Author Archives: David Joel Miller

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About David Joel Miller

David Miller is a California Licensed Marriage and Family Therapist, Clinical Counselor, faculty member at a local college, certified trainer and writer.

Can’t sleep? Is it Insomnia Disorder?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Insomnia.
Photo courtesy of Pixabay.com

Frequently poor sleep might be Insomnia Disorder.

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 too 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 bedtime, avoiding caffeine and other drugs that interfere with sleep close to bedtime, 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 weekend.

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 daytime 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 clients 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 causing 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 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

A meaningful life

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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.

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Success or failure sign

Success or failure.
Photo courtesy of Pixabay.com

Money alone won’t make you successful.

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 equal success.

It is a dismal failure who has piles of cash and no one who wants to be around them for 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 value 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 then once you get there you will have no purpose. If your purpose is to be of service there will always more opportunities to fulfill 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 to 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 downturn, a lot of people lost a lot of things. Homes and cars can go into 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 have reached it?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Why are sleep disorders listed as mental illnesses?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

View of dreamland.

Dreamland.

What are Sleep-Wake Disorders?

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. Your body’s physical ailments 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 versus when you are being monitored in a sleep lab and they can be detected right then and there. Your 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 disorders – 2 is 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 symptom 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 depression, 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 increase 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 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Psychology major may be bad for your Mental Health.

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

The Psyche

What is psychology?
Photo courtesy of Pixabay.com

Majoring in Psychology won’t fix you.

There is a repeating pattern in my public therapy work. Adults past the teen years show up for counseling referred by a government agency because of their depression, anxiety, unemployment, and substance use disorder. One thing many of them have in common? Many of them have been Psychology majors. What they find out too late is that knowing all about Psychology won’t fix you.

Addiction treatment has known this knowledge does not equal recovery for a long time.

Addiction and alcoholism treatment sprang from self-help groups, A.A. and N.A. mostly. The early founders of those groups tried going to professionals, psychiatrists, and psychologists, but while they received some help there, being diagnosed with addiction or depression is a long way from getting treatment for your issue.

Knowing you are an alcoholic, even knowing why you drink, does not result in sobriety. Not without some work on changing things. The same thing happens with depression and anxiety. Most of the things you learn in Psychology class about states and traits and the big five personality factors may give you some insight into your personality but it doesn’t tell you what to do next.

Psychology may explain your problem as you are an introvert and have a high need for security. But you are still lonely, afraid to go out of your house, and depressed all the time. Maybe you are drinking to manage your anxiety and depression. You may get pills from your doctor, but before long you find you are using more pills than prescribed and drinking way too much and you still have those problems. Now what?

Psychology and Therapy got a divorce.

Psychology and Therapy separated a long time ago. Not everyone got the memo, but these two disciplines are divorced. On college campuses, they live in different buildings. Psychology had a brief affair with counseling also but they have been estranged for some time now.

Psychology is mostly about brains, nervous systems, and how the normal brain works. Many pure psychologists spend more time with rats and mice than people. They give questionnaires and do studies to find out how many people have a particular problem and whether there is anything that is helping them.

You have to study psychology for a very long time before they let you experiment on people and by then your own issues have eaten you alive.

Therapy and Counseling are about helping the individual find the answers they need on how to change their lives. This works even if you do not change your big five-factor personality. You can still be an introvert but if you learn to develop a support system and have better social skills your problem may stop making you miserable.

Clinical Psychology is a stepchild.

Before I get everyone in the helping, changing people field mad at me I should mention that there is a group of people called clinical psychologists who study both how the normal brain works and how to help them with mental and emotional problems. This takes at least 6 years of college and some original research to get a Ph.D. This lets you help others but it won’t fix you.

You shouldn’t believe everything you read in a psychology journal.

I read a lot of research. Psych professors do research. That old publish or perish thing. Some of this research is really good. Some of it is suspect. Many of the things you learn about in psychology class are the result of studies those professors have done. They often use a “convenience” sample of psychology students. If people with mental health issues take a lot of psychology classes, and it looks from what my clients tell me that is true a lot of the time, then those studies of “normal” people are done on not so normal people.

For example, I have been reading a lot of research for the series about sleep dreams and nightmares I was working on. One of those studies, done on psych students, included 85% of women. In a clinical setting, women are more likely to be diagnosed with a mental illness than men and psych students may have self-selected into this class because of their own issues. I am skeptical of this author’s conclusions.

Do not take out your own appendix.

You can study all about anatomy. Know all about appendicitis and still, you shouldn’t take out your own appendix. It is also not recommended you do the operation on a family member.

Same thing with treating yourself for mental and emotional problems. Many counseling programs make their students go through the experience of getting personal counseling. This has two advantages. First, you learn what it is like to be the client before you put someone else through the process. More importantly, this gives prospective therapists the chance to work on themselves before they start working with others.

If you are thinking about becoming a psychology major, or have been one, I would recommend you look at why. If it is because studying rat brains sounds cool, have at it. But if you are doing this because you or someone close to you have emotional or mental problems, think about getting counseling for your problems first and then see if you still want to do this.

There are a lot of psychology majors, counselors, social work majors, philosophy majors and so on who are among the unemployed, mentally ill, addicted populations. I suppose that happens to many other majors also. Just wanted to put out that special warning that learning all about psychology won’t fix you. Regardless of your major, in order to have a happy successful life, financially or emotionally, you need to be mentally healthy first.

Staying connected with David Joel Miller

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Do you have Nightmare Disorder?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Nightmare

Nightmares maintain depression and PTSD.
Photo courtesy of Pixabay

Do you have bad dreams or is that a Nightmare Disorder?

We know there are connections between sleep, sleep disruptions, and a number of mental illnesses. The connection between nightmares and Posttraumatic Stress Disorder (PTSD) is fairly well-recognized. Dreams related to your trauma is one of the symptoms of PTSD. What often goes unnoticed is just how connected poor sleep and having a mental or physical health issue can be.

Sleep disturbances can be both the result of and the cause of significant life problems. Many people ignore their bad dreams and nightmares. You shouldn’t. Disturbed sleep may be a warning that something much worse is on its way. Some of these issues can threaten your life and your sanity. Frequent nightmares increase the risk someone will attempt suicide. Drinking to shut off the nightmares increases the suicide risk even more.

Nightmare Disorder is included as a Mental Disorder in the DSM-5.

Nightmares fall along a continuum which runs from an occasional upsetting dream through frequent bad dreams that leave you feeling upset when you wake up, to those severe things like Nightmares, and ends at the point of Sleep Terror Disorder where people wake up screaming. Sleep Terror Disorder along with Sleep Walking was combined in the DSM-5 getting the new name Non-Rapid Eye Movement Disorders, but that’s a topic that needs to wait for a future post.

Bad sleep is a symptom found in several other mental Illnesses so sleep disorders get little attention from most Therapists. Given the human tendency to pretend there is nothing wrong with us until we hit the wall so to speak, it is not surprising a lot of sleep disorders go undiagnosed or get diagnosed as something else.

Nightmare Disorder is part of a group of conditions called Sleep-Wake Disorders.

Sleep-Wake disorders do not get diagnosed or treated by therapists of counselors all that often. Usually, sleep problems get one of two problematic treatments. They could be referred to a sleep disorder specialist who uses the International Classification of Sleep Disorders (ICSD-2) with its myriad subcategories. The other possibility is that sleep disorders are often taken as a symptom of a more common mental illness.

Poor sleep could be anxiety, depression, or PTSD.

Nightmares or Bad Dreams can be a part of some anxiety disorders. Changes in sleep and appetite are key symptoms of depression. But just having bad dreams in and of itself does not automatically get you an anxiety or depression diagnosis.

Many nightmares are a part of Posttraumatic Stress Disorder (PTSD.)

Trauma- and Stressor-Related Disorders are such major factors in mental health that the Trauma- and Stressor-Related Disorders now have their own DSM chapter. Bad dreams and nightmares are one major factor in PTSD and other similar disorders that once you say you have bad dreams expect the professional to ask about any trauma history and any recent or current stressors.

If you have PTSD or another Trauma-Stress related issue nightmares are likely, but just because you have bad dreams does not mean you have PTSD. When I decide to write this post on Nightmare Disorder I looked up a hundred or so recent research articles on Nightmares and Bad Dreams. The largest part, a strong majority of those articles, were about Nightmares in people with PTSD. But there were a bunch of other mental health conditions that were connected to poor sleep also.

Nightmares and Bad dreams are connected to Borderline Personality Disorder, OCD, DID, GAD, and aging.

That is only part of the list. OCD stands for Obsessive-Compulsive Disorder, DID is Dissociative Identity Disorder and GAD is for Generalized Anxiety Disorder. Each of these diagnoses has related OCD like, Dissociative and Anxiety Disorders.

All these related disorders including bad dreams of one kind or another which makes me wonder if many people with one mental illness should also be getting a diagnosis of Nightmare Disorder. That and sleep disorders are one of the factors leading to the development of other mental health issues. In that vein, sleep disorders also greatly increase the risk of relapse in those with a substance use disorder.

What are the symptoms of Nightmare Disorder?

For the full text of the symptom see the official DSM-5 but here is my short, plain language version.

  1. Frequent, upsetting, bad dreams that really scare you.
  2. You can wake up quickly.
  3. These bad dreams are getting in the way of you living your life (family friends, job, etc.)
  4. Drugs, alcohol, or another mental illness are not the best explanation for why this is happening.

On top of these and a few other more specific criteria, Nightmare Disorder has a bunch of “specifiers” about when how often, and how bad these dreams are.

A word of caution here. This is post is an effort to explain some kind-of complicated stuff. Diagnosis should not be a do-it-yourself project. There are a bunch of other Sleep-Wake Disorders that might also need to be ruled in or out. Some sleep problems are a sign of life-threatening physical conditions. You may also have some other mental issue or guess what?

Your bad dreams may be a normal reaction to some stress in your life right now.

Drinking alcohol to quiet bad dreams is a really bad idea. The amount it takes to knock you out is very close to the amount that will kill you. Especially do not mix alcohol with prescribed sleep or anxiety meds. You can work with your doctor on meds for bad dreams but when the meds wear off the dreams can get worse.

If you are having sleep disruption, bad dreams, nightmares, night terrors, or related sleep problems, talk with your doctor or other professional and see if medication, therapy, or some other treatment might be helpful to you. Don’t put it off. Even normal sleep issues if left untreated can eventually impair your physical or mental health.

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

Sleep

Dreams and Nightmares 

Stay tuned, more on sleep’s connections to mental health, wellness and recovery are coming.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Today is Independence Day

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Today is Independence Day. What does that mean?

Declaration of independence.

Independence.
Photo courtesy of Pixabay.com

As mankind becomes more liberal, they will be more apt to allow that all those who conduct themselves as worthy members of the community are equally entitled to the protections of civil government. I hope ever to see America among the foremost nations of justice and liberality ~ George Washington

Make your space your own

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

home

Make it your place.
Photo courtesy of Pixabay.com

Make the place you spend your time in a happy place.

We live most of our lives in spaces. Spaces protect us from the elements when it is hot and when it rains.

Some of these spaces are of our choosing, but many more are spaces created by others. If you want to feel more comfortable with your life find ways to make the spaces you inhabit more of your own.

Below are some suggestions to transform places you are stuck with into places you want to be.

A view or pictures create personal space.

Windows open to views. You may have little control over what is outside that window but you can impact the views inside your space.

Consider planting a bush or flower outside your window when possible. Place something on that window sill. A plant, real or artificial can make that bare window sill feel more like your windowsill.

Put up some pictures. Create an environment that says this is my place. Pictures of what matters to you, of places you have been or want to go can all help to dedicate that space to your life.

Personal mementos or keepsakes make you feel at home.

Even on shared desks, people find ways to place their family pictures or mementos. Bring a rock or souvenir from your life and set it by that monitor to feel like this is your space, at least for now.

Just remember to pick it up and take it with you clearing the way for the next person at the desk to make it theirs while they are there.

Your music takes you home.

Having your tunes on helps make this place you are confined to your own. If you can play your tunes do so. Especially at home have that option. Are there others in your environment that do not like your music? No need to squabble. Get a set of headphones or earbuds and turn up the sounds.

Notice how music connects with your brain on a deep level. Change the music with the task and you will see how music sets the mood. Too much stress in your life, look for relaxing tunes to tame the chaos.

Have restful colors where you spend your life.

Color affects our moods. Green and Blue, the colors of Mother Nature, are restful to many people. Bright colors can spark your creativity. Decorate what you can in helpful colors.

Make things comfortable in your space.

A few minutes spent adjusting the chair, the footrest and the other things around you can make your time in any setting more positive. Can you move an end table or add one to make things within your reach? Maybe you need to move things so they are out of your way. Some of us need to get things out of our productive spaces and clear a path to use the space we claim as our own.

Plan for maximum safety.

Know how to get out of your space when needed. Make sure you have safety equipment, fire extinguishers, and the like available. What changes in your room will make you feel more secure? Safety means different things to different people. Find the things that turn your space into a sanctuary of safety.

Pets and plants say this is my space.

Having a pet or plant in your living area makes it so much more your own. Can’t have a dog or cat? Consider a goldfish or a potted plant. It is so much nicer to return home and find something alive there.

Leave room to move and stand.

Avoid environments that keep you restricted to one place to sit and another to stand. Create the option to stand and move about. Frequent changes in posture can relieve stress and tension. Include those options to the best of your abilities in your environment. Having created that space to move make use of it. Frequent breaks, even small changes of position can reduce fatigue.

Those are some of the ways that occur to me that might help you to create a place that feels like home. Feeling that this is your place, that you belong here, helps in creating that happy life that we all deserve.

Any other thoughts about how you have made where you stay your home?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Can you spare a cup of hope?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

A cup full of hope.
Photo courtesy of Pixabay.com

Do you have enough hope in you that you could share some?

Hope seems to be in short supply. People find it hard to hope. Hope is something that makes recovery possible. So what is someone to do who has lost hope? Maybe you can be that “cup of hope” this other person needs just now.

The quote “Can you spare a cup of sugar” goes back to a different time in our history. There was a time when people could go to their neighbors and ask for the loan of something that they needed at that moment. Asking the people around you for help seems to be less common these days. Help, like hope, seems to require you to pay a price nowadays.

Some people just are afraid to be involved with others. Connections are fraught with danger. So there are some of you who I know will not open your door. Not for a cup of sugar and certainly not to offer a neighbor some hope that things can get better. Has it really reached the point when offering up hope is a dangerous thing to do?

Sometimes we see people who need help and we wonder if helping them is something we should do. Giving an addict money may only add to their addiction. Giving them food may keep them alive today. But if you give someone hope then they may change their lives.

Hope is one of those commodities in short supply these days, like water in the desert. We are all wishing for the rain to end the drought but when will the showers of hope come?

Hope is one of those “core” values in a Wellness and Recovery Action Plan (WRAP.) Without some measure, a cup or a teaspoon full, of hope recovery fails to materialize. Sometimes all we can offer a struggling person is the “Hope that they will be able to cultivate a crop of Hope.”

Twelve-step groups talk about “sharing their experience, strength, and hope.”  People who have found recovery seem to have enough hope to spare. Hope comes from a well that never runs dry. The more of this hope thing you share the more you have. Without hope people perish, with hope, they thrive.

The seeds of hope are everywhere. What is lacking sometimes is a person to nurture them. Hope starts with a smile to someone who can’t smile. It grows in the attitude that someone believes this person is of value no matter what their current position. Judgment and disdain prune hope back.

Hope is the chance to find a job when you had come to believe you would never work again. Hope is seeing your family when you thought that connection was gone forever. Hope is a place to sleep for the homeless and a meal for the hungry.

For some hope is knowing that there is someone in your life who believes in you when you find it hard to believe in yourself.

In this country, one of the wealthiest on earth, it is hard to imagine that hope is in such short supply. How have so many lost their hope and see only the bad that can occur when every day there are miracles growing from the seeds of hope planted by caring people? Has hope become too precious and expensive for all of us to be able to share a “cup of hope” to those in need of an extra cup of hope?

Do you have enough hope that you can share some?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Mental Health Art

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By David Joel Miller.

Winners of the “My Art Matters” poster contest.

For some time now Fresno County department of Behavioral Health has sponsored a program called “My Art Matters.” Art entered in these contests comes from Mental Health Clients (Consumers) and their families. Over the course of this project, many wonderful pieces of art have been created.

www.co.fresno.ca.us/MyArtMatters

Recently the project sponsored a poster contest. I wanted to share with you the winner.

#1

Mental Health Art

Mental Health Art Poster #1 Courtesy of Fresno County Department of Behavioral Health