7 Relationship Destroyers.

By David Joel Miller.

How many of these relationship destroying skills do you practice?

Couple

Couple
Photo courtesy of Pixabay.com

Couples slip into patterns of behavior over time. Some of these repetitive behaviors make their relationship stronger, other relationship habits destroy your togetherness. What one partner does the other tends to copy. Over time using these relationship destroying skills becomes a habit.

Do you and your partner practice relationship destruction on a regular basis?

Attacking your partner devastates the relationship.

You want one thing and your partner wants another. It is easy to slip from disagreement to seeing your partner as the obstacle to getting what you want. Many couples start out with a conflict about a simple thing, household chores for example, but this conflict quickly escalates to an all-out attack on the partner.

Moving from complaining that you partner does not clean up after themselves in the kitchen to an all out global condemnation of them as a filthy, dirty slob is sure to damage your relationship.

Focus on the blame and make each other wrong.

Life can be hard. Bad things happen even to good people. When those inevitable difficulties come do you focus on making things better, what needs to be done, or do you slip into the blame game telling your partner it is all their fault.

Even if you partner has made a serious mistake staying stuck on the blaming part keeps you two from working together to figure out how you will get past this.

Control your partner for a one person relationship.

Many couples’ disagreements are not about the facts but about who gets to decide, who will be in control. Happy couples work together to make joint decisions. Generally they delegate some things to each person. If one of you is better at organization and scheduling let them set the schedule. If one person handles money better, then they may be the one to manage the finances.

Avoid arguments about who is in control of what and try to negotiate this. When someone is a “control freak” this often comes from a place of anxiety and fear. Help them to see that they can relax and let you do things and their world will still be fine.

Stop looking at control conflicts as who wins and who loses. Look for solutions where you both wins and no one has to be the loser.

Insisting on total control in the relationship is a formula for a dysfunctional unhappy relationship. If one person in the relationship has “control issues” consider getting professional help to work through this.

If you can’t win the argument enjoy the martyrdom. Placating and the victim stance.

Placating, giving in and taking on the victim role may work for a while. In the long run being the constant victim is a damaging part to play. Couples that adapt the winner and the loser way of communicating are less happy in their interactions. Playing the victim may take some of the sting out of not getting your way, but it undermines the relationship over the long haul.

Build walls to keep your partner out.

Relationships, primary sexual ones and even friendships, open you up to emotions. Wall building, cutting parts of who you are off from others can feel protective at the time. Over time the person who puts up the walls becomes progressively more isolated.

Put up enough walls and you end up living a lonely isolated life even in the midst of a relationship.

Avoiding the problems any way you can destroys relationships.

There are innumerable ways to avoid problems. Some people turn to drugs and alcohol to avoid painful feelings, others bounce from relationship to relationship. Affairs are a common way of avoiding dealing with the core issues a couple is experiencing.

When you use these negative coping strategies to avoid dealing with the problems you dig the hole deeper. Learning problem solving skills requires practice. If you don’t deal with an issue now you will need to deal with it later after it has grown to humongous proportions.

Resentments will keep you warm at night.

Resentments are a sorry companion. The feeling that it is someone else’s fault, refusing to let go of past hurts, will make you feel justified in staying stuck. Resentments can prevent any healing from taking place.

Holding onto resentments, large and small can isolate you and eventually Mr. or Miss Resentment becomes your primary friendship. It takes courage to let go of resentments but hanging on to them is a sure relationship destroyer.

Ready to let go of the resentment destroyers?

If you see that these relationship destroyers have taken up residence in your relationship, now is the time to start working on them. If possible talk with your partner about these issues and see if you can work through them. Pick a time when you are both calm and receptive.

If your relationship has been so badly damaged that fixing it is no longer a do it yourself project look for professional help, a Marriage or Couples Therapist, before the whole relationship gets condemned and torn down.

For more on this topic see:

Relationships

Family Problems

Couples Therapy 

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What can you imagine?

Sunday Inspiration      Post By David Joel Miller.

Imnagination

What can you Imagine?
Photo courtesy of Pixabay.com

“Everything you can imagine is real.”
― Pablo Picasso

Wanted to share some inspirational quotes with you.  Sunday seemed like a good time to do this. If any of these quotes strike a chord with you please share them.

Do you have Borderline Personality Disorder?

By David Joel Miller

What are the signs and symptoms of Borderline Personality Disorder?

Problems with identifying Borderline Personality Disorder.

Borderline

Borderline
Photo courtesy of Pixabay.com

Borderline Personality Disorder formerly called Borderline conditions has received a lot of attention recently. It is one of those troubling conditions that looks differently to different people.

If you have Borderline Personality Disorder you know the suffering having this disorder can cause. If you have lived with someone who has Borderline Personality Disorder you know how frustrating this can be. This difference in perspective is one of the problems with the increased attention to the disorder.

Many of the symptoms of Borderline Personality Disorder overlap or are the sane as symptoms of other disorders. So when should someone get a Borderline diagnosis and when should we call it something else? Sometimes those iffy cases get a notation put on their chart “Borderline traits” rather than the full diagnosis. Electronic medical records are making it harder to leave notes like that and this may result in more people getting the full diagnosis.

For the record, diagnosis is not a do it yourself project. Mental Health as well as physical health diagnosing should be done by a professional. But so many people out there are being call Borderline these days and talking about it is so common, it is worth looking at the whole “what is Borderline Personality Disorder?” question.

There are efforts to come up with some kind of definitive test for borderline and other mental health conditions. At this time we can read research reports of “markers” and risk factors for many mental illness but we can’t be sure what is causing them. For example over 95% of people with Borderline Personality Disorder also have a sleep disorder.

Lacking a good test mental conditions are diagnosed by looking at symptoms and seeing if someone has enough symptoms and if they are severe enough to need treating.

With so many Borderline symptoms overlapping or look just like symptoms of other mental illnesses, what name something gets called may depend on which symptoms are seen at any given appointment and the perspective of the viewer. We want to avoid normal problems of life being called diseases but this causes another problem.

Many mental illnesses are caused by identifiable life events. PTSD and other stress disorders need an identifiable stressor to get diagnosed. Many, but not all, people with Borderline Personality Disorder can point to some life event that started their symptoms.

As more people know about Borderline Personality Disorder more people are coming to believe that they have the condition. Family, Friends and relationship partners are likely to blame all the interpersonal or relationship problems on someone having Borderline Personality Disorder. I suspect that professionals are going along with this and giving the diagnosis out more often.

Is Borderline Personality Disorder an illness or a lack of mental wellness?

Symptoms of Borderline personality disorder can vary from person to person and they may vary in intensity. This is resulted in an increasing amount of discussion, and a past counselors soapbox blog post about whether there may be Levels or Types of Borderline Personality Disorder.  There has also been some professional discussion about whether some clients have been given the diagnosis because they angered the treating professional.

Some of you have noticed from my other writings that I believe strongly in Wellness and Recovery. (See post on Mental Illness or Mental Health.)

Many of the things we call “Mental illness” are on a continuum. Those problems get better or they get worse. Sometimes in life we get sad. When that sadness keeps you from working or enjoying life we call it depression and it deserves to get treated. The same thing is true of Borderline Personality Disorder. Many people with this condition do get better.

As we look at the symptoms of Borderline Personality Disorder below I will comment on some of the questions you might have about each symptoms. This discussion is based on the SAMHS publication titled An Introduction to Co-Occurring Borderline Personality Disorder and Substance Use Disorders. This publication was written primarily for professionals but I include it here in case any of you want to see the original source. The SAMHSA publication draws on the DSM-5 (DSM is a registered trademark of the APA,which some of you may also want to consult. The paraphrasing and comments are mine so let’s hope I get this right. If you have or think you may have this condition please see a professional in your area.

Below are some of the typical features of Borderline Personality Disorder.

Borderline Personality is not common except in psychiatric hospitals.

Estimates of how common Borderline Personality really vary. In the general populations it is estimated at around one to two percent. In inpatient psychiatric facilities the rate of Borderline Personality Diagnosis can reach 20%. That suggests to me that this is a very impairing condition.

Notice as we go through these symptoms that many of these are things that have been considered “female” characteristics. Turns out that three out of every four people who get the Borderline Personality Disorder Diagnosis are female. Also many of these symptoms are exactly what we would expect in someone with a Stress or Trauma Related Disorder as in Posttraumatic Stress Disorder or a Dissociative Disorder.

Borderline Personality Disorder is not simply a matter of being overly dramatic or wanting attention. Most, about 80%, attempt suicide and they die from suicide attempts at about 50 TIMES the rate of the general population. This does not need to happen as there are effective treatments for Borderline Personality Disorder available. Additionally about 80 percent of those with this diagnosis cut on themselves, which is often called Non-Suicidal Self Injury. Some people with this condition both cut and attempt suicide.

Symptom – Intense fear of abandonment and efforts to avoid it.

Many, not all, people with Borderline Personality Disorder were abused or neglected as children. Some had this experience in adult life. This suggests that these fears are both rationally based on experience and learned. If you learned to be fearful you can learn to not be fearful. But lessons learned very early in life may be much more difficult to unlearn. For many this fear of abandonment makes sense.

Borderline symptom – troubled, vacillating relationships with others.

In a single session with a therapist someone high in borderline traits may tell the therapist that they love them and they are the only on that ever understood them and then later they will say that they hate the therapist and “you just don’t understand at all.”

The same thing happens in their personal relationships. They fall in love quickly and they fall out just as rapidly. They have over inflated views of their potential partners and then they feel tricked, deceived and angry. Relationships with someone who has Borderline Personality Disorder can include fabulous sex followed by violent fights.

Don’t know who you are and who you are keeps changing.

People with borderline conditions have more difficult than others in telling you what they like who they are and they look to others to define themselves.

Impulsive acts are common in Borderline Personality Disorders.

Risky sexual behaviors are the most commonly noted behaviors. Over-spending and reckless driving are also included in this definition. Frequent conflicts with others are common.

Suicidal Behaviors or Self-Mutilation.

People with borderline personality disorder are often overwhelmed by emotion and then hurt themselves rather than express their anger towards the person that angered or hurt them. This kind of sudden flip in their feelings towards others and then their impulsive behavior can look a lot like Bipolar and turns out that many people get both diagnosis or they are moved back and forth. It is of course very possible for someone to have more than one disorder.

Borderline make people feeling empty.

Since people with Borderline do not know who they are and they fear being abandoned. This makes sense, if you look for your self-worth from others and then feel empty or nothing at all when you are not getting positive interactions from those others. Some of these characteristics can sound like an immature or selfish person. If you did not get enough food as a child you may be physically stunted. If you are abused or neglected as a child or abused drugs and alcohol then you may not have learned the lessons you need to learn back then. The result is continuing to use coping strategies that may have kept you alive or got some of your needs met as a child but they are not working now. This is true of some people with Borderline Personality Disorder but not all.

Remember that these explanations are ideas about how things could happen but not precise formulas for how it did happen to any one particular person.

Episodes of strong, excessive anger.

There is no specific diagnosis for “anger issues” despite how common referrals to therapy for “Anger Management” are. Anger is a symptom reported in many other mental or emotional issues. What further clouds this picture is the high rate of Bipolar Disorder and Substance Use Disorders among those with Borderline Personality Disorder. Depression can also lead to irritability and then anger. What is looked for in Borderline Personality Disorders is sudden explosive anger often with fights and violence, that come on unexpectedly with someone who shortly before was a close friend or loved one.

Borderline may include Stress related Dissociation or Paranoia.

This can be a problematic symptom in practice. Part of the way we identify paranoia is that the fear is excessive. Men are taught to approach things they fear. Kill it if possible. This results in men getting acting out, violence related diagnosis. Women are taught to avoid danger and if you have been victimized in the past you recognize danger coming. So if you have been abused once fear that your new boyfriend will abuse you sounds reasonable not paranoid. See how this can be an issue?

It is also possible that “dissociation” gets pathologized. Some dissociating or “spacing out” is normal in children or those who are overwhelmed. People who suffer trauma may well dissociate. So it seems to me that cases of excessive dissociation may get swept into the Borderline Personality Disorder category rather than being recognized for what they are. As before someone could have both Borderline Personality Disorder and Dissociative Disorder.

Those are my thoughts on recognizing Borderline Personality Disorder and how it and other conditions may be getting mixed together. If you or someone you care about may have this condition consider professional help. If they do not have this problem please stop calling everyone you dislike Borderline. You may also want to check out other counselorssoapbox posts on Personality Disorders.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Can’t sleep? Is it Insomnia Disorder?

By David Joel Miller.

Frequently poor sleep might be Insomnia Disorder.

Insomnia

Insomnia
Photo courtesy of Pixabay.com

Most people have an occasional night with poor sleep. That does not rise to the level of being a diagnosable illness. But if you have those nights often, you just might be having Insomnia Disorder. There are many connections between your physical health, mental health and biological functions. Sleep is a very important one of these connections.

Poor sleep can be a symptom of a mental or emotional disorder.

Poor sleep often accompanies Major Depressive Disorder. People who are depressed either sleep way to much or they find it hard to sleep at all. High levels of anxiety, any of the anxiety disorders may interfere with your ability to sleep. Low need for sleep can be a part of bipolar disorders. Lack of sleep now can also be a warning sign that an emotional problem is just around the next bend in the road of life.

Poor sleep can be a primary disorder all by itself.

Poor sleep, if it gets to be a big enough problem needs to be treated before it disrupts the rest of your life. Treating poor sleep is often a problematic issue. Medical doctors may treat it with medication which is a temporary solution but long-term you need to look at the connection between your sleep disorder and your mental and emotional health.

Counselors often see the connection between your sleep and your anxiety, depression or other mental illness but what may be missing is counseling about how to reduce the impact of your Insomnia or other sleep disorder on your life. Treating both problems at the same time is the recommended approach most of the time.

Mental Health practitioners use the DSM-5 as their guide to diagnosing and treating mental emotional and Behavioral disorders. (DSM is a registered trademark of the APA.)

For a full description of the way Insomnia Disorder gets diagnosed you should look at the DSM-5 but below is my plain language explanation of some of the things that would make a professional think that your sleep problems might justify a separate diagnosis of insomnia disorder.

Can’t fall asleep?

Most people experience occasional times when they have difficulty falling asleep. But if this happens to you a lot you should start looking at why. For many people this is simply a lack of good sleep skills sometimes referred to as poor sleep hygiene.

Sleep hygiene involves things like having a regular bed time, avoiding caffeine and other drugs that interfere with sleep to close to bed time, not watching an exciting sports event and then rushing to bed while still all wound up and so on.

Many people can cure their insomnia issues by practicing good sleep skills. Watch for an upcoming post on how you could do this.

If you have an anxiety, Major Depressive Disorder, or another mental illness, getting that emotional issue treated can improve your sleep. Nightmares, Bad dreams and Sleep Terrors also need treatment. The nightmares that accompany Posttraumatic Stress Disorder (PTSD) especially need treatment. You can treat those nightmares without having to relive all those traumatic life events. More on that also in an upcoming post.

A rough rule of thumb is, if it routinely takes more than a half hour to get to sleep, you need to take a look at why.

Can’t stay asleep, could be Insomnia Disorder.

People with Insomnia Disorder wake up a lot throughout the night. This frequent wakening reduces the quality of their sleep. Awakenings also reduce the total amount of sleep. Get poor quality sleep or too little sleep and you will be tired all day. These sleep deficits pile up over time. Sleeping in on the weekend may feel like it helps a little but just like overdrawing your bank account cost you fees, overdrawing your sleep accounts all week comes with costs that can’t be made up with a few extra minutes on the week-end.

People with Insomnia Disorder will find that even when they stay in bed extra time they can’t sleep anyway.

Is your poor sleep or lack of sleep a problem?

If you find that your concentration is off all day that may be because of sleep issues. Do you find yourself getting sleepy or dozing off during the day? Look at your nighttime sleep. If you are one of those people who can get by on less sleep and still feel fine then you probably will not get a sleep disorder diagnosis. If the number of hours of sleep gets too low and you think you are fine but others tell us you are off the hook we may start looking at a bipolar disorder as a possibility.

Take a hard look at your day time problems and consider if many of your emotional problems may be connected to your insomnia or other sleep problem.

Insomnia disorder can look like ADHD.

Poor sleep can also impair your attention. Lots of client’s referred for ADHD treatment turn out to have insomnia disorder or another sleep related problem. I have lost track of the number of people who came in for an assessment, especially teens, and it turned out they were staying up all night on social media, texting or the internet. That is a lack of sleep skills not ADHD.

Drugs, medications and foods can keep you from sleeping.

Most people know that street drugs, methamphetamine and cocaine, will keep you from sleeping. When you are high you don’t sleep. Then when you come down you crash and sleep for a very long time trying to make up for the awake run.

Caffeine from many sources can interfere with sleep. We miss how high the doses of caffeine little children are getting. Most sodas are loaded with caffeine. More and more people are drinking energy drinks and those beverages can also keep you awake long after you wish the effects had worn off.

There are lots of other medications that can mess up your sleep wake cycle. If you are experiencing insomnia or another sleep problem talk with your doctor about the possibility that something you are talking is casing that. Do not forget to mention over the counter and herbal products also. Remember those over the counter headache pills you take? Some of them are high in caffeine also.

You can’t sleep if you do not go to bed.

Lots of people who complain about insomnia, poor sleep quality and bad dreams are chronically sleep deprived. They are stressed or anxious about their awake life. Do not expect to fall asleep the second your head hits the pillow. Budget enough hours of your life to getting sleep if you want to have a happy, productive life.

Sleep times and cycles change as we age.

Sorry folks all of us are getting older. When we are young most of us want to stay up all night despite needing more than average sleep. Young kids need more sleep. If they do not get it they get grouchy, irritable and can’t concentrate.

Seniors and the elderly may need less sleep, they may also develop more sleep disorder problems.

What should you do if you have Insomnia Disorder?

Good treatment for most people with Insomnia Disorder involves three things. Talk with your medical doctor and see if there are underlying medical issues. Work on sleep skills, sleep hygiene, relaxation and other skills. Get your mental health issues treated. Nightmares, trauma, anxiety and depression are all treatable and they all interact with sleep quality.

Thanks for reading all this way. Sleep well and live well.

You might want to take a look at other posts on:

Sleep

Dreams and Nightmares 

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

 

A meaningful life

 

Sunday Inspiration

Photo courtesy of Pixabay.com

Photo courtesy of Pixabay.com

What life awaits you?

Wanted to share some inspirational quotes with you.  Sunday seemed like a good time to do this. If any of these quotes strike a chord with you please share them.

Being successful takes more than money.

By David Joel Miller.

Money alone won’t make you successful.

Success Ahead

Success Ahead
Photo courtesy of Pixabay.com

Very often we hear about people who had far more money than the average and still their lives turned out to be disasters. When you think of successful people do you only think about how much money they have?

Past posts here on counselorssoapbox.com have talked about having a successful life. After many of those posts I get comments from readers that they are not concerned about success because their lives are not all about money. It is as if, in their own heads they so equate lots of money with success they have given up on believing they can have money. This means they will avoid efforts to make their life a success because they think successes for them is unattainable.

Success means a lot more than just your bank account balance. You can have piles of cash and still your life can be in ruins. Success comes from having and accomplishing goals. There are many worthy goals in life that have very little to do with money. Money is an abstract thing. It is a medium of exchange. What matters is not how much money you have but what you can do with it.

Money is a tool that you might use to increase your successes but money can also be a stumbling block to those very important successes in the other areas of your life.

Here are some things other than money you need to be successful.

Good relationships with family and friends equals success.

It is a dismal failure who has piles of cash and no on who wants to be around them of any reason other than that money. Having good friends makes you rich in spirit.

One of the great fallacies of modern life has been the idea that men should go out and work, make lots of money which they send home to their family to support them. Men equated the things they give their families with being successful. What many men tell me is that they learned too late that buying their children things was not a measure of success. What matters more than what you buy them is the time you spend them.

Sacrificing those precious hours of your life for money is of no values if you gave up time with people to get it.

A purpose for your life makes you successful.

If you can find a purpose for your life you are well along the road to happiness. If your purpose is money than once you get there you will have no purpose. If you purpose is to be of service there is always more opportunities to fulfil your purpose.

At the end of your life the things you owned will be gone but the experiences you had will remain. Invest in a life well lived and you will get many rewards that can’t be measured dollars or yen.

Having a purpose for living makes your life a success.

Self-esteem, feeling good about what you do marks success.

Self-esteem ought not be based on what you have. Things come and go. You might lose your things tomorrow. But who you are and how you have lived that will continue.

In the recent economic down turn a lot of people lost a lot of things. Homes and cars can go in foreclosure. You may need to make do with what you have. Having is not the measure of success. Doing those things that matter that marks a successful person.

Success is maximizing your health.

Good health is not a universal gift. Money may buy you a good doctor or even a transplant but it can’t assure you good health.

Clearly some people will do all they can to be healthy and still ill-health finds them. But you should never consider exchanging your health for cash to be a good bargain.

That need to keep yourself as healthy as possible is not exclusive to your physical health. If that job or career is harmful to your mental health the money you are receiving is inadequate compensation for a mentally unhealthy life.

Are you walking along the pathways to success? How will you know when you are reached it?

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Why are sleep disorders listed as mental illnesses?

By David Joel Miller.

What are Sleep-Wake Disorders?

Dream or Nightmare

Dream – Photo courtesy of Flickr (Melody Campbell)

Are problems with sleeping or staying awake making a mess of your life? Then you may have a sleep-wake disorder on top of all your other problems. Why does this matter? Because an untreated sleep-wake disorder will make all your other problems worse.

These issues turn up in the therapist or mental health counselor’s office when people start talking about their concerns with both the quality and the quantity of their sleep. Often this is because those sleep issues are impacting their wide awake life. When sleep issues start interfering with your job, relationship, or just plain making you not care anymore it needs attention.

This group of disorders sits at the intersection of mental and physical problems and reminds us that the distinction between body and mind is not all that clear-cut. The nervous system connects with the limbic system so your thoughts and feelings impact your immune system. You bodies physical aliments affect your mood.

With the introduction of the DSM-5 clinicians in the mental health area are getting a chance to take another look at the connections between sleep and mental health. One rule for therapists is to not be practicing medicine. If a therapist has any doubts, they should refer you to a medical doctor to get a purely medical cause of your issues ruled out or treated before using a primarily talk method to help you.

Some sleep disorder problems can best be determined by sleep specialists. These issues look differently when you try to describe them the next day verses when you are being monitored in a sleep lab and they can be detected right then and there. You diagnosis may depend on whether the problem occurs during REM sleep or non-REM sleep. Even medical doctors can’t get this part sometimes without sleep tests. The International Classification of Sleep Disoders – 2 is a far more exhaustive than the DSM or other possible lists, but it requires a sleep specialist to run tests to get this right.

Poor sleep can be a symptoms of a mental disorder. Changes in sleep and appetite are one of the things that professionals look for in diagnosing depressive disorders. But poor sleep is not specific to depression or any one particular mental disorder. Sleep-wake cycle disorders affect a host of mental, emotional and behavioral disorders.

Poor sleep, especially distressing dreams, bad dreams and nightmares have been connected to depressions, anxiety disorders, panic attacks, ADHD, borderline personality disorder, dissociative disorders, substance use disorder, substance withdrawal, an increase in suicide risk, PTSD and non-suicidal self-injury also known as cutting.

While poor sleep is found in conjunction with a lot of mental illnesses, it has also been suspected to cause mental illnesses. For example nightmares are a key factor in maintaining Posttraumatic Stress Disorder (PTSD.) Having frequent distressing dreams in childhood predicts the development of an anxiety disorder 5 years later. While nightmares and bad dreams may change and decline as you age, the majority of people who will get diagnosed with an anxiety disorder will have symptoms in middle school at just the time disturbing dreams are at their worst.

Sleep problems are also connected to behavioral problems. Children who are treated for behavioral issues also have nightmares or bad dreams on a regular basis. People with insomnia are at risk to have more nightmares and more nightmares increases the risk of developing a stress related disorder like PTSD.

It is easy for a therapist or counselor to overlook sleep wake disorders. If you have depression or anxiety, those sleep issues may be considered symptoms of your depression or anxiety. Make sure you mention the sleep problems to your therapist. If you have sleep-wake cycle problems, whether they are caused by another mental illness or not, if they bother you they should get diagnosed and treated along with the other issue.

Some Nightmares are harder to treat than others. The ones found in PTSD about things that have really happened to you are harder to get rid of than other bad dreams, but there are treatments for these nightmares that do work. Bad dreams based on generalized anxiety have been treated in children with as little as one therapy session. There will be more on treatments for sleep-wake cycle issues in upcoming posts.

Here is the list of Sleep-Wake disorders based on the DSM with their most current numbers.

Scary list isn’t it? For a full discussion you would need to check out the APA’s book DSM-5. I will try to give you the short plain language versions of these issues in upcoming posts.

Sleep-Wake Disorders

Insomnia Disorder 780-52 (G47.00)

Hypersomnolence 780.54 (G47.10)

Narcolepsy (subtypes/specifiers have different numbers.)

Breathing –Related Sleep Disorders

Obstructive Sleep Apnea Hypopnea 327.23 (G47.33)

Central Sleep Apnea (subtypes/specifiers have different numbers.)

Sleep-Related Hypoventilation (subtypes/specifiers have different numbers.)

Circadian Rhythm Sleep-Wake Disorders (subtypes/specifiers have different numbers.)

Parasomnias

Non-Rapid Eye Movement Sleep Arousal Disorders

Nightmare Disorder 307.47 (F51.5)

Rapid Eye Movement Sleep Behavior disorder 327.42 (G47.52)

Restless Legs Syndrome 33.94 (G25.81)

Substance/Medication-Induced Sleep Disorder (you need a number chart for this one)

Other Specified/ Other unspecified – Insomnia/ Hypersomnolence or Sleep Wake Disorder (6 total)

Which sleep-wake disorders are mental health issues?

Some of these disorders are pretty straightforward, some are medical issues, some are psychological and a few are mixed, other sleep wake disorders are even more complex. Nightmare disorder is a good example of the confusion. In common speech nightmares are those bad dreams you have that upset you. In technical terms, bad dreams, nightmares, night terrors are all different things, sometimes. Even the researchers use different definitions in their articles.

In coming posts let’s look at the various sleep-wake disorders and treatments for them. Until then sleep well or consider getting help.

You might want to take a look at other posts on:

Sleep

Dreams and Nightmares 

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books