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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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Jan. 21, 2012
Depression sometimes shifts to bipolar disorder
By David Mrazek, M.D.
Many of you have suffered with depressive episodes for many years. Others are trying to cope with your first episode. I'm impressed that it's helpful for members of this "community" to share experiences. Particularly, those of you who've been successful in learning how to manage your illness can often provide insight to others who are just beginning to learn about their depression.
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Over the years, it's become clear to me that there's great variability in how depression can begin. Some children struggle with depressed mood from their earliest memories and by the time they're adolescents have already become relatively sophisticated about available treatment options. Others are free of depression through their entire adult life and then suddenly come face to face with the debilitating symptoms of the illness when they're ready to retire, anticipating some relaxing, satisfying years.
Of course, there are many stories that provide interesting contrasts. A common time to become depressed is during the college years. Another is after childbirth. Certainly the middle years of life can bring depressive symptoms for the first time after losing a job and becoming financially distressed. There's no single story.
One of the potentially confusing dimensions of dealing with depressive symptoms is the transition of what appears to be a major depressive illness to a bipolar disorder which begins with prominent depressive episodes. A common pattern is to have one or two periods of depression in the late teenage years followed by aggressive treatment for the depression and then a sudden manic or hypomanic episode.
It's believed that the biological bases of these two problems are actually quite different, but the reality is that the clinical presentation of these two illnesses can be identical. The first clue that someone is actually bipolar may not occur until two or three years after they begin seeking treatment for depression.
I suspect that it would be helpful for you to learn about the different presentations of other readers. It might be particularly interesting if you've experienced a shift from treatment for major depression to the treatment for bipolar disorder to share both the circumstances surrounding your first manic or hypomanic episode, as well as your experience with the two quite different forms of treatment. Thanks for sharing.
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