No name given
October 10, 2011 4:30 p.m.
I don't really know what is wrong with me, but I know I HATE coming to work, sometimes I HATE waking up. I hate mornings! I don't really have any reason to NOT be happy, so what is wrong w/ me. Sometimes I think it would be better to not be here anymore but I couldn't take my own life, it's just not me, but the thought of that alone bothers me. I have a new beautiful grandchild and two wonderful adult children and a great family, so what, what is wrong with me! I need to talk w/ my doctor b/c I'm tired of living like this. Crying or sleepign is what I seem to love and yet, I don't want that ANY MORE. It's time to step up my game because I want to be the winner here!!
- Tina
September 25, 2011 3:17 p.m.
I feel like I am in a cloud, hopeless unable to do the things around the home I use to be on top of. Married with 3 kids unable to contrate, guilty feel unhappy.
- Samantha
September 16, 2011 9:56 a.m.
Adam, I know how you feel...my fog gets more dense by the day, the will to live is gone, but I am not suicidal (I don't think).
- Patrick
September 13, 2011 10:47 p.m.
I wonder around in a fog, feeling that I have wasted and squandered my life, talent and opportunities. I think about suicide, but am afraid of what it would do to my three year old daughter. My wife and I have a very high conflict marriage, and I am always stressed out about it, and my life. I am not sure if this is the right marriage for me, as I love, but it does not fulfill me as I feel it needs to. I see a doctor, but I still have been depressed for most of a year, and it doesn't seem to get better. My wife is also depressed at time, and has borderline personality disorder, so I am afraid of her, in many ways, because she has scary rages. I feel constantly like i am letting everyone down, and under the gun and stressed. I guess that's all I can say. It's been rough.
- Adam
September 13, 2011 5:09 p.m.
I got sober on May 11, 2007. I am still sober without relapse for over 4 years now. My long run with alcohol has led me to many consequences. Loss of driver’s license since May of 2008, 3 jail terms (all DUI related), financial ruins, and many other personal situations which I have made amends one by one. Today, I can honestly say I am a grateful human being, and through a spiritual connection have maintained a loss of desire to drink, and cannot imagine life with alcohol any longer. My wife is a miracle, and has supported me throughout this recovery process which should have opportunities increasing next May 2012 when I can get a limited driver’s license back. In the mealtime, I pretty much have become dependent upon others for many things. Over the past 6 -8 months everything I try seems to fail as far as income opportunities, and my contribution or lack thereof is becoming more depressing by the day. Lately I have lost much weight, do not sleep well less than 4 hours per night, cannot focus on anything, and cannot start a or stick to single task. I feel more and more like a complete failure every day and do not feel important; rather I feel like I am a burden more than anything. I do not think of killing myself, but I really do not care if I do not wake up anymore. I once was successful, financially healthy, and had many friends. Today I have a wife, and my depressing self. Patrick
- Patrick
August 19, 2011 3:09 p.m.
Thanks very much for posting this article. It has given me some suggestions. I'm a Nursing Student in University. Been under a lot of stress from school non-stop and stress from the outside world. I'm only 21 and I have episodes of terrifying anxiety. I know the stigma around mental health and the fear of never feeling normal again. This article really encouraged me to talk to someone. I feel isolated a lot and feel like not a lot of people would understand and just think I am overreacting. I don't want to keep having nervous breakdowns.
- No name given
August 14, 2011 10:07 p.m.
dear no name given: you're very welcome, i'm glad i could help, keep in touch & let me know how you're doing
- denise
August 11, 2011 1:32 p.m.
Dear Denise, That you for your advice. I called a psychiatrist. Hopefully they can help me. They said it will take awhile but I figured I waited this long what is a lil while longer:) Thank you again
- No name given
August 7, 2011 8:45 p.m.
dear no name given: i'm glad that you wrote in, i can relate to the crying for days & not being able to stop, have u tried calling your local mental health clinic in your area, they should be able to help you get treatment, i think (in my opinion) that it's time 2 c a psychiatrist & get some treatment, they have new drug therapies & other ways of helping people with the symptoms that ur dealing with, i tell my family if i really can't stop crying, for a long period of time, that it's time for me to go in to the hospital, i no u said that ur on a low income (i am 2), but the hospital will help you get state ins. (medicaid), your daughter has a GOOD mother, you just need some extra help right now, i hope this helped you good luck, don't give up hope & let us know how you're doing ok??
- denise
August 4, 2011 1:01 p.m.
I was depressed when I was younger. The Drs. put me on welbutin and prozac I refused to take the pills because back then that was when all the kids were taking prozac and killing themselfs(they were taking it to get high tho) I was young then and thought that would happened to me. I went to councling but they kept changing ppl on me so I stopped going. I quit school just couldnt handle things. Finally after years I felt normal again. A couple yrs ago I was in a car crash(it was my fault I went out drinking knowing that it would make me more sad I was fighting with my bro he said something I grabbed the wheel and rolled the car. No one got hurt expect me) I seen a dr he put me on paxil. I felt the need to hurt everything around me.( I didnt do it) I called the dr they told me to stop the meds never gave me any thing to help. I had my up and down days way more down then up. At 29 I finished school and went to a trade school finished that. Now I am back to feeling like I am worthless,feel my daughter needs a better mother but I would never leave her cause I think she is the only thing keeping me aflot. My bf of almost 4yrs doesnt really do anything wrong but I cant stand for him to touch me.I know I need help but I have low income cant afford a dr. when I seen any they never helped any how. For the past 3 days so far I cant stop crying.How can I get a dr. to belive me
- No name given
April 19, 2011 1:09 a.m.
no karen you are not doomed to misery!!!!! keep talking to your psychiatrist about the fact that u dont feel better. there are many different meds that can be tried for you if effexor is not working. please dont give up. also ii hope you have a good therapist. you need grief counseling. and dont let anyone tell you to "snap out of it." that is ridiculous. you cant just snap out of depression. one year is actually not that long in the grief process. give yourself more time. also, ask your therapist or psychiatrist if they know of any grief support groups in your area. that could be a big help.
- michelle
March 31, 2011 9:36 p.m.
one year ago my mom bled to death from complications from surgery she was 63 the way her eyes looked things i didnt get to say haunt me i miss her so much husband says quit crying or move out all anyone says is get over it i try have no energy headaches weight gain just could care less have grandson new one on the way i should be happy keep telling doctor effexor is not working am i doomed to misery
- karen
March 30, 2011 2:29 p.m.
This is in addition to my comment prior to this one: IT IS OF UTMOST IMPORTANCE that you are faithful about taking your meds ---ALL THE TIME --- not just when you are feeling bad. This has never been an issue with me because I've seen what happens to people when they take their meds "sporadically". TAKE THEM AS THEY ARE PRESCRIBED BY YOUR PHYSICIAN!!
- Patti
March 30, 2011 2:13 p.m.
I have suffered depression for approximately 25 years and approximately 20 years ago was diagnosed with bipolar disorder. I have been hospitalized for these illnesses several times. At the present time with a combination of medication and talk therapy I am getting along very well. I just want to tell anyone who thinks they may be suffering from these mental illnesses or others: DO NOT BE ASHAMED to seek help for this illness --- it isn't any different than seeking help for diabetes, pneumonia or any other physical illness. I know from experience that a mental illness can destroy your life ---- IF YOU LET IT!!! PLEASE --- seek the help needed --- life is too short to be miserable.
- Patti
February 16, 2011 9:42 p.m.
I have not called my doctor yet, but have had a baby 5 months ago. I have a son who will be 16 in April. Never did I have post partum depression. All of a sudden this week, I have most all of the symptoms of depression. I do NOT however feel the need to harm myself or the baby in any way shape or form. I don't even feel like I can't stand the baby. I am just feeling overwhelmed with everything. I have been in out out of surgeries for kidney stones. My husband works hellish hours ALL THE TIME. So I am just feeling like I don't want to do ANYTHING!!!!. I feel guilty for noth cleaning the house, making dinner, etc., etc., etc..... I am not sure if it is depression, post partum depression or what. Can you get post partum depression 5 months later, and WHY!!!! I am an upbeat, go, go, go kind of person, and now I don't even want to pick up my feet when I walk. WHAT IS THE DEAL. I will call my doctor on Friday, just curious on some comments... Thanks!
- Keri
February 16, 2011 11:46 a.m.
I am feeling sick. Overwhelmed and yet bored with the whole earth. I feel like I could almost fly off like a bird. My job has changed from pleasant or BOriNg My constant life seems to be going to doctors, hearing aid doctors, doctors about my hands, diabetic doctors, doctors about my hands, Doctors about diabetes' I have to back to my dentist because I just broke the tooth they recappedl SThey just learned that not only have Dupuytrens s contracture but but arthritis . I keep falling asleep at work. I m t he only one in this office I basically HATE my life but thereapy has not accomplished one iota. evern after changing thereapist a a couple of times, I don'/t drink , smoke or use drugwsddddd
- Wiljean
January 18, 2011 5:57 p.m.
dear marina i am sorry 2 hear that u have 2 deal w. the auto-immune disease lupus, this has 2 b hard, don't know 2 much about it, but i know it attacks the organs of your body, u mentioned that u take the meds., but the depression won't go away, do u mind me asking has your dr. tried different meds.? again i'm not a professional, just a patient like u, there is hope, in my opinion if a med. is not doing any good within about 2 wks., i ask the dr. 2 change it or up the dosage, i don't wait the 4-6 wks. like they say 2 do, does your psych. dr. & your dr. for your lupus work together ? just a thought, 4 the anxiety i have taken ativan, zanax & klonopin, (not all @ once), 4 longer acting the klonopin works good, but i prefer the ativan myself, 4 the depression i'm starting on wellbutrin xl & it seems 2 b helping (don't want 2 say that 2 loud), hang in there, there is hope & keep writing if it helps u good luck
- denise
January 18, 2011 4:59 a.m.
TJ I just read that estrogen can play a part in depression. Speak to a good doctor and research depression and estrogen. Do not give up!
- marina
January 18, 2011 4:55 a.m.
Hi, To those who are suffering I sinceely hope you find relief. I have syatemic lupus and it can effect the brain. Years after being diagnosed I slowly developed depression. Now depression has had a strong hold on my life for the last 7 years. I take the medications but it will not go away. I am very tried of suffering. I have a physical illness and its complications, depression and anxiety. Somebody tell me there is some hope out there?
- marina
September 30, 2010 10:05 p.m.
Hi there, I have suffered from depression my whole life. When I was a teen my parents took me to the hospital and they told us that I was depressed but they could offer me any help. Over the years I have tried to deal with it on my own which has not helped. I tried some medication but the doctors always want you to get psychological counseling however when you get started and finally get comfortable with who you are seeing then your insurance stops paying for it. And who can afford to pay for it on their own. People tell me you can get over it just smile and think happy thoughts it will go away. I want to say don't you think I have tried that? I wish it was that easy. I don't want be unhappy but I don't know what I can do to get happy. I push people away because even though I don't really have anything to be unhappy about I can't seem to pretend to be happy. This causes them to be uncomfortable and they tell me again you can get over it. My life at almost 40 has not gone the way I had hoped. I am single having only one serious relationship that lasted less than 2 years which ended over 10 years ago but I can't move on. I wanted to have children but that is not in the cards for me now. Well thanks for listening to me I will continue to get up every morning and get through the day. I wish everyone that suffers from depression luck and best wishes to rise above it.
- JG

54 comments posted